By Katy Migiro
Isiolo Hospital in Kenya’s arid north is full of malnourished children with little apparent hope of a future, despite an influx of millions of dollars of emergency aid in response to last year’s devastating drought.
What has changed since then?
The media circus has moved on. But for the most part, depressingly little.
There is a sense of hopelessness; the same stories of suffering; the same inertia.
In the busy outpatient screening area, Makai Ali breastfeeds as she waits for her baby daughter, Jamila, to be weighed.
“I know that I don’t feed her well because I don’t have enough food for my five children,” says the 20-year-old mother.
Ali lives in rented accommodation in town with her husband, mother-in-law and their five children.
The family has no income. Her husband is sick. Ali begs neighbours for flour to make porridge for her children twice a day.
“Obviously, the child will get malnourished because she’s only feeding on one item which is not enough,” says one of the hospital’s nutritionists, Saida Abdirahman.
KIDS NOT IMPROVING
At 15.7 percent, malnutrition rates in Isiolo are still above the World Health Organization’s 15 percent emergency threshold.
Isiolo Hospital treated almost twice as many children for malnutrition in the first three months of 2012 compared to the same period last year, with 251 cases of global acute malnutrition (which includes moderate and severe malnutrition) up from 139.
"We have been dealing with kids like these for so many years," says Abdirahman.
“For so many months, you see these kids are not improving at home. As much as we are doing nutrition education, as much as we are doing health education, this does not change.”
In Isiolo County, 73 percent of the population lives below the poverty line and 63 percent receive food aid.
Traditionally, people here have depended on livestock to survive. But recurring droughts have wiped out their herds and left many destitute, without the education, capital or skills to venture into other economic activities.
Frequent crises have led to a plethora of humanitarian aid projects - from school feeding programmes to household meat vouchers.
When children are diagnosed as malnourished, the hospital has to feed the entire family what is known as a protection ration. Otherwise, the nutritious food provided to treat the sick child will be shared among half a dozen hungry siblings.
Such expensive responses are clearly unsustainable. They also fail to tackle the roots of the problem – poverty, conflict, early marriage and limited use of contraceptives.
It’s worrying to think how many children 20-year-old Ali, already a mother of five, will probably have had by the time she reaches middle age.
“Most of the residents are Muslims. They are not for contraceptives,” says nutritionist Abdirahman.
“It’s only with creating awareness of girl child marriages, polygamous marriages, that such things will not happen.”
BEGINNING OF THE END OF CYCLE OF HUNGER?
“Nutrition programmes need to work with other sectors to tackle basic, underlying causes,” says Brendah Akwanyi, nutrition sector coordinator for the U.N. children’s fund (UNICEF), citing a lack of clean water and poor hygiene as exacerbating factors. “Nutrition seems to be everyone’s business but no one’s responsibility.”
On paper, there are some signs of hope. The government has recently developed a food and nutrition security policy, which details how all ministries must work together to end drought and hunger emergencies.
And last year, it produced a 10-year strategy paper calling for $2 billion in investment to turn around the fortunes of Kenya’s neglected north. Half of this money would be spent on building roads and providing water and energy to pastoralist communities, long regarded as politically irrelevant.
The U.N. World Food Programme is shifting its assistance from food aid to “Food for Assets” programmes, where people work on projects that reduce their vulnerability, such as repairing roads and irrigation schemes, in exchange for rations.
But unless and until these policies start to bear fruit, the cycle of poverty and hunger looks set to continue.
Ali never went to school, marrying and becoming a mother at the tender age of 14.
Both her parents died when she was very young and she saw marriage as her only escape from a cruel stepmother.
For now, she has little hope of offering her children a better life.
“When these children grow up, they need education and I don’t have that money,” she says. “I don’t know what their future will be.”
One thing is certain - it will take a sea change in aid approaches to ensure that baby Jamila isn’t sitting in the same hospital cradling her own malnourished child in 20 years’ time.