The Gambia: Humanitarian Needs Overview 2016 (November 2015)

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Humanitarian needs & key figures

The Food Security and Nutrition crisis remains the principal concern for humanitarian actors in The Gambia.
The June 2015, Food Security Early Warning Bulletin issued by the Department of Agriculture revealed that commodity prices were higher compared to the same period in the previous year i.e. cereals (broken rice 6.4% increase), vegetables (imported onion 3.3%), root and tubers (Irish potatoes 4%) , meats (11.3%) as well as legumes (beans 3.6%). The impact of high prices is further compounded by the depreciation of the Dalasi against the USD resulting in exchange rate instability contributing to increased cost of importation especially of basic food commodities. Notably, the Gambia imports almost 50 percent of its food commodity requirements.

More than 100,000 children under five and pregnant and lactating women are projected to be at risk of acute malnutrition due to several factors including: poor infant feeding practices; increasing household food insecurity; increased disease burden particularly related to inadequate WASH services; limited knowledge and low awareness of care givers with regard to essential nutritional and hygiene practices. Inadequate access to basic social services such as health, safe and clean water, basic sanitation and hygiene aggravates high prevalence of childhood diseases, especially malaria and diarrheas, which have devastating effects on the nutritional status of children. Water and sanitation related-deaths represent 20 per cent of under-five (U-5) deaths.

Impact of the crisis

With a population of roughly 2 million people; the country is considered a low-income-food deficit with high poverty levels that contribute to the increasing vulnerability of its population to shocks - an estimated 71 percent of the population lives below the US$2 per day, (2014 human development index). Income poverty is concentrated in rural areas, particularly among households headed by subsistence farmers and unskilled workers (79.3 per cent and 65.4 per cent, respectively). Of these rural poor, women account for over 50 percent of the agricultural labour force and represent 70 percent of unskilled labourers according to a recent study of the International Fund for Agricultural Development (IFAD). Nearly 40% of the population in The Gambia is below 15 years, 21% between 15-24 years, and only 3.2% above 65 years. This demographic trend contributes to a high dependency ratio.

Low recovery rate since the 2011/2012

Food and nutrition crisis: The Cadre Harmonize results of November 2015 identified three regions Upper River, West Coast and Northern Bank to be in phase 3 of food insecurity classification and many parts the country in phase 2, with a total of 426,819 people at risk of food security (one quarter of the entire population). According to a WFP report issued in 2014 only 18 per cent of Gambian households were considered to be food secure, while the national malnutrition prevalence rate of 9.9 per cent edges on emergency thresholds in terms of severe malnutrition (SMART, 2012). Children are particularly vulnerable to food insecurity because reduced food intake and associated problems lead to chronic malnutrition, stunting, and wasting, all of which have adverse effects on child development.

The Gambian agricultural sector is predominantly subsistence, rain fed with very little irrigation or use of improved seeds and fertilizer. Erratic and declining rainfall pattern due to climate change makes the agriculture sector very risky and food security a huge development challenge. Lack of diversification has also led to dependency on a single major cash crop (groundnuts), resulting to a more volatile exchange rate earnings than would have been the case with a more balanced mix between groundnut, cashew nut and sesame. Cereal yields are generally low. For this reason, food selfsufficiency is relatively low, with an estimated national ratio of about 50 percent of needs met and the remaining 50% imported. A lack of supporting infrastructure (irrigation, roads, storage, research and development) has also created bottlenecks that limit the growth of the agriculture sector.

If the current trend continues, negative growth in agricultural output will further fall over time. The present output is still yet to reach pre-2011 levels. The result of which could be a reversal of the gains made in reducing poverty in the country. The urgent need to reduce reliance on rain fed production and increase the use of irrigation in rural areas has never been more relevant. It should be noted that as a sector that employs 32% of the labour force (LFS, 2012); agriculture serves as a main source of income for those into cash crops and source of food security for non-cash crop farmers.

Escalating trends in malnutrition

The Gambia continues to face worrying trends of malnutrition among children under five and in pregnant and lactating women. An estimated 116,899 children under five and pregnant and lactating women are at risk of acute malnutrition. This is an increase of at least 32,776 persons compared to the 2014 estimates of 84,123 cases of GAM. The burden of moderate acute malnutrition (MAM) among children under five is projected at 58,345, while severe acute malnutrition (SAM) is at 10,410; while the burden of malnourished pregnant and lactating women in the reproductive age group (15-49) is estimated at 47,789.

The rate of acute malnutrition among children under 5 varies per region with Central River and Upper River Regions (CRR and URR) representing the highest GAM rates at 16.1 per cent and 16.9 per cent respectively (Demographic Health Service – DHS, 2013). Preliminary results from the Standardized Monitoring and Assessment of Relief Transitions (SMART) survey (October 2015) indicate that the national prevalence of Global Acute Malnutrition (GAM) currently stands at 10.4 percent [95% CI: 9.5 –11.5] and Severe Acute Malnutrition (SAM) at 2.0 percent [95% CI: 1.6 – 2.5]. These results are slightly high compared to the previous levels of 2012 SMART survey, which stood at 9.9 percent [95% CI: 8.8 – 10.8] GAM and SAM prevalence of 1.6 percent [95% CI: 1.2 – 2.0]. These are very worrying statistics highlighting a serious problem with malnutrition in the country.

A significant variation in underweight among women has also been observed between urban and rural settings. The 2013 DHS reported that women living in rural areas were more likely to be underweight (20%) than those in urban areas (14%). The report further indicated that, the proportion of underweight women is highest in CRR (23.8 per cent) followed by LRR (21.5 per cent) and NBR (21.4 per cent). Under nutrition has however been on the rise in urban areas, affecting between 13-16 percent of women in most vulnerable urban dwellings. Over nutrition is also increasingly becoming a problem in The Gambia, especially in urban areas. According the 2012 national nutrition survey, over 22 percent of women of reproductive age in The Gambia were obese or overweight.

The Nutrition status of children under five and pregnant and lactating women in the Gambia, is likely to remain poor in 2016 due to chronic household food insecurity, poor infant feeding practices, increased disease burden particularly those related to inadequate WASH services at health structure and community/ household levels, limited knowledge and low awareness of care givers on essential nutritional and hygiene practices.

Limited access to Water, Sanitation and Hygiene (WASH) facilities

According to the GDHS 2013, 9 out of 10 households (91 per cent) in The Gambia get their drinking water from an improved source, while only 37 per cent use an improved toilet facility that is not shared with other households. This high national water coverage however, masks serious regional disparities and vulnerabilities which result from several factors, including rapid population growth which outstripped the existing water systems and poor maintenance of water facilities. In Upper River and Central River regions, which have the highest rates of under-five mortality and malnutrition rates, access to improved water sources and sanitation remains a major challenge. Across LGAs, 30 per cent of the population of Janjanbureh Local Government Area is using unimproved sources of water for drinking, while Basse LGAs has the lowest sanitation coverage at 39.7 per cent. The status has not changed since the last HNO planning cycle in 2014 due to inadequate funding to implement the interventions.

Scale up of emergency health service

The entire population of The Gambia is exposed to meningitis and malaria while approximately 65 per cent is at threat to cholera. In 2015 there was an outbreak of measles in the West Coast Region with an incident case imported from Guinea. A total of 100 cases of measles cases were reported in age 9 months to 15 years; and 79 meningitis cases with 19 deaths were also reported in the period of January to September 2015.

The biggest challenge faced by the health sector is inadequate human resource capacity, both in terms of quantity and the availability of adequate trained staff. This challenge spans across all levels of the health system and across all regions as acknowledged by the National Health Strategic Plan (2014-2020).The high attrition of health staff has also posed serious challenges to providing quality health services to the population. It has led to the inability of the health system to accumulate an adequately trained core of health personnel across all levels.

Education in emergency needs

While no assessments have taken place to ascertain the direct impact of food in-security and malnutrition on education, poverty is identified as a key barrier to accessing education in The Gambia.
In Central River Region (CRR) where most development indicators are low, education level is extremely lower if compared to other regions. For example, the ECD enrolment in CRR was 23.5 per cent compared to the national average of 45.5 per cent in 2015. Similarly, the primary enrolment for the same region CRR is 64.8 per cent compared with 101.2 per cent nationally in 2015. Families with low income are faced with realities of making decision about the opportunity cost of paying for the hidden cost of education (e.g. school meals, uniforms, etc.) or putting food on the table. Under these circumstances children are withdrawn from school to support the family on the farm or serve as caregivers to younger siblings. On the other hand children would be part-time street vendor resulting to school lateness and absenteeism.

Stunting is prevalent amongst The Gambia children. Stunting affects children’s overall development which could result in late entry into school, with increased drop out and long term learning difficulties.
Again CRR has the least primary completion rate (39.5 per cent) compared to the national average of 73.6 per cent in 2015. While generally schools are provided with school meals, many children are not reached and supplies do not always last for the whole year.
Availability of school meals has significantly encouraged attendance and participation in the learning activities.

Impact of floods on schools:

According to a preliminary report from the Ministry of Basic and Secondary Education (MoBSE), at least 15 schools were damaged by wind storm/floods during the 2015 rain season affecting access to education of 3,500 children. The Education sector will focus efforts in restoration of school services and the needs of the pupils in these affected schools as a priority in 2016.

Inadequate access to basic services:

It is augmented by factors such as high unemployment rates, lack of women empowerment, and social exclusion of vulnerable groups such as people living with disabilities. Estimates done by the Labour Force Survey (LFS) indicate that unemployment rate stands at 29.2% nationally, with the male and female unemployment rates at 20.9% and 38.3% respectively. There is a slight rural-urban difference in unemployment rates with the rural unemployment rate at 31.1 versus 28.4 for urban areas. The youth unemployment rate, defined as between the ages of 13 and 30, stood at 38% and is increasingly seen as the cause for migration, particularly to Europe – an estimated 11,300 people left the country in 2014

While women play a major socio-economic role, they continue to face challenges including lack of access to education (high illiteracy), lack of sufficient access and equal opportunity to work, right to land and property (farmland and credit), low level of awareness of their rights and negative impact of harmful traditional practices such as forced and early marriage. The household chores also contribute to the disempowerment of women and girls as they affect equal access to education of girls and give very little time to women to ensure equal access to decent work and remuneration.

Disabled persons in The Gambia, especially women and children, are considered to be among the poorest and most marginalized and their condition is aggravated by mythical, social and cultural beliefs about persons living with disabilities. Social condescending attitudes reinforce tendencies to exclude them from benefiting in many social development programmes.

UN Office for the Coordination of Humanitarian Affairs
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