The Politics of Famine

The news made headlines in July: The United Nations declared famine in drought-stricken Somalia, warning that up to 750,000 people, most of them young children, could perish. It brought memories of Ethiopia in the mid-1980s, with pictures of starving children and massive shipments of food aid.

Drought brought on the crisis, but Somalia’s famine, like so many others, is the result of a wider confluence of events, most tied to politics. “Drought is more the trigger than the cause,” says Daniel Maxwell, a research director at Tufts’ Feinstein International Center and an expert on food security and humanitarian crises. He has been assisting UNICEF and U.N. agencies dealing with the situation in Somalia.

Somalia lacks a functioning central government and is rife with armed conflict. The areas bearing the brunt of the famine are controlled by al-Shabab, an Islamist militant group proscribed by the U.S. government. The World Food Programme, the U.N. agency that distributes food during famines, pulled out of Somalia in January 2010, partly because U.S. policy made it illegal to benefit al-Shabab in any way. Not that al-Shabab would welcome the help: It considers food aid an insidious plot to undermine Somali farmers.

Despite the tragedy of the situation, humanitarian experts are responding to the crisis in innovative ways. They have developed new methods for feeding malnourished youngsters, who are always the most vulnerable in a famine. And in areas that can’t be reached by food aid, they’re using cash to help those most in need.

There’s a reason to try new approaches: The old ones haven’t always worked. Some critics of famine response in the past point to inherent problems with bulk food aid: It’s often inappropriate for small children; it is easily stolen; and it can depress prices for locally grown grains, exacerbating food production problems rather than solving them. Aid has also been used by repressive governments to bolster their political power, the critics add, reinforcing conditions that contribute significantly to famines in the first place.

The surprise is that any humanitarian response could work in such a chaotic country. But in Somalia, some things do indeed work—and the agencies are taking advantage of them. Cell phone service is widespread and inexpensive, some of the best in Africa, Maxwell says. And the banking system, called hawala, is based on trust and works remarkably well. “You can send money from a bank account in Dubai and be pretty sure that your cousin in some really rural place in Somalia will get the money,” he notes. “There’s a fee for it—it’s a commercial business operation—but it works.”

The Miracle of Therapeutic Food

In 2010, the rains in Somalia were actually good. It was the year of the El Niño-Southern Oscillation, in which the normally dry region received higher-than-average rainfall in both rainy seasons—especially during the long rains in late March to May.

But experts knew what was very likely to follow in 2011: La Niña, which meant not much rain. Like clockwork, the long rains barely came this year—it was the lowest rainfall recorded since the 1940s—and drought soon overtook many parts of the country, pushing the tottering economy over the edge.

Livestock—the backbone of the export economy—were hard hit. The sorghum crop, the mainstay for poor Somalis, largely failed. By mid-summer, it was becoming clear that the drought was pushing the normally precarious situation into famine. In some places, 50 to 60 percent of children under age 5 were suffering from acute malnutrition and were at serious risk of dying. “It’s really through the roof,” Maxwell says.

On July 20, when the U.N. officially declared famine in Somalia, the question became, how do aid agencies respond? “The frontline thing that you do is try to protect the lives of severely malnourished kids—they are the ones most at risk of dying,” Maxwell says. Working with Somali partners, humanitarian agencies could provide what Maxwell calls “one of the big revolutions in emergency nutrition”—something called ready-to-use therapeutic foods.

Packaged in individual sachets, the food looks and tastes like peanut butter, with milk powder and micronutrient supplements mixed in. “It’s practically a balanced diet, and it tastes good,” Maxwell says. To make sure the malnourished children get the food intended for them, families usually get an extra food ration in addition to the child’s supplement.

Another of the lessons learned from previous famines is that treating malnourished kids in a clinic or hospital was often counterproductive. When that happened, mothers would have to stay with their children but often weren’t fed themselves and couldn’t take care of their other children.

Now families of severely malnourished children are given the food sachets and taught how to use them—and then they return home. “That has really revolutionized treating severely malnourished kids who don’t have other [health] complications,” Maxwell says.

A number of Somali nongovernmental organizations have set up systems to deliver the food packets to malnourished children, despite harsh political conditions. “[The NGOs] have made their own peace, somehow or other, with the ruling authorities, to do what they do,” Maxwell says. “That’s often come at the expense of not being able to speak out about anything. They are in a tenuous situation. But that infrastructure—the bare bones of it—is in place.”

Banking on Cash

While severely malnourished children face improved odds of survival with the specialized feeding programs, there is simply not enough food for most of the 3.2 million people in the famine-stricken regions of Somalia. The only organization with the technical and logistical ability to deal with it is the U.N. World Food Programme, but it is out of the picture because of al-Shabab. Some smaller organizations are doing what they can with their Somali partners, but it’s not enough.

The answer, some experts say, is to send cash. Somalia traditionally imports more than half its food, and those food traders have been active through all the civil strife. In other words, the markets still work.

Cash transfers are successful in Somalia because the hawala banking system can reach even the most isolated villages. There is another advantage: Unlike food aid shipments, cash transfers are not visible, and thus, more difficult intercept and steal. The idea is that with additional demand for food, traders will import more food to meet the increased demand.

There are clearly pros and cons. “If food stocks don’t increase in response to what’s effectively an increase in demand through cash transfers, then all you do is ramp up the cost of existing stocks of food and actually make everyone worse off,” Maxwell warns. But on the other hand, he notes that “whatever else doesn’t work in Somalia, trade works, the banking system works and telecommunications work. And some people say that should be enough to make sure there is a robust market response.”

The other thing cash does is keep markets functioning, he says. If the famine response were the standard one, to provide food aid, that would mean local markets wouldn’t function as they usually would. “The whole idea of injecting cash is that you try to keep the market situation as normal as possible,” Maxwell says.

Will It Work?

The problem is that up until now, Somali traders have been importing higher-end staples such as white rice, wheat flour and pasta. “That’s not what most people eat, and not what’s needed to address a famine,” Maxwell says. Instead, humanitarian agencies are trying to reorient the traders to bring in sorghum, livestock products and beans or other protein-rich crops.

Learning whether the cash transfers work is part of the Feinstein International Center’s research program to improve humanitarian responses during crises, Maxwell says. Aid agencies have done pilot cash-transfer programs in the past, which served upwards of 2,000 households at a time. But the scale has changed dramatically: now they need to reach at least 150,000 households—some 1 million people—at a minimum.

“That’s orders of magnitude more, compared with what’s been done in the past,” he notes. “On the one hand, it’s innovative, but there are a lot of unanswered questions. So people will be paying very close attention to what happens in the next few months.”

The worst for Somalia was predicted to come with the rains of October and November. That had a plus side—it offered a chance for a modest agricultural recovery, and there was a big effort to get seeds and tools to the farmers. But given the very weakened human populations, the rains could quickly lead to the spread of devastating water-borne diseases, Maxwell says.

That makes the humanitarian response, specifically the cash transfers, all the more important.

Maxwell was in Kenya during the late summer and fall, working for international NGOs that still have ties to Somalia. He provided the humanitarian agencies with technical assistance, but also monitored which responses were working the best. “One of the reasons why we’re engaged in Somalia,” Maxwell says, “is to study these things for research and lessons learned.”