Reaching the unreached: An up close view of the unfolding Sahel crisis

April 3, 2012
There is much talk these days of reaching the unreached. But as I drive with UNICEF colleagues through the remote Hodh Gharbi scrubland in Mauritania, in north-west Africa’s Sahel region, there is little sign of any outside effort making its way here where the whimpers and restlessness – the signs of hunger – haunt the mothers in one scattered home after another. UNICEF estimates that across the eight countries of the Sahel, more than a million children are at risk of severe malnutrition, which can quickly lead to death if left untreated. The hope of the government here and humanitarian agencies is to respond now and thus avoid the horrific pictures of mass starvation, worsening poverty and social dislocation that could come if nothing is done.
There is much talk these days of reaching the unreached. But as I drive with UNICEF colleagues through the remote Hodh Gharbi scrubland in Mauritania, in north-west Africa’s Sahel region, there is little sign of any outside effort making its way here where the whimpers and restlessness – the signs of hunger – haunt the mothers in one scattered home after another. Each year, the period between the rains and the new harvest brings a lean season when mothers like Fatima Mohamed struggle to feed their children. In her case, seven of them. But last year there was no rain. This year’s lean season has come three months early. Without rain, the pasture for livestock disappears; the goats produce less milk for the children and the few crops only half grow. Families compete with birds and locusts for what crops manage to survive. Family members, often men and older boys, are already leaving to search for better pastoral land or piecemeal work.
© UNICEF/Mauritania/2012/Palitza | A malnourished child and his mother in a feeding center in Mauritania.

© UNICEF/Mauritania/2012/Palitza | A malnourished child and his mother in a feeding center in Mauritania.

I have come in a sputtering chorus of efforts to ring alarm bells of a looming disaster. UNICEF estimates that across the eight countries of the Sahel, more than a million children are at risk of severe malnutrition, which can quickly lead to death if left untreated. The hope of the government here and humanitarian agencies is to respond now and thus avoid the horrific pictures of mass starvation, worsening poverty and social dislocation that could come if nothing is done. Yet it is hard to keep Africa on the relief agenda nowadays, and part of me bristles at the constant need to compare and compete between African emergencies. Will the Sahel be as bad as last year’s famine in the Horn of Africa? How accurate are the numbers? Where are the images of starving children? There are patches of green here; can it really be that bad? An early hunger season Driving the 540 miles  from Mauritania’s capital of Nouakchott to the distant town of Aioun el Atrouss, I witness the changing colors of this harsh but magnificent terrain shift from orange to brown, each bearing its own variation of scrub and vegetation that illustrates the fragile existence for those who live in the Sahel. Mauritania, twice the size of France, is one of the world’s least populated countries, with 3.4 million people speckling the huge region. The Hodh Gharbi region is mainly home to pastoral nomads. Carcasses of dead animals line the road. The potential loss of livestock - an estimated one million camels, one million cows and more than 15 million goats and sheep live here–would be devastating to both households and the nation’s economy. The region is a major supplier of meat to urban areas. In November, the Government launched an emergency plan, requiring US$120 million, a large portion intended to buy fodder for livestock. With neighboring countries weathering their own crisis, it is not yet clear where Mauritania will find extra feed.
© UNICEF/Mauritania/2012/Palitza | Two young boys in Hodh Gharbi region in Mauritania.

© UNICEF/Mauritania/2012/Palitza | Two young boys in Hodh Gharbi region in Mauritania.

Further along the road a 20-ton truck, overloaded with charcoal, has overturned. The valuable cargo, made from burnt trees, is critical for tea and cooking and fetches $1 for 0.40 pounds in the capital. Research by the University of California Berkeley’s Center for Forestry found that in the Sahel, one in six trees died between 1954 and 2002 and one in five tree species disappeared. The research findings released in December 2011, revealed that rainfall in the Sahel dropped by 20–30% in the twentieth century, the most severe long-term drought since measurements from rainfall gauges began in the mid-1800s. Triggered by hotter temperatures and changing climate, the environmental degradation and fast-spreading desert puts pressure on communities to compete for diminishing pastoral and agricultural land. Our drive leads us to signs of relief agencies' attempts to reach remote communities. One of these signs comes in the tall, handsome shape of Dr Ahmed Ould Aida, food security and nutrition joint program coordinator in Mauritania’s two eastern regions, who has lived here for the past ten years and is passionate about his country. He takes us to a grain bank. It is part of a new scheme involving four agencies–UNICEF, the World Food Programme (WFP), the Food and Agriculture Organization and the World Health Organization – to coordinate investment in food security, and nutrition that has reached 36 villages over the past three years. The idea is not new. When people have extra grain, they bring it to the community village storage center and sell it for the market price, thus avoiding a fortune spent on transport to a distant buyer. It also means some of the grain stays within the community, as a backup in the lean season. The community has also organized a microcredit scheme that provides a safety net for families in difficulty. Families running out of food Dr Ould Aida next takes us to the local health center, which, with UNICEF help, is stocked with vaccines, essential medicines and therapeutic food to treat severe malnutrition. Nutrition centers now in many villages are stocked with corn soya blend, oil and sugar, supplied by WFP; mothers can bring moderately malnourished children to be weighed and take home supplies. With extensive community education, exclusive breastfeeding, a critical first line defense for young infants, has shot up to almost 85 per cent in the region.
© UNICEF/Mauritania/2012/Palitza | A child and his sister in Mauritania.

© UNICEF/Mauritania/2012/Palitza | A child and his sister in Mauritania.

With no rain and an early lean season, these signs of nascent resilience are not enough. Families are running out of food. “There is no doubt the investments in development have paid off, but today, we have an emergency and local communities cannot survive without more help,” Dr Aida explains, quickly defending any thought that an area this isolated can be habitable. “This is about a way of life and a culture in the Sahel that has existed for centuries. It may not match everyone’s standards but for us this way of life is viable and even beautiful when there is enough food for everyone. Communities here have a right to protect their way of life and we have a responsibility to help them.” Following Dr Aida, we stop at the mud-brick home of 12-old-girl peering out from the doorway. Her stickly frame is apparent under her colorful traditional mulafa dress. If we were in the West, I would have thought she was anorexic; but here this is not a teenage eating disorder. Dr Aida gently asks her some questions, speaks to the mother and makes a note to ensure the clinic nurse, more than 7 km away, visits them. Dr Aida takes us to the tented home of a mother with malnourished twins. Sitting against the carpets and pillows, she explains her husband has left in search of work. The grandmother, aged 70 and wrapped in a black mulafa, talks in anger as her worn wrinkled hands mix a bowl of millet. “Look at the people, not just children, even the adults, are feeble. When it rains, we normally have something, but now it is not just the children but all of us who suffer from hunger and no food,” she says. They are forced to rely on neighbors for scratches of a meal. We are joined by Khadetou Mint Beydar, the community health volunteer. She feeds us more distressing news. Since the introduction of therapeutic food, children can be treated at home. No longer do they need to spend a month in a hospital. Across two regions here in the south-west, 500 community volunteers have been trained in nutrition and other health practices. Beydar says a few cases of malnutrition at this time of year are not uncommon, but this year there is many. In Kiffa town (Assaba region), on the return to the capital, we meet Amadou Demba, who borrowed $20 to bring his wife and 21 month old daughter suffering from malnutrition to the health center here, 48 miles from his remote village, for help. They have decided to stay with relatives so they can be closer to the therapeutic food supply until his daughter is fully recovered. “There is nothing left for us there,” he says of his home. Other pressures The heavy stream of families moving to urban areas where even piecemeal work is hard to find is adding enormous pressure on relatives already grappling with the high cost of food. In the past two months, the price of rice has increased by more than 30%. A UNICEF colleague based here in the capital points out the impact as we drive through the city streets – the rising presence of children and mothers begging on the corners. Lucia Elmi, UNICEF Mauritania Representative, says the immediate challenges are threefold - logistics, security and human capacity. The country needs at least $ 3.2 million dollars for immediate need to prepare for a large-scale response to acute malnutrition as well as invest in health, water and sanitation services. More will be needed for the recovery and to sustain the efforts. Adding to the stress of long distances and reaching isolated communities, humanitarian responses may soon be challenged where they can go. Since the end of January, more than 10,000 people have crossed from Mali into Mauritania, fleeing renewed conflict between government forces and nomadic Tureg fighting for independence. Our trip to Hodh Gharbi had involved gendarmerie check-point stops every 31 miles or so. On our return to the capital, we pass a convoy of ten military vehicles heading to the border. Analysts warn of a potential escalation of conflict as fallout of the Libyan crisis and an influx of small arms and returning migrant workers. Mauritania exemplifies the UNICEF approach to equity, says Elmi. “There is no doubt it will be difficult to reach children in a country this large and with populations so spread out. But if our responsibility and mandate is to make sure every child counts, then it is critical we respond now, especially to reach the poorest and most vulnerable, wherever they are.” #sahleNOW: Four simple things you can do to sound the alarm for one milion children at risk in the Sahel.