On July 20, 2011, the United Nations took the drastic step of declaring parts of southern Somalia in famine. In so doing, it recognized that hundreds of thousands of people were at imminent risk of starving to death. As the crisis spread to more regions, the number of people in famine zones eventually reached 750,000. An estimated 13 million people were in critical need of food aid. Suddenly the Horn of Africa, a region seemingly so often in crisis, was in the global spotlight again. The world finally took notice of a dire situation.

In reality, the emergency in Somalia – and neighboring countries including Djibouti, Ethiopia and Kenya – had been long growing. Drought, a recurring phenomenon in this part of the world, has become increasingly devastating, due to factors including climate change, population pressures, new limits on access to water and pastureland, conflict, and poor or non-existent governance in some places. Six months later, the same number of people remain food insecure, in what remains the world’s worst humanitarian crisis.

The relief effort faces sobering new challenges, particularly in the area of security. Several national and international military forces are now involved in the conflict in southern Somalia. Escalating violence, suicide bombings, attacks on civilians, kidnappings and killings of aid workers, and the wholesale expulsion and looting of 16 U.N. agencies and other humanitarian groups by militants are leaving hundreds of thousands of desperate people without help, at a time of enormous need.

And yet we have made important progress. In the six months since the famine declaration, the situation has become marginally less critical. Today, “only” 250,000 Somalis remain in a famine situation, thanks to rapid humanitarian response and resumed rains in some areas. CARE and our partner agencies continue to scale up our emergency aid and longer-term efforts to help people become more resilient in the future. But the challenges remain huge, even as global attention has shifted elsewhere.

This will not be the last or the worst crisis of its kind. Traditionally, nomadic herders have responded to periodic drought by migrating to fresh sources of water and pasture. As climate change and environmental degradation continue their grim march, these age-old coping mechanisms are no longer sufficient. The only question is when, and how severe, the next drought will be. And the only solution is long-term adaptation.

The winds of change are blowing across the Horn of Africa, and its people critically need assistance adjusting to a new age.

CARE has scaled up our response in the worst affected countries. Currently we are reaching over 1.8 million people with crucial assistance including food, safe water, sanitation, health, education, livelihood assistance and protection for the most vulnerable people, including survivors of gender-based violence.

In addition to immediate relief, we support a number of long-term responses to the reality of recurrent drought – including innovative livelihood approaches to help vulnerable people earn a living in ways less dependent on the unpredictable rainfall.

Some examples of CARE’s most recent emergency operations, by country, include:

Djibouti

The most recent expansion of CARE’s response in the Horn of Africa is to Djibouti. This small country bordering Eritrea, Ethiopia and Somalia faces a disproportionate burden from the effects of drought, not just on its own people, but also due to the influx of refugees from neighboring countries. After six consecutive years of drought and erratic rainfall, more than 200,000 of Djibouti’s 800,000 people – two-thirds of whom already lived below the poverty line – are considered in need of humanitarian aid. The country has absorbed more than 22,000 refugees.

After conducting an assessment of the most critical needs, CARE determined that the best use of our resources is in Ali Addeh district, which hosts most newly arrived refugees but struggles with poor health, nutrition, hygiene and sanitation conditions.

Our approach, focused on refugee camps, will reach both refugees and host community members with health and nutrition services, including the opening of a health center with a target population of about 19,000.  The emergency response will focus on providing first aid, nutritional screening, vaccination, referral to secondary health care. As well, the activities will include ensuring access to safe water and improved hygiene practices.

CARE will pay special attention to the most vulnerable refugees and host communities affected, including women and children, and will provide psychosocial support to survivors of trauma and sexual violence. CARE’s intervention will have an emphasis on building local capacity, in order to ensure sustainability.

Ethiopia

As elsewhere in the region, CARE’s long-term objective in Ethiopia is to promote resilience in the face of future food emergencies. In the meantime, to meet immediate needs, we are continuing relief operations, reaching more than 709,000 people to date with interventions in four sectors: food assistance; water, sanitation and hygiene; nutrition; and support to livelihoods including agriculture and livestock rearing.

CARE’s emergency food distributions, in cooperation with the government and our humanitarian partners, are in their seventh round, reaching a total of about 450,000 people in Oromia Regional State, East Hararghe, West Hararghe and the Borana and Dewe zones of Afar region.

Other recent activities include:

Nutrition and Food

• In urgent cases of malnutrition, especially involving children, CARE supports emergency treatment through stabilization centers, outpatient therapeutic programs and supplementary feeding programs. Each month CARE reaches more than 3,800 individuals in East and West Hararghe and Borana with these lifesaving services.
• We distribute about 300 cartons of Plumpy’nut, a fortified peanut-based paste used as a frontline treatment for severe acute malnutrition, each month.

Water, Sanitation and Hygiene

• Each month, health education programs focusing on nutrition and hygiene in West Hararghe and Borana reach over 3,700 people.
• More than 2.3 million packets of water purifying chemicals were transported in late 2011 for delivery to East and West Hararghe.

 Livelihoods

• The three livelihoods projects run by CARE in Borana and East and West Hararghe zones of Oromia region had reached a total of 107,180 individuals as of December 13, 2011. Through these projects, CARE provided nearly 50,000 individuals with seed and planting materials, while the rest were assisted in maintaining the health of their animal herds by reducing herd sizes. Animals are slaughtered when they still have value, rather than waiting for them to starve, and when possible the meat is distributed to families. Herders receive cash compensation and feed for their remaining animals.

• In addition to direct food assistance, CARE is providing water purification and treatment products to pastoralist families and others, and supporting the construction or rehabilitation of water points and ponds.

Kenya

1. The Dadaab refugee camps

CARE distributes lifesaving aid, including food and water, to more than 460,000 refugees in the Dadaab camps in Kenya, the largest refugee site in the world.

The operating environment remains complex due to ongoing security concerns. In recent months escalating conflict between the Kenyan military and militants has been accompanied by fatal attacks on camp residents, threats to community leaders and the discovery of landmines and explosive devices within the camp area. The flow of new refugees into the camps has declined dramatically due to the conflict and Kenya’s official sealing of the border with Somalia.

As a result of the tense situation, many CARE activities and those of our humanitarian partners remain suspended. However, all lifesaving interventions, including regular food and water distributions to the all of the camp’s registered residents, continue uninterrupted. Furthermore, CARE’s dedicated team of 1,600 refugee workers, who live and work in the camps, continue to provide services including education and psychosocial support even in locations that are inaccessible to non-refugee staff.

CARE’s work in Dadaab falls into the following sectors:

• Water, sanitation and hygiene (WASH): CARE’s work providing safe drinking water and sanitation is more crucial than ever given a recent outbreak of cholera. Our system of boreholes and tap stands provides an average of 18 liters of water per day per person in the three main Dadaab camps – more than the international humanitarian standard of 15 liters. Monitoring staff continue to test the water quality twice daily.

• Public health promotion: In response to the steadily rising number of cholera cases, and unabated rains, CARE is scaling up our hygiene promotion activities, and taking the lead in mobilizing WASH and health partners in coordinating our response. Activities include soap distribution, jerry can cleaning, household hygiene visits, and disinfection of latrines with 1 percent chlorine solution. CARE is distributing sanitation tools in collaboration with WASH committees, constructing solid waste collection points in Hagadera camp, and overseeing the collection of animal carcasses under police escort.

• Food security: CARE is the primary distributor of food donated by international humanitarian partners to registered camp residents. Every day our logistics team oversees the distribution of 389 metric tons to 45,000 people. Due to security concerns and the sharp decline in the arrival of new refugees, immediate distributions of food to unregistered new arrivals remain suspended. 

• Education: CARE operates five schools serving 15,000 students in Dagahaley camp at Dadaab. Some services, and registration of new students, remain suspended for security reasons. Refugees who workfor CARE are a vital support in keeping classes operating, and Kenyan national primary and secondary school examinations were successfully conducted in November. School buildings remain severely overcrowded, with overflow classes held in tents and courtyards, and more space is urgently needed.

• Gender-based violence and psychosocial support: Newly arrived refugees have consistently reported an extremely high rate of violence, rape or abduction, and women and girls always face an elevated risk in refugee camp situations. Although the security situation currently prevents CARE from operating our regular system of psychosocial counseling through drop-in centers, we are continuing door-to-door campaigns, focus group discussions and road shows on sexual and gender-based violence and psychosocial support services. Our recent campaigns, with the crucial participation of CARE refugee workers, have reached over 34,000 people in Ifo and Dagahaley camps. 

2. Other affected areas in Kenya

In addition to hosting large numbers of refugees, parts of northern Kenya are themselves severely affected by drought. CARE maintains a broad range of programming in water, sanitation, hygiene, and longer-term efforts to help communities become more resilient. To date almost 477,000 people have received CARE’s help directly or indirectly through family members. Examples of our recent activities include:

• In Garissa, CARE scaled up emergency animal health interventions including mass treatment and vaccination, de-worming, active disease surveillance and training of disease surveillance committees.
• CARE and our partners in the Arid and Marginal Lands Recovery Consortium supported the district veterinary offices of Garissa, Mandera West and Wajir South on mass treatment, vaccination and de-worming and disease surveillance. A total of 208,351 livestock were treated.
• We identified vulnerable families, including those in Dadaab host communities, to receive emergency cash transfer payments – which have been demonstrated to be effective in addressing immediate food insecurity, while supporting local economies.
• A baseline survey on sexual and gender-based violence is currently ongoing in host communities.
• Water, sanitation and hygiene activities in the area included cash-for-work projects to improve infrastructure; training of community members as borehole pump attendants; and community hygiene training.
• ·         Drought emergency and resilience projects have included cash-for-work activities designed to rehabilitate range land and de-silt and expand rainwater harvesting pans. Members of the most vulnerable households are targeted as cash-for-work participants, with an emphasis on equal opportunity for women.
• CARE is working with community members to begin constructing latrines and hand washing facilities in six schools, benefiting 3,214 students including 1,737 girls.

Somalia

Despite the critical security situation in south central Somalia, CARE continues to scale up our humanitarian response. We operate both independently and through local partners in various parts of the country. Our priority regions include relatively stable parts of northern Somalia that are struggling to accommodate displaced people from the south.

Our emergency work in Somalia covers the sectors of water, sanitation and hygiene; food security; livelihoods; health/nutrition; and the distribution of other critical supplies. Our longer-term objectives include a variety of approaches to help communities build resiliency and sustainable livelihoods.

Recent activities include:

Water, Sanitation and Hygiene:

• In the semi-autonomous northern region of Puntland, CARE continues to conduct water quality tests on new and rehabilitated water sources and storage facilities completed under the recently completed Puntland Emergency Response Project. Communities took part in the work and are responsible for the long-term maintenance and upkeep of the infrastructure.
• In Galkacyo and Berbera, sanitation and hygiene promotion activities in schools including training to primary school teachers are ongoing.
• In Lower Juba, we provided clean, safe water, and aqua tabs for water treatment to 8,400 families.  
• To date, CARE has reached 63,000 individuals through WASH projects in Somalia.

Other activities:

• CARE’s distribution of essential non-food items kits, including kitchen and hygiene necessities, is reaching 2,400 people in Burao, Somaliland, who have been displaced from other parts of Somalia, as well as members of the host community.
• An additional 1,400 non-food item and 4,200 hygiene kits are destined for affected drought-affected households in Lower Juba.
• Given the crucial role played by CARE’s local partner agencies, especially in areas highly affected by insecurity, we continue to provide training in areas such as CARE's principles and procedures, quality and accountability, cross-cutting issues such as conflict sensitivity/do no harm, gender and prevention of sexual exploitation and abuse.                   

A Somali child in Dadaab

Links:

• Horn of Africa Crisis

In Ethiopia, Kenya and Somalia, CARE is mounting a large-scale crisis response, including general food distributions, emergency stabilization for malnutrition cases, water, essential household items, education and psychosocial support, reaching 1,758,825 people through the end of October.  In addition to immediate aid, CARE is also providing long-term assistance to reduce vulnerability to future disasters.

Some updates on CARE's activities in the Horn of Africa

In Kenya:

In Dadaab:

• Water/Sanitation/Hygiene (WASH) programs have been conducted.
• Public Health Promotions, including animal carcass collection, have been implemented. Communities are taking an active role in effective and hygienic collection and disposal of carcasses.
• CARE will be distributing Common Relief Items (CRIs) - including over 28,000 jerry cans - this month

Beyond Dadaab:

• Scaling up animal health interventions
• Training communities on disaster risk reduction
• Providing WASH services (including rehabilitation of boreholes and earth pans) through cash-for-work programs 

In Ethiopia:

• Nutrition and Food - Well over 1,000 children under five have been treated for malnutrition through stabilization centers, supplementary feeding and outpatient therapeutic programs. Thousands more are expected to be treated.
• The Productive Safety Net Program (PSNP) has begun, in collaboration with the World Food Programme, to shift chronically food-insecure rural people from recurrent emergency food aid to a more secure and predictable, and largely cash-based, form of social protection. The program has reached a total of 14,168 individuals.

In Somalia:

• WASH: Thousands have benefitted from clean water trucking, rehabilitation of water points, hygiene and sanitation training, provision of water filters, latrine construction and water quality training.
• Nutrition and Food: Food Security and Livelihoods: Supplementary Feeding Programs have reached 4,929 children under five and pregnant and lactating women. Additionally, hundreds of newly displaced families have received essential non-food items.

Dadaab - Connections

Links:

• CARE USA
• CARE in the Horn of Africa

The CBS Early Show profiled a CARE food distribution in Dadaab on Aug. 9. The segment included an interview with CARE Kenya’s Michael Adams and extensive coverage of CARE’s work on the ground.

Links:

• a brief, powerful segment on our work in the Dadaab refugee camp
• CARE's unique and innovative work with women in the Dadaab camp