Nutritional Situation in Burundi 29 March 2001 Joint report, UN Agencies

The current nutrition crisis results from the conjunction of crises – food insecurity and malnutrition, disease epidemics and a socio-economic crisis. In response to this multidimensional problem, the United Nations has developed a coordinated, multi-sectoral approach to consolidate and reinforce its own capacity and that of the Government, NGOs and civil society to respond to the crisis and prevent its future occurrence. This approach requires four types of responses:

 Emergency distribution/ intervention: Immediate and increased distribution of food, seeds, therapeutic products, vaccines and essential drugs.  Technical assistance and capacity building: Train and provide technical assistance to partners and communities in the areas of food production and nutritional and health care, in order to enable households to prevent the occurrence of a future crisis of this nature.  Advocacy: Work with the government, NGOs and donors to advocate for the prioritization of beneficiaries’ needs and sufficient resources and systems to address the enormity of the problem.  Coordination and information sharing: Reinforce collaboration with the government and NGOs in responding to the crisis as well as in the collection and analysis of information.

1. Crisis Situation:

A. Malnutrition crisis: Nutritional assessments conducted in seven provinces from January to August 2000 showed that the overall malnutrition rate varied between 5.89 and 23 percent, while the severe malnutrition rate varied between 0.6 and 15 percent. The number of children admitted to supplementary (SFC) and therapeutic feeding centers (TFC) rose dramatically between September 2000 and January 2001, as outlined below:

Date Supplementary Feeding Center Therapeutic Feeding Center September 2000 46,000 1,800 December 2000 75,000 2,800 January 2001 85,000 4,052

UNICEF estimates that if the situation is not adequately addressed, the number of people admitted to SFCs and TFCs could reach 100,000 and 6,000 respectively. It is expected that the number of cases will continue to increase from February to April and then decrease from May to July 2001 with the new harvest.

The escalating malnutrition rates result from a low agricultural output and food insecurity, disease epidemics, and the absence of coping mechanisms and support systems. Burundi has experienced a severe drought in the North for the past three years. Ninety percent of Burundians sustain their livelihood through subsistence farming. At the end of the agricultural year for 2000 (October 2000) the overall agricultural output was less than 5 percent of the normal level of production before the crisis. This has been coupled with severe malaria and measles epidemics which have greatly lowered productivity.

B. Epidemiological crisis: From the third week of October 2000, a severe malaria epidemic has affected provinces at an altitude of 1,400 to 1,800 meters, where there is no natural immunity to the disease. In 2000, 35 percent of health problems and 50 percent of hospitalizations resulted from malaria.

1 As a result of population displacements and REPORTED CASES OF MALARIA IN BURUNDI (1999 - 2000) insecurity, vaccination coverage rates were at their lowest in seven years in the first trimester 2000,
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[ The increased occurrence of disease and illness – Õ T ’ Õ S ’ Ñ Q has decreased productivity, increased food insecurity and heightened the vulnerability of the population to other illnesses. It is also evident that the increasing number of children with AIDS has meant that many do not fully recover from severe malnutrition and disease.

C. Socio-economic crisis: Seven years of war, displacement and a weak economy have exacerbated the humanitarian situation in Burundi. Burundi has seen a great increase in the vulnerability of its population and its need for assistance, along with decreased access to the most vulnerable. The capacity of the international community and the government to address the needs of the Burundian population has also been weakened as a result of continuing conflict, the embargo and a weak social infrastructure. Thus, the increasing need for and responsibility of the UN, Government and NGOs to provide assistance and support must be met by a correlating increase in capacity.

2. Coordinated Response The response of the UN, Government and NGOs to the current crisis can be broken down into the four areas outlined above – emergency distribution, technical assistance and capacity building and advocacy, coordination and information sharing. The responses outlined below are dependent upon the outcome of agricultural season 2001B, which will be harvested in May.

A. Emergency Distribution/ Intervention

I. FOOD AND AGRICULTURE ORGANIZATION (FAO) To ensure a good harvest in May, FAO is implementing the largest nationwide seed distribution campaign ever carried out by the FAO Emergency Unit in Burundi (Season 2001B, Jan. – May). This distribution is targeted toward 332,000 beneficiaries. In those areas worst affected, the quantity of seeds allocated has been increased – Bujumbura Rural, Gitega, Muramvya, Mwaro, Muyinga and Ngozi.

FAO will mobilize all of its resources and work to assemble the necessary conditions to ensure another good harvest in season 2002A (Sept. 2001 - Jan. 2002). The planned interventions for 2002A are as follows:  Double the seed ration from 10 kg to 20 kg per family to replenish stocks and food supplies. Based on the current number of vulnerable households (350,000), the needs are for 7,000 Mt. of bean seeds (20 kg per family) and 350,000 hoes (one per family).  Raise sufficient funding to purchase the needed amount of seeds and distribute them by early September 2001.

2 II. WORLD FOOD PROGRAM (WFP) WFP operates two large distribution programs – targeted family distribution and nutritional support. In response to the dire situation, WFP is also working with FAO to distribute food rations along with the seeds, to ensure that the seeds will be planted and not eaten. This distribution is targeting of 6,188 Mt. of food to the five provinces worst affected by the drought -- Karuzi (250,000), Muyinga (150,000), Kayanza (50,000), Muramvya (50,000) and Mwaro (50,000). The seed protection rations will continue until 8 March 2001 in line with FAO’s distribution of 3,500 Mt. of seeds to the same provinces.

WFP begins its targeted family distribution program in March in the worst affected provinces with the aim of assisting 1,200,000 beneficiaries per month through the end of July 2001. From March to July, WFP will need 10,889 metric tons of food each month to run this program.

To significantly reduce malnutrition WFP is distributing 1,000 tons of food a month to 100,000 beneficiaries in Supplementary and Therapeutic Feeding Centers (800 Mt. of CSB and 200 Mt. of oil).

III. UN CHILDREN’S FUND (UNICEF) In line with the worst case scenario of 6,000 admissions to Therapeutic Feeding Centers (TFC) and 100,000 admissions to Supplementary Feeding Centers (SFC), UNICEF is procuring 1,247 Mt. of F-100, 147 Mt. of F-75 and 7 Mt. of Resomal and is raising the resources to maintain a three-month stock of contingency supplies. UNICEF also procured 1010 Mt. of UNIMIX to cover the break in the supply chain for SCFs and TCFs. UNICEF provides essential medicine (mebendazole, antibiotics, etc…) and micronutritents (Vitamin A, folic acid, iron folate, etc…) to build the health and nutritional status of children admitted to TFCs and SFCs.

UNICEF has increased both measles and general immunization coverage. In Feb./March UNICEF will hold measles campaigns in the four unvaccinated provinces (Karuzi, Muyinga, Kirundo and Ngozi), and will continue overall immunization coverage through local and routine immunizations, and through the provision of vaccines and cold-chain equipment to implementing partners.

IV. WORLD HEALTH ORGANIZATION (WHO) WHO has launched a campaign to manage the rising caseload of malaria, measles and other diseases through the provision of medicine and technical assistance. Along with managing the current case load, WHO has increased its malaria, measles and disease prevention efforts through measles vaccination campaigns, the provision of anti- malaria products, education, the promotion of hygiene and sanitation and the provision of potable water. WHO works with the Ministry of Health, UNICEF and NGOs in these activities.

B. Technical Assistance and Capacity Building To reinforce seed distribution, FAO is carrying out rehabilitation activities, such as multiplication programs and vegetable production. In season 2002A FAO will build capacity through the rehabilitation of micro-irrigation canals to combat drought and support integrated crop and livestock activities.

UNICEF conducts training of health workers and other partners in nutritional care and nutritional protocols. Through building the capacity of caretakers to meet the needs of young children, UNICEF helps to decrease the potential for future crises.

3 WHO monitors the epidemiological situation and works with partners to share information, target activities and coordinate the overall response.

C. Advocacy, Coordination and Information Sharing All agencies work together with the Government, NGOs and other partners to advocate for the prioritization of the needs of beneficiaries in emergencies. In this complex emergency, the greatest needs are in the areas of food security, nutrition and health.

Each agency is specifically responsible for advocacy and coordination of the response in the following areas: WFP (food distribution), FAO (food security), UNICEF (Nutrition and Immunization), WHO (Health and disease prevention). At this point in the crisis, advocacy is necessary in order to achieve recognition of the crisis in Burundi and the provision of sufficient funding to cover the great need for assistance. This joint plan is representative of the coordination that is essential for an effective response to this crisis.

Information sharing among UN agencies, government, NGOs and civil society is also necessary to effectively assess and address the situation. WHO and UNICEF work together to monitor and evaluate the epidemiological situation. FAO and WFP monitor the food security situation. UNICEF monitors the nutrition situation.

All agencies are working together with the Government and NGOs to coordinate their activities, build capacity and ensure coverage. If deemed necessary, an inter-agency assessment should be conducted with partners to ensure that the humanitarian community is responding in the best way to the actual needs of this emergency.

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