2012

Hidden Hunger in Karamoja

The rains are a mixed blessing in Karamoja. They came initially as a relief in April, having not seen rain since last November. The dust settled, and the fields and hills turned green before our eyes. It was a welcome sight in a dry landscape that had become burnt and inhospitable. People began to dig and plant their crops.

It’s tempting to see the arrival as the rains as the beginning of something good, a positive moment in the annual cycle. But in Karamoja the rains also herald the start of something more worrying — the hunger season.

Karamoja, tucked in the northeast corner of Uganda, is a vast, flat plain, dry and dusty for most of the year. It is home to nomadic tribes, for whom cattle are both a source of food and wealth, and the center of the cultural and economic life. Conflict has been a feature of life here, as heavily armed warriors raid cattle from each other, a practice that is both a tradition with social and spiritual significance, and a means of survival.

Changing patterns of weather and migration mean that most communities no longer rely purely on their cattle, but on small-scale farming for their food. In an environment where the rains are sporadic and the soils are poor, it is a precarious existence. Markets are opening up, but prices are high and people do not have access to cash, or the means to make money — in hard times, many rely on selling what few possessions they have.

And what has become clear over the last few weeks is that for some families in Karamoja, these are extremely hard times.

Recent nutrition surveillance has shown that levels of malnutrition in Karamoja, especially for children under two years, are now above recognized emergency levels. In technical terms, this means that more than two percent of children under five years old are suffering from severe malnutrition. In some parts of Karamoja, the numbers are twice as high as ‘emergency’ levels. In practical terms, what this means is that more than 3,300 children are at-risk in Karamoja.

Concern Worldwide and our partners have been working with the local health services for the last number of years to help them deal with ongoing problems of child malnutrition, but also to prepare to respond when things get bad. Together we are now scaling up our response, putting this preparation into action.

The first step is a mass screening — literally going door to door in every village to make sure that we can identify those most at-risk. It’s a complex environment and much of the hunger is ‘hidden.’ We estimate that less than one-third of cases are properly identified and brought for treatment.

Secondly, we ensure that the local health centers have all the equipment and supplies they need deal with increasing numbers of children with severe malnutrition and sickness. We are also ensuring that those children who may not need immediate care, but show signs that they are at risk of malnutrition, can access programs where they can get rations of food to prevent them becoming dangerously sick.
In a region where the populations are so spread out, where in some places there are only three small clinics for 100,000 people, we are also supporting a mobile clinic to reach the most remote areas.
The causes of this crisis are complex. Even in good times, a harvest will not sustain most families until the next year. And while the rains are here, it’s unclear how successful the next harvest will be. At times the rain has been too strong and the ground too dry; which means in some places we’ve seen fields flooded and crops washed away.

The rain also brings the threat of disease. Around 70 percent of children in the recent surveillance were reported to have had an illness in the previous two weeks. Given the conditions, a simple case of diarrhea can be fatal. Malnutrition and sickness go hand and hand in a vicious cycle; a hungry child is more likely to get sick and a sick child is more likely to go hungry. That’s why the arrival of the rain brings both joy and misery.

We hope that the preparation we’ve done over the last three years and the increasing support will limit the impact of this crisis on the most vulnerable in Karamoja. Concern is committed to long-term solutions aimed at preventing malnutrition – working with parents on how best to care for their children, helping them to grow nutritious food and supporting people to create a more sustainable livelihood.

For now, what matters most is how we react to this situation, identifying those most at risk and reaching them in time. With the next harvest not due until September, the next few months are crucial for the most vulnerable children in Karamoja.

Read more: http://www.care2.com/causes/fighting-hidden-hunger-in-uganda.html

Discussing the use of technology for aid agencies

 from 31 August 2010

 

Dominic Crowley, Cormac Staunton, and Jennifer O'Gorman were interviewed for the Pat Kenny show on RTE Radio 1 last week.

They talked about Concern’s use of technology, explaining the role it plays in making humanitarian work more efficient.

http://www.concern.net/news-blogs/concern-blog/audio-concerns-use-technology

The Price of Everything

A blog post written in April 2011

Do you know how much of your income you spend on food? It varies from person to person, from place to place, but in richer countries the average is about 10 percent; around seven percent in the US, and some 12 percent in Central Europe. Sound about right?

In poorer countries this figure is much higher. When I surveyed people in rural Zimbabwe last year, they were spending nearly all their money on food, with only small amounts going on healthcare, education, transport.

These differences are important, particularly when we consider that the cost of food is rising. In fact, world prices are at their highest point since record-keeping began, and are predicted to rise further throughout 2011. This is going to have a huge impact on the poor.

If I spend ten percent of my income on food, a small rise in price means that I forgo something else in order to eat the same amount of food. Or I buy cheaper alternatives. But if you are spending 80 percent of your income on food, and your diet is already poor, then any price rise is going to have much more dangerous effects. To eat the same amount, you have to spend more, which means eating into the other 20 percent - healthcare costs, water, transportation, which aren’t exactly luxuries.

Alternatively, you can consume less, but for people already surviving on two meals a day that’s not a great option. Or you can buy cheaper food – which means less fruit, vegetables or meat and more staple, less nourishing foods like maize or rice.  

Of course, there are other choices. You can take your children out of school so that you don’t have to pay the fees, buy uniforms or books. You can eat less yourself so that they can continue to eat. You can borrow money, or sell something; tools, seeds, land. All such choices can have grave long-term consequences. But what choice do you have?

This why the “Food Price Crisis” is really a “crisis for the poorest.” It’s not just rising prices that are the problem. If prices are increasing gradually it’s generally a sign of dynamism that encourages people to invest and be productive. In such a situation, people’s incomes can rise gradually too. But over the last number of years, food prices have become more volatile, which means greater, increasingly unpredictable swings between highs and lows. There are many causes: extreme weather; the price of oil; population growth; an increase in the use of bio-fuels, which divert crops from food to fuel; deregulation of commodity markets; as well as local factors like elections, conflict, and domestic policies. Different countries will be affected in different ways, but the poor will always suffer most.

This really is a global problem, and since the first real surge in prices in 2008, the world has taken notice. Much has been done to try to protect the poorest from the volatility of the food markets. In the short term, food or cash assistance by the UN or NGOs has helped to off-set some of the shocks. Governments in poorer countries are now looking at new ways to provide “social protection” schemes to their most vulnerable citizens. The G8 and G20 have also put agriculture back on the agenda. A lot has been achieved, but much more needs to be done as this problem gets worse. 

Many of the world’s poor and hungry are small-holder farmers, and investment in agriculture—not just in increased production but all along the ‘value chain’—can ensure that farmers are able to grow enough food for their families and are protected against volatile market prices.

Some of the more controversial issues, like bio-fuels or the regulation of commodity markets need to be addressed with the impact on the world’s poorest in mind. Greater integration and cooperation between countries can also sustain confidence and prevent market panic. Harmonizing and pooling data on food production, consumption and stocks will make markets more transparent and help guide policy choices. It’s an increasingly complex problem that requires a whole suite of solutions from global to local levels.

Oscar Wilde famously described a cynic as someone who knew “the price of everything and the value of nothing.” When the cost of food is a matter of life and death, it’s not enough just to know the price. We have to understand its value.

My research available at IDS

A copy of my draft working paper on Cash Transfers versus Food Aid is available to view on the Institute of Development Studies website:

http://www.ids.ac.uk/files/dmfile/Staunton2011CashtransfersandfoodaidinZimbabweCSPconferencedraft.pdf

The Institute of Development Studies (IDS) is a leading global charity for international development research, teaching and communications. http://www.ids.ac.uk/

Hard Cash in Hard Times

Sophia Chitsatse was 65 when I met her in Nyanga, Zimbabwe, a widow looking after four orphaned grandchildren. Although she was a farmer, she struggled to grow enough food for her family to last from one harvest to another. As a result, she had been receiving food aid rations from the World Food Program (WFP) for several years.

This is the traditional response to a humanitarian crisis, to directly provide people with what they need most. It is hard to argue with the logic; if people are starving, they need food. If people's belongings have been washed away, they need essential items like soap, cooking utensils, and clean water.

But in the last number of years there has been an increasing focus on improving the way in which the world responds to emergencies. In late 2009, Sophia Chitsatse benefited from a new approach: instead of receiving food aid, Sophia was given cash.
We do it all the time in the western world. We have state pensions, unemployment benefits, and child-welfare payments. There are differences and debates as to the extent to which these should be provided, but most people agree that the best way to provide this assistance is through money, rather than goods.

Taking the same approach to a humanitarian crisis has many advantages, backed up by numerous studies. For one thing, giving cash is generally cheaper. There are huge costs involved in trucking and shipping large quantities of commodities across the globe.

Cheaper, of course, does not necessarily mean better. But providing cash has been proven to be very effective, because it allows people to prioritize their own needs. Women like Sophia can now choose the food they want to buy for their families, and how much. They can also choose whether, in addition to food, they need soap or toothpaste, or a blanket. These aren't always easy choices. But it is better that they are made by a family, rather than by a third party. Allowing them to make decisions gives power to the poorest and most vulnerable. It also results in the better outcomes, as each family purchases precisely what they need.

Of course, in some humanitarian crises, the goods that people need are simply not there. Providing cash in such cases is meaningless and can even be dangerous. The cost of scarce goods would sky-rocket and could make a bad situation worse.

However, often a crisis is not caused by scarcity, but because people cannot access the goods they need. Food might be available in a market, but people do not have money to buy it, or it is prohibitively expensive. This problem is made worse by the global rise in food prices. This points to another advantage to providing cash: the effect it has on the local economy.

Flooding local markets with free goods can undercut local suppliers and put local traders out of business. Cash, on the other hand, can stimulate local markets. When I met Sophia in Zimbabwe I was conducting a study to compare "multiplier" effects of cash versus food aid. The study -- the subject of an upcoming Working Paper for Trinity College, Dublin -- looked at food aid and cash transfers distributed by the WFP and Concern Worldwide in rural Zimbabwe in 2010. Building on previous work by the economist Simon Davies with Concern in Malawi, the study created a "Social Accounting Matrix" for the region where both cash and food distributions took place.

The model, quantifying how all the economic groups in the region interact, was used to calculate and compare "multipliers" for cash and for food aid. A multiplier measures the effects of injecting something into the economy, including benefits beyond the help given to the initial recipients of aid. The results showed higher multiplier figures for cash than for food aid.

Food did have some multiplier effects, for example, when it was used to barter for other items. But the majority of the food was consumed and where it was bartered, the deals that people got were often not very fair.

On the other hand, people like Sophia were now able to buy food from local producers and traders. Even though many people were suffering from a food shortage, some producers had enough to sell and local traders were able to respond to the demand for goods that the cash injection created. Prices did not increase significantly.

There's more. Sophia was also able to use the money to pay school fees and keep her grandchildren in school. The money she and others spent on these fees also allowed teachers' pay to be "topped up." Others told us that they paid fees at local clinics that covered maintenance, carried out by local workers. The teachers and the laborers would spend these earnings, buying food from a local trader, who in turn bought suppliers from a local producer.

This is the multiplier in action. At each stage, the added value of the cash is increasing and the cycle continues until the money leaves the local market. The study showed that in Zimbabwe, as far as the local economy was concerned, cash had a much more positive effect than food aid. The benefits were felt by more people -- many of whom were only marginally better off than the poorest that the programme was reaching -- than just the initial recipients.

While the advantages of giving cash are becoming clearer, there is still much to work on. Agencies are increasingly looking at new, better and safer ways to distribute cash, including the use of mobile phones and smart card technology, which has been pioneered by Concern in various countries, most recently in Niger. There is a need to look at what happens when projects are scaled up to see if many of the positive impacts still hold. Caution is also needed to ensure that cash is only used in appropriate settings, and that agencies are fully able to assess the impact of cash.

But for women like Sophia -- who now spends less time working on other people's land and more time on her own, who's grandchildren are staying in school and who is getting a fairer deal for the things she needs -- it is clear that cash is a more appropriate, effective and empowering way to help people in times of crisis.

This article appeared in the Huffington Post on 18 March 2011
http://www.huffingtonpost.com/cormac-staunton/hard-cash-in-hard-times_b_836845.html