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# Cases of acute and severe malnutrition in Somalia rise “exponentially”

BMJ 2009; 338 (Published 12 March 2009) Cite this as: BMJ 2009;338:b992
1. John Zarocostas
1. 1Geneva

Malnutrition rates have risen exponentially in parts of Somalia because of the worsening food situation, the country’s top United Nations humanitarian official has warned. More than 200 000 acutely malnourished children, of whom 60 000 have severe malnutrition, need immediate treatment, he said.

Unicef estimates that Somalia could see more than 330 000 cases of acute malnutrition, including 96 000 cases of severe malnutrition, among children this year and says that the situation “calls for a strong and expanded response.”

“Children will die and children are dying through malnutrition and diarrhoeal diseases,” said Mark Bowden, resident UN humanitarian coordinator for Somalia.

“If we are effective the mortality rates will be managed. I think the fact that there’s a global acute malnutrition rate of over 20% is an indication that the risks of dying without intervention are extremely high in the population.”

He told a meeting of donors that resources were lacking to tackle the mounting need, which includes an increase in supplementary feeding and urged them to be more forthcoming with funds.

“I’m concerned that we may not be adequately resourced to respond to the needs,” said Mr Bowden. Drought, hyperinflation, and conflict are aggravating the situation, he said.

The UN is distributing general food rations to 3.2 million people in Somalia, including 1.1 million internally displaced people, more than 45% of the population.

So far, only 19% of the $919m (£665m; €720m) in aid requested from donors in the UN’s 2009 consolidated appeal for Somalia, of which nearly two thirds was for food, has so far been received, said Mr Bowden. Some critical areas such as health, water, sanitation, and staff security have received little or no funding. As of 9 March, none of the$43.8m requested for health had been received, and just 1% of the $36m requested for water and sanitation and 16% of the$67.5m requested for child nutrition had been banked.

Unicef has established 14 supplementary feeding centres in the past few months.

Mr Bowden pointed out that in situations of acute malnutrition, “the risks of disease outbreak are very high.” He said that the UN has issued an alert on the need to get donors for water and sanitation activities.

“If we’re not able to provide adequate support for water it invalidates or minimises the impact of the work that’s being done on supplementary feeding in the area,” he said.

The World Health Organization said that between 31 January and 27 February 961 cases of acute watery diarrhoea had been recorded in lower and middle Jubba and in lower Shabelle, including 44 deaths. Most cases were among children under 5 years old.

## Notes

Cite this as: BMJ 2009;338:b992

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