In 2008, Southern Ethiopia was the epicentre of a vast nutritional intervention: more than 100,000 malnourished children received assistance from a mix of actors including both international actors and local health facilities. Given the structural factors affecting levels of malnutrition in this part of Ethiopia, most humanitarian actors expected similar problems in 2009. Thus UNICEF ordered a few months ago enough RUTF (Ready-to-Use Therapeutic Food) to treat more than 100,000 patients suffering from acute malnutrition (a number equivalent to the 2008 operation).
Yet, so far this year, there has been little mention of malnutrition in the country outside a small circle of specialists: neither international media nor NGOs have raised a public alert about high levels of malnutrition in Ethiopia. While MSF teams treated more than 38,000 severely malnourished children last year, MSF nutritional activities in 2009 have been almost inexistent so far.
Did malnutrition disappear in Ethiopia somewhere between 2008 and 2009? Should we be pleased with the absence of nutritional emergency this year in Ethiopia? Or should we be asking what changes have arisen in Ethiopia since 2008?
It is unfortunately difficult to answer this last question. The Ethiopian government has erected a wall of silence by strictly controlling the production and diffusion of nutritional data. No information, no crisis. The authorities have authorized only a very restricted number of rapid nutritional assessments. Moreover, they did not renew the working agreement of three international NGOs in SNNPR, the epicentre of the malnutrition crisis in 2008. Rumour has it that, in desperation, there have been NGO volunteers disguised as 'tourists' visiting health centres in suspected malnutrition hotspots.
Is there a deliberately hidden crisis? Some believe than one year ahead of national elections, Ethiopian authorities want to avoid the problems of 2008 and are therefore seeking to exert tighter control on NGOs. It is very difficult however to affirm that the government is denying malnutrition. It has set up a national system for treating malnutrition that is probably one of the most elaborate in Africa. With the support of UNICEF, this network of health facilities claims to have treated more than 45,000 severely malnourished children between January 2009 and May 2009. There is no other African state than can claim such a high level of curative activity. Is this fact or a 'technological smokescreen' as stated by François Enten to describe the Ethiopian Food security system François ENTEN, Food Aid and The politics of Number in Ethiopia (2002-2004), Cahiers du CRASH, 2008?
The situation in Ethiopia is a reminder that, more than the actual nutritional status of the population, it is the production of numbers and the control of information that determine the emergence or disappearance of nutritional crises.
To cite this content :
Jean-Hervé Jézéquel, Missing : malnourished children in Ethiopia, 29 July 2009, URL : http://msf-crash.org/en/blog/medicine-and-public-health/missing-malnourished-children-ethiopia
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