MALNUTRITION IN NORTHERN COTE D'IVOIRE UNDERSCORES

UNCLAS ABIDJAN 000186 DAKAR FOR OFDA/WNARO RDAVIS AND FFP ACCRA FOR USAID/WA GENEVA FOR RMA AND NKYLOH NSC FOR CPRATT NEW YORK FRO TMALY, DMERCADO USAID FOR USAID/A, AFR/AA/AFR/WA USAID FOR DCHA/AA, DCHA/FFP, DCHA/OTI, DCHA/CMM E.O. 12958: N/A TAGS: EAID PHUM PGOV PREL EAGR SOCI IV SUBJECT: MALNUTRITION IN NORTHERN COTE D'IVOIRE UNDERSCORES ONGOING HUMANITARIAN NEEDS REF: A. 08 ABIDJAN 279 ¶B. 08 ABIDJAN 214 ¶1. (U) SUMMARY: The absence of a functioning government in the north of Cote d'Ivoire and ongoing insecurity in the west are having increasingly negative effects on the resident populations. A SMART survey conducted in July 2008 revealed that the global acute malnutrition (GAM) rate in northern Cote d'Ivoire was 17.5 percent - a level above the internationally-recognized emergency threshold of 15 percent. ¶2. (U) A joint World Food Program (WFP) and Food and Agricultural Organization (FAO) study found that food insecurity was also a problem in western regions of the country. In addition to political instability, there are many reasons for the malnutrition problem that recently surfaced in the north, including sharp increases in the price of basic food staples on the regional and world markets and dramatic livestock losses. The UN issued a Critical Humanitarian Needs Appeal for Cote d'Ivoire in January 2009 that specifically cites nutrition and food security in the north as an area of special need. During recent trips to the north, local officials and NGOs have highlighted the malnutrition problem to Ambassador and DCM and pleaded for USG assistance. Embassy Abidjan believes we should assist to the extent possible and asks that USAID/Office of U.S. Foreign Disaster Assistance (OFDA) and USAID/Food for Peace (FFP) explore how we can respond to this new need, while also continuing support for vulnerable populations most affected by food insecurity in the west. END SUMMARY POVERTY RATES HAVE SKYROCKETED SINCE 2003 -------------- ¶3. (U) The rebellion that split Cote d'Ivoire in half in 2002 severely disrupted economic activity in certain sectors and regions of the country: as a result, many Ivoirians witnessed a precipitous decline in their standard of living. Residents of the north were particularly affected, since most government services withdrew completely, and markets and ports in the government-controlled south became virtually inaccessible to them. Studies done in conjunction with the most recent Poverty Reduction Strategy Paper (PRSP) show that the national poverty rate - defined as those living on less than 650 CFA (or approximately 1.30 USD) per day - increased dramatically from 10 percent in 1985 to 38.4 percent in 2002 to 48.9 percent in 2008. The poverty rate is even higher in rural areas and now stands at 62.5 percent. ¶4. (U) Since the signing of the Ouagadougou Political Agreement (OPA) in March 2007, the country has made progress towards peace and stability, and travel between government and rebel-controlled zones has expanded considerably. But many of the issues that sparked the conflict remain unresolved. Security remains fragile due to limited progress on the demobilization of militias in the west and Forces Nouvelles soldiers in the north. High unemployment, ethnic tensions, and land disputes continue to pose serious threats to social cohesion and internal stability. In 2008, dramatic increases in global food prices let to violent street demonstrations in Cote d'Ivoire, during which at least one person was killed and scores injured (see reftels). The GoCI temporarily suspended duties and taxes on basic food products to keep prices at a reasonable level for Abidjan residents. The government has depended on international organizations like the World Food Program (WFP),the Food and Agriculture Organization (FAO),and NGOs to assist most rural populations, especially in the Forces Nouvelles controlled zones. FOOD INSECURITY LEADS TO HIGH RATES OF MALNUTRITION -------------- -------------- ¶5. (U) Cote d'Ivoire is the largest importer of rice and wheat in West Africa. From August 2007 to August 2008, the price of rice increased by 134 percent in the north and 50 percent in the west, hitting the two areas that were already the most fragile, and further impacting food insecurity. Maize prices witnessed a 100 percent increase in the north and a 50 percent increase in the west. The dramatic price increases of these basic staples on the regional and world markets has meant that humanitarian organizations such as the WFP, which purchases commodities for distribution, cannot reach as many families as in the past. Additionally, the collapse of cotton companies in the north that provided credit for essential agricultural inputs (i.e. fertilizers, seeds, tools) led to a drastic decrease in household food production just as prices were skyrocketing, which severely reduced families' purchasing power. ¶6. (U) In addition, dramatic livestock losses in the north in recent years have compounded the problem. A study conducted by the FAO Emergency Unit in November 2008 confirmed that in several northern regions of Cote d'Ivoire, nearly 75 percent of livestock had died from lack of quality veterinary care and the misuse of black market medications that flooded the north after the government withdrew in 2002. The northern town of Ouamelhoro, for example, had 11,424 head of cattle in 2005. In 2008 however, that number had fallen to 2,857. Losses like these have produced a double whammy on the north: dramatic decreases in meat and a devastating loss of crop production capacity, as cattle are commonly used to till the land. To take the case of Ouamelhoro, the livestock losses translated into a 69 percent drop in the amount of land cultivated for crops. On a recent trip, DCM was told that women have now stepped in to try to fill this gap as the cultivators of the land. ¶7. (U) Current high rates of acute malnutrition in northern Cote d'Ivoire are directly linked to these factors. A July 2008 SMART (Standardized Monitoring Assessment of Relief and Transitions) survey jointly conducted by the WFP, the United Nations Children's Fund (UNICEF),and the GoCI's National Nutrition Program (PNN) found that the global acute malnutrition (GAM) rate of children under age five in five northern regions of Cote d'Ivoire was 17.5 percent. 13.5 percent were moderately malnourished, and 4 percent were severely malnourished. A follow-up study conducted by Medecins Sans Frontieres - Belgium in Bouna and Odienne found that the GAM rate was 23.9 percent in children age six months to five years. GAM rates over 15 percent are deemed "critical" by World Health Organization (WHO) international standards and require immediate action. In August 2008, a joint WFP-FAO study found that 12 percent of the population in the northern region of the Savanes were severely food insecure and 15 percent of the western region of Moyen Cavally were moderately food insecure. ¶8. (U) Although a SMART survey has not been conducted in the west, the WFP-FAO study confirms that food insecurity is also problematic in the west. Although the area is much more conducive to agricultural production, heavy fighting in the west in 2002-2003 destroyed infrastructure and produced large numbers of internally displaced persons (IDPs). The appeal issued by the UN in January 2009 states that between March 2007 and September 2008, humanitarian agencies recorded the voluntary return of approximately 70,000 IDPs in the west but notes that the return has not been without constraints and obstacles. A non-functional judicial system allows for widespread impunity and the continued presence of armed militias makes the security situation fragile. Simmering disputes over land between the indigenous population and IDPs often turn violent. In some cases, the indigenous population has blocked returnees from returning to their fields for more than 18 months, effectively holding their livelihoods hostage and further exacerbating food insecurity. Humanitarian presence and support for social cohesion and reintegration in the west continues to remain critical. HUMANITARIAN EFFORTS -------------- ¶9. (U) Given that the level of acute malnutrition in certain regions of Cote d'Ivoire currently exceeds the WHO's emergency threshold level of 15 percent, the international community needs to provide a robust response. Since 2007, however, international humanitarian assistance in general, and to the food crisis in particular, has been weak. Many humanitarian organizations have been obliged to reduce their activities due to insufficient funding, as many donors wrongly assumed or believed that Cote d'Ivoire's humanitarian needs had been met. WFP, for example, had to close several of its offices, including some in the north and west, where the need is greatest. Since January 2008, the exorbitant rise in the price of basic food staples has also meant that WFP has needed 40 percent more funding just to cover its initial, proposed budget. WFP has had to scale back many of its programs and is thus unable to fully support families with malnourished children or the return of IDPs. WFP's Humanitarian Air Service, which operated flights from Cote d'Ivoire to Guinea, Liberia, and Sierra Leone to support the movement of the humanitarian community, was terminated at the end of February due to lack of funding. ¶10. (U) In a March 3 meeting that Poloff attended at the United Nations Office for the Coordination of Humanitarian Affairs (OCHA),the Interagency Humanitarian Coordination Committee (IAHCC) discussed the UN's Central Emergency Response Fund (CERF) allocations. Cote d'Ivoire received 2 million USD from CERF/New York and the IAHHC discussed how best to apply this money. It was decided that one half would go toward addressing malnutrition in the north , to be divided among UNICEF, FAO, and WFP, and the other half would focus on reintegration efforts for returning IDPs in the west. These are the two priority areas of intervention outlined in the 2009 UN Critical Humanitarian Needs Appeal for Cote d'Ivoire. WFP, FAO, and UNICEF have also directly appealed to both Embassy Abidjan and USAID/OFDA and USAID/FFP in Dakar for assistance. USAID/OFDA recently signed a grant with FAO's Emergency Unit for agriculture coordination and to improve knowledge about nutrition and how to grow nutritious foods in the north. COMMENT AND ACTION REQUEST -------------- ¶11. (U) Embassy Abidjan supports the appeal for additional assistance to address the high rates of acute malnutrition in the north and asks that USAID Washington explore what contributions the USG can make to help alleviate this urgent need. The GoCI, which still does not have full control of the north, does not have the resources to address the problem. Given Cote d'Ivoire's recent history of conflict and the clear link between food security and internal stability, as highlighted by the 2008 demonstrations, supporting food security programs in Cote d'Ivoire remains essential. Embassy Abidjan also requests continued USAID support for humanitarian assistance for FY 2009, particularly assistance which can address the food insecurity problem in the north and west. NESBITT