Findings from five nutrition assessments(1) conducted in South and Central Somalia in May 2007 indicate a continuing critical nutrition situation with (2)Global Acute Malnutrition (GAM) levels above the emergency threshold of 15%. The retrospective Crude Mortality Rates (CMR) in these studies also indicate results above the alert threshold(3) of 1 death/10,000 population /day. In all the assessments the younger children 6-29months were at much higher risk of acute malnutrition, than the older children, highlighting the strong association between high morbidity and poor care practices and malnutrition. Of most concern is the critical situation in Lower and Middle Shabelle Regions mainly as a result of cumulative effects of confl ict, insecurity and concentrated displacement within the region which has led to stress on host communities over the last three months. These shocks are further compounded by the on-going acute watery diarrhea epidemic, losses from the last Deyr fl oods and three seasons of below normal cereal production. Lower and Middle Shabelle Riverine Livelihood Zone: GAM rate of 17.0% (CI: 13.4-20.5) and (4)Severe Acute Malnutrition (SAM) rate of 4.8% (CI: 13.0 -16.7). CMR of 1.31 (0.8-1.83) Lower and Middle Shabelle Agro Pastoral Livelihood Zone: GAM rate of 17.3% (CI: 13.3-21.3) and SAM rate of 4.5% (CI: 2.5-6.6). CMR of 1.07 (0.69-1.45)
In Burhakaba District, the latest assessment fi ndings indicate results in line with previous assessments conducted in 2000 and from the routine nutrition sentinel site surveillance, again highlighting the chronic nature of the nutrition crisis in Somalia The main underlying factors are reported to be high morbidity levels, poor access to health care services and poor child feeding practices in addition to the recent IDP infl ux, increases in prices of food and ongoing insecurity. Burhakaba Agro Pastoral Livelihood Zone: GAM rate of 15.6% (CI: 12.2 - 19.0) and SAM rate of 3.3% (CI: 1.7-4.9). CMR of 1.31 (CI: 0.86 - 1.77) Burhakaba Pastoral Livelihood Zone: GAM rate of 16.2% (CI: 12.1 - 20.2) and SAM rate of 3.9% (CI: 2.4 - 5.3). CMR of 1.88 (CI: 0.90 - 2.86)
In Galcayo Town IDPs, a deterioration in the nutrition situation has been reported from the most recent assessment conducted in 2004. This critical nutrition situation is linked to their vulnerability as IDPs, with poor access to food, income, health care and safe water further compounded by high morbidity. Assessment fi ndings: (based on an exhaustive nutrition assessment): GAM rate of 21.9% and SAM rate of 2.2%. CMR of 1.54
A sixth nutrition assessment conducted in the North East Coastal Deeh, also in May, indicates GAM results just below the emergency threshold of 14.9% (CI: 12.1 - 17.7) and SAM rate of 1.1% (CI: 0.2 - 1.9). CMR is stable at 0.62 (CI: 0.3 - 0.93).
Acute Watery Diarrhea (Ref: WHO Somalia AWD Updates)
North West Zone: Between March 22nd and June 16th, 2007, a total of 2060 cases of clinically diagnosed Acute Watery Diarrhea (AWD) including 30 related deaths, (5)CFR: 1.47%, were reported from Togdheer, Awdal and Woqooyi Galbeed Regions of the North Western Zone. Overall, Togdheer region reported 51% of the cases (i.e. 1046) including 30% (i.e. 15) of the total related deaths. There are also indications of an increasing trend in the number of reported AWD cases in this area.
South and Central Zone: Between January 1st and June 8th 2007, a total of 36, 275 cases of AWD including 1,102 related deaths were reported in the South and Central Zone. This translates into a CFR of 3.04%. The AWD trend showed that the number of reported cases is decreasing in all the 10 regions.
1 30 x 30 sampling of children aged 6 months measuring 65cm length-109.9cm height, and 30x30 households for mortality
2 Global Acute Malnutrition i.e. % of assessed children with Weight for Height Z Scores < -2 or Oedema
3 Moren et al, 1995 / Sphere 2004 defi nes 1.0/10,000/00 as the alert threshold
4 Severe Acute Malnutrition i.e. % of assessed children with Weight for Height Z Scores < -3 or Oedema
5 The Case Fatality Rate (CFR) refers to the number of deaths per 100 cases (WHO)