The situation is most extreme in the Kobe camp, where children comprise 88.6% of the camp's population of over 25,000. Most families are female-headed households with large numbers of children, including young relatives or orphans.
"We remain concerned about the high mortality rates due to severe acute malnutrition and diseases," states UNHCR spokesperson Adrian Edwards. Medical screening of new arrivals is recording severe acute malnutrition among 19% of children in Kobe camp. At nearby Hilaweyn, the rate is 16% while in Melkadida and Bokolmanyo the rates are 10% and seven percent respectively. Severe acute malnutrition is the most critical level of malnutrition, and poses a particular risk for children below the age of five. UNHCR considers a rate of over one percent to be alarming.
In light of these findings, an inter-agency task force agreed yesterday to increase food distribution points in the camps, to urgently open additional centers for nutritional feeding and to ensure that malnourished refugees receive appropriate supplementary food.
After consulting with the refugee community, awareness-raising campaigns will be conducted to encourage refugees to access health services. Outreach workers will go from tent to tent and look for malnourished children who are not enrolled in the feeding programmes. They will also trace children who may not be continuing with nutritional feeding treatment. Given the severity of the situation, UNHCR expects that malnutrition rates will remain high for some weeks until the situation stabilizes.
The number of separated or unaccompanied children is also alarming, as initial estimates indicate this number there may be as many as 2,500 children in the four camps in Ethiopia without a parent or guardian. "We are carrying out a screening this week in refugee camps in Dollo Ado to better understand the scope of the problem and determine what may be in the best interest of these children," Edwards says.
Many refugee women tell our teams in Ethiopia that it is not safe for Somali men to travel. They fear forced recruitment by armed groups and local militias. In many cases, men stay behind in Somalia to protect whatever property the family may have, to care for those too sick to travel and to tend to any remaining livestock. Some families simply do not have the means for everyone to travel together, so women and children are sent first. However, over the past few weeks UNHCR staff have observed that there are more single men arriving from Somalia to join their families.
Meanwhile in Somalia, UNHCR is supplementing food aid delivered by other agencies in famine-stricken areas in the south. According to UNHCR Somalia Representative Bruno Geddo, "It is imperative to scale up delivery of massive amounts of aid as quickly as possible to needy people inside Somalia if we are to maintain the recent downward trend in outflows towards Ethiopia and Kenya." He recently returned from Dollow on the Somalia-Ethiopian border and Mogadishu, and said that internally displaced Somalis he spoke with continued to express the desire to remain in their country rather than cross an international border in search of assistance.
The UN Refugee Agency is preparing to distribute 7,500 Emergency Assistance Packages (EAPs) consisting of plastic sheets, sleeping mats, blankets, jerrycans and kitchen utensils, for nearly 50,000 people in the Bay region of Somalia, where famine has just been declared by the UN.
A further 70,000 people are to be assisted in Lower Shabelle, also in famine. Over 50,000 people will be reached through distributions in Mogadishu and 30,000 will be reached in the Gedo and Lower Juba border areas.
All in all, by the end of August, UNHCR reached almost 220,000 people and aims to reach an additional 180,000 by the end of September.