US embassy cable - 05NAIROBI5074

UNCLAS SECTION 01 OF 02 NAIROBI 005074 
 
SIPDIS 
 
AIDAC 
 
USAID/DCHA FOR WGARVELINK, LROGERS 
DCHA/OFDA FOR GGOTTLIEB, MMARX, IMACNAIRN, KCHANNELL 
DCHA/FFP FOR JDWORKEN, SBRADLEY 
AFR/EA FOR JBORNS, SMCCLURE 
ROME FOR FODAG 
GENEVA FOR NKYLOH 
BRUSSELS FOR PLERNER 
NSC FOR JMELINE 
 
E.O. 12958:  N/A 
TAGS: EAID, KE, EAGR, ETRD, Malnutrition 
SUBJECT:  UNICEF APPEAL FOR NUTRITIONAL INTERVENTIONS 
IN KENYA 
 
REF:NAIROB 04607 
 
Summary 
 
1.  Results of an October UNICEF nutritional assessment 
revealed emergency levels of malnutrition amongst 
45,000 pastoralist children in three districts of 
eastern Kenya.  The lack of rainfall and its effect on 
pastoralist livelihoods is cited as contributing to the 
malnutrition, however, the survey cites other factors, 
including poor child feeding practices, inadequate 
water and sanitation facilities, disease, and a history 
of underdevelopment.  Humanitarian organizations are 
providing assistance to the affected areas through the 
provisions of general rations and programs to increase 
access to water.  UNICEF is appealing for international 
assistance totaling $900,000 to respond to emergency 
nutritional needs in the three districts.  End Summary 
 
Background 
 
2.  A drought emergency was declared by the Government 
of Kenya (GOK) July 2004.  Following an international 
appeal, more than 1.6 million Kenyans are receiving 
food and other assistance to lessen the humanitarian 
impact.  Although the 2005 long rains improved 
agricultural production and pastoral conditions in 
several regions, the northeastern districts of Garissa, 
Tana River, and Wajir were recently assessed as slow to 
recover.  The districts are mostly comprised of 
pastoralists that rely on livestock production for food 
security and livelihood. 
 
3.  UNICEF conducted a nutritional assessment in the 
three districts from October 6-20 to determine levels 
of malnutrition in children less than five years.  The 
survey measured 2919 children under five from 2002 
households in the districts using the two-stage cluster 
sampling method. 
 
Current Situation 
 
4.  In Garissa and Tana River districts, the assessment 
found global acute malnutrition (GAM) rates of 18 
percent and severe acute malnutrition rates (SAM) of 3 
percent.  Rates were extremely high in Wajir District 
(29 percent GAM and 4 percent SAM); and the crude 
mortality rate there was calculated to be 1.7 deaths 
per 10,000 children under five per day.  The World 
Health Organization standard is that a GAM rate of 
greater than 15 percent indicates a critical situation. 
 
5.  The UNICEF results highlighted several factors that 
contribute to the high malnutrition levels found during 
the survey.  More than a third of the respondents 
reported they did not seek medical attention for sick 
children due to the lack of medicines at local clinics 
or their prohibitive cost.  Measles immunization 
coverage was found to be slightly below the 95 percent 
WHO recommendation, however, polio vaccinations were 
well above 80 percent.  Exclusive breast feeding for 
newborns up to six months is not a common practice and 
infants are routinely given food comprised of glucose 
or cereal based porridge. 
 
6.  The lack of production from livestock (milk), low 
resale prices for animals sold (which limits the 
purchasing power for food), access to and availability 
of clean water, and endemic malaria were also cited in 
the assessment as contributing to the high levels of 
malnutrition found. 
 
Response to Date 
 
7.  The United Nations and NGOs have been responding to 
emergency conditions in the three Districts since the 
GOK's original drought appeal in July 2004.  The World 
Food Program (WFP) is currently distributing a seventy 
five percent ration to 238,000 Kenyans in the Tana 
River, Garrisa and Wajir Districts (twenty-five percent 
of the population).  The current ration includes corn 
soy blend (CSB), a fortified cereal-based commodity. 
 
8.  USAID?s Office of Food for Peace contributes 
approximately thirty five percent of WFP drought 
emergency commodities.  USAID?s Office of Foreign 
Disaster Assistance is supporting programs with partner 
CARE to increase access to water in Garissa District. 
USAID Kenya is investing $2 million in a multi-year 
livestock development program in all these districts. 
 
9.  Besides a contribution of cereals to the current 
WFP emergency program, there are few GOK resources 
addressing the humanitarian situation in the area. 
Government district hospitals have limited therapeutic 
feeding capacity to treat severely malnourished 
children.  UNICEF proposes to augment hospital capacity 
by expanding the number of mobile medical clinics to 
extend services to the rural pastoralists in greatest 
need. 
 
UNICEF Appeal 
 
10.  UNICEF has been supporting nutritional 
interventions in Garissa, Tana River, and Wajir 
Districts since the declaration of the drought 
emergency in 2004.  In October, UNICEF appealed for 
$900,000 to continue nutritional monitoring and 
surveillance activities through February 2006, which 
coincides with the end of the short rains season. 
UNICEF?s strategy is to provide immediate relief to the 
malnourished and assumes that improved rains during the 
current short rainy season will increase pasture and 
livestock productivity, which in turn will improve 
humanitarian conditions.  UNICEF has also appealed for 
an additional $2.5 million to provide immunizations, 
malaria protection, and mobile medical clinics to 
affected pastoralist populations throughout Kenya. 
 
Conclusions 
 
11.  Sixteen months of international assistance in the 
form of food and non-food support has failed to curb 
high malnutrition rates in Kenya?s Tana River, Wajir 
and Garrisa Districts.  Although the poor rains have 
negatively impacted local livelihoods and humanitarian 
conditions, a history of underdevelopment and 
inadequate resources is also contributing to high 
malnutrition levels. 
 
12.  UNICEF needs additional resources to continue 
supplemental and therapeutic feeding outreach to 
affected populations.  The GOK has shown little 
inclination to devote specific resources to address the 
elevated malnutrition levels. 
 
13.  The USAID/OFDA/ECARO plans to visit the recently 
assessed areas in Tana River and Garrisa to assess the 
situation and ground truth the UNICEF findings. 
BELLAMY.