Three United Nations agencies urged donors to support an appeal for a full package of assistance to cut malnutrition rates at crisis levels among children under five in refugee camps in Kenya. They warned that a host of problems linked with persistently high malnutrition had to be tackled now to save lives.

The United Nations High Commissioner for Refugees (UNHCR), the UN World Food Programme (WFP), and the UN Children's Fund (UNICEF) appealed to donors for a total of US$32 million to improve care for refugee children and their mothers in the camps in Kenya's arid north.

A total of 237,000 refugees, mostly Somalis and Sudanese, live in camps at Dadaab and Kakuma. According to a recent survey, the acute malnutrition rate among children under five years of age stood at 22.2 percent in the Dadaab camps and 15.9 percent in the Kakuma camps. Rates above 15 percent signal an emergency.

Anaemia rates, in particular, are alarming. A nutrition survey sponsored by UNHCR and the German development agency GTZ in the Dadaab camps in June 2006 found rates of 78 percent among children under five, and 72.7 percent among women.

The UN agencies said the high rates of malnutrition persisted despite the fact that over the past two years WFP has provided 95 percent of the general food distribution ration for refugees to meet the recommended minimum energy requirement of 2,100 kilocalories per person per day.

They said a complete package of assistance is needed to overcome chronic shortages in essential commodities such as firewood, energy-saving stoves and soap to ensure that refugees are not compelled to sell their food to meet the need for these items. There is also an acute need for complementary foods such as groundnuts that provide extra nutrients, supplementary feeding for more children and therapeutic feeding to treat dangerously malnourished children.

The three agencies are also calling for better-staffed health facilities in the camps to help children constantly threatened by malaria and other diseases. Over the past year, cholera, measles, meningitis and Kenya's first cases of polio in 20 years have been recorded in the camps, further aggravating the fragile nutritional status of young children.

"The malnutrition crisis that we are witnessing in the refugee camps in Kenya is the cumulative effect of years of recurrent budgetary shortfalls. Year after year we are unable to fully meet refugees' needs for firewood, soap and other essential commodities. We must get to the core of the issue if we are to eradicate malnutrition in the camps," said UNHCR acting representative Eddie Gedalof.

Gedalof said severe budget constraints meant that refugees receive less than 15 percent of the firewood and less than half the quantity of soap they need. Water remains inadequate with refugees receiving on average only 19 litres of water per person per day instead of the 20 litre recommended minimum. Some families receive much less, leaving them even more vulnerable to disease.

The essential relief supplies and programmes will cost a total of US$32 million over the next 12 months. WFP requires US$24.3 million for mixed food commodities; UNHCR needs US$7.17 million to supply soap, cooking fuel, energy-saving stoves and complementary foods rich in micronutrients such as ground nuts. UNICEF needs US$589,948 to support the management of high acute malnutrition and tackle underlying causes that include poor infant-feeding and breast feeding practices.

The harsh environment in the arid North of Kenya and government policies ruling out farming, grazing or work outside the camps mean refugees are entirely dependent on aid. Renewed conflict has seen an influx of 40,000 refugees from Somalia since mid-2006.

"If refugees don't get firewood, or soap, they have to sell their general food rations to buy it," said WFP deputy country director Marian Read. "When there isn't enough food to go around, it's the children and women who suffer most. One in every five children under the age of five is so malnourished that they need special care, and some of them will die. This can't go on."

Read said there was a possibility of a new major influx of refugees if conflict in Somalia worsened. While WFP has a buffer stock of three months' supplies in the camps, delays in funding could erode that margin, leaving WFP less capable of responding to increased needs.

WFP rations consist of cereals, pulses such as peas or lentils to provide protein, vegetable oil, salt and nutritious corn-soya blend. Taken together they will provide a basic balanced diet. But that is impossible when rations are sold to buy non-food items, to pay for milling of whole grains, or to buy food that families prefer - such as meat, vegetables or wheat flour.

UNICEF Country Representative in Kenya Olivia Yambi, appealed for urgent support for the initative, warning that this time of year was associated with the highest risk of malnutrition.

"In the camps, malnutrition is associated with at least half the deaths of children under five," she said. "Even for those who recover, malnutrition curtails the entire development potential of these children. We are appealing for immediate help from donors so that as many children as possible can swiftly recover and grow up to lead healthy, productive lives."

wfp