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