By Johan Heffick, Emergency Response Technical Advisor - European Union Humanitarian Aid department
I have just returned from a mission to the Dolo Ado refugee camps in southern Ethiopia, near the border with Somalia. This is where the European Union has recently committed Euro 15 million to support programs that address the humanitarian needs of the refugee population.
The first two camps, Bokolmanyo and Malkadida, were opened in 2009 and 2010 to host Somalis fleeing the conflict in the south central region of Somalia. Kobe and Hilaweyn have been established more recently to cope with the extraordinary influx of Somali refugees caused by the drought and exacerbated by the ongoing civil war.
In July, an average of 1900 people were reaching Dolo Ado on a daily basis. The camps now host about 121,000 people, the majority of whom (80,000) have arrived in 2011 as a result of two consecutive failed rainy seasons that have caused one of the worse droughts since the early 1950s.
I am a medical doctor by training and have been with the European Union Humanitarian Aid department for the past 14 years. Despite having been in some of the poorest places in the world and having witnessed intense suffering caused by both war and natural disasters, I was struck by the humanitarian conditions I found in Dolo Ado.
For starters, I was astonished by the amount of children I saw in these camps and by the high levels of malnutrition that we came across. Acute malnutrition rates in the camps are estimated to be between 37 and 57 percent upon arrival in the reception centre. These figures are three times the cut off values for emergency warning as defined by the World Health Organization.
Worse still, is the high mortality rate of children under five years, primarily caused by malnutrition. Whereas the “normal” under-five mortality rates in sub-Saharan Africa is approximately one death per day per 10,000, this refugee population faces four deaths per day, per 10,000 people. In some of the camps, this average is even higher.
If we consider that a major humanitarian crisis is declared when the rate of under-five deaths per day is two per 10,000; in the Dolo Ado camps we are two times above the emergency threshold, and four times above the sub-Saharan under-five mortality rate. When you look at the entire refugee population of the camps, this translates into the potential death of at least 900 under-five children over the next three months.
Thanks to Doctors without Borders, a partner of the European Union, the therapeutic feeding program is well established in the camps. Children who are acutely malnourished are immediately sent to the stabilization center and treated. Nevertheless, I was stunned to see how many children had Marasmus, a medical condition associated to malnutrition that wastes the body away.
I even saw a child who was clearly around 9 or 10 years old with Marasma, which is extremely rare since children of that age generally have a stronger immune system. Many of the new arrivals in Dolo Ado look like ghosts, a testament to the harrowing journey they endure in war-torn Somalia and while crossing the border into Ethiopia.
Another alarming fact that we recorded is that most children who arrive at the camps are not vaccinated and are thus prone to a gamut of infectious diseases. In July, there was a measles outbreak that resulted in hundreds of cases, particularly affecting the Transit Centre and Kobe camp. Thanks to a prompt medical intervention, all 15 year olds are now vaccinated and the epidemic is slowing down.
In Dolo Ado there is a major humanitarian crisis. Let’s face it; no child should be wasting away in the 21st century. The recent funding allocation by the European Union Humanitarian Aid department intends to support critical interventions that are currently missing or need strengthening. Our goal is to support a holistic approach that cuts across critical sectors, specifically food security, water and sanitation, reproductive health, obstetric care, protection, and the distribution of basic non-food items.