An extremely high level of malnutrition is apparent in Ethiopia's Dollo Ado refugee camps, which continue to expand in response to the on-going crisis in the Horn of Africa.

Dollo Ado, Ethiopia:

Malnutrition and overcrowding remain a real cause for concern in Dollo Ado, a collection of refugee camps in south eastern Ethiopia. The four camps at Dollo Ado are already at capacity with a total polulation of 137,000. It is set to open a fifth camp this weekend, Bur Amino. Though yet unpublished, recent results from a survey conducted in both Kobe and Hilaweyn camps have revealed extremely high malnutrition rates that surpass the emergency threshold of 15%. The issue is complicated by the fact that there is actually a good supply of food available. The World Food Programme (WFP), who are facilitating the General Food Distribution in the camps are providing staples such as cereal, pulses, Corn Soya Blend (CSB), oil, salt and sugar with other NGOs supplying further complimentary foods.

With the Ethiopian government and Médecins Sans Frontières treating those diagnosed with severe acute malnutrition, the WFP aims to tackle those with moderate acute malnutrition. If the programme is followed correctly patients can recover within 60-90 days. The fulcrum around which the programme revolves consists of a premix made up of CSB plus, oil and sugar. Every week, this is given to the mother of each household to distribute to their family. It is a vital part of the recovery process and Giorgia Testolin, Head of Refugee Section for the WFP in Ethiopia, believes that with this already available there should not be such widespread malnutrition across the four camps in Dollo Ado and claims ‘there is something wrong at the household level of the consumption of food’. The precise problem is yet to emerge although it has been suggested that it could be do with the sale of some of the provisions refugees receive. Many sell some of the food they receive in order to purchase other food items and commodities both within the camps and the host communities. However, Testolin believes that the premix is not sold and that ‘we expect refugees to sell part of the food to buy what is not in the food basket provided by WFP. Such as milk, meat, tomatoes and vegetables. They cannot have a standard diet every day’.

The problem of malnutrition does not therefore seem to be merely economic but rather manifests itself in a misconception of the nutritional significance of things like the premix and Plumpynut, a peanut based paste. Testolin believes that it is vital the refugee community develop a greater understanding of the importance of the consumption of the premix but suggests that this will take time for ‘it’s a cultural and behavioural change that cannot be reached in a couple of months... If you don't understand that this food is the right food for you, because as a pastoralist you may be used to camel milk and meat and you don't have that food which you believe is the food which will improve the health of your child. It becomes very difficult for the messages [outlining the importance of things like the premix] to pass through to the mothers and fathers...a lot more needs to be done in a community based approach through outreach workers.’ An assessment is due to be undertaken by the WFP, the UN Refugee Agency (UNHCR) and the Administration for Refugees and Returnee Affairs (ARRA) in December this year to try and both pinpoint the problem and develop a more comprehensive solution.

Overcrowding is also a major issue in the camps in Dollo Ado. Over seven thousand refugees are awaiting relocation in the transit centre with the opening of Bur Amino having been delayed for almost a month and the four remaining camps already at full capacity. The delay has been put down to a number of different factors. Previously, when the fourth camp opened early there were numerous problems with sanitation and services. It is therefore vital that because of the recent rains and overcrowding which increase the probability of the spreading of disease, that the fifth camp is completely finished before those in the transit centre move in. Furthermore, the soil around the site is particularly difficult to excavate and with the torrential rainfall taking the airstrip out of service and blocking the roads into the camps, many of the tools needed have been difficult to co-ordinate. However, Bur Amino is due to open this weekend, which will be a welcome relief for thousands of individuals and families. This could not have come at a more important time, in light of the recent intervention in Somalia by the Kenyan military and the tightening of border controls between Kenya and Somalia. Whereas before many refugees have suggested that Al Shabaab had blocked the route to Ethiopia and directed them toward Kenya, now those looking to flee Somalia will focus on reaching Dollo Ado rather than Dadaab.