The Journal of Disaster Studies and Management

Volume 13 No. 1 1989

Contents Agriculture and Food Security in Ethiopia NICHOLAS WINER The Food and Nutrition Surveillance Systems of Chad and Mali: the "SAP" after two years P. AUTIER et al. The Relief Operation in Puno District, Peru, after the 1986 Floods of Lake Titicaca L. SZTORCH, V. GICQUEL and J.C. DESENCLOS The Role of Socio-Economic Data in Food Needs Assessment and Monitoring J. SHOHAM and E. CLAY Diet and Nutrition during Drought: an Indian Experience N. PRALHAD RAO A case Study of Social Behaviour in a Natural Disaster: the Olivares landslide (Spain) J.L.G. GARCIA and M.V.S. PARRA Experiences of Non-Governmental Organisations in the Targeting of Emergency Food Aid J. BORTON and J. SHOHAM Seminar on Bangladesh Floods H. BRAMMER International Conference on the greenhouse effect and coastal areas of Bangladesh H. BRAMMER Forthcoming Events Book Reviews

Basil Blackwell for the Relief and Development Institute DISASTERS The Journal of Disaster Studies and Management

EDITOR Fred Cuny, Intertect, Derrick Jelliffe, School of Charles Melville, Faculty of Dallas, Texas Public Health, University of Oriental Studies, Bruce Currey Winrock California, Los Angeles University of Cambridge international Institute for ^ ^echat. Centre de ASSISTANT EDITOR Agricultural Development, Recherche sur Susan York, Relief and Bangladesh 1'Epidemiologie des Development Institute lan Davis, Disaster Desastres, 1'Ecole de Sante EDITORIAL BOARD ^"^ puu ue Universite oxford^TT ^ oxfordo , ^ ' Hugh Brammer, Relief P^Y ^^ ' ^ Catholique de Louvain, and Development Institute Frances D'Souza, Dept. of Brussels (Book Reviews Editor) Biological Anthropology, _, , , University of Oxford /-i. Robert Chambers Institute J; Children-T-i Fundr- -. , Londonr 1 of Development Studies, ^ ^ Washington David Turton, Department University of Sussex ^ DC of Social Anthropology, Lincoln Chen, School of Julius Holt, London School Faculty of Economics and Public Health, Harvard Hygiene and Tropical Social Studies, University University ^ Medicine °^ Manchester Edward Clay, Relief and Richard Hughes, Ove Arup Brian Ward, Asian Institute Development Institute and Partners, London of Technology, Bangkok

DISASTERS is the only journal to bring together research on disasters and relief and emergency management. Covering all forms of disaster from sudden onset disasters such as earthquakes and floods to famines and refugee migration, and taking a worldwide geographical perspective, DISASTERS promotes the interchange of ideas and experiences between relief practitioners and academics. The Journal maintains a balance between field reports from relief and development workers, case studies, articles of general interest and academic papers. It also contains book reviews and conference reports, and welcomes letters and discussion. DISASTERS is published four times a year, in March, June, September and December. Orders with remittance, enquiries and requests for sample copies should be addressed to: Journals Department, Basil Blackwell Ltd, 108 Cowley Road, Oxford 0X4 1JF or PO Box 1320, Murray Hill Station, NY 10156, USA.

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FOOD STUDIES GROUP Q.E.H. 21 ST GILES OXFORD 0X1 3LA Contents IIS?S%D^^

Agriculture and Food Security in Ethiopia NICHOLAS WINER The Food and Nutrition Surveillance Systems of Chad and Mali the "SAP" after two years P. AUTIER et al. The Relief Operation in Puno District, Peru, after the 1986 Floods of Lake Titicaca L. SZTORCH, V. GICQUEL and J.C. DESENCLOS The Role of Socio-Economic Data in Food Needs Assessment and Monitoring J. SHOHAM and E. CLAY Diet and Nutrition during Drought: an Indian Experience N. PRALHAD RAO A case Study of Social Behaviour in a Natural Disaster: the Olivares landslide (Spain) J.L.G. GARCIA and M.V.S. PARRA

REPORTS AND COMMENT Experiences of Non-Governmental Organisations in the Targeting of Emergency Food Aid J. BORTON and J. SHOHAM Seminar on Bangladesh Floods H. BRAMMER International Conference on the greenhouse effect and coastal areas of Bangladesh H. BRAMMER Forthcoming Events

BOOK REVIEWS Coping with uncertainty in food supply (I. de Garine and G.A. Harrison) D. TURTON Disabled persons and earthquake hazards (K.J. Tierney, J. Petak and H. Hahn) A. DARNBROUGH McGraw-Hill Encyclopedia of the Geological Sciences J. JACKSON Agriculture and Food Security in Ethiopia

NICHOLAS WINER

Food security in Ethiopia is discussed in the context of the repeated famines and me international responses both to them and to the socialist agricultural policies being pursued by Ethiopia. Increasing concern has been expressed by the international donor community regarding the ability of Ethiopia to absorb development funds without a major shift in emphasis in agriculturalpolicy-making. The background to Ethiopia's present vulnerability is shownboth in terms of the size of the vulnerable population and in terms of the poor performance of the agricultural sector in the last decade. The author looks at the present agricultural and marketing policy reforms and questions whether they are sufficient to generate the sort of international response needed to create the level of food security that would be required to avertfuture famines.

Food security in Ethiopia is a subject of Programme for 1988, including the im- continuing importance given the histori- portance of imports to the national food cal experience of repeated drought and picture. famine. By the 1980s the scale of Ethiopia's The figure for 1988 is unlikely to be vulnerability to the vagaries of the weather reached due to the problems caused by had become a matter of periodic inter- the civil unrest in the northern parts of national attention and concern . Govern- Ethiopia. It now appears that around ment attempts to cover up the extent of 670,000 mt. is predicted to be distributed the famine in 1973 and 1974 in the during the year as a whole. This is based northern region of Wollo are felt to have on a difference of 64% between what was contributed to the downfall of the Imperial actually distributed in the first quarter of regime. Famine and its management had 1988 and the amount that was planned for become a political issue. The famines of distribution (WFP, 1988). the 1980s have taken place against a This enormous emergency food aid backdrop of continuing civil war and thus requirement sits on top of the consider- they too have their political dimensions. able food deficit which exists in years of Although the public's attention was normal rainfall and food production. For focussed on the major relief efforts of the first half of the 1980s this deficit stood 1984/5 and 1987/8 there has in fact been a at around 350,000 mt. p.a.. This was based continuing need to provide emergency on a five-year average of food production relief in the form of food. Table 1 shows for the normal seasons 1979/80-1983/84 of the breakdown of food aid from 1985 to 6.2 million mt. which, set against con- the projections made by the World Food sumption needs for the same period of

DISASTERS VOLUME 13 NUMBER 1 Imported Imported Imported Total National Imports as Relief Food f or Commercial Food Food a % of Food Work Food * Imp orts Production Production

1985 765.60 155.00 124.00 1,044.60 4,370.00 23.90 1986 735.00 151.00 321.80 1,207.80 5,495.00 21.98 1987 287.85 69.00 131.00 487.85 6,650.00 7.34 1988 1,085.46 160.00 100.34 1,345.80 5,678.00 23.70

*AMC year runs from July to July. 1985 = 1984/85 AMC year. NB: All units are OOOs of metric tonnes. (Sources: WFP, FAO, Agricultural Marketing Corporation (AMC), Central Statistical Office (CSO), 1988)

6.55 million mt, shows an estimated must be in a position to acquire the annual deficit of 350,000 mt. (UNEPPG, necessary food. There are thus problems 1987) . This deficit will increase annually of both availability and income which as the growth in food production during need to be addressed. the 1980s has not been able to keep pace How any government decides to ad- with the 2.9% p.a. population growth. dress these issues can determine the levels Thus even under optimum conditions of assistance made available. Donors to a the country itself has a large food import programme initiated by a government will requirement. At the individual household look at it in terms of their own policy pos- level, food insecurity is manifested in itions on such issues. For the Ethiopian various ways. National food consumption government, with its avowedly radical figures (see Figure 1) indicate that a vast Marxist policies, this has resulted in a number of Ethiopians, although having lower level of external assistance, particu- access to food, do not actually have a bare larly from the industrialised West, than minimum diet as recommended by the the Government had been seeking. Food and Agricultural Organization of the The political context of working in U .N. (FAO). These people for whom Ethiopia therefore dominates all other malnutrition is chronic, possibly number- issues for those interested in the developing more than 14 million, comprise the ment of the agricultural sector. The frame- largest single group suffering from food work of government and the policies it insecurity in Ethiopia. Emergency food pursues provide the boundaries within aid is not designed to alleviate this which work is or is not possible. Despite problem. the complete overthrow of the feudal The problem is a structural one, capitalism of the Imperial regime, the w^A \s teesA so\ved frnoug^ goverrcmeTn con&i'noTi oi 'ine ^AYnopian peasant seems action supported by adequate levels of hardly to have changed under the new development assistance. The problem it- regime. self can be broken down into two major Despite its aspirations and rhetoric the parts. Firstly food itself needs to be avail- post-revolutionary government of Ethiopia able whether through local production or has managed to move from a commitment importation, and secondly, individuals to the poor in general to one in which the

DISASTERS VOLUME 13 NUMBER 1 At 2 rates of annual growth in output and with 2 rates of per capita consumption p.a

10r- i———] __ Deficit at 1.0% growth and 185 kg consumption p.a.

Deficit at 3.25% growth and 185 kg consumption p.a.

7.5 - | | Deficit at 1.0% growth and 140 kg consumption p.a. B) and 140 __ ^^^ 3.25% growth p.a. E ^^ | Deficit at kg consumption [|

E 5

2.5

1990 1995 2000

Based on 1981-84 production averages of 6.7 m. mt. p.a. [Source: CSO & IBRD}

FIGURE 1 Ethiopia - Projected Grain Deficits to the year 2000 interests of consumers are favoured over p.a. rate of population growth. Recent producers. That this is a relatively wide- economic growth, despite surges in spread trend amongst the smaller devel- periods immediately following drought oping nations has been noted by, amongst years, is less tha 2% p.a. thus leading to others, Colburn (1986) and I.B.R.D. (1986). greater and greater levels of impoverish- This has led to the vistas that were ment. A new time series for the 14 years opened up in Ethiopia by the radical land 1974—88 shows zero growth in food pro- reform programme becoming obscured duction, heavily influenced by the chaotic and then compromised by the political aftermath of the revolution (1974-78) and need to ensure adequate levels of food by the drought and hostilities from 1983 availability for the urban centres, the civil to 1985 (Payson , 1988). service and the armed forces. Investment in agricultural develop- Currently the per capita availability of ment has continued unabated throughout grain is falling as the growth in population this period but appears to have made little outstrips any growth in food production. impact. This is in part due to a bias towards This trend has been evident for about a State Farms, export oriented agriculture decade. USAID estimate that per capita and capital intensive schemes, as opposed availability of grain has dropped 22% in to programmes in support of the small the last 10 years (Faught, 1987). This will farmer (Payson, 1988). Ambitious planning inevitably continue to be the pattern and food production targets must there- unless net food production, including fore be seen as out of place at a time imports, can rise at faster than the 2.9% when all efforts should be put to ensuring

DISASTERS VOLUME 13 NUMBER 1 that the gap between consumption needs great reluctance on the part of most of the and food availability can be held at the rural communities to leave lands that they traditionally manageable levels of up to have lived and worked on for generations. 350,000 mt. a year. The Government has recently commis- Clearly change of one sort or another sioned an enquiry into the resettlement is urgently needed. The highlands are programme that is intended to cover the overpopulated and more and more land views of those living in the highlands, the holdings are becoming less and less able means by which the programme has been to provide even self-sufficiency . A favour- carried out and its chances of success in able climate, a relative absence of pests, the chosen resettlement areas. The report fertile soils, available water and the sea- should be of great interest if it is ever sonality of cropping all contribute to a pre- published . ference for the highlands. The Ethiopian The issue of greatest importance re- Highlands Reclamation Study funded by mains how to address the problem of the the World Bank and executed by the FAO dramatic decline in the per capita avail- in 1985 estimated that although the high- ability of food grains. The peasant farmer lands of Ethiopia covered 536,000 square has little or no encouragement to improve kilometres or 44% of the country, they yield per unit area. The fa rmer's ability to contained 88% of the human population invest in his/her holding is severely cur- and 66% of the country's eshmated 70 tailed by a bewildering variety of demands million livestock. This densely populated on income or grain surpluses such as they area represents about 95% of the regularly may be. It has been estimated that small cropped land and 90% of the country's holders now pay more to government col- economic activity. The highlands were lection agents than they did under Haile defined as those areas above 1,500 metres Selassie (Cohen and Isaksson, 1987.) . with their associated valleys (FAO, Government revenue from taxation 1986). sources rose from 592.7 million birr in Soil erosion rates are so severe that 1974/5 to 1,674.5 million birr in 1984/5 the report claims that "today 's children (World Bank, 1987). Normal rates of will see one third of the highlands in- taxation are added to by demands for capable of sustaining cropping while the further sums such as War Tax, Famine population trebles in their lifetime" (quoted Tax, dues to the Peasant Association, con- in UNEPPG, 1987). Such an extrapolation tributions to community based services, suggests that a tripled population of supply of materials and labour for infra- around 122 million people could eke out a structural development, lost time attend- living on such a greatly reduced land ing compulsory meetings and enforced area. Under present conditions this is not grain or pulse deliveries to official mono- a tenable view. poly purchasing agencies, such as the The Government has effectively dem- Agricultural Marketing Corporation or the onstrated that voluntary resettlement is Oilseeds and Pulses Corporation. not an option capable of making a sig- For many farmers it would be easy to nificant contribution to the resolution of make the case that there is little reason this problem. Resettlement of one sort why they should increase output above or another has been considered as a that needed for subsistence. The agricul- possibly important component of any sol- tural sector represents 80% of the em- ution to the perceived over-population of ployment in Ethiopia and its viability is the Ethiopian highlands. However recent thus crucial to the economic position of experiences have shown that there is a the country ; more especially as it also

DISASTERS VOLUME 13 NUMBER 1 contributes 85% of the export earnings. ised farmers, who will fall outside the Yet the entire sector is characterised by: scope of credit-based supply programmes. The issue of incentives is clearly - Over taxation, crucial, yet difficult to assess. It lies at the - Low producer pricing for commodities heart of the debate taking place within and delivered to the Government marketing between donors and the Government. agency (AMC), There are the normal economic incentives - Enforced quota deliveries, of the market place around which negoti- - Restrictions on grain movements, ations between the Government, the World - Restrictions on licensing traders, and Bank and the EEC revolve. There are also - Restrictions to the freedom of traders the socio-economic conditions created by to sell. the revolution and which are equally difficult to assess and discuss as they fall Under these conditions marketed food under the ban of being 'political'. surpluses and disposable incomes are so Under this second group it has been low as to lead to chronic under-investment noted in a study of a conservation pro- at the farm level. If the farmer can see gramme in Hararghe involving terracing little reason to invest, it is difficult to see and tree planting that "some intensification on what grounds aid agencies can encour- of labour would be possible if it was in the age investment in the agricultural sector. peasants' interest" (Galizia, 1986). The gap The drought of late 1987 came at a between what the peasant sees as in his time when the agricultural strategy of or her interest and what the Government concentrating all new resources in the 31 believes is in their interest is widening at awrajas (provinces) designated as surplus this time. producing had only just been unveiled. The land is not held by any individual The current agricultural debate as to with any security of tenure. Land tenure whether the Government's reforms in the thus remains the key to peasant motiv- fields of agricultural pricing and market- ation. For most people in the rural areas a ing, announced in December 1987, are multiplicity of landlords has simply been meaningful or not needs to be set against replaced by one; the Government. The the overall targets of the Government. Government instituted its land reform pro- These include self-sufficiency in food programme though the creation of Peasant duction by 1994. Associations in 1975 under the Rural Land One aspect of the promotion of this Proclamation . All rural dwellers are now strategy was that more fertiliser was dis- theoretically members of such an associ- tributed for the 1987/88 cropping season ation. These associations were set up to than possibly ever before. The returns "distribute land to former tenants and on this investment during a period of landless persons for personal cultivation, drought were poor indeed. The conse- and to handle the economic and social quences in terms of access to future problems inherent in the radical agrarian- credits for 'input' supply for farmers who reform programme" (Schwab, 1985). cannot repay these loans may be serious The size and position of a family's and may also jeopardise the future 'input' holding is constantly at risk of change as supply programme as a whole, to the children grow up to press their claims, extent that new supplies may only be and individuals enter or leave a Peasant available to those who have repaid earlier Association, causing adjustments to be credits. This in turn may create an ever- made in the interests of an equitable growing group of increasingly marginal- distribution of land. It is further at risk

DISASTERS VOLUME 13 NUMBER 1 whenever a Producer's Cooperative is prices relative to those charged to con- formed. This demands a contiguous block sumers in the metropolitan areas" were of land and results in a redistribution of felt to be the major agricultural marketing land within the Association in order to problem of the time (lEG/MoA, 1973). The hand out land to those who have lost same comments could well be made theirs and at the same time to redistribute today. the holdings of those who have opted for It is against this background of con- joining the Producer's Cooperative. tinuing debate about how to respond to Yet "Secure tenure and rights to the poor performance of the agricultural resources and adequate livelihoods are production and marketing sectors that the prerequisites for good husbandry and sus- reforms of December 1987 need to be tainable management" (Chambers, 1987). seen. Under them producer prices paid by When this is not the case, it is difficult to the AMC are set to rise by an average of look at long term strategies requiring not 7.7% (Fraught, 1988). This increase will just a commitment to the land on the part not however catch up with the fall in real of the farmer, but also a commitment to incomes since the revolution. A reduction significantly increasing food production. in the number of check points along the At the same time, the issue of deter- roads is also proposed, which should mining what constitutes effective market encourage greater movement for com- incentives is also fraught with difficulties. modities. The Ministry of Domestic Trade The food supply requirements which re- will also renew private traders' licenses. forms are expected to address can be seen This last move should not be taken at this in Figure 1, which shows varying levels of stage as anything other than a return to national food deficit at two different rates the status quo ante. The quota for the of economic growth, and assuming two issuing of licenses has not been fulfilled different levels of food consumption. It is for a number of years. The World Bank worth noting that growth rather than stag- has been given to understand that what is nation or decline is presumed, and that intended is the issuing of licenses up to the levels of food consumption represent the previously set limit. These licenses are the current national pre-drought average being issued at the regional level. and the much higher FAO-recommended The AMC quota will be "scientifically" minimum acceptable level. levied and will not exceed its capacity to It is also worth emphasising that prob- market. Traders who receive licenses will lems of low production and of low effective also be allowed to appoint five agents demand pre-date the current Government. each and will not have to pass on their They therefore cannot be seen solely in the entire purchases as was previously the context of the tenurial problems thrown case. The AMC will require 50% of a up by the post-revolutionary Government. trader's total volume of purchases to be In 1973 the Ministry of Agriculture felt passed to it and the Oilseeds and Pulses that "within the agricultural sector the Corporation will require 25% of total most significant weakness for develop- volume to be passed onto it at fixed ment has been the absence ot an eriicient prices. The peasant is authorised to sell agricultural marketing system which can any surplus on the free market once he stimulate both output and consumption has met the AMC quota and within the simultaneously". This in 1973 was further restrictions imposed on internal travel. A complicated by the imbalance in the Price Review Institute is also to be set up. relationship between producer prices and These changes raise a number of consumer prices. In 1973 "low producer immediate questions which would need

DISASTERS VOLUME 13 NUMBER 1 to be answered before an assessment of Mengistu, offered little that could be their value can be made. These principally interpreted as supporting the early optim- concern the importance that the Govern- ism that accompanied these limited policy ment intends to give to: reforms. Although the collectivised sector Italy. Report statements issued during the 9th Plenum AG:UTF/ETH/037/ETH of the Workers Party of Ethiopia (effec- Galizia, M. (1986) Man-Environment Relation- tively the Government) held in November, ships in the Western Chercher Mountains / 1988. The meeting, chaired by President Hararghe, Ethiopia. Research Report 12. 1986.

DISASTERS VOT.IJMK 13 NUMBER 1 p

FIGURE 2 Republic of Chad. The SAP covers the zones situated over the eleventh pa ra l lel.

AREAS COVERED BY THE SAPs Figures 1 and 2 show the areas covered by mill ion people. Administrative sub- thc SAPs in both countries. Administra- divisions of Mali (total population: 7.1 tive subdivisions of Chad (total popula- million) are called the "Regions", tion: 5 million) are called "Prefectures", "Cercles" and "Arrondissements". An "Sous-Prefectures " and "Canton s". A "Arrondissement" contains an average of "Canton " contains an average of 13,000 26,000 people and the SAP covers 168 of people and the SAP incorporates 192 of them, which represents about 4.4 million them, covering a population of abou t 2.5 people.

DISASTERS VOLUME 13 NUMBER 1 The Food and Nutrition Surveillance Systems of Chad and Mali: The "SAP" After Two Years

PHILIPPE AUTIER, JEAN-PIERRE D'ALTILIA, JEAN-PIERRE DELAMALLE and VINCENT VERCRUYSSE

The "Systemes d'Alerte Precoce" - the SAPs - of Chad and Mali havebeen in operation since April 1986. Their purpose is to forecast (or more realistically, detect as early as possible) food shortages in the drought-prone areas of each country . T hey are based on a multidisciplinary strategy, taking into account all relevant phenomena, from meteorology to nutritional status, and are imp lemented through the governmental networks. The present experience shows that, compared with the devastations due to famine and the cost of emergency food aid, they are not that expensive and they seem sustainable over the long term. "Faultless " prediction is not yet the rule, but several procedures permit progressive improvement in the ability of the systems to analyse and interpret. This paper explains the functioning process of the SAPs and presents several operational results. Additionally, it covers innovative concepts that haveproved to be successful, such as the " participative information network" .

INTRODUCTION prevailed (Pons, 1986). Early detection (or In 1986, two Sahelian countries - Chad prediction) makes possible early interven- and Mali - decided to install a food and tion, which is more effective than catch- nutrition surveillance system (FNSS) in up operations executed under crisis con- the drought-prone areas. Like other ditions. Without timely detection, food African countries, both experienced aid may arrive so late that it is no longer severe famines in 1972-73 and in 1984-85. necessary. In October 1985, late-arriving The FNSS had to respond to three main relief grains competed with the local new problems. harvests and contributed to the collapse First, when food aid is required, it has of cereal prices. Hence, in order to help to reach the affected areas in time. There- the recovery of the agricultural sector, a fore prediction, or at least early detection FNSS should be able to determine when of food shortages, must be possible to food aid should be curtailed (Hervio, ensure that relief operations be launched 1987; Jost, 1987). in time to avoid famine. In 1984-85, food Second, even if the emergency food relief arrived late, when famine already aid needed is accessible (e.g. security

DISASTERS VOLUME 13 NUMBER 1 mu4

Arr. of Balle

15th F

•VI Idth P at' of <„. _ y •^r- Cercle Douentza .—-<^.; ^u\lun % ^?-^ai Mopti Region ^

FIGURE 1 Republic of Mali. The SAP covers the zones situated around and over the fourteenth paralle l stocks, rapid transportation from abroad), even when they do not become famines, beneficiary communities must be identi- cause economic hardship and financial fied and the timing of initial and subse- losses (e.g. selling cattle at low prices in quent distributions arranged. Thus, order to buy cereals which have become prediction or early detection must be valid expensive). Because they provide critical for small-scale geographical entities: information in a timely fashion , FNSS may which population is going to face food help the identification of more "structural" scarcity and when? Detection must also responses (Anderson and Woodrow, be sensitive to the severity of a food or 1988; Mason et al., 1984; Clay and Everitt, nutrition problem and able to observe the 1985). Such responses are impossible impact of the interventions. when a food crisis is already in process. Third, food shortages are usually me^ In Chad and Mali, the FNSS are called with emergency food aid. More develop- "SAPs" (for Systemes d'Alerte Precoce). the operational mentally oriented and community-based This paper summarizes alternatives should be attempted in order and methodological lessons learned after to lower the vulnerability to food crisis. two and a half years of project experience 1 Furthermore, recurrent food shortages, in those two countries.

DISASTERS VOLUME 13 NUMBER 1 Auou , / )

rs. ft IM t M j >/ ^ I / BILTIN ~ Bite\ \ ^y " / I•- y\ \ /^ BATHA I ?LAC^———<- {-"H.I.-./ ^-

•""^i ^GUERAy;°"

i^^—. / \:^ 7 11th P K^^-^^ / ^SALAMAT

LOGONE ' onlE ^ iV--," .

FIGURE 2 Republic of Chad. The SAP covers the zones situated over the eleventh parallel

AREAS COVERED BY THE SAPs

Figures 1 and 2 shosvjhe areas covered by million people. Administrative sub- the SAPs in both countries. Administra- divisions of Mali (total population: 7.1 tive subdivisions of Chad (total popula- million) are called the "Regions", tion: 5 million) are called "Prefectures", "Cercles" and "Arrondissements". An "Sous-Prefectures" and "Cantons". A "Arrondissement" contains an average of "Canton" contains an average of 13,000 26,000 people and the SAP covers 168 of people and the SAP incorporates 192 of them, which represents about 4.4 million them, covering a population of about 2.5 people.

DISASTERS VOLUME 13 NUMBER 1 EXAMPLES OF EXAMPLES OF BUFFER FACTORS AGRESSIVE F/

A 'Security Stocks <•— Food Production <•— l*Drought

UJ commercial Stocks i rGrasshoppers g *Wild foodstuffs j Food ^ Availability ^^ §F *Food Reserves) \ gA *Assets \ 0 M (e.g. cattle) --- Purchase on market "•— *Food prices I ' revenues \ i L l TA Y Migrations• Individual food consumption

< LU I §^ f < *Breast feeding —- Nutritional Status -— *Energy Expenditure a^- 'Immunization "Infectious diseases i— m< =3 1 ^ Mortality

FIGURE 3 Schematic representation of the relations between aggressive and buffer factors

In Mali, the areas covered may be which represents the ratio between food divided into three different zones: the availability and food needs, and nutri- "sudano-sahelian" zone, around the 14th tional balance, which represents the parallel, mainly populated by cultivators; relation between individual food intake the "sahelian" zone, around the 15th and nutritional status. We say that a parallel, populated by a mix of cultivators, "food risk" exists when the food needs of pastoralists, fishermen and agro- a population are not fulfilled and that a pastoralists; and the "sahelo-saharan" "nutritional risk" exists when the lack of zone, north of the 15th parallel, popu- food at the individual level negatively lated mainly by pastoralists. In Chad, two affects the nutritional status. Some impor- zones have been defined: the "sudano- tant nutritional risk factors are not directly sahelian" zone, between the llth and food-related: for instance infectious 13th parallel; and the "sahelian" zone, diseases or family behavior towards the north of the 13th parallel. children. A deterioration of the nutritional situation is generally accompanied by a rise in the mortality rates. BASIC ASSUMPTIONS We make a further distinction The SAPs are based on a concept which between the factors able to influence food we call "rising-risk monitoring" . In every and nutritional balances. Figure 3 shows population there exist food and nutri- this distinction. "Aggressive factors" (AF) tional balances. These balances are highly include the phenomena adversely affect- dynamic and depend on many factors, ing these balances. "Buffer factors" (BF) from food production and purchasing include all the possible mechanisms that power to infectious diseases. A distinction individuals or families or regions or coun- has to be made between food balance, tries can develop to prevent or counteract

DISASTERS VOLUME 13 NUMBER 1 the effe ct of the AF. Hence, food and "NORMAL" SITUATION nutritional balances will be influenced by the impact of the AF and the capacity of AF = 0 and/or BF strong the BF to maintain the balance. A food sufficient food availability or nutritional crisis is more likely to appear if AF are strong and BF are weak. Food price may determine the success or failure of certain BF. SITUATION "UNDER SURVEILLANCE Financial resources may become insufficient to buy foodstuffs if their prices rise. Moreover, AF = f and/or BF fragile local percep- sufficient food availability tions create new realities: certain AF/ such as a rainfall deficit, may cause price hikes, even when real food availability remains more or less unchanged.1 SITUATION "AT RISK" A "food crisis" occurs when food availabilities become inferior to the food AF= ft and/or BF deficient needs. Similarly, one will Food availability in families speak about a still sufficient but with adaptations "nutritional crisis" when the nutritional status of individuals deteriorates. A famine may be considered as an outbreak of malnutrition associated with the occur- "FOOD CRISIS" rence of miscellaneous demographic or economic vicious circles aggravating the AF = ft and/or BF ineffective situation . An example of the latter are Familial fcod availability \\ economical losses + massive displacements of people. A food shortage may force people to move. Significant numbers of hungry people arriving in neighboring villages only mar- "NUTRITIONAL CRISIS" ginally better off , quickly deplete available feedstocks and provoke an increase in the Individual food consumption becomes food prices. This pressure on food availa- very deficient and the nutritional bility in the reception status deteriorates zones may in turn mortality tends to f engender a food shortage. Figure 4 summarizes the different stages leading from a "normal" situation to a famine one. The boundaries between the stages are not FAMINE always clearly defined , but such a classification facilitates our comprehension of "Outbreak" of malnutrition and apparition of vicious circles the events preceding a famine. mortality ft We are conscious that the classification of phenomena into AF and BF is somewhat rudimentary, and that the FIGURE 4 Schematic representation of the classification of a specific factor as AF or evolution of a fo od and nutritional situation from " BF may be arbitrary. Nevertheless, these normal" to "famine " (AF = aggressive f actors and concepts provide an analytic framework BF = buffer factors). with which to tackle the complex reality of the food and nutritional problem, and many of them have already been suggested

DISASTERS VOLUME 13 NUMBER 1 RISK LEVEL

-— arrival of families

OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUQ SEP OCT MONTH

FIGURE 5 HypotheticalHypothetical exampexamplele of f ood "rising-n"rising-risk" variation. by other authors (Cutler, 1984 and 1985; the reinforcement of the BF and the Dirks, 1980; McCorkle, 1987; Pacey and prevention of the AF. Payne, 1985; Rivers et al., 1976; Seaman and Holt, 1980; Sen, 1981; Torry, 1984). METHODOLOGY To summarize, the "rising-risk monitoring" is a framework to assess and The SAPs are completely integrated follow up the level of risk to which a within governmental structures and group is exposed. Figure 5 graphicall y operate through the governmental net- represents such an approach. AF and BF works of national technicians and admin- may combine, and the subsequent inter- istrators up to the level of the Canton or action might exacerbate or cancel out their the Arrondissement. effects. Early detection and forecasting are the existence of associa- made possible by Indicators tions between certain phenomena (or pattern-combinations of phenomena) with Usually, an FNSS is based on the use of the occurrence of food or nutritional "indicators" related to the fluctuations of crisis. Phenomena may occur simultan- the food and nutritional conditions. An eously with the crisis and therefore abundant literature has evolved about the require early detection; or they are early usefulness of various indicators (Autier warning signals which facilitate predic- and Ronsmans, 1984; Cutler, 1985; Lechat tion. and de Ville de Goyet, 1977; OMS, 1976). Interventions are possible at very In Chad and Mali, the selection of the different stages of the evolution of food indicators has been made according to and nutritional conditions and may con- past project experiences and the existing cern very different aspects . Emergency literature. Because of our "rising-risk actions are likely to be designed to comba t monitoring" orientation, the first goal was particularly menacing AF (e.g. grass- to gather a set of indicators covering all hoppers) or the nutritional crises (famine the important domains concerned with relief actions). Development-oriented food and nutritional conditions. Each actions (structural interventions, rehabili- domain did not have to be covered in tation) are more likely to concentrate on depth but, as far as possible, all the

DISASTERS VOLUME 13 NUMBER 1 relevant aspects within a specific domain Information is also collected about had to be appraised in order to achieve a some very important wild cereals or consistent monitoring system. From the vegetables and about the cultivations beginning, the SAPs have scrutinized the starting at the end of the rainy season properties of the indicators. Our primary (rice, vegetables, certain varieties of concerns were: 1. relevance (is the indi- sorghum). cator related to food or nutritional Phase 2 examines: 1. demography problems?); 2. usability (can it be easily (migrations of men or whole families of applied?); and 3. reliability. This per- cultivators; nomadism); 2. markets (retail manent evaluation process has led to prices of cereals, approximate quantities occasional modifications of the indicators. offered, prices of cattle); 3. food habits (unusual changes in the daily food quality and possible consumption of toxic food); General organization of the SAPs and 4. the food reserve levels. The latter The SAPs are organized into three differ- is only performed for the stocks of international organiza- ent phases. Phases 1 and 2 involve a governmental or continuous but simple monitoring of tions, since reliable and accurate assess- agronomic, economic and behavioural ment of private stocks (commercial and on a regular base is phenomena at the level of each "Arron- households) dissement " or "Canton ". Phase 3 is a field impossible (even with ample means). survey whose purpose is to verify and Data is collected monthly in all the means specif y the results of phases 1 and 2. Cantons and Arrondissements by Phase 1 is focused on the quantitative of questionnaires. These are filled out by measure of rainfall and river levels (in the same technicians and administrators Mali), and on the qualitative monitoring as in phase 1. Questions are usually of crops and grazing patterns. Crop data qualitative. Only the market indicators are are collected through four questionnaires quantitative. At the level of the Sous- filled in by the administrators and tech- Prefecture or Cercle, market data are nicians of each Arrondissement or collected, in Chad, by a person hired by Canton. The first questionnaire is com- the SAP, and in Mali, by a member of the pleted by the end of July; the second by governmental administration. the end of August; the third just before If any deterioration of the food condi- the harvests (end of September); and the tion is detected (or forecast) by phases 1 last one during or just after the harvests and 2, then phase 3 is launched. Phase 3 (October). Questions vary according to is a field survey which aims to verify the the passage of the rainy season . They are detections or predictions of phases 1 and state of household usually qualitative and analogical, for 2, evaluate the instance: "are the harvests expected in resources (food stock, incomes, assets your area better, equal to or worse than such as cattle), and assess the nutritional last year?" or "does the rainfalls seem status of the population. Generally, sufficient, not quite sufficient or very phase 3 is applied at the level of the "how Arrondissement or Canton. It is also used insufficient for the crops?", or many 1 months of grain needs will this harvest to assess the impact of the interventions. cover?". Data about rainfalls and river Family resources are very important levels are collected in collaboration or BF but it is very difficult (and even through the national meteorology and impossible) to estimate them correctly process like hydrology services. They are collected through a surveillance surveys yield daily and synthesized monthly. phase 2. Socio-economic

DISASTERS VOLUME 13 NUMBER 1 Ad Data and comments •National from central technical Authorities, services •International Organizations

* Draf t of Capital SAP Office ————»• the Monthly——^ National SAP (Bamako) A , Bulletin Working Group

Decision Monthly Bulletin for phase 3 Monthly Report + Questionnaires

Regional SAP Wor king Group Regional Technical (first analysis) Services

Data about Main Markets

Questionnaires phases 1 & 2

Village, Family Phase 3 Survey if necessary Individual

FIGURE 6 Functional organization of the SAP in Mali

better information but they are time money (work; commercial activities; sale consuming and often are difficult to of a cow; begging?). The amount of interpret. For this reason, we devised a income actually earned is never asked. rapid and indirect assessment method for Only the kind and the number of sources household resources. A family question- of income are surveyed. naire is constructed as follows: 1. it begins The level of acute malnutrition among with a question about what the family children from six months to four years of members ate the previous day; 2. Among age is used to indicate the nutritional the foodstuffs consumed the previous status of a population. Acute malnutrition , which day appeared as the more indis- is defined as a relationship of weight to pensable for the family?; 3. Where did height less than 80% of the NCHS/CDC/ these indispensable foods come from WHO reference median. (family reserves; bought on the market; During such surveys, other problems recent harvest; donation from other may be explored such as suspected people or organizations?); 4. If they were avitaminosis A problems, the recent purchased, how did the family get the apparition of "camps" of displaced

DISASTERS VOLUME 13 NUMBER 1 people/ the effects of grasshoppers. of the Monthly SAP Bulletin is produced The phase 3 surveys are implemented and first distributed to several national on samples of 450 children and 210 services and authorities as well as to some households. Samples are first degree donor agencies or NGOs particularly duster samples with 30 clusters of seven active in the field of food security or households and fifteen children . nutrition. Then, these organizations dis- On average, a phase 3 survey takes cuss the draft during an official meeting two weeks, one for the survey itself and a called the National SAP Working Group. second for data processing. At the begin- Just after the meeting, the final ver- ning of the projects, the phase 3 surveys sion of the Monthly SAP Bulletin is were performed by one special team printed and sent to all the governmental, attached to each project. Currently, they national or international organisms as are performed by two mobile teams of the well as to the Regions, Cercles and Ministry of Health in Chad, and in Mali, Arrondissements. A bulletin usually com- by mobile teams of the regional represen- prises a summary of the most salient tation of the Ministry of Health and Social events and trends of the past month, the Affairs (one team per region). Supervision recommendations for action, a view of the of the teams is still ensured by the SAPs. food and nutritional conditions prevailing in each Cercle, the phase 3 survey results and any particularl relevant information Functioning of the SAPs y such as the rainfall levels during the wet To fadlitate the explanation, only the case season. A bulletin is not a mere sum of of Mali is described below (that of Chad is facts, and comments or analysis are sig- very similar). Figure 6 summarizes the nificantly present. Each month, 450 copies flows of information within the system. of the bulletin in Mali and 300 in Chad are Once every month, when data have distributed. The whole operation, from been collected in the Arrondissements, the data collection till the distribution of the questionnaires are sent to the head the bulletins takes a maximum of 3 town of the Region by any possible weeks. means. Regular verification of the reliability of At Regional level, a first analysis of the SAP data is ensured by the phase 3 the data is performed once every month surveys, by the supervision tours of the by a regional SAP working group. This Regional SAP Representative, by the group is constituted by all the regional Regional SAP Working Groups and by the services concerned with food and nutri- active collaboration of the technical tion problems and by the Regional SAP services. From time to time, seminars and Representation (RSR). The RSR has to meetings facilitate the discussion about facilitate the functioning of the SAP how to ameliorate information quality and within a Region and to help at the first reliability. analysis and interpretation of the data. A Regional SAP Report is established and Interpretation of the information sent to the central SAP office of the capital and to the Regional authorities. For phase 1 and 2, the analysis process is In the capital, the SAP headquarters based on the evolution of the AF and BF. analyze, interpret and synthesize all the The objective at this point is to assess information. Information and analysis whether AF tend to accumulate and how coming from the governmental services in BF are behaving. The more a food (and the capital are taken into account. A draft nutritional) crisis approaches, the more

DISASTERS VOLUME 13 NUMBER 1 these phenomena tend to combine their tory; the average number of months of effects and appear "unusual". food needs that will be covered by the To assess if a phenomenon is present harvests. This information "unusual" one has to compare the current takes into account not only the tradi- data with: tional cereals (millet, rice, sorghum) but also some wild foodstuffs (e.g. the - baseline data, for instance, the yearly "fonio" or the "cram-cram"), variation of the millet prices or of the - the observation of food prices, mainly population movements. With baseline for cereals. Usually/ if the harvest data, for a given area, it is possible to expectations are optimistic, grain prices compare changes from one year to tend to diminish before the harvests. another or to compare the current Usually also, prices after the harvests localized developments with the decrease. The magnitude and length of circumstances of a larger geographical the decrease may vary considerably zone; from one area to another according to - information relative to neighbouring the actual food reserves of the families areas with the same eco-system; after the harvests. Some families, even - structural information; for instance, if if they have had good harvests, may phase 1 shows that in a given area the have poor food reserves because a great rice harvests have failed but if the part of the cereals had to be sold in structural information proves that rice order to pay off previous debts or taxes. is usually a minor food resource, then On the other hand, poor harvests may the failure may not be considered as a be counterbalanced by good food real threat. reserves set aside in the previous years and consequently lead to a better food Gathering of baseline and structural situation than the current harvests information is a continuous process: the would lead us to expect; SAPs/ through their longitudinal and - the observation of migration patterns. If regular collection of information build harvest expectations are pessimistic, databases that enable the SAPs progres- then usually one observes early depar- sively to improve analysis and interpreta- tures of young men before the harvest. tion of data. This process has been called If the short term food situation of the " the progressive refinement of analysis family is threatened by poor harvests and " interpretation . (and when concurrently other assets or During the rainy season , judgement food reserves of the household are about the development of crops and deficient), then the whole family may harvest expectations rest on the following move prematurely. 1 considerations: It is already possible to have an idea - the rainfall levels plus (in Mali) the river of the most "at risk" Arrondissements or levels; Cantons by August. This is accomplished - the subj ective satisfaction of the tech- by considering the set of indicators nicians and administrators in the presented above, plus the food conditions Cantons or Arrondissements about the that prevailed during the previous year. crops' development; the comparison of Interpretation of phase 3 data will be their current growth with the previous explained more comprehensively in a 1 year and with a reference year when further article. For the purpose of this harvests were considered as satisfac- paper, stated simply, the analysis con-

DISASTERS VOLUME 13 NUMBER 1 siders the distribution of good incomes thousand kilometres away from the (revenue able to feed a whole family) and capital had better collection and trans- of food reserves within the sample of mission records than the one situated households. Attention is paid to the nearby the capital. families that have to buy their food and to The constitutions of reference base- the number and quality of incomes. The lines and of structural databases represent quality of the revenues is determined another significant result. Many baseline thanks to studies that estimated the pos- data did not exist before and had to be sible income one could gain from a gathered by the SAPs. The already exist- specific activity (e.g. Hesse, 1986; Davies ing baseline data were related to agro- and Thiam, 1987) . meteorology and several market data, the In the absence of previous data, the latter being usually of limited geo- level of 10% of malnourished children in graphical significance. The structural the age group from six months to 4 years information existed more fully but had to 11 months is taken as the cut-off point be standardized and completed. Figure 7 from which we consider that acute mal- shows the comparison between 1986 and nutrition becomes a significant problem 1987 of the harvest results in Mali. These (UNHCR, 1982). This cut-off point also results are simply the computation of represents the limit between a food and a answers given by each Arrondissement in nutritional crisis. phase 1. As in many Sahelian countries, Information about "exceptional" facts the harvests of 1987 were worst than in and phenomena is also taken into 1986. In 1986, less than 11% of the account, e.g. the establishment of a Arrondissements had reported insuffi- "camp" of displaced people. cient or very insufficient harvests. In 1987. this proportion rose to 48% (this does not mean that 48% of the Arron- RESULTS dissements actually experienced food problems since other resources existed, Operational results mainly the food reserves gathered the The first result of the SAPs is certainly the previous years). "participative information network" they Figure 8 shows the variations of the have been able to foster. At each level of average millet prices in the 29 principal the network, information is discussed and markets of the areas under surveillance in opinions exchanged. A "conveyor-belt of Mali. The average prices are lower in the information" has been created and it is southern producing areas (sudano- now possible to compare what is going on sahelian zone) than in the north, where in the different areas of a country . Most of millet production is less prevalent (sahelo- the information needed already existed saharan zone). The harvests of 1985 and (actually or potentially). The main work 1986 were considered to be generally very was to standardize it, to improve its good and, as a result, the prices declined reliability and usability, to support a after November 1986 and stayed at a low network of collection and transmission of level for at least 14 months. In 1987, the data as well as develop analytic pro- rainy season was insufficient in many cedures and interpretation frames. In areas and harvest expectations in Sep- 1987, in Chad 94% of the questionnaires tember were not as optimistic as in the of phase 1 and 2 were filled out and in two previous years. But thanks to the Mali this proportion was 80%. Interest- good food reserves accumulated before, ingly, in Mali, the Regions situated one the millet prices rose only slightly during

DISASTERS VOLUME 13 NUMBER 1 NUMBER OF ARRONDISSEMENTS 120

Hi 1086 Sia87 100 93

60 46 43 40

GOOD SUFFICIENT INSUFFICIENT VERY INSUFFICIENT QUALITY OF HARVESTS

FIGURE 7 Republic of Mali. Number of Arrondissements covered by the SAP, whose harvests, in 1986 and 1987, were considered "good" (with excess of production), " suff icient " (covering the needs of the year), "insufficient " (cover between four months and one y ear) or "very insufficient" (covering three months or less). The results involve 148 Arrondissements ( the Arrondissement of Kidal is not represented ) and concern the millet , sorghum, rice and wild "fonio " or " cram-cram" .

PRICES (FCFA) 300

Qeoflraphlcal Zone + SUDANO-SAHELIAN 150

100 'y-^ '

50 4. +- -1——4= ^-

NDJFMAMJJASO NDJFMAMJJAS 186 I 87 I 88 I YEAR/MONTH

FIGURE 8 Republic of Mali. Variations in the average millet prices on the main markets of the three zones covered by the SAP, f rom November 1986 to September 1988. The average prices for Mopti Region are also represented. Prices are indicated in FCFA per kilogram (1 ECU = 343 FCFA).

DISASTERS VOLUME 13 NUMBER 1 % OF CANTONS 30

Geographical Zone 25

JFMAMJJASON JFMAM JJAS I 87 88 I YEAR/MONTH FIGURE 9 Republic of Chad. Variations in the proportions of Cantons where departures of families of cultivators have been reported, from J anuary 1987 to September 1988. the rainy season of 1987. After the 1987 Almost the same characteristics of harvest, the price diminution observed in price and of migration variation have November and December was short-lived been observed in Chad and Mali. and from January 1988 on, a steady rise in prices took place and continued up to Results from the surveillance July. The wet season 1988 was very good, and consequently the prices began to fall Figures 10, 11 and 12 concern the Arron- before the harvests, in August. Price dissement of Balle, situated in the fluctuations for Mopti Region are also Sahelian zone of Mali (Figure 1) and represented in the graph. Mopti expe- which experienced a food and a nutri- rienced the worst crop results in 1987. tional crisis in 1986-87. This was due to One can see the prices rising more rapidly the fact that the actions recommended by in that Region during the 1987 wet season the SAP were not executed. This situation and they even surpassed the average thus represents a "failure" of the SAP in prices for the entire sahelian zone. the sense that, even though the crisis was Figure 9 represents the monthly forecast and detected, actions to prevent evolution of the proportion of Cantons it did not take place. reporting departures of whole cultivator In August 1986, the phase 1 reports families in Chad. Departures are more showed that the Arrondissement of Balle likely to occur just after the harvests or (about 19,000 inhabitants) was experienc- before the rainy season. During the rainy ing an invasion of grasshoppers and that season, people prefer to cultivate (when it had not rained for 20 days. In possible) and migrations are rare. Because September , harvests were predicted to be the harvests of 1987 were worse than in less than in 1985 and 1985 was already not 1986, the level of departures was higher a good year! in 1987 as a result of more families In October, final phase 1 results moving south in search of food and indicated that families had sufficient food revenues. reserves for about three months. Conse-

DISASTERS VOLUME 13 NUMBER 1 % OF FAMILIES 80 -1

—— 0000 REVENUES l__j YOUNO MAN ABSENT so -i n

Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sap Oct Nov I 86 I 87 YEAR/MONTH

FIGURE 10 Republic of Mali. Variations in the proportions of f amilies declaring "good" incomes , or f lu absence of a young man in the Arrondissement of Balle , f rom December 1986 to August 1987. quently, the SAP recommended that a reports consistently showed departures of food security stock be established near the families. Arrondissement before February 1987. In In June, another phase 3 survey was November, the cattle moved south earlier performed. As one would anticipate, the than usual because of the lack of grazing nutritional situation had deteriorated and and water. a nutritional crisis had taken place (14.2% In December, the SAP performed a of malnourished children, comparison phase 3 survey. Figures 10 and 11 show with December: p < 0.001). Most of the the main results of this survey and of families had to buy their food (58.6%) those that followed. By December, many while the prices were at their highest young men had left their families to find level. A significant proportion of the work in the southern areas and less than families (34.3%) could not buy food any- 5% of the families had good incomes. more and lived from charity donations Moreover, wild foodstuffs had dis- (mainly from relatives or neighbours). appeared because of the previous Household food reserves were gone and drought, the grasshoppers and the over- one could expect a further worsening of consumption. Because most of the herds the situation. had migrated far away, milk, an impor- Paradoxically, family incomes had tant food resource, had become rare. increased (24.6% of families with good There clearly existed a food crisis but revenues in June instead of 5.0% in nonetheless, the nutritional situation January, p < 0.001). This was mostly seemed not to have deteriorated (mal- attributable to the return of the young nutrition rate of 4.2%). New recommen- men with money and food (29.5% of dations were made but only partially families with one young man away in implemented, mostly because of logistical June instead of 51.5% in January, problems. p < 0.001). The new rainy season was After January 1987, food prices rose beginning and with the first rains, some significantly (Figure 12) and phase 2 herds were also coming back. All this

DISASTERS VOLUME 13 NUMBER 1 % OF MALNOURISHED CHILDREN 16

NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV I 86 I 87 I YEAR/MONTH

FIGURE 11 Republic of Mali. Evolution of the malnutrition rate in the Arrondissement of Balle, f rom December 1986 to August 1987. should lead to a bettering of the food of malnourished families tend to lower conditions and the SAP did not make new the malnutrition rate.1 recommendations. In August, a last phase 3 survey was conducted just before the new harvests. ANALYSIS WITH SCORE SYSTEM The malnutrition rate had lowered The analysis of food conditions is per- (10.2%, comparison with June, two sided formed using a whole set of indicators. test: p = 0.07) and more families bene- The levels of risk associated with the data fited from good revenues than in June values are compared with the baseline (58.0% , comparison with June: data, the structural information and also p < 0.001). Returns of young men and across similar areas. This process has two cattle continued and contributed greatly main limitations. First, it is difficult to to the general improvement of the situa- compare between scales. How can one tion. Furthermore, the rainy season was aggregate phenomena which have very excellent and the grasshopper threat different meanings and units of measure- under control, so that lots of wild food- ment (for example, prices and migrating stuffs were newly available and the families)? Second, not all the variables harvests were expected to be good. have the same importance, and certain Figure 12 shows clearly the decline of indicators may appear more significant in millet prices that occurred at the end of certain areas than in others. the wet season. To cope with these constraints, we When looking at the situation before have devised a score system that weights June, one might ask whether, given the relative importance of the indicators. similar circumstances, the June nutritional Of course, in the beginning, most of the situation might have been worse. It is weighting procedure rested on empirical entirely possible. It is worth noting, considerations. But with the "progressive however, that departures usually involve refinement of analysis and interpretation" those families with the worst nutritional process, a constant remodelling of the situation. Hence, preferential departures relative weights has taken place. The

DISASTERS VOLUME 13 NUMBER 1 PRICE (FCAF) 1BQ

-B- 140 ARR. OF B

120

100

NOV DEC JAN FEB MAR APR MAY JUN JUL AU6 SEP OCT NOV I 86 I 87 I YEAR/MONTH

FIGURE 12 Republic of Mali. Variations in the price of one kilogram of millet in the Arrondissement of Balle , from November 1986 to November 1987.

practical procedure for setting up a score true diagnostic method and therefore, has already been discussed in a previous they are never included in the SAPs article (Autier, 1988a). Currently, the monthly bulletins. scoring system is mostly used for phase 2. Figure 13 shows the average scores for RECOMMENDATIONS FOR ACTION the three zones covered by the SAP in Mali. The higher a score, the more likely a Up to now, most of the recommendations crisis may exist. The score of the Cercle of have concerned the targeting of food aid Douentza, which belongs to the sahelo- and the management of security stocks. saharan zone and the Region of Mopti The principal goal pursued by recom- (Figure 1), is also represented. This Cercle mendations is to avoid food crises. experienced bad harvests in 1986 and Targeting of the food aid is usually made 1987. Its score increased dramatically at at the Arrondissement or Canton level each end of the rainy seasons, mainly (sometimes, targeting concerns only a because of the displacement of young part of an Arrondissement or Canton) . men and families, the consumption of Estimation of the food aid needs for the "exceptional" foodstuffs and the cereal following year is possible at the end of the price hikes. During the 1987 wet season, rainy season by summing up the indi- its score rose more rapidly than the rest of vidual needs of each Arrondissement or the sahelo-saharan zone, indicating that Canton. From August on, this latter food conditions were worse in this Cercle. process is based on the quality of the The important decreases observed in current wet season and the food condi- March-April 1987 and rrom May-June tions that prevailed the previous year (see 1988 are largely due to food aid distribu- the interpretation of data above). The tions. permanent surveillance performed by the Though being a real application of the SAPs permits these estimates to be recon- "rising-risk monitoring" method, it is sidered throughout the year. essential to note that the scores are used Schematically, to calculate the food only to aid interpretation. They are not a aid needs, the following rule of thumb is

DISASTERS VOLUME 13 NUMBER 1 SCORE VALUE (MAX • 140) 100 Geographical Zone 80 +• SUDANO-SAHELIAN •-•-• SAHELIAN -X- SAHELO-SAHARIAN -B- DOUENTZJI

40 rf—+ X-- - -X

20 ,+---h +• .4- -+ - ^• . 1,.^-+-+-^..+...+-+^- —^--4—+-' Nov Jan Mar May •Jul ' .Sep Nov Jan ' .Mar • May 186 I 87 I 88 I YEAR/MONTH

FIGURE 13 Republic of Mali. Examp le of phase 2 "scoring " for the three zones covered by the SAP, from November 1986 to June 1988. The fourth curve concerns the Cercle of Douentza. used: "number of persons at risk x lessen the vulnerability to food shortages. number of months from the beginning of First, the SAPs are studying the possibil- the f ood crisis up to the next local f ood ity of targeting the emergency f ood aids production x 7 Kg of cereal". This more accurately.1 Up to now, the target- amount of grain corresponds roughly to ing unit was the Arrondissement or the half the minimal monthly needs in cereal Canton. Correct targeting at the village f or an adult. If unfortunately a nutritional (or group of villages) level is not an easy crisis has evolved , then 14 Kg of cereals task, but it would represent an improve- per person as well as other actions, such ment in the sense that the most vulner- as avitaminosis A prophylaxis or immun- able population could be better reached ization against measles, are recom- with lower emergency f ood aid quantities. mended. As a result, possible side effects of emer- By "food aid", the SAPs do not mean gency f ood aid could also be reduced. that this has to come f rom abroad and is Second , the SAPs, with many other intended f or "mass distributions". There- national or international organizations, f ore, decisions must also concern the are encouraging research into alternative origin of the food aid (e.g. local purchases answers f or local f ood problems. More in the productive ozones, triangular and more, the basic administrative levels actions, f ood aid f rom abroad) and the are involved in the decision-making way they will be implemented (e.g. emer- mechanisms when f ood problems are gency "mass" distributions, "food f or expected. Third, the SAPs may participate work", market interventions, highly in the identification of development pro- targeted nutritional programs). jec ts which reinforce the BF and monitor Current discussion within the SAPs is their impact at local level. This latter aimed at achieving f urther reductions in aspect is being debated at present. Several emergency food aid and shifting project observers think that information systems emphasis to structural actions intended to like the SAPs are not suited for participat-

DISASTERS VOLUME 13 NUMBER 1 ing directly in a development process and (PRMC) and its primary goal is to institute that they should focus exclusively on the an efficient food commercialization early warning and management of food system in Mali, and nutritional crisis (Lalau-Keraly and Past experiences showed that rapid Winter, 1988) . We rather consider that transmission of data from the periphery thanks to the "participative information to the capital always represents a vulner- network" they support, the SAPs could able component of any information facilitate the identification (not the study!) system. After two and a half years, the of structural projects (Autier, 1988b). evidence is that sufficiently rapid transmissions are possible without any FINANCIAL AND OPERATIONAL ASPECTS sophisticated and expensive means. Only a few radios had to be installed in some The total annual cost of a SAP is esti- Cantons or Arrondissements where sur- mated at between 170 and 250/000 ECUs. face transmissions are impossible during These costs include logistics, production the rainy season. of the monthly bulletins, several salaries, computers, and the material for the collection and transmission of data . The instal- DISCUSSION lation costs are higher, although they may Acceptance of the SAPs vary a lot from one country to another, depending on the territory to be covered Prevention of food and nutrition crises is and the existing information gathering not merely a problem of detection or and processing facilities. One year of SAP forecasting. It necessitates a good balance functioning in Mali is cheaper than trans- between the information, decision- porting 1,300 tons of food from Europe to making and action implementation Timbuktu, a town situated in the sahelo- aspects. The SAPs propose actions. But saharan zone of Mali (European Economic the decisions concerning their application Community costs figures of 1987). are beyond their scope. The effective Several of the SAP's procedures lower application of the SAP's recommenda- the costs of this kind of information tions is a critical issue for the viability of system: for instance, the organization of the system. If their information is not the SAPs into sequential procedures limits taken into account, the data collectors the application of more expensive methods may tend to become discouraged and the only to those situations when they are system could collapse. The transformation actually necessary . As a result, the phase of the recommendations into effective 3 surveys absorb less than 10% of the actions was not automatic to start with. total cost of a SAP. Further cost reductions Time was required for the decision pro- are possible by transferring certain tasks cedures to adapt to the newly created to other technical services. information environment. Currently, Currently, financial support of the even if the recommendations are not SAPs tends to originate from "pools" of always followed literally as they stand, all donors ana tine goveiraneYrts. YOT decisions about iood aid are based on tine instance, in Mali, funds proceed from an information provided by the SAPs. The organization constituted by the govern- SAPs have made possible a better corres- ment and the majority of the international pondence between the food aid quantities organizations present in the country . This and the actual needs (Lalau-Keraly, 1988; organization is called the "Programme de Lalau-Keraly and Winter, 1988) and they Restructuration du Marche Cerealier" permit earlier interventions than a few

DISASTERS VOLUME 13 NUMBER 1 years ago (Hervio, 1987). ships should be able to measure the FNSS like the SAPs are not simply probability of the occurrence of a crisis instruments that facilitate information given the existence of certain previous gathering and analysis. Their significance conditions. Prospective longitudinal may lie in the way they foster important studies of the conditions that lead to food transformations within the decision- or nutritional crisis may lead to under- making processes, and remodel the standings which would accelerate the awareness that national or international improvement of the SAPs' prediction officials have of the food or nutrition capabilities. For ethical reasons, it is problems. impossible to perform such studies Confidence in the SAPs relies upon a directly. It would be ethically inadmissible widespread perception that their findings for projects like the SAPs to observe are impartial, and upon the reliability of passively the evolution of a food situation the information they provide. Mechan- up to the point of a nutritional crisis. isms that guarantee reliability are crucial Technical considerations also hamper even if they are costly. Therefore, the such studies: how to choose "control phase 3 survey plays a central role in the situations", for instance? Many indicators validation of the phase 1 and 2 informa- are of interest not because they are related tion, and the feed-back of the information to "causal" events but rather because they towards the periphery motivates the field provide evidence about the evolution of a personnel to keep sending in high-quality situation (e.g. the "stress" indicators). information because they see that their Most phenomena linked to food or nutri- work is taken into consideration. tional problems have close mutual inter- Over time, the acceptance of the SAPs relations. When examining the has increased and their position within relationship between two of them, the the national structures been strength- effects of other phenomena often obscure ened. Compared with the cost of the food the "apparent causality " that seems to aid and of the devastations due to exist. Because of these reasons, inter- famines, they are not that expensive. "It pretations like the one made for the is not conceivable any more for the Arrondissement of Balle are always ques- decision-makers to see disappear this tionable. instrument the utility of which is recog- However, valuable insights have been nized by everybody" (Lalau-Keraly and obtained through analysis of the failures Winter, 1988). Currently, additional of the SAPs. SAPs' failures fall into three assignments for the SAPs are being categories: true crises that were actually examined, such as support for the identi- predicted or detected but where the fication of structural projects (that has interventions failed (the example of the already been discussed above), or its Arrondissement of Balle); crises that were involvement in the monitoring of the food predicted or detected, but where no commercialization processes (Lalau- actual crisis occurred when no significant Keraly, 1988). intervention was made (false positive); and crises that were not predicted but occurred (false negative). Fortunatel Prediction and early detection y, up to now, there have been no false nega- True causal relationships between phen- tives and situations like the Arrondisse- omena related to food or nutrition condi- ment of Balle remain the exception. The tions are very arduous to establish. A most frequent failures are the false procedure for ascertaining causal relation- positives. False positives may result from

DISASTERS VOLUME 1.1NUM BER 1 erroneous prediction of crises, or bad a period to allow the achievement of a prognostication of the severity of an "faultless" SAP, but nonetheless, given actual crisis. False positives happen the present results, we are optimistic that mainly at the end of the rainy season, we shall soon see satisfactory FNSS in the when the SAPs provide estimates about two countries. food problems to be encountered during Data interpretation will never be auto- the following year. At that season, many matic, however, and expertise will always food situations are "borderline". Because be necessary to interpret the complexities the SAPs want to avoid any false nega- revealed by the SAPs. Analysis and inter- tives, the food aid quantities anticipated pretation of the data require a good in September-October are somewhat working knowledge of the situations overestimated even when they are more encountered. This represents a major realistic than they were before the exis- limitation to the use of scoring systems tence of the SAPs. No information system such as the one explained above. Scores can avoid such anomalies and false actually prove to be of great help, but positives are likely to be more frequent they are not a diagnostic tool. when the phenomenon to be observed is uncommon and the observation system Indicators used sensitive (Bayes' theorem: see Fleiss, 1981). As a result, we take advantage of The SAPs are built on a multidisciplinary these failures to examine where and why approach. They use quantitative and the system was unsatisfactory. qualitative information. Some information Other major insights are obtained looks fairly subjective. The ability of the when confronting the information from subjective information to encapsulate crop phases 1 and 2 with the information from development and harvest expectations phase 3. In Mali, of 30 phase 3 surveys, has been recently supported by studies 41% invalidated the conclusions drawn demonstrating that the subjective judge- from the analysis of the two previous ment of the peasants or local technicians phases. The crucial role played by phase 3 about cereal production may be as valid emphasizes the difficulty of maintaining a as the statistical methods used to perform very sensitive and reliable early warning objective measurements of cereal produc- system based solely on a continuous tion (Verma et al., 1987). surveillance process. All the indicators utilized are "proxy" In conclusion, given the constraints indicators. If used individually, none can enumerated above, the SAPs are not yet provide an unequivocal determination of (and perhaps will never be) perfect pre- food conditions. The only one we con- dictive systems. Early detection is the rule sider as true "outcome" indicator is the and accurate forecasting the exception. malnutrition rate. Results of its applica- The prediction and early detection capa- tion during the phase 3 survey serve to bilities of the SAPs are to be steadily define whether a nutritional crisis exists improved thanks to the "progressive or not. Unfortunately, its usefulness is YefiTiewierA oi aTia\ys^s arid mVeTpYete- Yimited by Us sensitivity \o the departure tion". This continuous mechanism of malnourished families in time of food 1 includes the construction of the baseline scarcity . Furthermore, as already men- data, the structural information data- tioned by several authors, this indicator is bases, the analysis of the "failures" and late and thus, it is never used for predic- the comparison of the results of the tion or early detection of food crises different phases. Two years is a too short (Autier and Ronsmans, 1984; Lechat and

DISASTERS VOLUME 13 NUMBER 1 de Ville de Goyet, 1977; Mason et al., vant or difficult to use, for example health 1984) . It is also never recommended as a related indicators such as mortality rates, tool for making accurate food aid targeting birthweight, disease surveillance and 1 (Autier, 1988b). level of health activities. Indicators related The search of "ideal" indicators has to livestock (e.g. prices, market demand never been a priority since we believe that or supply) are too difficult to interpret such an indicator simply does not exist (if and reliable data are hard to obtain. The it does exist, then the conditions needed number of meals per day turned out to be to "discover " it seem non-existent). By a useless indicator. "ideal" indicators, we mean indicators that would be at the same time extremely lementary "sensitive" (ability to predict or detect); SAPs are comp to the food balance sheet method very "specific" (ability to avoid erroneous prediction/detection of food crisis); timely, The SAPs are complementary to informa- reliable, and easy to use. Theoretically, tion systems concerned with the equilibria only two or three indicators of this kind between the food needs of a population would be necessary to establish a FNSS. and the food available. The latter method We rather prefer to use sets of indicators is generally called the "food balance sheet and combine their respective qualities. As method" (FAO, 1980). Schematically, food some authors have put it (Beghin et al., balance sheet (FBS) methods focus mainly 1988) "an indicator may not be good by on the estimation of food production, itself , but may be valuable if it helps to food stocks (private, public, family), and compare groups or regions, or to identify food imports and exports in order to trends - particularly if it has practical and evaluate global food availabilities . These operational uses, and if other indicators food availabilities are then compared with complement it". Moreover, it is often not needs, that is, the sum of all the indi- the indicator by itself that poses prob- vidual food requirements within a popu- lems, but rather the way it is applied: e.g. lation (population x minimal food what is the understanding of the ques- requirements per capita). If the food tions by the responders? Is the indicator balance is negative, then there exists a addressed to the right person? So, for gap in food availability and dedsions instance, the indicators dealing with have to be taken in order to fill it (increase incomes would be inapplicable in phase 2 imports; request food aid; launch alterna- whereas in phase 3, when using an tive food crops?). If it is positive, then an indirect method, it is possible to obtain a excess of food exists and commercial reasonably good appreciation of the exportations or creation of long term food number and quality of household stocks may be envisaged. Unfortunately, incomes. The process of "progressive the FBS method suffers from many defic- refinement of analysis and interpreta- iencies, such as the lack of precision in tion", and the continuous examination of the estimation of the food production and the quality of the data allows one to reserves . Moreover, accurate demo- improve certain indicators or to decide to graphic data in developing countries are eliminate the less interesting ones. But, as often scarce and "food minimal require- a rule, the SAPs must "keep an eye" on ments per capita" are very difficult to every domain implicated in food and determine. As a result, imperfections in nutrition conditions. the calculation of the food balance may Several indicators, usually proposed occur easily (Pacey and Payne, 1985). It for FNSS purposes, proved to be irrele- has been demonstrated that the combina-

DISASTERS VOLUME 13 NUMBER 1 tion of all possible errors may lead to of land occupancy) . Third, they cannot contradictory judgments about the state observe the level of imports-exports and of the food situation in a country (Hervio, the effects of international mechanisms on 1987) . As Figure 3 shows, the SAPs prefer the national food flows. Fourth, gathering to observe the factors influencing a food data about food commercialization is not a balance or that are evidence of its varia- primary goal of the SAPs. They just tions. They achieve a kind of short-cut in assess the eventual side effects of the the direct quantitative apprehension of a deficiencies in the commercialization food balance. The FBS method exhibits processes. Fifth, they do not provide other major limitations: for instance, it is sufficiently detailed information for the laborious to perform food balance estima- surveillance of the grasshopper threat, or tions at smaller scale than the entire the fight against numerous other para- country, because, for instance, of the sites. All these tasks are generally covered need for more accurate (thus more better by the information systems used demanding) sampling procedures for the with the FBS method . quantitative estimation of crop yields at Consequently, the two approaches the local level. Thus, they do not provide are complementary and they actually information about the distribution of food share much common information. within the country (Martorell, 1982) . Accordingly, G. Hervio (1987) proposes Additionally, even if accurate measure- that the former be called "macroFNSS" ments of cereal production could be done and the latter "microFNSS". The current at limited geographical scale, it would prospect for the SAPs is to participate in often be arduous to know the actual the strengthening of the information significance of such data. For instance, capacities of the "macroFNSS". cereal production may appear insufficient in an area while the necessary food needs may be fulfilled by other resources.1 Phenomenon of Hence, the FBS method appears incapable proximity and the limited crisis of targeting food aid interventions. They focus mainly on cereals and experience Crises like the one described in the many difficulties in appraising other very Arrondissement of Balle are more fre- important food inputs; they do not take quent than one would expect. Since into account incomes and other BF such malnutrition rises to a significant level, as migrations and wild foodstuffs; they these crises must be considered as more provide no information about the nutri- serious than the usual seasonal changes tional and health situation, and are of the food and nutritional patterns unable to assess the impact of emergency generally described in the literature. In interventions. these limited crises, the neighbouring On their side, the SAPs also have areas function as BF. Their better food several significant limitations. First, they conditions tend to stabilize prices, and are not designed for the quantitative families from the threatened area may evaluation oi rood productions and thus arrive to find work and food. As other may not provide estimates of the amounts authors have suggested (Cutler, 1984), the of food potentially available in a country. occurrence of a real famine is conditional Second, they are not much involved in on the emergence of a "critical mass" of the specific information needed to distressed areas, so that neighbouring improve the cereal or livestock produc- areas do not represent BF for each other tions (e.g. agrometeorology, management any longer.

DISASTERS VOLUME 13 NUMBER 1 ACKNOWLEDGEMENTS Clay, E. and Everitt, E. (1985) Food aid and emergencies: a report on the third food aid The authors wish to acknowled ge seminar. International Disasters Studies, Mr. Oumar Coulibally (Comite Interetats Brighton, UK. de Lutte centre la Secheresse dans les Cutler, P. (1984) Famine forecasting: prices Pays du Sahel-CILSS, Ouagadougou) and and peasant behaviour in Northern Mr. Gilles Hervio (European Economic Ethiopia. Disasters 8(1), 48-56. Community) for their collaboration. We Cutler, P. (1985). The Use of economic and social also wish to acknowledge Mr. Prof. M.F. information in famine pr ediction and response. Lechat (Catholic University of Louvain- A Report Prepared for the Overseas Belgium) for his advice and Mr. Ronald Development Administration, London. Carter (DEd at the Harvard Graduate Davies, S. and Thiam, A. (1987) Progression lente vers la , alerte precoce School of Education) for editorial assis- famine , migrations et reinsertion apres la secheresse, cas des p ersonnes tance. The authors alone are responsible deplacees a Gao-Ville. Doc. SCF/FERU, for the content of this paper. Bamako, Mali. Dirks, R. (1980) Social responses during severe food shortages and famines. Current Anthro- pology 21(1), 21-43. NOTES FAO. Food and Agriculture Organization 1. Certain subjects will be covered more (1980) Food Balance Sheets. Rome. Fliess, (1981) Statistical methods rates and broadly in future papers. These are the J.L. for edition, migrations and their relations with nutri- proportions. Second John Wiley and Son, London. tional status, the importance of the subjec- Hervio, G. (1987) Evaluation des Systemes tive perception of food problems by the d'Alerte Precoce mis en oeuvre dans Ie Sahel. people, the interpretation of the socio- OCDE/OECD/CILSS/Club du Sahel, Paris, economical data of the phase 3 surveys and Doc. Sahel D (87) 308. the problems posed by food aid targeting. Hesse, S. (1986) La population f lottante de Douentza. Oxfam-UK, Bamako, Mali. REFERENCES Jost, S. (1987) I/Aide Alimentaire au Sahel. OECD/OCDE/CILSS/Club du Sahel, Paris. Anderson, M.B. and Woodrow, P.J. (1988) An LaIau-Keraly, A. (1988) Rapp ort de Mission sur Ie Approach to integrating development and relief Projel Systeme d'Alerte Precoce du Mali. Office programming: an analytical f ramework. Inter- des Statistiques des Communautes Euro- national Relief/Development Project. peennes, Luxembourg. Harvard University, Graduate School of LaIau-Keraly, A. and Winter, G. (1988) Rapport Education. de Mission devaluation du Projet Systeme Autier, P. and Ronsmans, C. (1984) Proposition D 'Alerte Precoce au Mali. Office des Statis- d'un systeme de surveillance nutritionnelle pour tiques des Communautes Europeennes, une zone Sahelienne. Medecins Sans Luxembourg. Frontieres-Belgium, Doc. ref. 237/84. Lechat, M.F. and de Ville de Goyet, C. (1977) Autier, P. (1988a) Nutrition assessment Early warning systems of nutritional deter- through the use of a nutritional scoring ioration in emergency periods. Archivas system. Disasters 12(1), 70-80. Latinoamericanas de Nutricion, (English Autier, P. (1988b) Ciblage des aides alimentaires et edition), vol. XXVII, no. 2, 64-80. personnes dep lacees en Republique du Mali. McCorkle, M.C. (1987) Foodgrain disposals as Comite Interetat de Lutte Contre la early warning famine signals: A case from Secheresse dans les Pays du Sahel. Burkina Faso. Disasters 11(4), 273-281. Ouagadougou, Burkina Faso. Martorell, R. (1982) Nutrition and Health Beghin, Y. et al. (1988) A Guide to Nutritional Status Indicators. Living Standard Measure- Assessment. World Health Organization, ment Study, paper no. 13. The World Bank, Geneva. Washington DC. DISASTERS VOLUME 13 NUMBER 1 Mason, J.B. et al. (1984) Nutritional Surveil- Sen, A. (1981) Poverty and Famines: an essay on lance. World Health Organization, Geneva . entitlement and deprivation . Clarendon Press, OMS. Organisation Mondiale de la Sante Oxford. (1976) Methodologie de la surveillance nutri- Torry, W.I. (1984) Social science research on tionnelle. Rapport d'un Comite Mixte FAO/ famine: a critical evaluation. Human Ecology FISE/OMS d'Experts, Geneva. 12(3), 227-252. Pacey, A. and Payne, P. (1985) Ag ricultural UNHCR. United Nations High Commissioner Development and Nutrition. Hutchinson, for Refugees. (1982) Handbook for Emer- London. gencies, Part One: Field Operations. Geneva. Pons, R. (1986) La Prevision des situations Verma, V., Marchant, T. and Scott, C. (1988) al imentaires critiques dans les pays du Sahel: Evaluation of crop-cut methods and farmer systemes et moyens d'alerte precoce . Comite reports fo r estimating crop production: results of Interetat de Lutte centre la Secheresse dans a methodological study in f ive African countries. les Pays du Sahel/Organization pour la Longacre Agricultural Development Centre Cooperation et Ie Developpement Econ- Limited, London. omique, Paris. Rivers, J. et al. (1976) Lessons for epidemiology from the Ethiopian famines. Annales de la Philippe Autier, Jean-Pierre Societe Beige de Medecine Tropicale 52, D'Altilia, Jean-Pierre Delamalle and 345-357. Vincent Vercruysse Seaman, and Holt, (1980) Markets and J. J. European Association for Health famines in the Third World. Disasters 4, 283-297. and Development (AEDES) Rue Joseph II, 34, Brussels 1030 (Belgium)

DISASTERS VOLUME 13 NUMBER 1 The Relief Operation in Puno District, Peru, afte r the 1986 Floods of Lake Titicaca

L. SZTORCH, V. GICQUEL and J. C. DESENCLOS

The 1985-86 rainy season in Peru was disastrous due to very high precipitation. Because of the unusual level of floads in the Lake Titicaca area and the increasing number of affected people, the PeruvianGovernment established an emergency relief plan and appealed for internationalaid. At that time the situationwas already very critical.The lack of preparednessmade the implementation of the relief operation difficult. Our paper describes the interventionof a French N.G.O. (Medecins Sans Frontieres), requested by the Peruvian authorities. The early phase of the relief programmeand its methodology are described. Problems withinthis relief programmeand the further long-term development action that should be undertakenare discussed.

AuPerou , la saison des pluies 85-86 a ete catastrophiaue par I'importance des precipitations. Au cows des premiers mois de I' annee 1986, devant I' ampleur inhabituelle des inondations dans la region du lac Titicaca et Ie nombre sans cesse croissant de sinistres, Ie gouvernementperuvien decide de mettre en route un plan national de secours d'urgence en faisant appel a I' aide internationale. Mais la reponse est deja tardive et Ie manque de mesures preventivesfait aue V organisation des secours se heurtea un grand nombre de difficultes. Notre etude se situe dans Ie cadre de I'intervention d'une organisation non gouvernementaleeuropeenne , sollicitee par Ie gouvernement peruvien pour une collaboration dans la phase des premiers secours a cette population. Les problemesposes lors de cette operation et la suite a donner a I' assistance a moyen et a long terme sont discutes.

INTRODUCTION , , . rising of Lake Titicaca in early 1986 in the Peru is a country often subject to natural region of Puno, Peru (Figure 1), as an disasters, which in the short term cause example of a region that was heavily human and material losses, and in the affected by climatic phenomena. At the long run lead to a serious slowing down same time, it is an account of the relief of social, economic and health pro- operation of the French organization grammes (Dollfus, 1972). These difficulties "Medecins Sans Frontieres", in the im- are at times compounded by Peru's geo- mediate aftermath of the disaster. graphic isolation. The following is an account of the recent floods caused by the

DISASTERS VOLUME 13 NUMBER 1 COLOMBI

FIGURE 1 Map of Puno Department

THE 1986 FLOODS IN THE LAKE TITICACA Geographical, Administrative and REGION Demographic Data In early 1986 Lake Titicaca started to The Region of Puno (72,382 square kilo- overflow , slowly flooding villages and metres) is situated in the south-east of crops as it encroached upon the sur- Peru and shares a border with Bolivia rounding countryside. The toll was (Figure 1). It represents a very small part heavy: on 20 March 1986, the Prefecture of the "Altiplano Andino". At its lowest of Puno counted as victims some 40,000 point, the altiplano is 3,812 m above sea f amilies, roughly 20% of the department's level, the same altitude as Lake Titicaca . total population. This represents approxi- The lake covers an area of about 8/500 mately 240,000 persons; 180,000 in rural square kilometres and lies in the centre of zones and 60,000 in urban zones. It was a large basin surrounded by high snow- only then that the Peruvian government covered mountains (Dollfus, 1968; realized the extent of the damage, both Romero, 1971). The region is situated human and material. Prior to this, the between 14 and 17 degrees south latitude, government's unawareness of the situation which places it squarely in the tropical did not permit an adequate response. The zone (Romero, 1971). The Altiplano has news was disseminated outside the two seasons: the summer, f rom October country by UNDRO, and Peru asked f or to March, has heavy rain (Fig. 2) and international assistance. The non-govern- higher temperatures; the winter from mental organization to which we belong April to September , has a total lack of was solicited by the Peruvian Embassy in precipitation, causing an intense drought Paris f or logistical aid to the victims, sometimes accompanied by very low tem- consisting of blankets and tents. peratures (Fig. 2). The existing "micro-

DISASTERS VOLUME 13 NUMBER 1 climate" of Lake Titicaca favours living date of the last serious drought, there has conditions on the banks of the lake and been greater precipitation than normal explains the region's high population (Table 1 and Fig. 5). The lake has several density (Romero, 1971) (Figs 3 and 4). important tributaries and has one effluent It is impossible to overlook the cyclic to the south, towards Bolivia (Romero, pattern of drought and flooding which 1971). has long been a part of the Andean A mass of lacustrine vegetation, for climate. But it seems that since 1983, the the most part Totora, is a useful forage

18C 160 E 140 | | 120 g 100 S 80 §' 60 01 n: 40 20

Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug

1985 1986

Source : Elaborated by OOPP-CORPUNO (1986) with information from SENAMHI (45 meteorological stations)

FIGURE 2 Monthly Pr ecipitation in the Puno Department (in mm) 1985/86

200 000r- |——i Urbar 180 0W- I———' 160 000[ - [__] Rural c 140000 '- I 20 000 > ' C 00 000 ^ i BO OOOt eo oooh 40 000 f 20 OOO t

HunoPuni Azanqaroangaro CaLarabfiiv?va! Chucutio .rn.JlLh rL-.tmpnfi Meigar Sandia San Romar

Source Mationa! lns;g!u!e o! S^ihsSiCs i1981i

"he province o! Yunguyo , crerUed in 1985, »s no! included in tins dfagriin

FIGURE 3 Population per Province* in the Urban and Rural Sector . Puno Department , Peru (1981)

DISASTERS VOLUME 13 NUMBER 1 San Roman Puno Sandia 11,56% 0 5,32°/ 19.26 /

Melgar / '' / 6,92°/( 14,67% ) Azangaro 4,38% Lampa 12,26% 3,72% Hiiannanfi 21,25% Carabaya

Chucuito

Source: National Institute of Statistics (1981 )

FIGURE 4 Population distribution per province and construction material for houses and Incas and from even more ancient cultural boats. This vegetation is utilized for many groups (Dollfus, 1972). The region's pro- purposes by the people living on the ductive sector is of a primary type, lake's shores and islands. The vegetation predominantly agro-pastoral (Dollfus, is specific to the high altitude; between 1972). Fifty-eight percent of the gross 3,800 and 4,800 m the grass steppe "La national product comes from the primary Puna" spreads, and there are almost no sector, 11% from the secondary sector trees growing naturally without human and 31% from the tertiary sector (Cortazar, assistance (Pahlen and Reist, 1977) . 1984) . Of the 7,238,244 hectares in the The population of the region of Puno entire region, only 3.4% of the land is is about 1,200,000 inhabitants distributed agricultural, while 45.6% is used for throughout 10 provinces; 70% of the raising livestock. The reason for this low population is rural (Fig. 3) (National agricultural activity is that the ground is Institute of Statistics, 1981). The town of of poor quality, and difficult to work. Puno (3,827 m altitude) with 70,000 Only the land bordering the lake, which inhabitants, is the administrative capital. is rich in alluvium deposits, allows a good This is the seat of organizations promot- agricultural production. The region of ing regional development. Juliaca, how- Puno leads the nation in raising livestock, ever, with 60,000 inhabitants, is the which consists of sheep (36%), cows economic centre: it is located at the (11%), alpacas (56%) and lamas (28%) crossing of important roads and railways, (Cortozar, 1984). Although the profits and has a national airport. Half of the from agriculture and livestock are mini- region's population lives on the shores of mal, it is remarkable that an agro-pastoral the lake, making the population density Vife subsists at an altitude of 4,000 m. more than 100 inhabitants per square kilometre (Dollfus, 1972). The Floods of 1986 The rural population, comprising Quetchua and Aymara people, is Table 1 shows that the precipitation organized in small communiti es, their which began in November 1985 was much social organization is inherited from the higher than the average recorded during

DISASTERS VOLUME 13 NUMBER 1 TABLE 1 Monthly precipitation level (in mm) for 1985-1986, compared with the expected level (precipitation mean of the last 10 years) of Puno, Moho and Desaguadero districts

Puno Moho Desaguadero

1985-86 1985 1985 Monthly Expected Monthly Expected Monthly Expected Level Level Level

Sep. 85 40.1 41.6 115.5 54.4 54.4 23.0 Oct. 85 33.7 44.4 42.3 80.4 35.7 45.8 Nov. 85 123.5 60.7 254.4 60.6 171.1 52.0 Dec. 85 136.6 92.1 224.5 127.7 120.2 99.5 Jan. 86 145.1 125.1 Feb. 86 251.0 137.0

... No data available

Source: CORPUNO (1986)

the preceding years. This pattern con- Chucuito (40%), Huancane (22%), Puno tinued into the early months of 1986. The (20%) and Azangaro (10%). Among the inevitable result was a rise in the lake's urban areas, those of Funo (40%), San water level, shown in Figures 5 and 6. Roman (28%) and Huancane (10%) were This was a slow process, 1 to 2 cm per the hardest hit (CORPUNO, 1986). day, but by 28 February 1986, the water On 28 February 198fc some 47,000 had risen 1.73 m over the normal level hectares of cultivated land were flooded , (Ministry of Agriculture, 1986). as shown in Table 2. Included in the By overflowing its basin, the lake flooded areas is 38% of the land planted caused more and more floods, resulting in for the 1985/86 season, and more than extensive and serious consequences. 80% of the total arable land (Ministry of The most seriously affected zones Agriculture, 1986). were those on the lake's shores, primarily The consequences of the floods were agricultural land. The situation was all the more heavily felt by the rural population, more serious because these zones were which lost housing and had to take refuge also densely populated . The town of in more elevated areas. The precarious Puno and other important urban centres housing, made of earth, could not long were among these zones; the surround- resist the advancing waters. The culti- ings of these towns were affected the vated ground was flooded and the next most. The three rivers, Ramis, Coata and crop was lost, creating a food shortage for Have, also overflowed, creating difficult the following year among the population, situations along their shores; the rural which had no habit of storing large provinces which were most seriously quantities of provisions. The livestock touched (measured by the number of suff ered from the absence of grazing-land families affected) were the provinces of and was also forced to follow the exodus.

DISASTERS VOLUME 13 NUMBER 1 45 40 35

S 30 C 25 ^ t 20 S 15 10

Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Months Source: ENAFER. elaborated by CORPUNO (1986)

FIGURE 5 The levels of Lake Titicaca per year since 1940 (in inches) 100

.•> 50

1501 1 i 1 i 1 i 1 i 1 I i 1 i 1 i 1 i 11 I 1 1940 1950 196C 1970 1980 1986 YEARS Source: ENAFER , elaborated by CORPUNO (1986)

FIGURE 6 Titicaca lake level variations December 1985 to November 1986 The resettlement of families, even if water level was not dropping and the only provisional, created problems, such number of victims was increasing, that as choice of an adequate area, shelters, the decision for national action was taken. share of construction materials, water and The region of Puno was declared a food supplies. The severe climate made "disaster zone", and an emergency relief the situation more difficult, especially in plan was begun, organized and adminis- rural zones where resources were scarce. tered by the National Civil Defense (Civil Defense of Peru, 1986). The Civil Defense was responsible for THE PERUVIAN "FIGHT-PLAN" coordinating the different sectors affected During the first few months, when the by the disaster (housing, health, agricul- flooding began, no local or government ture, food, etc. . .). They did not have action was taken to control the situation. enough funds for an efficient transporta- Slight flooding is frequent in the region tion system, so they had to depend upon and nobody imagined its potential severity. the assistance of all the available institu- It was only in February, when the lake's tions. The Peruvian government appealed

DISASTERS VOLUME 13 NUMBER 1 Cultivations Number of Affected Area Total Lost Cultivations Sowed (Flooded) Hectares Hectares % of Hectares % of Value in Total TotalIntis(*)

Potatoes 40,410 14,140 35 6,800 17 134,640,000 Quinoa 17,375 6,950 404,700 27 29,962,500 Barley 24,300 14,580 605,300 22 14/310/000 Beans 5,423 1,900 35 710 13 5,325,000 Canihua 4,455 890 201,190 27 1,904,000 Corn 691 350 50 50 7 166,250 Green f orage 25,000 6,250 253,650 15 27,838,550 Oiluco 665 130 20 30 5 492,000 Others 6,000 1,500 25 50082,500,000 Total 124,319 46,690 38 22,930 18 217,138,300

(*)1 intis = 0,058 U.S. $ (01.05.86)

Source: Ministry of Agriculture (1986) in March 1986 for international aid. Any the number of victims, the material help from outside was also to be managed damage, the health and food situation, by the Civil Defense. At the national the condition of livestock, the loss of level, a multisector commission was crops, etc. . . Periodic repetition of these created in Lima, the capital of Peru. This surveys allowed for continual monitoring commission was comprised of representa- of the situation and setting of priorities, tives from the Civil Defense, from the which could be modified when needed. Ministry of the Presidency, Ministry of The strategy of the Peruvian emergency Health, Ministry of Agriculture and aid was therefore a strategy of priorities others. The commission had the responsi- with immediate and secondary objectives. bility for centralizing information, study- Along with the coordination of efforts, ing the situation and coordinating actions each institution retained its own share of among all the sectors affected by the responsibility for its undertakings. disaster (Fig. 7). At the regional level, the The first objective was to provide Civil Defense Committee, headed by the immediate care for the rural and urban prefect of Puno, was in charge of the population affected by the flood. This had relief aid operations in the field . The to be done by evacuating inundated zones Committee organized the formation of and by resettling the population and survey commissions, including also repre- livestock in nearby temporary settle- sentatives from each institution. The goal ments. The first task was accomplished of these commissions was to evaluate through the collaborative efforts of periodically the extent of the catastrophe: CORDES (Governmental organisation in

DISASTERS VOLUME 13 NUMBER 1 MINISTR

MINISTRY OF OF HOUSING AG RICULTUF

FIGURE 7 The organization of the emergency plan for the Puno Department during the inundations Peru, March 1986 charge of rural development). Civil emergency existed at the time (Ministry of Defense and the Ministry of Housing Health, 1986). The departmental Com- (CORPUNO, 1986). Boats or trucks were mittee of the Ministry of Health organised used for the evacuation; land was lent to the establishment of mobile health teams evacuees for a pre-determined length of to undertake this surveillance and to time; construction material was distri- supply basic medicines for each rural buted to build temporary housing. The health centre. second goal was to provide acceptable One of the priorities was also the living conditions for the population, rehabilitation of the damaged communica- through the distribution of shelters, tion lines and the protection of those at blankets and clothes to protect against the risk of being damaged, so that com- cold and damp, food in sufficient quantity munications would not be interrupted. and water for basic needs. The local authorities, aware of the prob- At the same time Civil Defense and lem, took rapid steps and arrangements CORDES undertook fuel distributions. were begun during the month of March. The branch of the national office for "Medecins Sans Frontieres" was nutritional aid (O.N.A.A.) in Puno started involved in this first stage of the relief immediate food distributions in February plan. Based on the information collected (milk, sugar, rice, oil, and salt) based on during the field surveys, it was decided to the need and the surveys made regularly help the population of the region by in the field. The food (national and providing material and logistical services, international donations) was stocked in but not medical assistance. The materials Vuno in warehouses oi ftie 0,'N.A.A., provided were immediately necessary which was in charge of its distribution items, such as tents, blankets, plastic management. sheets, plastic receptacles for food and On the health level a new primary cooking stoves. health infrastructure was set up, oriented The relief assistance was carried out principally towards epidemiological sur- in several stages: (1) The safe delivery and veillance of the victims, since no medical registration of the material in Lima; (2)

DISASTERS VOLUME 13 NUMBER 1 The transport and storage of materials to that this inclement weather was viewed the affected region; (3) The establishment as "normal". It was not the first time that of a work-plan with quantitative data in people living around Lake Titicaca organ- collaboration with the local authorities; ized themselves and the government did and (4) Only then was the distribution not intervene, expecting as usual that the begun, starting with the most seriously problem would resolve itself. affected areas. The situation had to become very So far as possible , distribution of critical at the end of February , before the materials was made directly in each com- emergency assistance began. The region munity, so that intermediaries could be of Puno is difficult to reach because of its avoided. The distribution was accom- geographical situation. This inaccessibility panied by the signing of a donation act by leads to a certain isolation of the region the local lieutenant-governor and by a from Lima, and consequently from public reading of this act. governmental decisions. When the situa- At the end of the relief supplies tion was considered severe enough at the distribution , evaluation visits were carried national level for intervention, the plan of out at random. Collaboration with Civil action was quickly elaborated. The plan, Defense was constant throughout the which seemed logical and coherent, was operation. Finally, a detailed and quanti- difficult to implement. The coordination tative report was written, including sum- between the national authorities and the mary tables of the distributions. These local representatives was inadequate. The reports were distributed to the Peruvian local staff and the different services authorities and to the "Medecins Sans involved were not prepared and they Frontieres" headquarters in Paris. operated without organization. Up to the time of the catastrophe, the population would evacuate the flooded area itself, DISCUSSION looking with some difficulty for a place History shows clearly that the disaster prepared to welcome them. However, was not unpredictable . This region has such "wild" exodus soon becomes prob- regular periods of drought and flooding. lematic and produces conflicts. Providing Since the last drought in 1983, there has relief assistance, be it domestic or foreign, been an increasing trends towards heavy was difficult, not only for financial but rains during the rainy season, according also for technical and logistical reasons. to meteorological studies carried out in The programme lacked truly competent different sites of the region (CORPUNO, and responsible officers . There was no 1986), although this is too short a period preparation for the reception of inter- of observation to be necessarily indicative national aid (problems concerning the of a climatical change. Nevertheless, it clearance of goods for example). All these seems that insufficient attention was paid problems impaired the relief process. to the findings of these studies. They Therefore, it seems that an established remain as simple observations without preparedness plan, with the same meas- the establishment of any sort of threshold ures, could efficiently avoid most of the alarm. Could the cause for this be the lack problems mentioned (PAHO, 1982). of coordination between the different Many international and national services? organizations (both governmental and Because of the lack of preparedness, non-governmental) were present in this there was no immediate response to the region of the Andes. There are more than situation. One of the reasons seems to be 70 altogether, but they are exclusively

DISASTERS VOLUME 13 NUMBER 1 involved in local development projects for a solid project with defined objectives. and not in emergency situations. At the The Region of Puno is one of the time of the operation, surveys done by poorest in the country . The Indian popu- OXFAM, United Nations and the E.E.C. lation (80%) lives in very difficult condi- were going on. Financial, material and tions: harsh weather/ high altitude and food donations from other countries rugged topography (Cortozar, 1984). An started to arrive after Peru's appeal. This emergency relief plan should involve the raises the question of the international possibility of drought and flood , making help and of the participation that a operations more complicated and ex- governmental or non-governmental pensive. Peru is experiencing a difficult organization such as "Medecins Sans political and economic period and the Frontieres" can have in an assistance effects can also be felt in this region of the operation of this kind. Andes. As regards flooding problems, it It appears that financial, material and should be remembered that the best human assistance was necessary . The ground for livestock and agriculture is human presence allowed for collaboration situated by the shores of the lake, where in the field. But the control of financial the population density is the highest. and material assistance was more compli- These grounds are the only wealth of the cated . How was this aid to be managed Andean farmers. Losing them would leave in such affected areas? Would it go where them completely dependent on outside it was expected to go? Was this help aid. In the case described here, returning adapted to the situation? to their homes and land is excluded for It is also possible to imagine the role most of the victims. The experts do not of an efficient organization with an inter- envisage the return of the lake to its national focus, in future intervening at all normal limits for at least the next three levels of a national emergency assistance years (CORPUNO, 1986; Ministry of Agri- plan and under its coordination (such as culture, 1986). The lost ground is therefore Pan American Health Organization). At not recoverable for a long time. This the time when preparedness plans are raises the problem of the permanent made, it could lend its human and resettlement of the population with all its material collaboration to elaborate a plan, implications: the total restructuring of its to educate the local staff and to inform the economic, social and political life. Is Peru population. In the second stage during able to deal effectively with such a situa- and just after the disaster, the organization? Would the early implementation of tion could participate with logistical and a preparedness plan have lessened the health assistance by providing staff and gravity of the problem? basic materials. In the rehabilitation There are certainly three possible phase, it could take charge of the rehabili- attitudes (Collin-Delavaud, 1983); the first tation of the sanitary system in a defined consists of doing nothing, leaving things area or it could collaborate with the as are they are and continuing to utilize Ministry of Health in a more general way. the fertile grounds near the lake, accepting \\ covAd a\so paiticvpate m a piogiamYne tine everAua\ human and material sacri- of environmental health and hygiene. The fices. The second attitude is the complete participation in the rehabilitation phase abandonment of this fertile ground, pro- after a natural catastrophe of this type has hibiting urbanization on the lake shores, to be considered in the long term on three and resettling the population in another levels: funding, materials and personal area . This means accepting the conse- assistance. Thus, it emphasizes the need quences of a great economic and social

DISASTERS VOLUME 13 NUMBER 1 upheaval with the respective costs at all Collm-Delavaud, C. (1983) Sobre las inunda- levels. Finally, the last attitude, which ciaones catastroficas del Norte del Peru . El.Nino: seems the most reasonable, lies not in the mitos y realidades. In El Comerao, 30 October abandonment of the land, but in trying to 1983, Lima. protect the land, reaping benefits from CORPUNO (Departmental office of Budget the water through the construction of and Planning) (1986) Plan de emergencia por inundaciones Puno, Peru . levees, dams and irrigation channels, , Cortazar, P. F. (1984) Puno-Documental del Peru. allowing safe development of agricultural Basic National Encyclopaedia, Puno, Peru. activities for the population. This hypo- Dollfus, 0. (1968) Le Perou: Introduction geo- thesis fits with a more general preventive graphine a I'etude du developpement. Hautes approach. Does Peru, a developing Etudes Institute of Latin America, Paris. country, have the human and economic Dollfus, 0. (1972) Le Perou, pp. 52-53, 112-11 3. resources to consider such a project? University Press of France, Paris. International assistance should invest in Ministry of Agriculture (1986) Evaluacion de this preventive and developing plan, danos de la Compana agricola 1986-1987 par rather than have to respond, belatedly, as efectos de la excesivas precipitaciones pluviales, did the Medecins Sans Frontieres, to 28 February, Puno, Peru. Ministry of Health (1986) Evaluacion de las purely short-term needs created by a new acciones por estado de emergencia. Health Area flood in the future. of Puno no. 56, Puno, Peru. National Institute of Statistics (1981) Puno en Acknowledgements cifras . Regional office of Puno. Pahlen, K. and Reist, D. (1977) Perou. Elsevier We would like to thank all the individuals who Editions, Paris. contributed to the relief programme and to this PAHO (1982) 'Hygiene du milieu apres une paper. Among them we are particularly grate- I^ catastrophe naturelle. Pan-American Health ful to: Mr. Mujica Alvarez Calderon (Presidency Organization, review no. 430, 13-40 . Minister), Mr. Ahumada Vasque (General Romero, E. (1971) Peru, una nueva geografia , Director of National Development), Dr. Delgado Part I, pp. 196-198, 202-219. Studium S.A. (Ministry of Health), Mr. Rose (Cultural Publishing House, Lima, Peru. Attache, French Embassy), Mr. Urbiola W.H.O. (1987) Health, emergency preparedness Garrido, Mr. Duenas Peralta, Mr. Lescano and response. Report of the interregional (Director of CORPUNO), Mr. Mercado (Direc- meeting, 13- 16 April 1987, W.H.O., Geneva . tor of Microgefion Juliaca), M. Langlois (M.S.F.), G. Massis (M.S.F.), Dr. A. Crouan (M.S.F.), Dr. A. Destexte (M.S.F.), Mr. C. Dupont (M.S.F.), to Miss E. Arnold who translated the manuscript, and to Miss N. Cochard who typed it and to Dr. G. Desve for L. Sztorch, V. Gicquel and computer assistance. ). C. Desenclos Medecins Sans Frontieres, References 68 Bd St-Marcel, Civil Defense of Peru (1986) Situacion nacional el 75005, Paris, 18 de Marzo de 1986. Report no. 035 DC/SE France (17), Lima, Peru.

DISASTERS VOLUME 13 NUMBER 1 The Role of Sodo-Economic Data in Food Needs Assessment and Monitoring

JEREMY SHOHAM and EDWARD CLAY

This paper reviews six case studies examined as part of a project to review targetting methodologies emp loyed b non-government y organisations in Africa during the 1984-6 food crisis . Most agencies have not yet fully evaluated the role of data in informing decisions during their policy respective emergency programmes. The case studies a presented reflect wide variety of approaches to targetting emergency food aid that are based largely on the use of'socio-economic ' data. The recent emergency relief operations in Africaseem to indicate a change in relief agencies' approaches to the assessment and monitoring needs of the affected populations. Earlier of dependance on nutritional data has given way to an increasing reliance on the use of socio-economic indicators. There was a wide variation in the case studies of the type indicators of collected and utilised in needs assessment and monitoring. Ther e were those who relied almost exclusively on nutritional data to target r esources during the 1984-86 African crisis, and others whose experiences during that period lead them to attach more wei ght to socio-economic data. Other agencies appear to have recognised the problems rel of y ing solely on nutritional data to target food aid during their 1984-86 emergency programmes, and thus more or less abandoned classical anthropometric surveys in their needs assessment and monitoring methodologies during this period. Thus nutritional data has a less significant role in the decision making process than previously had been the case.

INTRODUCTION paper we illustrate these developments and seek _ to draw provisional conclusions . . - , Context: learning; from recent NGO..r^^, from the analysis of selected NGO (non- . . - " - , .,, . . ' . , . . . • experiencer in Sub-Saharan Atnca governmental organisation) experiences , . -„„ ., -no? • a. during 1984-1986 in drought-affected-i ^ ^ -i Reports and assessments of relief op- regions of Sub-Saharan Africa . These ex- eranons during rhe African emergency periences were examined as part oi a indicate a change of approach b y relief project to review targetting methodologies agencies assessing and monitoring the employed by NGOs, during the African needs of affected populations. The earlier emergency. Most agencies have not yet dependence on nutritional data has given fully evaluated the role of data in inform- way to increasing reliance on an array ing policy decisions in their emergency of "socio-economic" indicators. In this operations. Furthermore, the project on

DISASTERS VOLUME 13 NUMBER 1 targetting is at a preliminary stage, so measurable at the macro (i.e. regional or there may be information gaps even for national) level by shortfalls or deficits in the six cases included in this review. the supply of basic food stuffs (harvest The case experiences of relief organis- data) in relation to aggregate require- ations operating in drought-affected Chad/ ments. The crisis at micro-level is expected Ethiopia and Sudan show the variety of to manifest itself in terms of malnutrition approaches to assessment and monitor- or undernutrition. The extent and severity ing, even when these are based on of these conditions will be revealed by data what are described in this paper as on the nutritional status of potentially vul- "socio-economic" data. There was a wide nerable groups, especially children under variation in agency practice in terms of the five. In this biological model of the type of indicators collected and used. Some processes within the food system supply organisations relied almost exclusively, deficits are translated directly into a decline and seemingly uncritically, on nutritional in nutritional status. Both the deficits and data to target resources during the 1984-86 the prevalence of malnutrition give snap African crisis (Morris-Peel, 1986). There shots of the food crisis. Crude macro were others whose operational experi- balance sheets provide the information for ences and changed circumstances during the scale of resources required. Micro the emergency led them to attach more data identify the target groups as well weight to socio-economic data (Jareg, as the types and scale of interventions 1987) . Other agencies appear to have per- needed. ceived shortcomings in relying solely on The use of other "socio-economic" nutritional data to target relief food, and data implies a different model of food practically abandoned classical anthropo- crisis and famine. The types of data used metric surveys during this period (Autier, vary between agencies, as well as, under- 1988). Nutritional data were becoming standably, with location and population less significant in the decision making group. However, there are specific , more process than had previously been the commonly used indicators: case, or at least the idea, in relief assessment practice. - staple produce (harvest) and grain stor- The preliminary analysis of these age experiences also raises several issues rele- - income earning opportunities (including vant to current professional discussions, production and sales of cash crops), and indicates certain guidelines that may - livestock holdings and sales be useful for future operational practices. - food staple, possibly cash crop, and livestock prices. Types of socio-economic data collected and used in food needs assessment and Some agencies have used other types of the monitoring of relief food operations data including:

The choice made in terms of types of data - collection/consumption of famine foods collected and used by agencies reflects - number of displaced people in a popu- their implicit or explicit adoption of specific lation group models of the processes of, and responses - causes of displacement to, food crisis. The conventional reliance - type of person displaced and homo- on food production and nutritional data geneity of families. implies a deficit model of food requirements. In this, the scale of the crisis is The use of these types of data implies

DISASTERS VOLUME 13 NUMBER 1 an underlying model of the food crisis/ situation. The status of affected groups famine as a socio-economic process. Such and the aggregate food supply provide models recognise the effects of behavioural the data for intervention. Reassessment of responses and coping mechanisms in food status is required to modify the level and crises. They are explicitly or implicitly type of intervention. The second ap- based on Keynesian concepts of effective proach, effective demand or entitlement demand and the entitlement approach based, calls for socio-economic indicators of Sen (1981) who is widely cited as of stress in terms of command over food a source of conceptual support. Social or loss of entitlements. It requires the anthropological observations of the se- measurement of resource reserves (stocks) quence of response by vulnerable popu- and resource flows through time as well lations to economic stress, including the as the causal factors that determine the impact of unfavourable environmental and process. If a relief intervention goes be- man-made conditions on their way of life, yond the immediate needs of population are also integrated specifically into such groups and takes account of the evolving approaches. socio-economic situation, the second type Many relief agencies react spon- of indicators, which reflects social pro- taneously and under considerable oper- cesses of adaptation and response, has a ational pressure, so there is little time potentially important role. Decisions can to draw up a conceptual basis for collect- then be taken about which local responses ing and using needs assessment data . should be encouraged or discouraged. Consequently, the models characterised These different indicators are useful at in this paper are drawing out the implicit different stages of an intervention. Their assumptions, the unanalysed constructs, ability to reflect changes over time is one on which their action was based. Indeed, advantage of using socio economic data in it is probable that, more often than not, place of , or to complement, nutritional logistics and resource constraints were data on needs assessment. important determinants of the types of data eventually collected and used by agencies. Potential advantages of socio-economic Furthermore, common needs assessment over nutritional data takes place in a political context in which the responding agencies are often subject A critical weakness of the simple nutri- to pressures which confound their at- tional data approach is that it gives little tempts to assess needs objectively. The indication of the aggregate food needs of an effect of political constraint is difficult to affected population or of its need relative quantify and varies from case to case. Con- to other population groups. For example, sequently, this paper focusses only on the the fact that 18 percent of the under-fives technical constraints which affect agencies' in a community are malnourished, does monitoring and assessment. They must not tell us much about the quantity of expect to face the political factors prag- food that community needs nor about its matically in future operations. relative need compared to a community To describe the d'Hrerent models ot with a 25 percent incidence ot under-five food crisis and identify the indicators that malnutrition. Furthermore, there are no reflect them, it is useful to distinguish the formulae to indicate when and whether a basic types of indicator that are in use. community with a certain level of children The first approach, the measurement of malnutrition will suffer large scale child nutritional status, may be characterised as mortality. The data that exist on the describing and quantif ying the current association between nutritional status and

DISASTERS VOLUME 13 NUMBER 1 risk can only be applied correctly at of the indicators are unlikely to vary individual level when weight is being greatly within a population and data can carefully monitored. These relationships therefore be collected from a handful of are also highly location specific (Chen sample points. Examples of potential stress et al., 1980, Kasonga Project Team, 1983). indicators are the market price of cereals In addition there are confounding factors, and livestock, participation in food works such as disease, which can adversely programmes, income earning opportun- affect nutritional status yet which should ities, and types of famine food being con- not necessarily be taken into account sumed. The rapid rural appraisal methods when assessing the need for relief food. It employed by agencies to collect socio- may be argued that a comparison of economic data (discussed in detail below) nutritional survey data with baseline data were seen to confer advantages and over- indicates the extent of any deterioration in came a number of the obstacles normally a population's nutritional status; but in encountered in classical anthropometric reality baseline data are rarely available surveys. These rapid survey procedures for regions prone to food crisis . Some were expected to save considerable time agencies with a long term commitment to and therefore allowed coverage of greater particular drought-prone regions are re- areas and more locations. cognising the potential advantages of Medicins Sans Frontieres (MSF) having nutritional baseline data and are Belgium, which conducted anthropo- beginning to collect them in advance of metric surveys and rapid rural appraisals emergency programmes. However, for at 28 sites (Autier, 1988), found that a reasons already outlined, they can at best sample of 4500 families was required for only be used for monitoring changes and the anthropometric assessment, whereas not for assessing and quantif ying need. a sample of only 1200 families provided In contrast, socio-economic data can sufficient data for the socio-economic/ be used to indicate the actual need of clinical nutrition indicator they were population groups in terms of food deficits using. In Kordofan, Sudan, the Catholic and therefore how much relief food is Fund for Overseas Development (CAFOD) required and for how long. Although the found that, by the time sufficient nutri- application of these data varies between tional data had been collected and analysed agencies, implied in each method is a to demonstrate the present and past notion of subsistence requirement and the needs of specific rural councils, there had extent to which each potential target popu- been an aggregate improvement in the lation can fulfill its requirement without food situation, the level of prices, the relief food. availability of food and the other indi- Another potential advantage of socio- cators of socio-economic distress in the economic indicators is that costly and diffi- whole area, which led to a decision to cult sampling procedures and measure- close down their programme (Sudan Aid, ment may be avoided. The collection of 1986). Before this, all rural councils had nutritional data from which inferences received equal priority in terms of can be derived requires rigorous sampling per capita rations. But subsequent re- methods to ensure statistical validity and ports indicated that had the nutritional credibility. Reliable socio-economic indi- status data been available earlier, some cators from potential target pouplations, attempt at targetting would have been by contrast, can be identified and moni- appropriate. tored without painstaking and costly data Rapid appraisal techniques could also collection . Thp rationale is that the values obviate the major problem of having to

DISASTERS VOLUME 13 NUMBER 1 provide a reliable sample frame. Reliable such procedures could not be used to population data are rarely available for ascertain credible base line values of regions likely to be affected by food nutritional status. Third, nutritional status crises. A related problem of the anthro- indicators are seen as unable to provide pometric approach, the requirement that unambiguous evidence of the need for a minimum number of children in each intervention. For example, reports of survey site be measured, when such emergency programmes note that nutri- numbers may not always be easy to tional data are more difficult to interpret if locate, is also avoided. For example, this no account is taken of infant mortality problem was reported in the initial assess- rates (MacLean, 1985a) . However, similar ments by Oxfam in the Red Sea Province problems of interpretation may also arise in Sudan, where even the prerequisite with socio-economic data . For example, if sample size of 30 children per village was the poorest or most vulnerable families in not always attainable. However there is, a community have been forced to migrate, so far as we are aware, no published then survey findings can provide a mis- evidence to support the view that certain leading assessment of the need within the types of socio-economic data obtained community. through a non-random procedure, can A scrutiny of actual experience reveals legitimately be seen as statistically re- the difficulties of standardising methods presentative of larger population groups. of collection and interpretation of both Assertions to this effect often prove to be nutritional and socio-economic indicators. based on subjective and intuitive under- For example, the choice of cut-off levels standing of local conditions and experi- with mid-upper-arm circumference ences, and, as such, cannot be accepted (MUAC) measurements can lead to uncritically. Nevertheless these techniques over-estimation of the implied levels of are potentially precious and deserve malnutrition (Taylor, 1986). But without further immediate research to establish weighed intake measurements, how can whether such methodologies are accept- quantities of famine foods be assessed and able. compared between communities? The sen- There are other alleged advantages of sitive collection and use of socio-economic basing assessments on socio-economic in- data in practice requires a high level of dicators, and drawbacks of the anthro- professional skills no less than anthropo- pometric approach. First, indicators such metric surveys (Hale, 1986a). There are as harvest prospects or income earning also advantages of employing nutritional opportunities are seen as likely to be more status data rather than socio-economic static over a short period of time than data for needs assessment. Perhaps the nutritional status measurements, and their most important is the emotive value and use, therefore, requires less frequent moni- power of apparently objective evidence of toring. However, such claims, particularly the incidence of malnutrition. This evi- about harvest prospects or price behaviour, dence is more likely to trigger donor are not supported, for example, by recent reaction and public sympathy than report- experience in Ethiopia since 1984J1985. ing the subsistence resources available to Second , where baseline survey data are a community . Indeed an explicit reason absent, some quantification of baseline for etablishing a nutritional survey pro- values can be attempted from recall of the gramme may be to arouse or maintain previous season-year's harvest, or of a donor interest (Hale, 1986a). "normal" one . But the reliability of such The conventional nutritional data focus retrospective analysis is in dispute; and attention on children, who physiologically

DISASTERS VOLUME 13 NUMBER 1 are undoubtedly the most vulnerable sec- need to implement a programme. Certain tion of a population in a food crisis. This agencies were responsible for very large has been the rationale for the choice made areas where poor infrastructure made by some agencies (Jareg, 1985). Of course, programme coverage even more problem- it could be argued that the focus of atic and time-consuming. Some agencies nutritional assessment on children results in fact made no attempt to sample while in underestimating the problems of adoles- others tried to minimise bias by conducting cents and adults. A technical advantage some form of random selection and strati- claimed for indicators derived from an- fication in the survey process. Others thropometric measurement in contrast to followed rigorous sampling procedures qualitative socio-economic indicators is but, as will be discussed , found that this that they are less affected by inter-observer presented difficulties. A brief description variation. The potential range for indica- of each case study illustrates the variety of tions of malnutrition can be roughly approaches and associated problems. anticipated from earlier experience. Thus The Redd Barna programme currently oper- it may be easier to determine minimum ating in Northern Shoah, Ethiopia, is using appropriate sample sizes for an anthro- data from a combined socio-economic and pometric survey than for a socio-economic health survey based on interviews in a one. non-random selected group of house- Perhaps one conclusion to be drawn holds. Redd Barna acknowledge that the from this list of the potential advantages survey therefore failed to include many of and disadvantages of each approach is that, the most vulnerable families , who may where resources permit, it is desirable to have been unable to get to the place of employ both nutritional surveillance and interview (Jareg, 1987). the socio-economic methods of assess- MSF ( Belg ium) in Chad: Assessment was ment. Indeed, a number of agencies have based on the work of mobile survey tried to use both types of data in a teams. Many socio-economic indicators complementary way. A more detailed were incorporated in their nutritional review of recent agency experience pro- scoring system which was used to assess vides insights into the problems that must needs between 1985 and 1986 (Autier, be confronted in a practical way under 1988). During the acute phase of the pressure in an emergency situation. There famine the mobile teams concentrated are potentially some lessons for improving on locations where they suspected more future practice. severe nutritional problems. Later their evaluations were conducted more system- DATA COLLECTION: THEORY AND atically, following the geographical and PRACTICE administrative boundaries of the country. Normally the team took a random sample Sampling methods used to obtain socio- of 30 families from each population unit economic data regardless of size. As the basic data were converted into scores subjectively, prob- The six case studies examined reveal a lems of assigning confidence intervals, variety of practices. Some agencies con- and therefore the related question of ducted socio-economic surveys without sample sizes in relation to sample frames, using classical sampling techniques. This were bypassed. The resulting data are was done to save time because human assumed, based on the judgement of the and other resources were too limited to evaluators, to represent the population allow rigorous sampling, given the urgent groups from which they had been ob-

DISASTERS VOLUME 13 NUMBER 1 tained . MSF demonstrated that this system Oxfam in Kordofan , Sudan: also conducted a would obtain results more rapidly than form of needs assessment and monitoring, the classical anthropometric approach. but it was not responsible for food distribu- But as discussed below, this advantage of tion, in contrast to the Red Sea Hills area speed may have been gained at the (discussed next). The focus of this pro- expense of desirable levels of accuracy . gramme was therefore far more on moni- Care: who were responsible for food toring the evolving situation than on needs distribution in Kordofan, Sudan between assessment. Survey sites were selected by 1985 and 1986, collected socio-economic a weighted systematic random sampling data for needs assessment and monitoring procedure using the 1983 population cen- through their monitoring teams. They sus as a sampling frame. Interval random report that: sampling ensured some form of stratifica- tion without counteracting the population "Random sampling of monitoring sites weighting, and therefore allowed wider was not adopted , in the main because the geographical coverage (MacLean and extreme urgency of the situation in many areas Williams, 1986). The number of planned demanded a trouble shooting approach to feed village survey sites was increased over the back the critical information to El Obeid to take three monitoring cycles eventually rising remedial action. The region was divided into to 150, including 20 nomadic groups eight zones to correspond to the eight monitor- (MacLean, 1985b) . One purpose of in- ing teams, with one team monitoring each creasing the number of survey sites was zone every month". "To complement the to increase the potential usefulness of the action oriented sty le of the one time visit surveys to other agencies involved in monitoring, a secondary plan for longer term targetting relief. The socio-economic data plotting of trends was included by randomly were collected from village meetings as selecting four sentinel sites in each zone to be well as through household and farmer monitored every month. In order to assess a questionnaires. Unfortunately, difficulty community's status as accurately as possible, in locating nomadic groups reduced the the monitors were to first conduct the question- number of planned nomadic survey sites naire in ten private households before meeting that could be sampled, leading to a the community in an open gathering and re- probable under-representation of these conciling the comments made in the seclusion important groups. of their homes with the sheikh's and commit- Even with the increased number of survey tee's public statements." (CARE-Sudan, 1986). sites in the later surveys it was recognised that great care had to be taken in applying This method implied that inferences the data to large areas, as the variation from data could be made only up to rural within an area could be enormous. This council level , and that with some caution, was borne out by examples of discrepancy but not to village or village council level, between Oxfam and CARE data from the thus limiting the usefulness of the inform- same rural councils, which showed that it ation for targetting purposes. CARE did is not always appropriate to extrapolate make some attempt to minimise bias data to administrative units which take caused by non-random selection by select- little account of environmental gradients ing villages which were perceived to (MacLean, 1985b) . However, it should be represent a cross section of ecological noted that generally Oxfam Kordofan and zones, while within these selected villages CARE Kordofan data, where extrapol- households in good and bad states of ated to rural council level, were in agree- repair were purposively selected. ment, in spite of the fact that only the

DISASTERS VOLUME 13 NUMBER 1 former employed classical sampling tech- economic data could only be used to niques. obtain estimated values at district level Oxfam's needs assessment and monitoring because of large confidence intervals asso- programme in the Red Sea Hills of Sudan ciated with the small sample size per underwent modifications over time with village. concomitant changes in sampling method- Save the Children Fund, ( UK) in Darfour: the ology (Hale, 1986a). Initially, Oxfam used NGO responsible for logistics and distri- field monitoring teams (FMT) who were bution in that region adopted a complex gradually able to visit all villages to draw up set of sampling procedures. An SCF report lists of inhabitants, collect socio-economic states that "given the need for quick data and conduct a nutrition survey. The results to allow targetted food aid alloca- RSP (200,000 sq.km) is considerably smal- tions to be made it was decided to stratify ler in area than Kordofan or Darfour the area councils of Darfour into agro/ (445,000 sq.km). The socio-economic data socio/economic zones" (Buckley, 1987). It were obtained from public meetings for was assumed that a relatively small survey men and by questionnaires administered sample within any zone would be repres- to women. As the programme evolved, entative of the entire zonal population. more quantifiable data were obtained. SCF field officers living in each area Attempts were also made to ensure that defined zones with local help. One hun- data were obtained from settlements as dred and sixteen zones were identified in well as central villages. As the intention 11 rural areas. Six village councils per was that all villages would eventually be zone were randomly selected with prob- surveyed, it was felt that the initial ability of selection proportional to popu- selection of villages could be non-random. lation size. Within each village council the Later, Oxfam employed another survey associated villages were weighted for team, the nutrition survey team (NST), population and one was randomly selected which as well as collecting nutrition data by the enumerators as a survey site. At obtained data on the contribution of all each survey site two clusters of five house- sources of food and income to a family's holds were interviewed. A minimum of nutritional needs in all seven districts. thirty households in three villages per These data were translated into district zone were then interviewed. averages (means). In each district, be- In parallel to this system SCF employed tween 6-14 randomly selected villages field officers who tried to visit 30 villages were visited and interviews were conduc- per month collecting general socio- ted by female nutrition workers with economic data at village meetings. The village women selected randomly wher- intention was that the household survey ever possible (Hale, 1986b). As initial data would be applied to zonal level for surveys showed that minor food and targetting purposes and that targetting income sources made only a small contri- decisions within zones would be taken by bution to food intake, the district mean field officers . However, government un- values could be applied to all villages. To familiarity with the concept of zones and summarise, it appears that the socio- the large volume of work involved in economic data initially obtained by the collecting and analysing data from 116 FMTs could not be used or extrapolated zones, led SCF eventually to aggregate beyond village level as the choice of the data to the larger rural council level villages had been non-random. While for targetting purposes. Also, in several with the exception of minor food and instances, the aggregate zonal estimates income sources, the later NST socio- were found to be inconsistent with the

DISASTERS VOLUME 13 NUMBER 1 observations of field officers. These differ- indicators and is likely to be location- ences disappeared only when the data specific. A rapid reconnaissance or pilot were further aggregated to rural council study is needed to determine the feasibility level. A number of SCF staff , when inter- of such an approach. viewed, felt retrospectively that trained Third, initial surveying should try to land use specialists should have been used determine whether some socio-economic to delineate the zones in terms of agro- food-related activities may contribute little ecological and socio-economic character- to overall food consumption or vary istics, and that simple random sampling marginally in scale. If this is found to be techniques, rather than cluster sampling so then estimated mean values obtained at village level, would have provided for a few locations within a large area may more representative data . The SCF survey be safely applied to the smaller sub- teams also reported that some villagers population within these areas, thereby became reluctant to answer questions obviating the need for further data collec- because of the frequency and number of tion on these variables. questions: three surveys were undertaken Fourth, and similarly, if specific indi- in five months. cators can be identified which are unlikely To summarise, the methods of samp- to vary greatly in value within small sub- ling used by agencies varied enormously population units, data collection can be as did the degree to which the data were restricted to a few respondents or to a statistically representative and were found consensus at village meetings. Again pilot to be useful for the purposes of extrapol- studies can establish whether rapid rural ation or inference. appraisal methods of data collection are appropriate for some indicators. Sampling issues Fifth, where there is initially very limited information on population char- These case experiences suggest a few acteristics and the nutritional situation, tentative lessons for information gather- a sequential approach to survey design ing as part of a relief operation and in involving pilot studies that draw on quali- circumstances where the existing data do tative knowledge of agro-ecology and the not provide a bench mark for needs socio-economic situation will be the most assessment. cost-effective. First, the choice of survey design and sampling should be carefully based on an assessment of the time and human and USING SOCIO-ECONOMIC DATA other resources available and how these Food needs assessment could be employed to strengthen other aspects of the emergency operation. The The experiences of the six agencies dis- size of area and geographical distribution of cussed above illustrate the diversity of the population to be covered in the needs practice in actually using socio-economic assessment are critical considerations. data in needs assessment. The least com- Second, any potential bias introduced plex methodology is that currently used into data bv the use of improper or by Redd Barna in Ethiopia. Food-for-work compromise sampling procedures (e.g. interventions are located on the basis of small sample sizes) can be reduced by food production estimates derived from stratified non-random features of survey survey data, and expressed as a percentage design . Such a design may only be of "normal" harvest for three ecological suitable for collecting data for selected zones, highland, midland and lowland.

DISASTERS VOLUME 13 NUMBER 1 As a result of these estimates, projects output for a village site was estimated and were started in the lowland and midland extrapolated to the group of surrounding areas of Redd Barna operations as soon as villages. The derived produce levels were it was administratively possible, so as to deducted from estimated subsistence repre-empt further deterioration in the food quirements and these deficits were aggre- situation. As this programme continued gated at rural council level (MacLean, Redd Barna also planned, for monitoring 1985b). The time period of deficit (in purposes, to collect data on grain stocks months) and the total shortfall (in tons of and cattle and grain prices (Jareg, 1987) . grain) were taken as the period for and This simple method of assessment did not the quantity of relief food requirement. take account of indigenous coping mech- Both CARE and Oxfam employed, at a anisms, or allow for variations in deficit at disaggregate level, the conventional food peasant association level, but the form of balance sheet approach. Their assess- intervention (food for work) was thought ments for rural councils were also similar. of as less likely to distort the local Only Oxfam were somewhat circumspect economy and coping mechanisms than in their recommendations for providing gratuitous relief. relief food aid (MacLean 1985b). Amongst CARE, Kordofan , Sudan: data were collected the reasons why both CARE Kordofan on livestock numbers and deaths during and Oxfam Kordofan failed to utilise the the previous six months, current sources majority of their collected socio-economic of family income, and local prices of durra data for estimating food needs were: (white sorghum) and other staple foods. However, apparently only food production - lack of time to analyse the data, data were used in estimating the need for - lack of an agreed methodology for relief food. The need assessments for each analysing the data sets that were not rural council area involved estimating how used, long stocks from the previous harvest - lack of confidence in the accuracy of the could sustain consumption at required data, levels. Recommendations for food assist- - subjective attribution of more importance were made equivalent to the residual ance to production data in needs assess- "deficit" . Part of the rationale for this was ment. that traditional farmers would require continual aid during 1986 to avoid indebted- A narrow food balance approach in- ness and to allow sufficient reserved seed volves the risk of overestimating needs for planting (CARE, 1986). if other resources are not taken into Ox/am in Kordofan were also collecting, at account. This possibility was highlighted the same time, a variety of socio-economic by the Oxfam experience in the Red Sea and nutritional data: food production as a Hills Province of Sudan. Two cycles of percentage of subsistence requirement, NST tours successively estimated average cash crop production levels, family live- household income and food sources com- stock holdings, local cereal prices and bined in the province as 34 percent and 59 data on nutritional status. Some data percent of subsistence needs, largely due indicated appalling conditions amongst to a fall in cereal prices in the intervening specific nomadic groups, eg. the returnee period (Hale, 1986b, Hazerjian, 1986). nomads from Omdurman. However, as OXFAM Red Sea Hills Project, Sudan: The with CARE, Oxfam only appear to have type of data collected/ methods of collec- utilised the data on harvested food output tion and use were substantially modified to assess need. The mean harvested over the life of the relief programme. Data

DISASTERS VOLUME 13 NUMBER 1 initially collected on food availability, household stocks of major and minor livestock, the state of housing and child sources of food and income by district. health were found to be of little value for District mean values were subsequently assessment purposes. There were prob- used in estimating income from minor lems of unsatisfactory survey design and sources to simplify the tasks of the FMTs. inadequately trained survey team mem- The "full ration" for a village was then bers . Selection of houses surveyed was assessed on the basis of the average not random, some data were not quantifi- village stock holding and major sources of able and those from different villages food and income, recorded by FMTs, and were often not comparable. In a second the minor sources of income and food, phase the team began to collect quantita- evaluated by NSTs. It was assumed that tive data on pre-drought and current 75 percent of family income would be spent stocks of major foods and sources of on durra. Within villages there was further income. These data were then used for discrimination between the pauperised medium-term assessment of ration re- nomadic pastoralists (full rations), those quirements based on stocks and income. with subsistence incomes (half rations), Assessment of relief for a village was and merchants and public sector em- based on the cost to a family at current ployees (no rations). prices of one sack of sorghum per SCF in Darfour. During this large scale month. If the mean family purchasing relief operation socio-economic data were capacity was only half that level the obtained predominantly by household deficit was set at half a sack per house- survey. They included production of hold . A comparison of stock levels and sorghum and millet, production of other sources of earnings made it possible to dis- crops, livestock holdings, availability of tinguish the marginally better-off villages, wild foods, and income-generating activi- allowing differential rations to be set. ties. The aggregated production data were Data on nutritional status were also then converted into grain equivalent food used in this model to determine short- availability at a rural council level. If the term decisions on distribution. If mal- food balance equation (food availability nutrition rates (moderate and severe) less estimated population times the level for under-fives exceeded 20 percent, full of per caput subsistence requirement) ration levels would be set for the forth- indicated at least a 40 percent deficit , coming distribution, without regard to the rural council would be allocated food other socio-economic indicators. Where equivalent to that deficit. The cut-off malnutrition levels were in the range point for a food allocation to a rural 10-19 percent, a half ration was set. council was set at a seasonally adjusted Where these practices implied large differ- level ranging from a 20 percent to 35 ences between the estimate of immediate percent deficit, on the assumption that need and required medium-term ration below this level vulnerable groups would levels a policy of gradual reduction was find sufficient support within the com- adopted (Hale, 1986a). munity . Livestock were not assessed in The eventual need to distinguish dif- terms of their capital value, but as part ferent socio-economic categories of people of a herd providing income to the owner in the village was also recognised. With at a sustainable offtake level, based on the availability of NST data in late 1985 assumptions about reproductive rate, life a new approach to needs assessment expectancy and infant mortality for each emerged. As discussed above, the NST' s type of livestock (Buckley , 1987). Parallel findings were used to estimate mean with this comparatively sophisticated

DISASTERS VOLUME 13 NUMBER 1 household data gathering system, field - type of persons displaced off icers with responsibility for area coun- - homogeneity of families cils collected more general socio-economic - type of foods consumed data from village meetings. These officers - family food reserves and the ability to made targetting decisions within zones or buy food. rural council areas based on first-hand knowledge of villages and village councils Clinical nutritional and approximate mor- that allowed them to cross check the tality data, as well as data on the existence household data. of avitaminosis, were also collected. Each Only SCF, in their analysis of livestock indicator was then given a subjective risk data, and to some extent Oxfam Red Sea value based on field staff experience in Province, appear to have recognised ex- the country. For example, if the seasonal plicitly the need to restock. This represents displacement was habitual but occurring a significant and desirable improvement earlier than usual, the indicator would in assessment methodology for nomadic score two points. But, if the displacement and agro-pastoral communities. There are was of cultivators who normally do not potential situations in which livestock migrate then a score of three points was numbers indicate a need to destock before assigned. The differing predictiveness of relief food is provided if intervention is to indicators as a measure of nutritional address the cycles of self-perpetuating land stress was taken into account by ranking degradation. But, in none of these cases, them according to four criteria: with the exception of Oxfam in the Red Sea Province,1 was there an explicit attempt to - their ability to detect nutritional prob- consider such longer-term issues. lems SCF also did not use collected case data - the degree to which they could indicate in its needs assessment, for reasons similar a specific nutritional outcome to those of other agencies. There appears - ease of measurement, e.g. their accuracy to be a quite general problem that insuf- - acceptability to decision makers. ficient consideration is given, in making decisions on data collection, to capacity Each indicator was weighted according for processing and analysis. But the more to the foregoing criteria and overall scores detailed analysis of SCF household survey were adjusted accordingly. It was found in the final evaluation also found that that this nutritional surveillance scoring there were not always positive correlations system correlated well with an indepen- between the different socio-economic re- dent anthropometric survey: a score of 30 sources recorded. The inference is that it approximated to 13 percent incidence of may be necessary to survey most poten- severe malnutrition amongst under fives. tially significant resources if seeking to Using UNHCR (1982) guidelines of 10 quantif y needs more precisely. percent incidence of severe malnutrition MSF in Chad: the needs assessment and as a possible threshold for intervention, monitoring methodology adopted was per- and where no baseline data were avail- haps the most innovative of the six case able, a score of 30 was set as the threshold experiences. The socio-economic data infor intervention. Although a majority of cluded: the indicators used by MSF were "socio- economic" as defined in this paper, approx- - numbers of displaced people in each imately half of the potential overall score population unit was contributed by the purely nutritional - cause of displacement ones. Thus the MSF methodology inte-

DISASTERS VOLUME 13 NUMBER 1 grated currently observable indicators of Some issues nutritional status with monitoring of the raised by agency practice underlying social process. Five categories The agency experiences reviewed, in of intervention were consequently estab- quite diverse situations, suggest a num- lished, ranging from full dry ration feeding, ber of lessons for ways in which socio- in conjunction with supplementary feeding economic information can be used to including Vitamin A prophylaxis, to con- assess need. The assessment of needs tinued surveillance to see how conditions should be sensitive to indicators quantif y- changed. MSF in an initial evaluation of ing and accounting for the resources their methodology for needs assessment besides food production available to the concluding that the choice of indicator and affected population. This will help to attribution of risk values will be highly dampen the effect of relief intervention on location-specific. The system, it was con- indigenous coping mechanisms and poss- cluded, must also be validated by anthro- ible disruption of the local economy. The pometric survey on a more selective basis. resources upon which people draw are These conclusions underscore possible likely to be considerable even following limitations on potential use of and risks repeated harvest failures. inherent in the MSF approach. Agencies To take account of requirements in the without a longstanding involvement in an medium-term rehabilitation and recon- area often begin to operate on a task basis struction phase, a more refined assessment in response to an emergency request, as of some needs, beyond a food balance in the case studies in three regions of sheet calculation and a crude assessment Sudan. In these circumstances, the scope of sources of purchasing power, is re- f or initially using a subjective approach to quired , especially for agro-pastoral and needs assessment is limited. There is also nomadic groups. For example, the desir- need for caution in regarding validation able destocking/restocking of livestock by anthropometry as providing an objec- should be considered. Similarly, it may be tive yardstick. Measurements of nutri- necessary to discourage certain types of tional status may be confounded by many coping mechanism if these are not thought factors, such as incidence of disease or to be in the long term interest of com- high infant mortality rates not related munities (e.g. charcoal production). directly to levels of food intake. Inter- Relief agencies should not be over- observer variability (errors of observation) ambitious about survey design and the and the subjectivity in assessing scores for volume of data they collect. The more each indicator, may make the use of quali- significant indicators should be identified tative indicators less accurate than methods where possible, initially through a pilot involving quantified assessments of re- survey or rapid appraisal, and then careful source availability. The great attraction of consideration given to selecting only those the MSF approach is that it provides a for which the agency has time and rigorous framework for systematizing the resources to collect and analyse the data. informal, subjective knowledge. For in More forethought should be given to practice many decisions were unavoidably ways in which the data will be employed, made on the basis of such knowledge. and to the survey costs, before selecting To summarise, this innovative ap- the indicators. proach is not a variant of the balance Where a needs assessment method- sheet method. It breaks new ground by ology aims to acount for all major house- integrating nutritional and socio-economic hold resources, data on all potentially information. significant contributors to income and

DISASTERS VOLUME 13 NUMBER 1 food must be collected as these are not village or village council level, because it always positively correlated. Proxy indi- would mean surveying too many locations cators cannot be used for those for which and households. data are not collected. A rapidly implementable parallel data Monitoring in relief system involving collection of more sub- programme jective data should be considered as an management adjunct and a cross check for quantita- Monitoring a relief operation may involve tive nutritional status and socio-economic socio-economic surveying: surveys. Before deciding to make an assess- - to re-assess the need for relief as ment based only on qualitative/subjective circumstances change socio-economic data, there should be care- - to minimise potential negative side- ful consideration of the agency staff's effects of relief aid, e.g. disincentives to experience in the affected regions and of agriculture whether geographical problems and the - to indicate when interventions should agency's resource constraints and other be made. responsibilities oblige it to adopt that approach . The six case studies agencies monitored in different ways and to different effect. In Kordofan , Socio-economic assessment and targetting Oxfam conducted three monitoring sub-populations within the survey region tours collecting nutrition and socio-economic data over a period of one In four of the case study operations the year. CARE also monitored periodically in agencies only used socio-economic data to Kordofan, collecting data on socio- determine overall levels of relief require- economic conditions as well as on per ments and to make targetting decisions capita food receipts and population for relatively large spatial units, e.g. rural numbers (CARE-E1 Obeid, 1985, 1986). councils in Sudan. The exceptions, MSF However, this appears to have been cost- in Chad and Oxfam in the Red Sea ineffective, since only production data Province, were able to survey a large were used for subsequent re-assessment. number of sub-populations. On the basis SCF appears to have undertaken the most of this more disaggregated data, Oxfam intensive monitoring, conducting three attempted to target in the Red Sea Province surveys in Darfour within five months in within villages by categorising three types order to re-assess needs at each allocation 2 of recipient. point within the relief operation. In the The potential of using socio-economic Red Sea Province, Oxfam initially planned data to inform targetting programmes for field monitoring teams to visit the within communities requires further con- villages every 45 days, but in practice it sideration. There are practical constraints was only feasible to monitor villages and also doubts about the reliability of every six months. It was, however, ob- data for such discriminating practice served that the socio-economic indicators (CARE, 1986) . monitored changed little over the first The case study experiences suggest three 45-day food allocation cycles which that an agency task force which becomes thus provided justification for less fre- involved in a large scale emergency will quent monitoring. The NSTs established find it difficult to undertake socio-economic later conducted three monitoring tours assessment for targetting purposes at collecting socio-economic and nutritional

DISASTERS VOLUME 13 NUMBER 1 data. MSF carried out a single needs tional status can change quickly but, unless assessment and restricted subsequent supported by consistent socio-economic monitoring to communities with scores evidence, can be misleading. For example, just below the threshold for intervention even following a relatively poor harvest or reportedly experiencing deteriorating the short-term post-harvest improvement conditions. in food availability may be reflected in measured nutritional status. Food and livestock The role of monitoring in assessing needs prices may be better indicators as they reflect market knowledge of im- Some agencies found it impractical to pending food shortage. undertake regular socio-economic monitoring to re-assess needs during each Monitoring potentiall negative effects cycle of relief aid alloca tion, while others y of emergency food aid made no attempt to do so. Perhaps a practical compromise would be a combin- None of the six agencies whose experience ation of the continuous monitoring of is reviewed apparently addressed the issue only selected socio-economic indicators of disincentive effects directly. Oxfam and and less frequent intensive monitoring. SCF, monitoring conditions in Darfour, For example, Oxfam's Red Sea Province did report on a dramatic price-lowering NSTs conducted only three tours over a effect of relief food . SCF also reported year and these provided enough data to potential negative effects, such as a reduc- re-assess needs as the programme pro- tion in food production in the following ceeded. Decisions on how intensively to season as farmers responded by alter- monitor should reflect the resources avail- ing production patterns away from food able to an agency/ what is known about grains. The inflationary effect on certain the stability of the environment, and the agricultural wages of cheap food, which scale of the intervention. Continuous reduced incentives to work and created monitoring of a few selected variables labour scarcity, were also recognised ef- chosen on the basis of the initial socio- fects. Monitoring of future emergency economic assessment because they reflect programmes should watch for potential local conditions, is always desirable. disincentive effets to allow for mitigation and avoidance of these. Further research is required both dur- "Phase-Out": The role of socio-economic data in terminating relief operations ing continuing emergency operations and through the retrospective analysis of data The reports on the six relief operations from previous ones, to establish whether are not explicit on what data were used guidelines can be provided for identifying to inform phase-out decisions. However, and monitoring indications of potentially in each case it is implicit that harvest negative effects. prospects in conjunction with supportive socio-economic evidence were the main determinants of programme closure. Acknowledgements Two agencies report that nutritional The authors would like to acknowledge the data were used to support their decisions, help of the NGOs whose experience is con- Oxfam Red Sea Province and CAFOD in sidered in this paper for providing document- Kordofan . There are, however, reasons not ation on their operations during the African to base programme closure decisions solely emergency. The paper benefitted from the on nutritional data. Indicators of nutri- comments during discussions both at the out-

D1SASTERS VOLUME 13 NUMBER 1 line and draft stage of a small working group CARE-E1 Obeid (1985) Emergency programme including Professor Philip Payne, Dr. John monitoring report on durra distribution in Rivers, Ms. Wendy McLean of the Department Kordofan Reg ion, Oct. 1985. CARE, Sudan. of Human Nutrition, London School of Hygiene CARE-E1 Obeid (1986) Emergency programme and Tropical Medicine and Dr. John Seaman, monitoring report on durra distribution in SCF (UK). The paper draws on findings from a Kordofan Region, Nov.-Dec. 1985. CARE, project to review targetting methodology sup- Sudan. ported by a grant from the British Overseas CARE-Sudan (1986) Kordofan Supplementary Development Administration. The paper has Feeding Programme. Final Report , CARE/ its origins in discussions with the late Martin London. Forman whose interests and commitment to Chen, L.C. et at. (1980) Anthropometric assess- nutrition policy is much missed. ment of energy protein malnutrition and subsequent risk of mortality among pre- school age children. American Journal of Notes Clinical Nutrition 33, 1836-1845. Hale, S. (1986a) The Oxfam food targetting and 1 Oxfam purposely neglected to account for monitoring programme in the Red Sea Province resources generated by charcoal production 4185^186. Oxfam, Red Sea Province, Sudan. in the Red Sea Province, in the hope that by Hale, S. (1986b) Report on the nutritional status of "over-providing" food aid, this potentially 2226 children and economic life of 557 families land-degrading coping mechanism would be in the Red Sea Province, Nov . 1985-Feb. 1986. discouraged. Oxfam, Red Sea Province, Sudan. 2 The outcome of this attempt at intra-village Hazerjian, J. (1986) Follow-up report to the second targetting is not known. However one Province wide cycle of tours on nutritional report states that most "responsible men" status of 2583 children and economic life of 1151 (individuals charged with responsibility for families in the Red Sea Province, March-July village level distribution) felt unable to 1986. Oxfam, Red Sea Province, Sudan. exclude anyone from relief distribution on Jareg, P. (1985) Guidelines fo r nutritional inter- the grounds of wealth. This is despite an vention by Redd Barna, Ethiopia. Redd Barna, Oxfam survey finding that amongst the Beja Addis Ababa. of the RSP, perception of the vulnerable Jareg, P. (1987) Report to the Resident Representa- households were much the same as Western tive of Redd Barna. The recent drought develop- perceptions, i.e. large families, families with ment and disaster preparedness, P4004. Redd no livestock (Alfred, 1986). Barna, Oslo. Kasonga Project Team (1983) Anthropometric assessment of young children's nutritional References status as an indicator of subsequent risk of dying. Journal of Tropical Paediatrics 29, Alfred, C. (1986) Famine and food among the Beja 69-75. (R eport of research into some aspects of relief MacLean, M. (1985a) A report on the nutritional food aid in the Red Sea Province). Oxfam, Red status of 1888 children in Kordofan, Feb.-March Sea Province, Sudan. 1985. Oxfam, Unicef, and Kordofan Autier , P. (1988) Nutrition assessment through Regional Government Nutritional Surveil- the use of a Nutriti onal Scoring System. lance and Drought Monitoring Project, Disasters 12/ 1, 70-80. Oxfam, Kordofan, Sudan. Bu ckley/ R. (1987) Results f rom the Household MacLean, M. (1985b) A report on the nutritional Survey undertaken b y the information depart- status of 4575 children in Kordof an Region, ment in Darfour Region, Sudan, f rom March- Sep.-Oct. 1985. Oxfam, Unicef and Kordofan July 1986. Save the Children Fund, London. Regional Government Nutritional Status CARE (1986) CARE' S position on food needs for and Drought Monitoring Project , Oxfam, 1986 Kordofan Region and Kassala Province. Kordofan. CARE , Khartoum. MacLean, M. and Williams, C. (1986) Proposed

DISASTERS VOLUME 13 NUMBER 1 protocol for nutritiona l surveillance in N. SudanAid, (1986) Report on the N utrition I nter- Sudan. Oxfam, Darfour, Sudan. vention Programme in En Nahud, N. Kordof an Morris-Peel, S. (1986) A review of the health and SudanAid emergency relief and rehabilitation nutritional aspects of the League' s drought relief programme, July 1985-January 1986 , Diocese of operations in Chad , Mali and the Suda n 1984- El Obeid , Sudan . Catholic Fund for Overseas 86. Independent Review and Evaluation of Development, London. the African Drought Relief Operations 1984- Taylor, N. (1986) Nutritional status data, W. 86 of the League of Red Cross and Red Sudan 1986, Tonbridge, Kent. Crescent Societies, Report No. 3, Institute Williams, C. (1986) Report of March-April survey of Development Studies, Brighton. 1986 , Nutritional Surveillance and Drought Petrie, C. (1986) A Review of the droug ht relief Monitoring Project , Darfour. Oxfam, Darfour, operations of the League of Red Cross and red Sudan. Crescent Societies in Mali and Chad , 1984-86. Independent Review and Evaluation of the Jeremy Shoham African Drought relief Operations, 1984—86, of the League of red Cross and Red and Crescent Societies. Report No. 4, Institute Edward Clay of Development Studies, Brighton. Relief and Development Institute Sen, A. (1981) Poverty and fami nes: An essay 1 Ferdinand Place on entitlement and deprivation. Clarendon, London NW1 SEE , UK Oxford.

DISASTERS VOLUME 13 NUMBER 1 Diet and Nutrition during Drought An Indian Experience

N. PRALHAD RAO

In 1987 India experienced one of the century ' s worst droughts with two-thirds of its sown area receiving ' scanty ' or 'deficient' rainfall. Delayed rains in some parts, thoug h to some extent they relieved the water scarcity , did not brighten the prospects of agricultural production. In order to assess the diet and nutritional situation of the vulnerable p opulation in the severely affecte d areas, rapid surveys were undertaken by the National Institute of Nutrition, Hy derabad , in f ive States of the country, namely Andhra Pradesh, Tamil Nadu, Karnataka, Orissa and Gujarat, during the months of October-December 1987. Results obtained during the current surveys are compared with the dietary situation observed in earlier droug hts in the 1960s and 1970s, and it is concluded that the widespread hunger and its consequences encountered in earlier droug hts could be averted, due mainly to the better food security and distribution mechanisms now available in the country .

survey to assess the diet and nutritional INTRODUCTION situation in the drought-affected areas In 1987 India experienced what was in several states, following the recom- labelled the century's worst drought, both mendations of the Indian Council of in terms of intensity and geographical Medical Research Expert Group. The sur- spread. As many as 15 states and six vey was carried out between October and union territories were declared to be December 1987. drought effected. Two hundred and fifty two districts (out of 412) in the country re- SAMPLING METHODOLOGY ceived either 'deficient' or 'scanty' rainfall, heralding grim prospects of agricultural The survey was carried out in the states production (Surpal, 1987) . of Andhra Pradesh, Karnataka, Orissa, The adverse impact of such a drought Gujarat and Tamil Nadu (see Fig. 1). As on the country's economy in terms of a the survey was intended to be carried out drop in agricultural and industrial output, in the worst drought-hit areas, the local reduced purchasing power, and concomi- officials concerned were consulted over tant rise in unemployment, particularly of the selection of one or two districts in the rural labour force, can well be under- each state and one or two blocks/taluks/ stood. mandals in each of these districts. At The National Institute of Nutrition, block/taluk level, a list was obtained of Hyderabad, therefore under took a rapid severely affected villages and the relief

DISASTERS VOLUME 13 NUMBER 1 Guiaral

/ Onssa \

STATE DISTRICT Andhra Pradesh 1. Mahaboobnagar Onssa 1 Kalahandi 2. Pulbhani 3. Ganjam 4. Korapul Guiarat 1. Banaskantha 2. Kulch a » » Tamil Nadu 1. Dharmapuri 2. Ramanad 3. North Arcot ^ 4. Tanjavur i ( Karnalaka 1. Mysore 2. Hasan 3. Tumkur 4. Kolar 5. Dharwar

FIGURE 1 Areas Surveyed /or Drought Survey l987-8o

DISASTERS VOLUME 13 NUMBER 1 State No. of No. of No. of No. of children No. of Total No. of districts blocks / villages adults individuals taluks

Andhra Prad esh1 5 788 710 1498 Orissa48 1160 1919 3079 Gujarat24 2059 1952 4011 Tamil Nadu48 739 1449 2188 Karnataka 5 14 1153 1911 3064

Total 16 39 162 58997941 13840

"workspots" (wherever these were in labourers' households during the pre- operation) with particulars of the popu- drought (non-drought) period reported by lation. Four to five villages per block/taluk the National Nutrition Monitoring Bureau were randomly selected for the survey. of India. In areas where no relief works The following method was followed for were in progress, surveys were conducted ensuring that the survey sample included in villages taking care to include landless the vulnerable population of landless and poor communities. labour, small/marginal farmers etc.

- Information was sought on whether INVESTIGATIONS any relief works were in progress in the The survey consisted of the following village or its neighbourhood. investigations: General conditions in the - All the workers participating in the area; assessment of dietary intake by relief work were examined on the spot the family diet questionnaire; assessment for nutritional status. of clinical and anthropometric status - Every fifth person examined was ques- (body weight and height) using standard tioned on (i) the wages he received and procedures; and on-going rehabilitation (ii) the number of his famil y members measures. engaged in relief work.

In addition, the surrounding villages RESULTS from where the relief workers were drawn were visited, to cover their chil- Coverage dren and other members of their households. Food consumption at household A total of 5,899 pre-school children and level was assessed, using a family diet 7,941 adults were examined for nutritional survey questionnaire on a subsample of status, and 1,035 households covered for households (every 10th household covered dietary assessment from 162 villages, dis- b y the study), and results were compared tributed over 39 blocks and 16 districts of with the food/nutrient intakes observed in the five "states (Table 1 and Fig. 1).

DISASTERS VOLUME 13 NUMBER 1 Drought affected Cereal Pulses Green Other Roots Milk Fats Sugar areas andl eafy vegetables and anda nd millets vegetables tubers oils jag gery

Andhra Pradesh 505 12 13 585; 10 17 7 5 Orissa 488 28 23 555, 29 7 4 4 Gujarat 494 17 03:38 57 55 14 30 Tamil N adu 475 25 12 638576: 4 Kamataka 550 27 10 545- 20 23 3 16 RDP 460 40 40 606< 50 150 40 30

*RDI - Recommended Dietary Intakes for Indians (ICMR, 1981)

„ , „ .... returnedreturn to their habitual farm work due General Conditions , to premonsoonpre: showers (though delayed). Many of the districts covered in different TThet district of Kutch, which included a states were areas where drought condi- sizeabsizeable pastoral population (like Rabaris), tions of varying degrees were known to was hardh hit, as the livestock had either prevail even under 'normal' rainfall sea- perishedperish or found refuge in specially estab- sons. In some of the areas surveyed, the lished cattle camps. Fodder was trans- drought conditions were stated to have portedportec by rail and road from Haryana and prevailed for the proceeding three years, Uttar Pradesh . Scarcity of drinking water as in Mahaboobnagar district of Andhra was acu; te, mainly in the districts of Pradesh and Kutch district of Gujarat; and GujaratGujar ; , though deep tube wells and with low yields of dry crops and high water supplies transported by lorries and prevalence of under-employment, migra- camel carts brought some relief. tion of labour to neighbouring areas was reported. The cumulative effect of drought „. Dietary situation in these areas was visible in the drying up of water sources for crops, including dug The 1levels of food consumed by the wells and canals and acute shortage even householdshouse during the drought are given of drinking water. Scarcity of fodder was in TaTable 2. They have been compared very acute in Gujarat in the districts of with those reported by the National Kutch and Banaskantha, resulting in the NutritNutrition Monitoring Bureau (NNMB) re- mass movement of cattle to the nearby preserpresenting the 'normal' (non-drought) and cattle camps where fodder was supplied RecorrRecommended Dietary Intake (RDI) levels on a nominal payment. (ICME(ICMR, 1981) (Fig. 2). The following In some parts of Mahaboobnagar observationsobsen can be made: (Andhra Pradesh) and Orissa, the belated onset of rains had delayed agricultural - BotiBoth during drought and non-drought operations. In Karnataka, relief works conditionscom , most food items, except initiated in the months of July-August stapstay le cereals and millets, were being 1987 had been discontinued at the time of consumedcon; much below the recommen- the survey, as the labour force had ded level of intake (RDI).

DISASTERS VOLUME 13 NUMBER 1 * * * 100

A.P ORI GUJ T .N KAR State

* Non-drought Severe ^^ 1 1%^ Mi^

" Drought Moderate Norma

FIGURE 4 Distribution (%) of 1-5-year-old Children by Degree of Malnutrition (Gomez et al., 1956) were lower than the weights during non- to the landless labourers, marginal farmers drought periods, except in the case of and other affected persons in and around females in Kamataka, where the weights their habitat. This measure, which mini- tended to be similar. mised their migration to neighbouring Anthropometric data of pre-school urban and semi-urban areas, was most children (1-5 years) on growth retard- visible in Gujarat and Kamataka. The size ation, defined in terms of weight-for-age of the labour force (50 to 500 or more) defici ts (Gomez et al., 1956) are given employed per "workspot" depended on in Figure 4. The prevalence of severe the type of nature of the work. One or grades of undemutrition (weight deficit of two members from each family were more than 40% of healthy normal chil- given employment and in Gujarat, at the dren) was about three times higher in time of team's visit, a maximum of three Mahaboobnagar (Andhra Pradesh) during members per family were reportedly al- the present drought. Such drastic change lowed to work. On an average each was not, however, found in the other worker received about Rs. 11 per day. In areas. Kamataka, the workers reported that Drought Relief Measures their wages were Rs. 9-50 per head, part of it paid in the form of foodgrains. Other Relief Works. Public works like road con- developmental programmes like National struction, earth embanking, excavation of Rural Employment Programme (NREP), tanks and canals, provided employment Rural Landless Employment Generation

DISASTERS VOLUME 13 NUMBER 1 Drought affected Males Females areas Present NNMB Present NNMB study 1974-79 study 1974-79

Andhra Pradesh 46.9 5U.6 41.3 43.2 Orissa 48.7 50.5 40.0 41.6 Gujarat 51.2 50.0 44.8 43.9 Tamil Nadu 49.9 50.3 42.3 44.2 Karnataka 48.6 50.0 42.3 42.5

- During the drought, consumption levels unit per day). The percentages of such of almost all food items in all the states families were only 0.7%, 1.0% and 1.5% were lower than non-drought levels. In in the states of Tamil Nadu, Orissa and Gujarat, a slight rise in cereal consump- Karnataka respectively. Surveys previous- tion was noted during the drought. A ly conducted in severely drought-affected drastic reduction in the levels of con- areas of Andhra Pradesh (Swaminathan sumption of milk, pulses, sugar and et al., 1967), Bihar (Swaminathan et al., jaggery was observed in some of the 1969) and Maharashtra (Krishnamachari areas surveyed, e.g. milk in Andhra and Pralhad Rao, 1974), indicated that the Pradesh, Gujara t and Tamil Nadu; and percentages of families subsisting on such pulses in Andhra Pradesh, Gujarat and 'starvation' diets were 47% , 8.2% and Karnataka. 3.8% respectively. - It is noteworthy that large-scale consumption of wild leaves and tubers Nutritional Deficiency Signs (famine foods) eaten in distress conditions, was not noticed during the Nutritional deficiency signs encountered present survey. were of Protein Energy Malnutrition (PEM) among young children and vitamin A and B complex deficiencies and anaemia Nutrient intake in other age groups. Prevalence rates of The average nutrient intakes, presented these signs were not much different from in Figure 3 (a-c), reveal clearly that the those observed during non-drought diets were deficient in energy and vitamin periods (NNMB surveys, 1976-78) . A in all the states. Protein intake, which otherwise was normal during the non- Anthropometry drought period (NNMB), was also deficient in three of the five states surveyed. Body weight is known to respond even to A study of the frequency distribution short-term changes in food intake. The of the households by energy intake showed average body weights of adult men and that not a single household in Gujarat women are given in Table 3. It was only or Andhra Pradesh was subsisting on in Gujarat that the body weights of both very low levels of energy ('Starvation men and women were higher by about Diet' - less than 500 Kcal per consumption 1 Kg. In the other states, current weights

DISASTERS VOLUME 13 NUMBER 1 (a) 2969 (b)

(Kcal) : Proteins (g) Calories ^ ?4nn RD

2200 60 RDI

2000 40

180C 2C

1600 '—UAt—'—'"—'—"" ' Yf " '—c^—1 0'—''"' ' "'"—•—•"^—'—^—-— "-— A.P ORI GUJ T.N KAR A.P ORI GUJ T.N KAR State State

(0 Vitamin A (IJLQ; (RDI = 750) 360

300

24n

180

1 ^" A.P ORI GUJ T.N KAR State

| | Drought

|%$ i Non-drought

FIGURE 3 Average Consumption of Nutrients (cu/day) during Droug ht and Non-Drought Periods

DISASTERS VOLUME 13 NUMBER 1 *. *« 100

A.P ORI GUJ T.N KAR State

* Non-drought

** Drought Moderate Normal

FIGURE 4 Distribution (%) of 1-5-year-old Children by Degree of Malnutrition (Gomez et al., 1956) were lower than the weights during non- to the landless labourers, marginal farmers drought periods, except in the case of and other affected persons in and around females in Karnataka, where the weights their habitat. This measure, which mini- tended to be similar. mised their migration to neighbouring Anthropometric data of pre-school urban and semi-urban areas, was most children (1-5 years) on growth retard- visible in Gujarat and Karnataka. The size ation, defined in terms of weight-for-age of the labour force (50 to 500 or more) deficits (Gomez et al., 1956) are given employed per "workspot" depended on in Figure 4. The prevalence of severe the type of nature of the work. One or grades of undernutrition (weight deficit of two members from each family were more than 40% of healthy normal chil- given employment and in Gujarat, at the dren) was about three times higher in time of team's visit, a maximum of three Mahaboobnagar (Andhra Pradesh) during members per family were reportedly al- the present drought. Such drastic change lowed to work . On an average each was not, however, found in the other worker received about Rs. 11 per day . In areas. Karnataka, the workers reported that their wages were Rs. 9-50 head, Drought Relief Measures per part of it paid in the form of foodgrains. Other Relief Works . Public works like road con- developmental programmes like National struction, earth embanking/ excavation of Rural Employment Programme (NREP), tanks and canals, provided employment Rural Landless Employment Generation

DISASTERS VOLUME 13 NUMBER 1 Programme (RLEGP), etc., were in oper- difficulty of separating the direct effect of ation with additional emphasis in the drought on health from the effects of affected areas. associated factors, such as migration, the Supplementary Feeding . In Orissa, special break-down of the social frame-work, and emergency feeding programmes were be- other conditions of insecurity (Prost, 1988). ing operated, based on rice and pulses for The primary effect of drought is on young children and women. Each pre- agriculture; hence its worst victims, from school child received cooked food consist- the stand-point of nutritional health, are ing of 80 g. rice and 20 g. pulses, while rural landless labourers and marginal and adult women (pregnant and lactating) and small-scale farmers. Dietary surveys have the elderly received about 160 g. rice and shown that even in 'normal' times i.e. 40 g. pulses. In the district of Kutch when the rains are normal, their diets are (Gujarat), distribution of 'Sukhadi', a cen- deficient in important nutrients like en- trally processed 'ready-to-eat' preparation ergy, vitamins and minerals. That drought based on wheat, jaggery and oil, had just imposes additional stress on the already then been started by a voluntary agency - deficient food intakes, needs no emphasis. Bansali Trust. Each pre-school child re- In the present study the consumption ceived 80 g. of Sukhadi (340 calories and of almost all the food items showed a 6 g. protein) and pregnant and lactating decrease. In the case of protective foods - women received double that quantity . A pulses, vegetables and milk - the drop school meal programme providing about was more distinct than that seen in the 500 calories and 10- 12 g. of protein per staple food (cereal/millet). So also the head, was operating in Gujarat for chil- levels of consumption of oils, fats and dren of 6- 11 years. Tamil Nadu had sugar were much reduced. Hence, the feeding programmes, in which pre-school adverse impact was thus found more on and school children were receiving a dietary quality (vitamins and protein) cereal-pulses-vegetable supplement. In rather than on quantity (energy content). other states the ongoing Integrated Child In most areas the energy content of the diet Development Services Scheme (ICDS), tended to remain at former consumption Special Nutrition Programme (SNP) and levels, despite the widespread drought. Mid-Day Mean Programme (MDMP), pro- Strictly speaking, comparison of dietary vided Supplementary Feeding. and nutritional conditions of the current drought with those obtained during the droughts of the sixties and early seventies COMMENTS AND CONCLUSIONS may not be valid, because of the changed Drought conditions invariably develop circumstances. However, a comparison of when the monsoon fails to materialise. the experiences of the past droughts with Their severity, usually measured in terms the current one can be expected to high- of crop failure, depends on the decline in light differences in food availability and quantity and/or regularity of rainfall. Drop the management strategies adopted. The in agricultural production (farm income) results indicate that during the current and industrial output, and the enforced drought: idleness of the labour force are some of the adverse economic effects of drought. - the average energy intakes of land- However, there are no clear-cut and reli- less and other labourer households in able nutrition or health indicators which general has been found closer to the could be considered to reflect the impact former (non-drought) level of about of drought. The reason for this is the 2000 Kcal, reported by NNMB surveys,

DISASTERS VOLUME 13 NUMBER 1 as against the 1100-1400 Kcal revealed apparent progress made during the past by earlier drought surveys of 1965-67 several years, continues to be sensitive to and 1973. the weather and a buffer stock of the - the households subsisting on starvation order of 23 million tonnes is not much of diets (/500 Kcal/cu/day) (less than 2%) a consolation, as a shortfall of about 20 have been f ar fewer than in the earlier million tonnes in output due to one very droughts, and there was a virtual ab- bad season is enough to almost wipe it sence of households subsisting on wild out (Velayudham, 1987) . leaves and tubers (famine foods), such Communicable diseases like gastro- as was seen in the drought of 1965-66. enteritis (cholera) in epidemic forms , food intoxication (e.g. cyanide and aflatoxin These observations if anything speak of toxicity) resulting from consumption of the better availability and supply position wild tubers and fungus-infested grains, of food grains, which in turn would usually followed past scarcity situations indicate the better infrastructure facilities, (Krishnamachariet al., 1975). Their absence food distribution machinery , and above during the current drought is noteworthy. all management strategy now prevailing However, prevalence of night blindness in the country for meeting such a crisis. in epidemic proportions reported from It is pertinent to mention here that certain areas of Rajasthan (K.A.V.R. towards the beginning of 1987 the country Krishnamachari, personal communi- had food grain stocks of about 23 million cation) compared to its absence in the tonnes, (of which 3 million tonnes were neighbouring districts of Gujara t, calls for stated to be unfit for human consumption) further investigation. Perhaps, under food and these stocks have been built up over scarcity situations caused by drought, the years. By the middle of 1988, the vitamin A deficiency is one of the earlier stocks were reduced to eight million signs of malnutrition to manifest itself , tonnes. Given the fact that a transfer of rather than signs of anaemia and other food from surplus to deficit areas does not vitamin B deficiencies. The development happen automatically, but needs political of drought into distressing famines as and economic discipline (Hay, 1986), the witnessed in recent years in some of the brisk movement of food grains from the African countries can be traced as much Food Corporation of India (FCI)s ware- to the non-availability of a viable food houses to distribution outlets in areas of security system or distribution mechan- scarcity, reflected the awareness and com- ism at country level, or to unstable socio- mitment of the Government of India to a economic and political conditions, rather policy of national food security . The than simply to a lack of food (Miller and availability of stocks of food grains within Holt, 1975). The logic of 'more food the country not only reflected a measure production = less hunger' at a general of success achieved by the agricultural level works only if other socio-economic sector, but also suggested the presence and political conditions are conducive to of an implementable food policy . But for organised action on a continuous basis. this policy and otYier concerted eirorts TYie Indian s'rtuauon seems \arge\y to m&i- by the regional governments, the country cate this. Maintenance of a near 'status quo' would have witnessed widespread hunger nutritional position in young adults and and the adverse consequences encoun- pre-school children in most areas, cannot, tered during earlier droughts. The recent of course, be considered an outstanding drought, perhaps, has also brought out achievement. But neither can it be entirely clearly that India's agriculture, despite dismissed, since it stands out in sharp con-

DISASTERS VOLUME 13 NUMBER 1 trast to the situation seen, for example, in Acknowledgements Bangladesh refugee camps, where the proportion of the severely malnourished The Author is grateful to the Director was much higher than was usually seen in General, Indian Council of Medical Re- the community (Swaminathan et al., 1973). search, for providing the opportunity to However, the continued vulnerability conduct the survey. Thanks are due to of food productivity to the vagaries of the past and present Directors, National the weather and the absolute dependence Institute of Nutrition, who have been of the rural poor in scarcity relief works helpful in guiding the survey from time to (for income) and fair price shops (for time. The active help and cooperation food grains) in times of such crisis has rendered by the Officers of the different become abundantly dear. Loss of live- State Health Directorates and the District stock reported in some areas like Gujarat, and Block level Officials, is highly appreci- demonstrate the weakness of the present ated. Finally, grateful thanks are due to system in this respect, which leaves the community members for their whole- livestock under stress to fend for them- hearted participation in the survey. selves. The drought has also underscored This article was prepared on the basis the need for maintaining adequate food- of the report of the Division of Field grain stocks, extending the network of Studies, National Institute of Nutrition, fair price shops in drought-prone areas, Hyderabad - 7. The members of the and for the creation of subsidiary employ- survey team were Mr. D. Hanumantha ment on a permanent basis. Rao, Dr. G.N.V. Brahmam, Mr. J. The most important observation de- Gowrinath Sastry, Dr. K. Vijayaraghavan, rived from the present survey, from the Dr. K. Satyanarayana, Dr. K.V.R. Sarma, stand-point of diet, is the drastic reduc- Dr. J. Neela, Mr. Ch. Gal Reddy, Mr. tion in the consumption levels of pulses. Sharad Kumar and Mr. M. Ravindranath. With the ongoing distribution of the staple cereals and edible oil through References the fair price shops, a minimum quantity of 40 g. of pulses, besides 500 g. of Gomez, P., Ramos, S., Frenk, S., Cravioto, J., cereal per person per day, would be Chavez, R., and Vanquez, J. (1956). Mortality sufficient to maintain the protein content in second and third degree malnutrition. /. Trap. Paed. 1, 77-83. of diets during drought. In other words, Hay, R.W. (1986) The Political Economy of this would mean that a supply of about Famine. Nutrition and Health 4, 71-82. famil 5 kg pulses to a y of three adults and ICMR (1981) Recommended Dietary Intakes for two children (four consumption units) Indians. Indian Council of Medical Research, should be ensured. In order to curb any New Delhi. likelihood of the misuse and resale of Krishnamachari, K.A.V.R. and Pralhad Rao, N. pulses, the feasibility of distributing them (1974) Food and Nutritional situation in the mixed with cereals during drought con- drought affected areas of Maharashtra. A ditions could be explored. Similarly, pro- survey and recommendations. The Ind. }. grammes of specific nutrient supply, like Nutr. Dietet. 11, 20, p. 20. supplementary feeding, massive doses of Krishnamachari, K.A.V.R., Ramesh, V., vitamin A and iron and folic acid for Bhat, V., Nagarajan, V. and Tilak, T.B.G. (1975) Hepatitis due to Aflatoxicosis : An vulnerable groups, should be an integral outbreak in Western India. Lancet I, 1061- part of any food distribution strategy, so 1063. that the worst forms of malnutrition and Miller, D.S. and Holt, J.F.J. (1975) The their consequences can be prevented. Ethiopian Famine. Proceedings of the Nutri-

DISASTERS VOLUME 13 NUMBER 1 tion Society 34, 167-172 , as quoted by Frost Swaminathan, M.C., Visweswara Rao, K. and (1988) . Hanumantha Rao, D. (1969) Food and Pralhad Rao, N., Gowrinath Sastry, J. and Nutrition Situation in drought affected areas Narasinga Rao, B.S. (1987) National Nutrition of Bihar. Ind. J. Nutr. Dietet. 6, 209. Mon itoring Bureau - Achievements and Con- Swaminathan, M.C., Vijayaraghavan, K. and straints. A Report. National Institute of Hanumantha Rao, D. (1973) Nutritional Nutrition, Indian Council of Medical Re- status of refugees from Bangladesh. Ind. J. search, Hyderabad. Med. Res. 61, 278-284. Prost, A. (1988) When the rains fail. World Velayudham, T.K. (1987) Monsoons and the Health Forum 9, 98-103. economy. Economic and Political Weekly 11, Surpal, B.B. (1987) Consequences of Deficient no. 49 (5 December 1987), 2108-2111. Rains and Drought in India: Drought - Medical and Healt h Problems - A brief report. National Institute of Primary Health Care (NIPHC N. Pralhad Rao Activity No. 2), p. 9. (Chief , Division of Field Studies) Swaminathan, M.C., Visweswara Rao, K. and National Institute of Nutrition Hanumantha Rao, D. (1967) Food and Indian Council of Medical Research Nutrition in the drought affected areas of Jamai-Osmania, P.O., Andhra Pradesh. Ind. ]. Med. Res. 55, July Hyderabad-500007 1967. 55.

DISASTERS VOLUME 13 NUMBER 1 A Case Study of Social Behaviour in a Natural Disaster: The Olivares Landslide (Spain)

JOSE LUIS GONZALEZ GARCIA and MARIA VICTORIA SORIANO PARRA

The modernsociological literatureon disasters highlights the fact that many the ideas about humanb ehaviour in of disasters which were long considered as wrong. The main valid, are discovery is based on the fact that situations moral of crisis increase people' s principles and capability of response. This paper illustrates some of these ideas, in a case study of a village which was struck b y a naturaldisaster in the north of Granada (Spain) in 1986. The population ' s attitude revealeda hugepotential of resources that were underestimated by professionals disaster of management. The analysis shows that it is necessary to bring civil protection systems and the population ' s capability into close harmony. of response

INTRODUCTION 1983) now point out that these ideas are wrong, or, at Over the least, they have been years, much research has been overvalued . carried out in North America on human The studies behav carried out in the last 30 iour in disasters. Study of the re- years have shown that panic behaviour is sulting literature shows some interesting rare, even non-existent, in natural dis- find ings about people's behaviour and asters, and only constitutes an important reactions in emergency situations. These problem in fires or other similar circum- findings cast doubt on the image given by stances, in which the human being the cinema, the television must or the press/ cope with complex situations destroying the that evolve myths that were previously very quickl considered y and in which the information fundamental in disaster man- available for agement. decision-making is very sparse (Canter, 1980). The belief that the population will be It has also affected b been pointed out that y panic or hysteria, and the idea looting and that d antisocial behaviour are rela- isasters engender social chaos, anti- tivel y r are, with the observation that social behaviour, confusion and bewilder- Police files show no increment in the ment, have been common among the crime rate during the emergency period . mass media and those responsible for The notion that disasters cause a public planning and disaster relief efforts. situation of bewilderment and paralysis Howev er, several social researche rs (the "disaster syndrome") cannot be con- (Quarantelli, 1973; Dynes and Weng er , sidered as a universal model, because the

DISASTERS VOLUME 13 NUMBER 1 scientific literature is full of remarks occurred, and had the chance of making which show that the persons who rescue several direct observations and of carry- the victims are the victims themselves, ing out informal interviews with the the ones who take care of the injured people. people are the affected people themselves, One of the most remarkable aspects of and the recovery of the essential services their social behaviour was the population's is carried out by the survivors themselves. high sense of participation and solidarity, These discoveries, generally verified which existed in every moment. This is in in the U.S.A., have not been sufficiently contradiction with the belief that disasters confirmed in other countries, and although produce discouragement and antisocial there is a parallelism among the disasters behaviour, and which usually leads those which have happened in different coun- responsible for civil protection to under- tries, it is necessary to confirm these facts estimate the local possibilities of self- by observing situations which arise out- reliance. side the U.S.A. People affected by the emergency were not bewildered or disoriented at all. THE LANDSLIDE OF OLIVARES On the contrary , they reacted positively and efficaciousl y, with a high sense of res- In April 1986, some of the observations ponsibility. Many of the civil protection mentioned above were illustrated during activities, such as the closing of the an emergency which took place in the affected area, the organization and main- north of the province of Granada (Spain) tenance of an operational coordination as the result of a landslide that menaced centre, and some actions of logistic sup- Olivares, a litle town with a population of port, were correctly carried out by volun- 1,000. teers who were coordinated by the local The landslide destroyed several agri- authorities. One of these, the Country cultural enterprises, a factory related to dry Council of Granada, made a brilliant goods, communications, the electricity response from the start, by supplying supply systems and the water pipes, and experts, evaluating the damage and even very seriously threatened the school, the examining the affected area from the air. church and the eastern side of the town. Besides this, no measures to provide These facts made necessary the inter- temporary housing of the people affected vention of several public works services, were necessary, since all the evacuees the Red Cross, the Police Department, the were lodged by their families and friends. Military Forces and scientific teams, who There was no panic or hysteria among evacuated 70 families from the high risk the population, although the circum- zone of the designated security area stances of imminent danger persisted. On (Gonzalez Garcia, 1987). occasion, it was even necessary to convince Although the emergency did not cause the curious of the instability of the slope serious damage to health, it is clear that the and the danger of blocks sliding. gravity of the economic losses and the Yet, at the same time, there was a heavy and mwiinent threat of destruc- general feeling of fear and nervousness tion of the town because of the advance of amongst the neighbourhood. Unlike the the landslide front, had a deep influence curious who arrived from other areas, the on the usual social behaviour of the inhabitants of Olivares had received better population . information about the nature of the hazard One of us was sent, as a coordination that threatened them, which made them officer, to the place where the emergency feel the anguish of losing their houses

DISASTERS VOLUME 13 NUMBER 1 and properties. This natural anxiety, an unreal image of-disasters, by including faithfully reflected in the local press (El in their reports an overdose of the tragic Ideal de Granada, 16 April 1986) gave those aspects of these situations. responsible for emergency management some qualms about the appropriate level CONCLUSION of public information. They were very concerned to calm the population down The landslide of Olivares was a good and avoid excessive alarm, for fear of chance to confirm in Spain several find- causing panic. ings about social behaviour in natural These concerns inevitably caused a disasters, which have been formulated certain anxiety over the broadcast of elsewhere, particularly in America. warning messages and some ambiguities Panic and hysteria were absent during and limitations in the information made the emergency, the social atmosphere was available, which brought about the pro- rather good, and the local and volunteer pagation of rumours and a loss of con- organizations showed a capability of re- fidence in the civil protection officials. sponse even greater than would be expec- Those affected were insatiable for ted in a normal situation. information about the causes and evalu- Such remarks induce us to highlight ation of the phenomenon, which was an the following observations: embarrassment for those responsible for The local population is a basic and public information. potentially active element in disasters, Many specialists thought that the responding with a high sense of altruism disaster had been triggered off by the ex- and efficacy. ploitation of a quarry within the affected Harmonizing the different forces area. According to them, the quarry which take part in a disaster is a complex would have altered the natural drainage and difficult task. The difficulties of co- of the ravine, modifying the gravitational ordination, deficient communications and balance of the slope. However, other the lack of adequate knowledge to take experts were less sure about the role decisions, can never be perfectly resolved. played by the quarry. How should these The affected population and the local doubts be transmitted to the population? organizations are the main elements The mass media were not very helpf ul, which provide the response to many because they were obsessed by the search disaster situations. Outside relief groups for a tragic end and the visualization of an must complement and support those ac- image that distorted the nature of the tions, but never take the place of the local phenomenon, which they called "the relief efforts and self-reliance. walking mountain", "the earth's revolt" These observations lead us to consider or other similar epithets. that emergency planning cannot be con- The misuse of sensational headlines, ceived of as a task that is only carried out the selection of certain pictures of the by management emergency officers and destroyed area and the reporting of dra- relief groups. Emergency planning must matic anecdotes, created an image that also be envisaged from the point of view exaggerated the real significance of the of the survivors and the affected citizens. situation. We think that the most adequate solution This fact supports a theory that has to these problems lies in conceiving of been tested by some social researchers disaster planning as a process composed (Dynes and Wenger, 1983), according to of three stages. whom, the mass media involuntarily give As a first step, the organizations

DISASTERS VOI .1 IME 13 NUMBRR 1 responsible for civil protection and disaster Dynes, R. (1970) Organized behavior in disaster. management elaborate a basic plan, and Health Lexington Books. D.C. Heath the guidelines for the relief groups. In the Company, Lexington. second stage, all the relief groups formu- Dynes, R. and Wenger, D. (1983) The environ- late concrete proposals for operating within ment of disaster. Preparing for disabled and elderly persons. FEMA, Washington, U.S.A. a planning committee. In the third stage, Gonzalez Garcia, J.L. (1987) El deslizamiento de the public response to hazard and disaster tierras de Olivares, Cuadernos de Proteccion through public infor- is prepared, chiefly Civil, n° 16, Madrid, Spain. mation and education programmes. Quarantelli, E.E. (1973) Human behaviour in We believe that these three stages of disaster. Proceedings of the Conference to planning must be interconnected. We Survive Disaster, IIT Research Institute, cannot formulate operational concepts Chicago, U.S.A. while assuming that the population is Roger, G. and Nehnevajsa, J. (1984) Behavior going to behave in accordance with the and attitudes under crisis conditions. University actions projected by the authorities. of Pittsburgh, Pittsburgh, U.S.A. The emergency planning of the first and second stages must take into account the possible behaviour of the population, Jose LUIS Gonzalez Garcia and be flexible enough to allow improvis- and ation and unpredicted emergent phenom- Maria Victoria Soriano Parra ena. Direccion General de Proteccion Civil c/ Evaristo San Mi References guel, No. 8 Canter, D. (1980) Fires and human behaviour. 28008 Madrid, Spain John Wiley, New York .

DISASTERS VOLUME 13 NUMBER 1 Experiences of Non-Governmental Organisations in the Targeting of Emergency Food Aid A report on a "Workshop on Emergency Food Aid Targeting" at the London School of Hygiene and 1 Tropical Medicine, London 4-6th January 1989

JOHN BORTON and JEREMY SHOHAM

identify other areas requiring follow INTRODUCTION up and further research. In January 1989 a two and a half day "Workshop on Emergency Food Aid Tar- The response to the African food crisis of geting" was held at the London School of 1983-86 differed from previous large scale Hygiene and Tropical Medicine (LSHTM) international relief activities in Africa in supported by a grant from the Health and that: Population Division of the Overseas Development Administration. This was a) substantially greater volumes of food their part of a study of the methods used by were distributed to people still in Non-Governmental Organisations (NGOs) place of normal residence as opposed in targeting emergency food aid in Africa to camps. Though the data to support carried out jointly by the Relief and this assertion is poor it would appear Development Institute (R.D.I.) and the that over half of the 5.4 million tonnes Human Nutrition Unit/ LSHTM. The of cereals provided as emergency food objectives of the workshop were: aid between mid-1983 and mid-1986 (at a total cost in excess of $1.5 billion), i) to provide an opportunity for partici- was distributed to people still living in pants to share their experiences in their area of normal residence. targeting emergency food in Africa b) the role of NGOs in these distributions during 1983-86; was substantially greater than ever ii) to obtain feedback on the overview before. In the two major recipient paper and additional details on the countries (Ethiopia and Sudan) NGOs case studies which had been prepared were frequentl y the preferred channel as part of the overall study; for distribution by donors for a variety iii) to look for areas of consensus on of operational, accountability and issues raised by the study and to political reasons.

DISASTERS VOLUME 13 NUMBER 1 Through their involvement in the ing Programme, Sidamo Province, distributions NGOs were frequentl y Ethiopia 1985-86 involved in the process of selecting areas 13. Save the Children Fund: General and population groups to receive the Feeding Programme, Darfur Region, distributions. As a result many NGOs Sudan 1985-86 gained considerable experience in the "targeting" of emergency food aid . Thus Case studies numbers 1 and 7-13 were the RDI/LSHTM study was intended to presented at the workshop. assist in the documentation and analysis The workshop was organised primar- of these experiences. ily around presentations of case studies As part of the overall study, the by eight of the participating agencies. For following 13 case studies were prepared the purposes of the workshop a some- using documentation made available by what arbitrary distinction was drawn the participating agencies and interviews between General and Supplementary with agency personnel. Feeding Programmes so that each broad type of programme activity was discussed 1. CAFOD/SUDANAID: Supplementary on separate days. As a preliminary to Feeding Programme, En Nahud Area each of the first two days the researchers Council, North Kordofan Province, presented sections of an overview paper Sudan 1985 prepared after an initial review of the 2. CARE: General Feeding Programme, material in all the case studies (Shoham and Kordofan Region, Sudan 1984-85 Borton, 1989). Three working groups dis- 3. CARE: Supplementary (Wet) Feeding cussed topics identified during the first two Programme, North Kordofan days of the workshop and their findings Province 1985-86 were presented during the final session . 4. CARE; Supplementary (Dry) Feeding There were enormous differences Programme, En Nahud Area Council, between the programmes reviewed at the North Kordofan, Sudan 1986 workshop in terms of the type of activity , 5. CONCERN: Supplementary Feeding the scale of operations, the level of Programme, Sidamo Province, resources available and degree of auton- Ethiopia 1984-85 omy enjoyed by the agency. Thus the 6. ICRC: Methods used in the targeting largest programme presented was the of ICRC feeding programmes Save The Children Fund - UK (SCF) 7. LRCRS: Supplementary Feeding General Feeding Programme in Darfur Programme, Chad 1985-86 which distributed 190,000 tonnes of cereal 8. MSF Belgium: Programming of between late 1984 and late 1986, whilst General and Supplementary Feeding the smallest was the highly targeted "wet- Interventions, Chad 1984-85 feeding" programme implemented by 9. MSF FRANCE: Supplementary Feed- MSF-Holland in North Darfur, which at ing Programme, Tahoua and Maradi its peak in early 1985 was distributing Departments, Niger 1985-86 approximately 40 tonnes/per month to 10. MST HOLLAND: Supplementary 5,000 recipients. Despite such differences, (Wet) Feeding Programme, North it was agreed that there were many Darfur Province, Sudan 1985-86 similarities in the experience of the par- 11. OXFAM: General Feeding Pro- ticipating agencies. For example, all programme, Red Sea Province, Sudan grammes experienced the difficulties of 1985-87 designing targeted interventions on the 12. REDD BARNA: Supplementary Feed- basis of very limited knowledge. All

DISASTERS VOLUME 13 NUMBER 1 programmes had to adapt to rapidly^ practice and the evaluation of perfor- changing situations, and virtuall y all pro- mance. The frequent absence of clear and grammes experienced logistical problems, concise objectives is understandable for a This report aims to synthesize points number of reasons. raised during the workshop and discusses First, relief operations involve many them under thematic headings: Targeting: different organisations and groups of definitions and objectives; The choice of people (the donor public, donor organisa- indicators; Role of the donors; Taking tions, NGOs, host governments and the account of the perceptions of the affected affected populations themselves), all of population; Issues in the choice of pro- whose perceptions of the situation, and amme; gr Issues in the evaluation of so of objectives, may differ, targeting methods and Issue s for further Second, emergency situations are consideration. inherently dynamic and the objectives of a relief programme may alter substantially TARGETING: DEFINITIONS AND during the life of a programme. The OBJECTIVES importance of flexibility in the design and In their overview paper, Shoham and management of relief programmes was Borton (1989, p. 5) defined targeting as stressed on several occasions during the "the process by which areas and popula- workshop. tions are selected to receive a resource Third, there is limited understanding (emergency food aid) and then provided of the underlying processes operating with it". The reasons why agencies target during food crises in different areas and situations emergency food aid were suggested to be: . Relief agenices are therefore forced to make assumptions when design- - limited resources; ing and managing programmes, with only - the desire to concentrate on the worst sketchy information on such complex affected areas and populations; matters as coping strategies of the - the desire not to damage the local affected population, the effectiveness of economy. traditional institutions and the operation of local grain traders and markets. Some Neither the definition nor the suggested of these assumptions may later turn out reasons for targeting were challenged by to have been incorrect. An example cited participants. was that of an agency operating in Nevertheless , an issue that underlay Karamoja in northern Uganda where many of the discussions (and conse- family rations were distributed on the quently is discussed at greater length at assumption, derived from experience different points in this report) was that of elsewhere in Africa, that the food would the objectives and assumptions implicit be shared within the family. However, within targeted interventions. It was three months later the high mortality recognised that NGOs, together with rates had not been reduced and the many of the other organisations involved agency came to realise that "uneconomic" in relief programmes, rarely make explicit members of the family were being dis- their objectives. Notions of saving life and criminated against in the allocation of reducing distress are implicit in their food within the household . actions but are too broad as objectives The lack of clarity in objectives is against which actions can be tested. The perhaps most evident in the case of lack of clarity in objectives creates signifi- General Feeding Programmes. There cant difficulties in the anal ysis of agency often appears to be some uncertainty as to

DISASTERS VOLUME 13 NUMBER 1 whether the objective is to save life or Problems in the Use of preserve asset holdings and thereby anthropometric Data improve the rate of recovery in the post- emergency phase. Significantly different There was general agreement that anthro- 2 targeting methods might follow from the pometry is not the "exact science" that it adoption of either of these as the primary is often claimed to be. objective. The total cost of the General One conceptual problem with anthro- Feeding programme implemented by SCF pometric data which continues to be in Darfur from late 1984 until late 1986 is poorly appreciated by non-nutritionists estimated to have been US$ 86 million, if (including decision-takers within donor all food and logistics costs are included in bureaucracies) is that such measurements the estimate . It was suggested that these of malnutrition do not necessarily reflect operations may have been less cost- insufficient food intake of the measured effective when assessed in terms of saving individual. There are many causes of life than in terms of assisting recovery . malnutrition which are not related to food availability, the most common being THE CHOICE OF INDICATORS diarrhoea. Whilst not intended to detract from the awful suffering involved, it was Introduction suggested that representatives of the western media who search out the most Before designing surveys for targeted emaciated children during emergencies f ood relief programmes an agency must may in some cases be focussing on establish which indicators are to be used children who have been suffering from for differentiating need between areas chronic diarrhoea . These children might and populations. A substantial part of the therefore respond more to medical treat- discussion during the workshop con- ment than food relief. cerned : a) problems in the use of anthro- A further problem is that of using a pometric data for targeting purposes, and single anthropometric cut-off point. This b) the potential role of socio-economic involves converting something which we indicators for targeting purposes. The know to be a continuous function into a attention given to these two subjects single "Yes/No " situation. Such cut-off reflected a general feeling that too great a points are arbitrary and contribute to the reliance has been, and continues to be, false air of quantification surrounding placed on anthropometric data, such as anthropometric data. One nutritionist weight-for-height data, for targeting pur- explained how she had attempted to poses. In addition there was a real sense introduce some flexibility into a Supple- that recent experience had demonstrated mentary Feeding Programme which had that socio-economic indicators, such as been strictly employing anthropometric grain and livestock prices and migration, cut-off points to assess eligibility for offer a valuable, if not presently well admission, by allowing the final decision understood, tool for targeting. At times on whether or not to admit a child to the tVie discussion veered towards an either programme to be taken by the medical or format but this was inconclusive. There and nursing staff managing the feeding was in the end a consensus that in most centres. This resulted in subsequent diffi- situations the two types of indicator are culties with Head Office staff and donors complementary and so, where possible, who questioned the inconsistencies both should be employed in targeting between the numbers below the cu t-off interventions. point and the numbers receiving rations.

DISASTERS VOLUME 13 NUMBER 1 The technical difficulty of carrying out The issue of how to reduce the accurate anthropometric measurements importance attached to anthropometric was noted. A stark example was an data was discussed at length. The attitude experiment in Darfur in late 1985 in which of the donors was seen to be crucial (see the same 131 children were measured by below). However, it was felt that non- two nutritional assessment teams, one nutritionist Head Ofice staff of some of from MSF-Holland using the weight-for- the large NGOs were also to blame. height method and the other from the Anthropometric data offered such staff a League of Red Cross and Red Crescent "technically respectable" set of figures on Societies (LRCRCS) using the Nabarro which to base their decisions to allocate Chart method (Soeters, 1986) . The former resources. Figures were favoured because estimated that 24% of the sample were they gave decision-takers a basis for less than 80% weight-for-height whereas decision, as well as subsequent cover the latter estimated that 48% were less should a particular decision be queried at than 80% weight-for-height. Thus two a later date. One participant saw non- different teams reached conclusions on technical superiors in agency Head the incidence of malnutrition which dif- Offices operating as a "filter" to effective fered by 100% . communication between nutritionists and The difference was attributed primar- the donors. He was confident that if he ily to observer error rather than were allowed direct communication with differences between the methods used, donor officials then the case for greater though it was noted that the results from flexibility in the use of anthropometric the Nabarro Chart for children above the data would be received and understood. age of three could show differences from An example from Chad was dted those measured using the weight-for- where, despite a rapid anthropometric height standard. It was pointed out that survey which had revealed comparatively the Nabarro Chart was used widely by low rates of malnutrition, socio-economic MSF-Belgium in Mali but only in conjunc- information obtained by the nutritionist tion with a head and foot-board. The fact convinced her that the situation was that this additional equipment was not bound to worsen. Nevertheless, on the used by the LRCRCS team may have con- basis of the anthropometric results, the 3 tributed to the degree of observer error. Head Office of the agency concerned was This example shows how the tech- extremely reluctant to make an inter- niques involved in anthropometric vention in the area. surveys are not as straightforward as It was, however, pointed out that this sometimes thought by non-nutritionists. experience - of too much significance It was acknowledged that some agencies being attached to anthropometric data by failed to realise the importance of Head Office staff and donors - was not repeated training and checking of those common to all participants. A participant staff responsible for carrying out the from Redd Barna pointed out that anthro- measurements. The LSHTM's experience pometric data was collected by their of anthropometric surveys in Britain has programme in southern Ethiopia, but was shown that inter-observer error could be never requested by the agency's Head reduced to less than 5%, but that this Office. required repeated observer evaluations. It was naive to expect staff to be able to get consistent results after only one training session.

DISASTERS VOLUME 13 NUMBER 1 The Potential of Socio Economic economic indicators. It was noted that the Indicators system had been accepted by the donor community soon after its commencement Most agencies had used socio-economic at the end of 1984, because: information both in their assessments and for targeting purposes and had found - the Government of Chad had adopted them of considerable value, either when it as its system for allocating emer- used alone or in conjunction with anthro- gency food aid, and; pometric data. No attempt was made to - the first results had shown a high define the term "socio-economic correlation with anthropometric indicator" and it was frequently used in a surveys carried out by MSF-Belgium in very broad sense to encompass variables the same areas; such as agricultural output, household - an independent and highly regarded income and asset surveys, reports on the organisation (the Centre for Disease incidence of wild food consumption, Control) had given the Scoring System trends in grain and livestock prices, the its stamp of approval at an early stage. incidence of displacement, etc.4 There was general agreement that the Lessons from this experience might be perception of socio-economic indicators as drawn by agencies facing problems in "woolly" is not justified. There is no convincing donors of the utility of other reason to believe that it is inherently more systems utilising socio-economic indi- difficult to construct a logical framework cators. for using socio-economic information than The validity of attempting correlations anthropometric information. As high- between anthropometric and socio- lighted during the workshop, anthro- economic data was questioned as there is pometry itself is not an exact method. It the danger that the same things are being was however acknowledged that further compared and good correlations are prob- investigation is needed to develop the able. This provoked a lengthy discussion theory underpinning the use of socio- about indicators and outcome variables. economic information for monitoring and One conclusion of this discussion was targeting purposes and to establish more that socio-economic indicators may cor- situation-specific models for different relate in some situations with anthro- food crisis-prone areas. However, this pometric indicators but not in others. should not be interpreted as rendering That such correlations may vary even the concept and much of present practice within the same area was shown by the of little use. results of a study in Kerala, India, where There was much interest in the Scor- there was little relationship between ing System used by MSF-Belgium in stunting and income in areas which were Chad. Nine indicators had been selected poorly served by water and electricity and weighted on the basis of their ability provision, but a stronger correlation was to predict a nutritional decline. Mobile apparent in areas which were better teams touring the country gave a score 10 served by such services. each indicator. The total of the scores was Another conclusion was the recogni- then used by the Government to set the tion that the search for a single indicator level and type of intervention by agencies which will tell us everything we want to in different areas of the country (Autier, know is futile. Each indicator can tell us a 1988). This was seen as having been the little about complex processes, but single first attempt at weighting different socio- indicators capable of summarising pro-

D1SASTERS VOLUME 13 NUMBER 1 cesses in different areas simply do not lying processes was usually available. exist. Chen's work in Bangladesh has One view was that situations in which shown that the best predictor of mortality little was known are in fact rare. Informa- is the floor area of the home. In another tion does exist on different areas, but may country with different living conditions be difficult to obtain because it is spread and a different disease spectrum this across several different disciplines such as indicator may have only limited predictive anthropology, geography, agricultural power (Chen, 1980). Of all the socio- economics, politics, tropical medicine and economic indicators examined in cross- nutrition. The need, according to this country comparisons, female literacy view, was for agencies to go to greater always gives the best correlation with the lengths to ensure that personnel are nutritional status of children. aware of all the available information Though the MSF-Belgium Scoring before departing on a new assignment, System had been developed by staff with The "excuse" of time pressure for this not a good knowledge of the country, it was happening more often was frequently not suggested that the values attached to each valid . It should be possible for agencies to indicator were possibly more a reflection anticipate areas where emergency pro- of the opinions and value statements of grammes are likely to be implemented these staff, than of an underpinning body several weeks ahead of additional staff of theory on such matters as the relation- being sent. ship between household migration and An alternative view, shared by many food intake. The need for further work to participants, was that most of the know- develop this theory was agreed. Again it ledge available to agencies is obtained was pointed out that by virtue of their from "normal" situations and may not be role and collection of data, NGOs had a relevant to understanding the abnormal key role to play in the development of conditions of a food crisis. Famines are this body of theory . the result of a collapse of the social and Whilst the problems of anthropo- economic systems in an area. As a corol- metric data were acknowledged, some lary, it was pointed out that the lack of participants pointed out that the collec- information and understanding is in part tion of socio-economic data was also a reflection of the failure of agendes to sometimes fraught with problems. Falsi- carry out more in-depth studies during fication of answers to questionnaires with the course of emergency operations. This the intention of obtaining more resources point was exemplified by the significant from an agency was not uncommon. Civil contribution made to our understanding conflict is often a major contributory of the underlying social and economic cause of famines, yet in such situations it processes in Darfur, by a social anthro- was often not possible to obtain reliable pologist employed by SCF during 1985-86 information on the size of households (de Waal, 1987) . However, this was because the presence of men of recruit- acknowledged to be something of an able age was concealed. exception. It was agreed that the important and increasing "front-line " role of NGOs in relief operations carried with it Knowledge of Underlying Processes an obligation to study the situations in- Operating During Food Crises and Type depth and to share such studies as widely of Survey Procedure as possible. It was suggested that, There were different views over the because of their access in situations which extent to which information on the under- were politically sensitive and physically

DISASTERS VOLUME 13 NUMBER 1 difficult , NGOs were better placed to fill ceived need for Supplementary Feeding important gaps in understanding such Programmes. This need, together with situations. the availability of limited quantities of The Overview Paper defined three European Community (EC) food aid in broad categories of survey procedure for Darfur as a result of the EC Airbridge differentiating need between areas and Operation, led to MSF-Holland imple- populations. These were: menting a highly targeted wet-feeding programme in North Darfur. - the use of anthropometric survey data In the Red Sea Province, Sudan, in conjunction with qualitative/anecdotal OXFAM invested substantial effort and socio-economic information; resources into surveys which were used - reliance on quantitative socio-economic to recommend ration levels for each data collected by some form of objective village to the World Food Programme sampling procedure; (WFP), who were responsible for supply- - a systematically conducted subjective ing food to the affected population. For a assessment using a panel of socio- number of reasons distribution schedules economic and nutritional/health indi- were frequently not met and in any given cators. period actual deliveries to the villages were significantly below the recommended ROLE OF THE DONORS levels.

The influence of donors was a recurring T theme throughout the workshop as they ype of Assistance provide the resource being targeted by Aid donors, both bilateral and multi- the NGOs. lateral, were frequently perceived as not sufficiently prepared to provide resources Logistics other than food aid in response to emergencies. This restriction therefore ties The capacity and performance of the agencies into programmes which may not logistics system in providing food sup- be appropriate or cost-effective . A topical plies was seen as having a crucial instance was described by an agency influence on the design and effectiveness working in southern Sudan. Here the of the intervention, and therefore on the readiness of donors to provide food aid targeting methods that could be contrasted with the view of the affected employed . Experience in Sudan provided population that their priority require- a number of examples. For instance, the ments were for cattle vaccines and poor performance of the bulk logistics improved health care . The two main system from Port Sudan to Darfur during factors contributing to this situation were 1985 had a number of effects on targeting seen as being: methods. When combined with political pressures from the local government and - food aid is a more readily available rne iooA shortages laced by wbaYi popula- resource due to surp\us iood productions, SCF was obliged to give y high tion in many donor countries; priority to urban populations in its distri- - the widely held view, among the butions during that year. The general public and donor agencies, inadequacies of the General Feeding that food aid is the most appropriate Programme in Darfur contributed to a form of response to an emergency decline in nutritional status and the per- where famine threatens.

DISASTERS VOLUME 13 NUMBER 1 The famine in northern Ethiopia pometric data for programming and during 1984-85 was considered by several targeting purposes than is justified by participants as an atypical famine in terms either the quality of that data or the ability of its scale, severity and form. Most of such data to accurately differentiate "famines" were not of this "classic" type, "need" between areas and populations. in that interventions usually began at an Several participants explained how their earlier stage, when at least some food was decision to invest scarce resources in still available for those who could afford undertaking anthropometric surveys it. Excess mortality therefore tends to during emergency programmes had been occur in pockets of affected areas and is strongly influenced by the attitude of the the result of a complex array of factors donors towards this type of data. that are not all related to household food Donor organisations, it was recog- availability . Ideally free food distributions nised, are by nature risk-averse institu- should form only one component of tions, and it was thought that this has a intervention strategies in most "famines". significant bearing on their information Signs that some donors are beginning requirements. The practice of using socio- to adopt more flexible responses, for economic indicators for targeting pur- example by providing cash for employ- poses is comparatively recent and the ment creation schemes and de-stocking conventional wisdom among donor schemes, were welcomed. Nevertheless, officials continues to be that anthropo- it was felt that NGOs still needed to metric data are the best proxy indicators educate donors away from the notion that of risk of mortality in food crisis situa- free food distributions should be the sole tions. Given the substantial level of response model for all "famines". The resources that bureaucrats may be asked importance of public opinion in shaping to mobilise in response to a food crisis donor response strategies, and possibly in there is bound to be resistance to newer restraining moves away from strategies and less generally accepted concepts and based on free food distributions, was methods. recognised. NGOs would therefore have One reason why donors prefer to include the public in their educational anthropometric data is that they are efforts. obliged to make programming choices However, more than one participant between countries and relief operations. saw a fundamental conflict between such Anthropometric indicators appear to pro- efforts and the present role and funding vide a credible quantitative basis for basis of relief agencies. Many agencies comparison. Inter-country comparisons of now derive a substantial part of their socio-economic indicators are inherently funds from the "well oiled machine" of more problematic because they are so the response system, which regularly situation-specific and in many cases diffi- . presents an image of crisis and social cult to quantify. collapse in which outsiders are required Examination of the targeting system to step-in, distributing commodities to the used by SCF in Darfur during 1986 destitute and starving. suggested that donor preference may indeed not be restricted to anthropometric data, but take account of any Information Requirements of Donors information which can be quantified and A recurrent theme of the workshop was so appear "scientifically respectable". The that donors are perceived to accord SCF system did not involve the collection invariably far greater weight to anthro- of anthropometric data, though such data

DISASTERS VOLUME 13 NUMBER 1 were available for randomly selected approach (involving a programme of sample sites throughout the region, as the public meetings in all villages), the agency result of surveys by combined Oxfam/ was sensitive to these differences in UNICEF/Ministry of Health teams. Instead perceptions and Oxfam field staff saw there was a significant investment by SCF themselves as an information channel and in Household Surveys which quantified intermediary between the two. Consider- socio-economic resources at household able effort was put into explaining the level. programme and planning decisions to the In practice many of the targeting affected population, and representing decisions in Darfur were taken less on the their views to WFP, who were providing basis of results from the Household the resources. Another innovative feature Survey than subjective information pro- of this programme was the setting up of a vided through the network of Field Complaints Desk (also referred to as the Officers based in each Area Council. "Sheik Desk") in the Oxfam office in Port Preliminary findings of an anthropologist Sudan to which, in theory, anyone could working in the area were also valuable in come to discuss the operation of the gaining insights into the social and econ- programme. omic processes operating within the area. There was agreement on the need to Due to data management problems much involve the affected population more in of the data from the Household Surveys the design of the programmes, but there were not processed until the end of the was not always agreement on how this programme. Nevertheless the initial could best be done. Calls for more results of the Household Surveys were responsibility to be given to "the people" used as the basis of presentations to were countered with examples of social donors in Khartoum and were invariably differentiation and questions about who accepted without questions being raised "the people" were. This led to discussion about data quality or alternative ways of about which groups or individuals could interpreting the results. be taken as representative of the affected population. One participant felt there was a need to differentiate between the TAKING ACCOUNT OF THE PERCEPTIONS "affected population" and the recipient OF THE AFFECTED POPULATION group, which in many programmes was a The different perceptions of the affected subset of the whole population in an area. population's need held by governments, Through their Supplementary Feeding donors, NGOs and the people themselves Programmes many agencies dealt primar- was a recurring theme during the work- ily with mothers and children and there shop. The mismatch cited earlier between were significant difficulties in organising the priority needs as perceived by the channels for representing this group. For Dinka in southern Sudan and what the an agency to operate as an agent of social donors were most readily prepared to change and institution builder was per- give was a classic example. The role of fectly acceptable but this depended very Oxfam in Red Sea Province provided food much on the agency's time frame. Some for thought. The agency had been res- felt it was simply not possible to consider ponsible for monitoring the distributions or address these issues when an agency of food by WFP and for recommending arrived at a late stage of a crisis. ration levels for different areas. By virtue It was felt that government officials, of its intermediate position between the even those at the Provincial or District affected population and the donor and its level, should not automatically be relied

DISASTERS VOLUME 13 NUMBER 1 upon to be representative of the affected One of the working groups addressed population. Because of the impossibility the question "How can the perceptions of of carrying out detailed surveys of need the affected population be better drawn over whole regions, several agencies had upon in programme design?" As its start- used local government officials to direct ing point it took the not uncommon them to the "worst affected" areas before scenario of an agency team arriving in an carrying out local surveys. The extent to area and rapidly having to assess the which local government officials could be situation and design an intervention. relied upon in this role was apparently Pressure of time usually means that it is not supported by the experience of not possible to carry out surveys designed CAFOD/SUDANAID in En Nahud Area to draw out the perceptions of the Council in Kordofan. The last Rural affected population. However, a number Council to be included in the Supplemen- of ways were suggested in which these tary Feeding Programme revealed the perceptions could be obtained: highest rates of malnutrition. The poor awareness of the severe problems in that - anthropometric or socio-economic sur- Rural Council may simply have been due veys carried out in the area should to its distance from, and poor representa- involve an explicit attempt to seek out tion in, the Area Council administrative and interview the most resource-poor offices in En Nahud town. households; The scope for communities to carry - including an anthropologist on the out their own targeting by selecting assessment team or, failing this, desig- "needy" families from within the com- nating a member of the team familiar munity was discussed. This approach was with the local language to be specific- seen to be problematic, as it lays those ally responsible for obtaining a sense of responsible for the selection open to the population's perceptions; tremendous social pressures and may - using local staff wherever possible and skew distributions to those able to wield ensuring that their knowledge was fully greater pressure. Furthermore, it raises utilised; difficult issues over differences in percep- - guarding against an over-reliance on tions of "need" between agencies and the officials and, where relevant, staff of affected population. In southern Ethiopia the implementing partner agency; Norwegian Church Aid ran a trial in - trying to consult people from as many which the elders of a community had different sections of the community as been asked to select those in need. A possible and double checking what is weight-for-height survey was then carried said; out of all children under five years and it - being aware of the strong possibility was found that only 50% of those who that the worst affected members of the were malnourished (i.e. less than 80% population will be "invisible". weight-for-height) had been selected by the elders. The proportion was even less The scope for using local staff as a for the severely malnourished, only 30% channel for representing the views of the of those below 70% weight-for-height affected population was stressed. Local- having been selected. Whilst Norwegian isation of as many decision-taking posi- Church Aid continues to use "community tions as possible was seen as crucial. The selection" in the area, this is always done earlier an agency could become involved in conjunction with anthropometric in an area, the more opportunities it surveys. would have to interact with the affected

DISASTERS VOLUME 13 NUMBER 1 population. It was suggested that there There may be an incentive for some were two ways in which the perceptions agencies to operate these high profile of the affected population could be looked programmes as a result of their fund at . First, the way their perceptions raising potential. affected programme implementation and, The issue of the appropriateness of secondly, ways in which the local popula- Supplementary Feeding Programmes tion could be integrated into structures where General Feeding Programmes are deciding the programme design and poorly operated or completely absent was allocation of relief food. addressed. One view was that Supple- mentary Feeding Programmes should ISSUES IN THE CHOICE OF PROGRAMME never be considered in such situations and that NGOs would do better to lobby for more effective General Feeding Pro- Supplementary Feeding Programmes grammes. By setting up Supplementary One session focussed on the appropriate- Feeding Programmes some pressure is ness of Supplementary Feeding Pro- taken off donors and governments to grammes as a response to food crises. A provide effective General Feeding Pro- key issue is the relative cost-effectiveness grammes. Furthermore, if the General of Supplementary and General Feeding Feeding Programme is inadequate then Programmes. Supplementary Feeding there is little practical or ethical reason for Programmes, especially wet-feeding pro- operating a Supplementary Feeding Pro- grammes, are extremely resource- gramme which will have to readmit intensive and in many situations have not children soon after discharge from the achieved the results desired. For example, programme. The opposing view was that although nutritional impact evaluation in some situations adequate General was recognised to be problematic, the Feeding Programmes may be impossible experiences of Norwegian Church Aid to implement for non-political reasons. and the International Committee of the For example, for MSF-Holland in Somalia Red Cross (ICRC) in Ethiopia showed that the problem was one of bulk logistics. In intensive wet-feeding programmes for such situations agencies may not feel able severely malnourished children, had on humanitarian grounds to stand back limited nutritional benefits. The view was and refuse assistance. It would make expressed that in terms of the numbers more sense simultaneously to operate involved, more mortalities occur in the Supplementary Feeding Programmes and large group of moderately malnourished lobby donors and governments for a more children than the smaller group of effective General Feeding Programme. It severely malnourished, and that it might is also unlikely that some of the smaller be more appropriate for programmes to agencies would be heard unless they be targeted on the moderately mal- joined together and presented a united nourished. The opportunity cost of wet- lobby. feeding programmes is often so high that A second working group attempted to some more the tar^etin^ of other numer- define the circumstances in which Supple- ous group may be warranted. More rigor- mentary Feeding Programmes might be ous information is needed to clarify this appropriate in more detail. issue. However, it was also recognised The working group concluded that that there will always be support for when a food needs assessment identified programmes that attempt to save the lives a need, General Feeding should always of the most seriously affected individuals. have priority and that Supplementary

DISASTERS VOLUME 13 NUMBER 1 Feeding Programmes were only accept- some form of Supplementary Feeding able under certain conditions, for example Programme has been carried out and may where the number of kwashiokor cases be appropriate in the future: were high; where the agency did not have sufficient resources to implement a - When there is need to establish family General Feeding Programme; or where food security if the general ration is not there was concerted political pressure for appropriate for some groups in the the implementation of a Supplementary family. This might be thought of as Feeding Programme. complementary feeding. The working group attempted to - When there is a need to prevent deter- define those situations where different ioration of nutritional status of vulner- types of Supplementary Feeding Pro- able groups. gramme might be more appropriate. Two - When there is a need to set up a types of Supplementary Feeding Pro- curative programmes to assist large gramme were identified: numbers of malnourished children. - Where there is no General Feeding - Supplementary feeding of an entire Programme and only limited resources population if their ration or diet was for a Supplementary Feeding Pro- inadequate; gramme, so that decisions need to be - Supplementary feeding of vulnerable taken about who to feed, carry out groups within a target population if triage programmes. their ration or diet was inadequate . While it may be possible to establish Wet on-site feeding or dry take-home broad guidelines, the actual decision is rations could be considered for either type often influenced by a number of external of programme. Commonly cited advan- factors, such as logistics, which are tages and disadvantages of each type of beyond the agency's control. Thus if programme were identified. For example, agencies wanted to commit themselves to dry ration programmes are known to drawing up clear guidelines, based on the incur less expense but allow little control premise that Supplementary Feeding Pro- over the use of the ration at home. Wet grammes are only useful in very specific rations were acknowledged to be better circumstances, then problems of inappro- targeted to those in need, but to be cost priate emergency "food baskets" and and personnel intensive while excluding tardy donor responses would need to be the family from certain responsibilities. tackled. For example, emergency food aid It was felt that it is usually possible to supplies do not provide sufficient quanti- define firm criteria for the establishment ties of foods appropriate for weaning-age of Supplementary Feeding Programmes children. This reflects a genuine shortage for refugee populations. However, it is far of these commodities and dependence on harder to draw up guidelines for non- one or two donors. Finally, the working refugee populations. Many more variables group concluded that most Supplemen- would have to be taken into account, tary Feeding Programmes should have a including the stage of the emergency measles vaccination and vitamin A distri- when the agency becomes involved and bution component. the context of the emergency, such as Subsequent discussion focussed on geographical constraints and political defining the circumstances in which wet climate. Taking account of these variables, or dry feeding might be appropriate. four situations were identified where Some participants felt that wet feeding

DISASTERS VOLUME 13 NUMBER 1 had only very limited use, two reasons for such a regime, providing there were no this being: complicating factors. When children on therapeutic feeding were examined it was - there is recent evidence from relief found that many had underlying disease programmes to show that mothers or social problems that would have reduce a child's food intake at home if existed normally but were exacerbated by the child is seen to be fed at a centre; the emergency . - wet feeding takes the control and care The most appropriate way to deal of the child away from the family. It with situations where there were large was suggested that wet-feeding might numbers of kwashiokor and/or marasmk only be appropriate in certain very cases received lengthy discussion . It was limited circumstances. One example eventually agreed that kwashiorkor cases was a conflict situation where the would have to receive therapeutic feeding government or forces controlling an but that marasmic children could receive a area would not allow a dry ration dry supplementary ration . distribution for fear that the food would leak to opposing forces. A number of participants cited their own ISSUES IN THE EVALUATION OF experience of this type of situation. TARGETING METHODS Another example was in refugee The overview paper stressed that agencies camps where large numbers of new should evaluate their emergency pro- arrivals were physically and emotion- grammes more often. This would enable ally distressed and where there were some of the operating assumptions to shortages of fuel and water. In this be tested and subsequent practice to be type of situation a wet general ration improved. Several examples arose during might be appropriate. Even here the workshop where it was agreed that it though it was suggested that it might would have been valuable for the agency be better to provide such distressed to have evaluated a new technique. For populations with the means to prepare example there should have been an their own food, thereby allowing them assessment of MSF-Holland's practice of to retain some control over their cir- taking malnutrition rates in two villages cumstances. to be representative of a "conglomera- tion" of villages in Darfur, or problems It was suggested that where there encountered during the programme, such were large numbers of malnourished as the causes of the high drop-out rates children one approach might be to dis- encountered in some of the wet-feeding tribute a general ration with a dry supple- programmes. mentary component to all children under Evaluations of emergency programmes 80% weight-for-height, including the are difficult for many related reasons. severely malnourished. Therapeutic feed- Improvements in the nutritional status of ing would then be restricted to children the population may be due to a period of TOA. mvpTOvmg o\\ ^he

DISASTERS VOLUME 13 NUMBER 1 Programme where the recovery rates low cost in relation to the overall, far were very poor, even though the ration larger, expense of the various components being provided was 1,500 Kcal. A pro- of relief programmes. Such evaluation can posal by a nutritionist within the agency therefore be highly cost-effective. Further- for more detailed monitoring of the situa- more, as famines develop slowly, it tion was resisted by the nutritionist's should be possible to design and imple- superiors because it was suspected that ment evaluation components as part of a this would lead to the programme's relief programme. However, it was also closure. recognised that many agencies only Cost-effectiveness was recognised as a become involved in relief programmes at particularly poorly understood aspect of later stages of a famine when evaluation emergency programmes. Some of the may come into conflict with the opera- discussion of objectives within General tional requirements of urgently admin- Feeding Programmes and the wisdom of istering relief. implementing intensive feeding pro- The working group emphasised the grammes made implicit assumptions need to involve national counterparts and about cost-effectiveness considerations institutions actively in the process of which have never been studied. continual evaluation. While recognising A third working group studied the that some of the evaluation topics and question: "What aspects of targeting components may best be undertaken by should be evaluated as a matter of course the organisation itself , others may be before, during and after emergency pro- more suitably evaluated by outside grammes?" in more depth. research groups given the operational There was agreement on the overall demands on agency staff. However, it is need for evaluation of relief programmes. important that such research groups are But, it was recognised that organisations conversant with the operational con- have their own characteristics and back- straints on user agencies so that the ground so that it may be difficult to practical needs of agencies can be impose uniform evaluation procedures. addressed in conducting evaluations. The Methods of evaluation would therefore development of closer links between relief need to be adapted to account for the organisations and research communities objectives of the organisation and pro- may therefore be appropriate. grammes. A number of key subjects for evalua- An unresolved issue was whether tion were identified by the working impact evaluation should include groups group. These included: or areas not targeted in the relief programme, in order to provide baseline information and to assess the overall - Quantitative and qualitative aspects of impact of the programme in relation to socio-economic variables, e.g. the quan- the wider community. titative variation of certain types of It was felt that there are a number of indicator within defined areas or popu- routine management information com- lation groups. ponents within agency relief programmes - The appropriateness, and in some cases that need to be formalised in such a way cost-effectiveness, of different levels of that internal evaluation procedures for targeting. For example, the disadvan- these components becomes routinised tages and advantages of targeting and institutionalised. These evaluation within defined populations rather than procedures must be seen in terms of their feeding all members of that population

DISASTERS VOLUME 13 NUMBER 1 (intra-village versus inter-village target- ISSUES FOR FURTHER CONSIDERATION ing) . - The reliability of data and information Suggestions were made for possible collected from local information follow-up/further research on targeting sources, e.g. needy areas identified by related issues. There was widespread local officials . Does this information support for the proposal to repeat the reflect actual need for food relief or workshop at a country level, thus involv- political/cultural perceptions of need ing country-level NGO staff and indigen- which external agencies may see as an ous agenices in a review of targeting inaccurate reflection of need? experiences. As many case studies related - What happened to families who to programmes implemented in Sudan it received no food? was felt logical to aim to hold the first of - What were the long term effects of the such workshops there. Additional case food emergency especially in relation to studies should be compiled for future vulnerability to subsequent food emer- workshops on both indigenous NGOs' gencies? experiences and more recent experiences since the period 1984-86. A recurring theme was for the need Discussion centred around the use of for more detailed investigation into the non-target groups as control groups for relationship between anthropometric and evaluation. Some participants felt that it socio-economic data. Therefore, the was very important to have control proposal to analyse existing data sets, groups. Others suggested that it was held by some of the participating unlikely that control groups and local agencies, where there was an overlap in survey teams would participate readily in the areas surveyed, was welcomed. information gathering if there were no It was generally felt that the work- tangible relief benefits. Examples were shop provided a valuable opportunity for cited of sophisticated information systems the exchange of ideas and experiences. collapsing as soon as relief programmes The method followed during the targeting ended. This was contrasted with situations study (ie. of independent researchers where information is regularly collected drawing together case study material and without short-term benefits for the pro- then hosting a small, informal workshop) viders of information, e.g. household was seen as a particularly useful budget surveys . approach, enabling NGOs to review their It was suggested that investigation experiences together. Pressure of time on should be pursued in areas where infor- agency staff and a certain reluctance to mation is provided on an apparently share experiences on a formal basis meant selfless basis. Tigray and Eritrea were that such a method offered real benefits. suggested as possible areas, as data Thus, it may be useful to consider the collection is an integral part of administra- possibility of examining other issues of 5 tion within each community and informa- agency practice using such an approach. tion is subject to verification from a number of different levels. The inference to be drawn was that administrative and NOTES political structures may be important 1. Prepared as part of a joint study by the factors in determining the success of Relief and Development Institute and the information systems which aim to use London School of Hygiene and Tropical control groups. Medicine.

DISASTERS VOLUME 13 NUMBER 1 indicators measure the 2. Anthropometric REFERENCES growth performance of children and com- pares this to international standards, and Autier, P. (1988) Nutrition assessment through uses this as a proxy indicator for a number the use of a nutritional scoring system. of factors including food intake and there- Disasters 12(1), 70-80. fore the level of malnutrition. Chen el al. (1980) Anthropometric assessment 3. For further information on the Nabarro of energy protein malnutrition and subse- Chart, see reports compiled by Nabarro et quent risk of dying among pre-school age al., 1982-84. children. American Journal of Clinical Nutri- 4. For the benefit of those unfamiliar with the tion 33, 1836-1845. concept of socio-economic indicators a De Waal, A. (1987) Famine that Kills. Save the definition is offered here. Socio-economic Children, London. indicators attempt to define the degree of Nabarro, D., Verney, J. and Wijga, A. stress being experienced by a population by (1982-84) SCF-LSHTM weight-for-height chart measuring the economic and social circum- project. Evaluation Report No. 3, SCF, stances and changes in these circumstances London. as the population responds to the stress. Shoham J. and Borton J. (1989) Overview 5. Participants made a number of constructive Paper on the methods used by NGOs in the suggestions on the structuring of such targeting of emergency food aid. Paper workshops. They are included here as they presented to the Workshop on Emergency may be of use to others involved in running Food Aid Targeting, London, 4-6th January similar workshops. By presenting fewer 1989. case studies longer periods would have Soeters, R. (1988) Pitfalls with weight-for- been available for discussion. More time height measurements in surveys of acute should have been allowed for Working malnutrition. Tropical Doctor 16(4), 174-176. Groups. Participants should be encouraged to study all the case studies before the Workshop, possibly by making attendance conditional upon the response to a questionnaire on the material. One agency representative felt that the occasions on which John Borton and Jeremy Shoham agency personnel came together in such an informal group were so infrequent that an Relief and Development Institute additional day could have been added to 1 Ferdinand Place the schedule, and participants allowed to London select topics for discussion unrelated to the NW1 SEE, UK subject of the workshop.

DISASTERS VOLUME 13 NUMBER 1 Seminar on Bangladesh Floods: Regional and Global Environmental Perspectives, Dhaka, 4-7 March 1989

Traumatized by the devastating floods Technical recommendations emerging which struck the country in 1987 and from these groups were overshadowed by 1988, the Government of Bangladesh the organising committee's presentation brought together about 25 international at the closing session of a "Dhaka Dec- and 100 Bangladeshi scientists for a laration" for consensual acceptance . The seminar to discuss global, regional and bottom line of this declaration was a local aspects of the floods which regularly resolution to set up an International disrupt economic life in Bangladesh. The Institute of Environmental Studies and seminar, held in Bangladesh's new Inter- Disaster Management in Dhaka under the national Conference Centre in Dhaka, patronage of the President of Bangladesh was inaugurated by the President of and with an advisory panel of 23 inter- Bangladesh. Mr Kazi Zafar Ahmed, national and Bangladeshi scientists. Since Deputy Prime Minister and Political the foreign scientists invited to the Adviser to the President, was Chairman seminar were present as individuals, not of the Seminar Organising Committee. as official representatives of their govern- Fifty technical papers were presented ments or international agencies, the estab- in two-and-a-half days of discussions lishment of such an international institute which were organised within five groups: will probably take some time.

1. Permanent flood control and management. 2. Floods: socio-economic and legal aspects. H. Brammer 3. Living with floods: the need for disaster 37 Kingsway Court management. First Avenue, 4. Geomorphological processes leading to Hove, floods. E. Sussex 5. Anthropogenic perturbations of the environment and the greenhouse effect.

DISASTERS VOLUME 13 NUMBER 1 International Conference on the Greenhouse Effect and Coastal Areas of Bangladesh

Concerned by alarmist statements about about 1cm a year, but receiving annually an impending rise in sea-level of l-3m around 2 billion tons of river alluvium which would submerge one third of which apparently balances this subsi- Bangladesh, the Coastal Area Resource dence. Probably, tidal sedimentation Development and Management Associa- would continue to raise coastal areas tion (CARDMA) organised a one-day concurrently with a rising sea-level, and seminar in Dhaka on 5 March 1989 to sedimentation during annual floods review the state of "greenhouse" know- would continue to raise river levees. The ledge and possible implications for areas which might suffer most seriously Bangladesh. CARDMA is a voluntary would be interior Hoodplain areas (and association of 13 Bangladeshi Members of coastal polders protected from tidal flood- Parliament with coastal constituencies, ing) where seasonal flooding is by supported by a panel of technical experts. ponded rainwater, not silty river or tidal The seminar was opened by the President water. Pump drainage or warping (flood- of Bangladesh, and the two technical ing with silty water) would be needed to sessions were chaired respectively by the counter such adverse effects of a rising Ministers of Finance and Planning. Four sea-level. Environmental impact study foreign and six Bangladeshi scientists sites need to be established to measure presented technical papers. and assess possible changes. The seminar should do much to allay No formal recommendations were public fears concerning the impact of a made at the end of the seminar, but it was rising sea-level on Bangladesh's coastal arranged that CARDMA's panel of areas. The latest predictions of a global experts would prepare an action plan sea-level rise are of only 15-30 cm by based on information and recommenda- 2030. More worrying for Bangladesh are tions presented during the seminar; (a predictions that global warming might report on CARDMA's first conference to increase the frequency of tropical cyclones prepare an environmental action pro- and storm surges in the Bay of Bengal, gramme for the coastal areas is under- and might increase monsoon rainfall (by stood to be in the process of publication). 5- 100 per cent in different projections) and so increase the frequency and severity of river floods which already plague H. Brammer Bangladesh. 37 Kingway Court, The effects of a rising sea-level on First Avenue, Bangladesh are difficult to predict. The Hove, Ganges-Brahmaputra-Meghna delta is E. Sussex. dynamic; subsiding near the coast by

DISASTERS VOLUME 13 NUMBER 1 FORTHCOMING EVENTS

PASTORAL ECONOMIES IN AFRICA AND a consideration of some of the issues LONG-TERM RESPONSES TO DROUGHT involved in understanding drought in pastoralist Africa and in devising long- term strategies. In particular, do drought Colloquium at the University of Aberdeen problems in Africa have a special character in April 1990 because they are in Africa: does the continent's geography and its historical Aberdeen has long had a special interest experience create a unique context neces- in the problems of pastoral economies in sitating particular kinds of longer-term Africa as a result of the work of animal responses? scientists and research organisations con- The Group would welcome offers of cerned with nutrition. The African Studies papers for delivery at the Colloquium Group at Aberdeen proposes to organise and subsequent publication. Specifically, its next Colloquium in April 1990 around it would welcome case studies of responses the question of long-term responses to by outside agencies or by the pastoralists drought in African pastoralist societies or themselves to drought. The Group also in- in mixed economies with a significant vites discussions of problems of implemen- element of pastoralism. tation in Africa , as well as the dilemmas The Group would expect to base the inherent in discerning the nature of the Colloquium on discussion of research on problems. For further information, please pastoral areas of Africa (in either the contact Jeffrey Stone, Secretary, Aberdeen recent or the more remote past). The University African Studies Group, L.10 intention is to draw participants from Link Block, Taylor Building, King's different backgrounds and disciplines into College, Aberdeen AB9 2UB, U.K.

DISASTERS VOLUME 13 NUMBER 1 BOOK REVIEWS

Coping with Uncertainty in Food Supply, hunter-gatherers of northeastern Zaire; de edited by I. de Garine and G.A. Harrison Garine and Koppert on the Massa and Oxford Scientific Publications, Clarendon Mussey of Chad and Cameroon; and Press, Oxford, 1988, pp.xiv, 483, price £50 Little, Galvin and Leslie on the Turkana of northern Kenya). Several chapters, This handsomely produced book is the on the other hand, demonstrate that result of a conference held in Bad the institutionalisation of hunger - of Homburg, Germany, in December 1982, permanent food insecurity - is a pheno- under the auspices of the Werner- menon of the 'modern' world. Watts, for Reimers-Stiftung and the Maison des example, in an intricate and theoretically Sciences de 1'Homme and organised by most important study of food insecurity the Commission on the Anthropology among Hausa peasants, shows how of Food of the International Union household and community vulnerability of Anthropological and Ethnological to famine is associated with the historic- Sciences. Practically all the 20 contribu- ally 'uneven' development of the market. tions deal with the certainty of seasonal Three papers on Indian groups (Malhotra fluctuations in food supply in small-scale and Gadgil on pastoral and non-pastoral traditional societies, living at subsistence nomads of Maharashtra; Pingle on level. various populations of central India; and The first three chapters (Hiadik, Bharati and Basu on villages in western Harrison and Stini) deal with biological Bengal) provide eloquent and telling testi- and evolutionary aspects of seasonal mony of the disastrous impact economic variations in food supply. It is clear that 'development' can have on the food adaptation to such variations has had security of rural people in the Third important physiological consequences for World. While Marshall Sahlins' character- human populations, which raises the isation of hunter-gatherers as the "original possibility that "loss of this adaptation affluent society" may be too extreme, his . . .° may not be a progress in human general, depressing point that "Now , in evolution" (p. 23), There is plenty of the time of the greatest technical power, evidence in the case studies which follow starvation is an institution . . . the that seasonal variations are not, in them- amount of hunger increases relatively and selves, a threat to survival (e.g. Wilmsen absolutely with the evolution of culture" and Durham on !Kung San foragers (Stone Age Economics, Tavistock Publica- in northwestern Botswana; Bailey and tions, 1974, p. 36) finds strong empirical Peacock on the Efe, tropical rainforest support in these pages.

DISASTERS VOLUME 13 NUMBER 1 Despite the strong (and understand- successfully in their discussion of 'com- able) biological and ecological emphasis mon issues' in the final chapter. This is that runs through the book, social and the kind of book which only a reviewer is cultural anthropologists will be pleased to likely to read all the way through and any find that the symbolic importance of food review of which is bound to be highly and customary diet is not ignored. selective. I hope this one has conveyed Freeman's chapter on the Inuit of Canada, something of its riches and its potential Alaska and Greenland is an elegant importance in helping to identify areas for demonstration of the importance of tradi- future research and (dare one hope?) tional foods and customs associated with political action. their procurement, sharing and consumption, in shaping political identity: "[Though] I have learned more of the David Turton white man's ways ... I am still Inuk Dept. of Social Anthropology because I grew up on Inuk food" (p. 166). Faculty of Economics and Social In teasing out the complex relations Studies between the Oto and Twa of the Lake University of Manchester Tumba region of Zaire, Pegazy ives us g Manchester M13 9PL another example of how customary diet can function as an identity marker. Perhaps the best general demonstration that, even in the "serious matter" (as Wilmsen and Durham call it) of "getting food", human behaviour cannot be explained in terms of animal models, is Disabled Persons &• Earthquake Hazards, by provided by de Garine and Koppert. They Kathleen J. Tierney, William J. Petak and conclude that the Massa and Mussey aim, Harlan Hahn. Institute of Behavioural above all, to satisfy cultural demands for Science, University of Colorado, 1988. prestige "and then to reach an acceptable, but not optimal, nutritional comfort" This book was written in the light of re- (p. 253). search carried out by an interdisciplinary This is, as the editors admit, a "mixed team of researchers at the University of bag": an attempt to explore the biological Southern California, which has been ex- and social implications of food supply amining, since 1983, earthquake mitigation variations, without pre-judging the most and emergency response issues from the important issues and the most fruitful standpoint of members of the population lines of enquiry. The strengths and weak- with physical disabilities. The authors set nesses of the book follow from this. On out to discuss why physically disabled the one hand it conveniently brings persons in the population warrant special together some impressively detailed and emphasis in natural hazards research and methodologically rigorous descriptions of policy . It was felt that a policy is now food production, distribution and con- all the more important because whereas sumption in a wide range of economies disabled people were in the past very and environments. On the other hand, often residentially and institutionally seg- each of the contributions stands very regated, now they are more dispersed much by itself , a problem to which, throughout the community, living inde- inevitably, the editors respond only half pendent lives. There is not necessarily

DISASTERS VOLUME 13 NUMBER 1 someone immediately on hand to lend protective actions may not always reduce assistance in the event of an emergency . the risk of injury and, conversely, that the Very little has been written on this inability to move about during and im- subject. Perhaps this is not surprising mediately after earthquake impact may given the enormity of the calamity in not necessarily increase risk. It was dis- most earthquakes and the widespread covered, for instance, in an earthquake in devastation that can be caused, therefore Japan that produced damage and casual- making it difficult to single out the effects ties in several towns, that the more people of the disaster on particular groups of moved about during the shaking period, people. The authors, given the paucity of the more the chance of injury was in- information available, were not able to creased. The authors draw the conclusion, add very much. The data they had were therefore, that "the empirical evidence considerably limited and were based on does suggest that individuals with mobility studying 18 disabled people who had limitations do not necessarily face a higher been affected in the Coalinga (California) risk of injury during earthquake shaking event in 1983. than fully ambulatory persons, so long as However, their discussion on disasters they have some means of avoiding being generally and how these affect disabled hit by falling or moving objects." people provides useful insights into ways Nevertheless, the authors accepted, in which disabled people themselves can as a result of scrutinising epidemiologic be prepared to cope with disasters and studies, that disability is a risk factor emergencies, and how services can be when considering the effect of earthquake- made aware of any special needs of related injuries. It was not possible to say people with disabilities. Their reflections whether this was due to the limitation on disability generally and their analysis of imposed by disability or whether disabled the various models of disability - medical, people are more often found in environ- economic, and sociopolitical - provide in- ments that are inherently more hazardous sights which many researchers in the field - for example substandard buildings (as a of disability ignore. It is pointed out how result of their socioeconomic status), or difficult it is to generalise about response to whether as the result of a combination of earthquakes, given the very different de- factors . grees of disabling factors and how specific Having considered the special prob- disabilities hindered an individual person's lems that disabled people face in earth- reactions. For instance, the problems of quakes, a number of conclusions and hearing impair people when they cannot recommendations are made by the authors. hear fire alarms or understand spoken These are based on little empirical evidence warning messages and instructions. but rather more on intelligent observation The authors started their research and insights. assuming that people with disabilities This book serves a useful function in face a higher risk of injury in earthquakes examining the practical problems sur- because their physical limitations may rounding disabled people in the event of reduce their ability to carry out recom- disasters affecting the environment, in- mended self-protective actions. However, cluding earthquakes, and can be recom- it was interesting to note that recent mended on this score. However, in so far studies of building occupant behaviour as the book aims to concentrate on and earthquake-related injury suggest that earthquakes specifically, the long research attempting to take recommended self- undertaken seems to have uncovered

DISASTERS VOLUME 13 NUMBER 1 very little. Hopefully, the information that its crystals are tabular parallel to gathered together in this academic way {0001}? Such information is correct, but I will be used and interpreted in a practical doubt whether anyone who understood it way for the benefit of disabled people, would be looking for it in an encyclo- and will serve to mitigate the worst effects paedia. For the professional Earth Scien- of disasters - not only earthquakes. tist this book is interesting to browse through and useful for teaching. Much of the content is perhaps too geological for readers of Disasters, though articles on, Ann Dambrough for example. Earthquakes, Volcanoes, AHRTAG Plate Tectonics, and Soil are well-written 1 London Bridge Street and provide good introductions to sub- London SE1 9SG jects of interest to this journal. The content is restricted to that implied in its title (perhaps surprisingly in these days when most universities have departments McGraw-Hill Encyclopedia of the Geological of Earth Sciences rather than Geology), Sciences, Second Edition, Maidenhead, and there are no articles on, for example, 1988, pp. 722, Price £69.95 climate or oceanography. This imposed narrowness may be responsible for some This is a large and lavishly produced puzzling omissions: the word, "tsunami" book, with many illustrations (though for example, cannot be found in the index none in colour) and tables. Many, per- and is not discussed under earthquakes or haps half , of its 520 articles are necessary, seismology. All the articles list a brief though unexciting, entries on specific bibliography for further reading. The rocks or minerals: mercifully these tend to index is satisfactory if you already know be short. The rest are longer accounts of where you are likely to find something, particular subjects or disciplines, and are, but will be less easy to use for those who on the whole, well-written and sensibly find themselves turning to this encyclo- illustrated by people who are authorities paedia for help with a technical term or in their field. These set pieces are cer- expression that they cannot associate with tainly the strength of the book, but one a wider subject. can't help wondering who they were written for: they are generally at the Scientific American level but with occasional detailed technical information that seems inappropriate without more James Jackson space to explain it. What does one make, Bullard Laboratories for example, of the second-order differen- Madingley Rd. tial equation used to describe the behav- Cambridge iour of a seismometer, or of the fact that CB3 OEZ illmenite belongs to space group R3 and

DISASTERS VOLUME 13 NUMBER 1 LONDON SCHOOL OF HYGIENE & TROPICAL MEDICINE (University of London) MSc/Diploma in Human Nutrition

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