Zimbabwe + 6 more

UNICEF Humanitarian Action: Southern Africa Crisis Donor Alert 18 Jul 2002

A multi-causal crisis demands a multi-sectoral response

  • Up to 12.8 million people require assistance, more than half of whom are children and 2.3 million are children under five

  • Situation compounded by high prevalence of HIV/AIDS in the region


Multiple causes lead to humanitarian crisis

The humanitarian crisis in southern Africa-- Zimbabwe, Malawi, Zambia, Lesotho, Swaziland and Mozambique-continues to deteriorate with fear of much greater levels of distress in the coming months. Almost 13 million people, of whom half are children, in southern Africa are on the very edge of survival as the region struggles with drought and massive harvest failures. The crisis facing southern Africa is due to a complex mixture of factors that include erratic rainfall, and in some cases, chosen economic policies. The scope of the humanitarian emergency is much broader, however, than shortages of food. The situation of women and children is exacerbated by a range of difficulties - such as the high HIV/AIDS prevalence rates - that existed before the onset of the present drought.

There is a direct link between HIV/AIDS and food insecurity. As people become increasingly desperate for food and other resources, they may engage in high risk behavior such as prostitution or migration that leaves them vulnerable to infection. For people living with HIV/AIDS, food shortages bring a host of problems such as secondary infections, as their resistance declines due to poor nutrition. The resulting increased costs of care-giving and loss of productive labor has an asset-stripping effect on households. Money spent on care-giving means that there is no cash for school costs or clothing. In addition, poor nutrition can accelerate the development of AIDS.

Moreover, the current crisis has contributed to an increase in school drop out rates throughout the affected region as parents have a difficult time shouldering the short-term opportunity costs of sending their children to school. Children are continuously pulled out of school to care for ailing parents, or to work when their parents can no longer do so. Dropping out of school, engaging in hazardous work, exchanging sex for food or cash all place children at risk of violence and their own HIV infection. Keeping children, particularly girls, in school is not only necessary for their learning and development, but is one of the strongest protective strategies for reducing their vulnerability to violence, sexual exploitation and HIV.

UNICEF and partner agencies have geared up their response but more assistance is required. The governments of Lesotho, Malawi, Zambia and Zimbabwe have declared national disasters and have appealed for international assistance to cope with the situation. In March, UN agencies, NGOs and Southern Africa Development Community (SADC) joined efforts to begin more systematic assessments that are now on-going or have been completed in all countries affected by the current crisis. Moreover, the current crisis in the region is also affecting the already desperate situation in many parts of Angola (described in the forthcoming revised UN Consolidated Appeal for Angola).

Across southern Africa new initiatives are urgently required to meet current needs, and to avert an even greater humanitarian disaster. Resources are being sought now for activities from July 2002 through July 2003.


To ensure an effective and coordinated response to the emergency, UNICEF is working closely with partner agencies. Emergency response activities initiated to date include the following:

  • In Zimbabwe, a countrywide measles campaign began on the 2 July; and supplementary and therapeutic feeding is being provided to 32,000 malnourished children under five.

  • In Malawi, 50,000 children under five and 185,000 pregnant women and lactating mothers are benefiting from supplementary feeding; 8,000 chronically and severely malnourished children being supported.

  • In Zambia, UNICEF has expanded the drilling of boreholes in drought affected areas, and is providing jerrycans and other water and sanitation supplies.

  • In Lesotho, UNICEF is working with NGOs and the Peace Corps to identify malnourished children.

New UNICEF humanitarian interventions will focus in the areas of nutrition, health, water/sanitation, and education and protection. The following are among the on-going or planned UNICEF emergency activities in each of the affected countries.

To support and guide the response to the crisis, UNICEF will establish a sub-regional co-ordination unit, to be co-located with WFP and OCHA, in the newly established Regional Support Office in Johannesburg. Among other specialists, the unit will include a nutritional advisor as well as an HIV/AIDS specialist who will provide technical support on interlinkages between HIV/AIDS and food insecurity. The unit will ensure that UNICEF country offices receive the necessary multi-sectoral support to effectively respond to the crisis, and that UNICEF partners receive timely and pertinent information on the impact of the crisis on women and children.


Lesotho is one of the poorest countries in the world. With a per capita income in 1999 of US$ 415, the country is grouped among the 49 Least Developed Countries and is ranked 120 out of 162 countries on the United Nations Development Programme (UNDP) Human Development Index. The country continues to struggle with low levels of economic growth and an estimated 58% of the population is trapped below the income poverty line. Progress made in human development and poverty over the past decades is being rapidly reversed by one of the most severe HIV/AIDS pandemics in the world. National prevalence rates are estimated at 23% and over 40% in the capital district of Maseru. The pandemic threatens to undermine the productive sectors of the economy, delivery of social services and indeed the entire social fabric .

  • UNICEF has identified 85,000 children under the age of five, in addition to the 445,000 people identified in the WFP crop assessment, in need of immediate supplementary feeding. Another 30,000 children may require therapeutic feeding between July 2002 and June 2003. Some 75,000 pregnant and lactating women will also require nutrition support. UNICEF is leading a coalition of NGOs to support the Government in responding to the nutritional needs of the vulnerable population, particularly of children under the age of five. In addition, UNICEF is supporting partners to improve early detection and effective management of the major childhood illnesses. Micronutrient supplements and iodized salt will also be provided to the affected children and women.

  • UNICEF is supporting the Government in accelerating routine immunization in the targeted areas to prevent measles outbreaks. Support will also be extended to strengthen the capacity of health workers, community-based organizations and NGOs to implement effective nutrition and health surveillance systems.

  • Despite the current emergency situation, UNICEF strives to ensure that children continue have some sort of normalcy in their lives through its education programmes. UNICEF, together with the Ministry of Education and other partners, is addressing the most urgent schooling needs of the affected children such as the lack of educational materials, textbooks, teachers and recreational activities. UNICEF is leading a rapid assessment of the educational and psychological needs of children in affected areas. UNICEF will continue extending its support for the establishment of classrooms and provision of shelter materials, construction of water and sanitation facilities, training of up to 1,000 teachers on educational and psychosocial programmes, including hygiene education and awareness messages on HIV/AIDS prevention.


The situation in Malawi prior to the current crisis was characterized by chronic poverty, with a high level of vulnerability to shocks. Today, crude mortality rates are rising due to a combination of severe malnutrition, high prevalence of HIV/AIDS and recurrent outbreaks of diseases such as cholera. The crisis has eroded capacity to respond and added to the number of people marginalized or excluded from basic social services. In some districts, school attendance has dropped by 50%.

  • To address the problem of acute malnutrition in Malawi, UNICEF is working with the Ministry of Public Health, WFP and NGO partners to provide therapeutic feeding programme to 4,000-6,000 severely malnourished children each month. UNICEF is providing supplementary feeding supplies to at least 40,000 women and children each month. UNICEF is working with donors and other partners to develop short- and long-term nutrition rehabilitation strategies.

  • Malawi suffered from an unprecedented outbreak of cholera earlier this year, with over 28,000 cases and close to 1,000 fatalities. UNICEF is drawing on lessons learned from the previous outbreak to prepare for additional cases of the disease. UNICEF will strengthen the surveillance system and will pre-position additional supplies for cholera response. Training will be conducted for health workers and local health centres on early detection and case management. Public awareness on cholera prevention and control will be increased through the development and dissemination of information materials.

  • Acute shortage of food has raised the opportunity cost of sending children to school, and information from the Ministry of Labor indicates that children have been exposed to harmful and exploitative forms of labour as the only option left for families to survive. Lack of food with a subsequent breakdown of family structures has placed more children on the streets where they find themselves at risk of mistreatment, sexual exploitation, physical and emotional abuse. UNICEF is working with WFP to expand the number of schools included in school feeding programmes to help encourage children to stay in school.

  • Given the increased vulnerability of children, UNICEF will work to prevent their sexual exploitation and abuse by increasing training and social mobilization on child rights violations and their implications.


Working with Government, UN and NGO counterparts, UNICEF is supporting the development and implementation of multi-sectoral vulnerability assessments in ten of the worst affected districts. Preliminary results indicate that over the next two-three months access to food and potable water may be seriously compromised, which will have a significant impact on malnutrition levels, incidence of diarrhoeal diseases, and other related health and social problems. Despite the fact that crop production numbers are not as dramatically low as in other affected countries in the region, a number of problems leave Mozambique vulnerable to the current crisis. 64% of Mozambicans live below the poverty line, HIV prevalence is increasing, malaria is a continuous problem and many areas of the country affected this year by drought have not yet recovered from flooding in 2000-2001.

  • Immediate response activities include establishing and strengthening surveillance mechanisms (nutritional, epidemiological and special protection issues), and the implementation of a supplementary feeding programme for children (6-59 months), pregnant and lactating women. Priority actions will continue to focus on reducing vulnerability to the impact of the drought through strengthening access to care at the community level (health, water supplies, and education), in particular for vulnerable children.

  • More than 65% of the rural population rely on unprotected and unsafe water sources (shallow hand-dug wells, small streams, ponds, and rivers). Those relying on these surface water sources are already experiencing some difficulties in particular in parts of Tete, Inhambane and Gaza provinces (in districts susceptible to drought). In response, UNICEF will support the provision of water in critical locations, including schools and health centres - through the rehabilitation of existing water points or the installation of new water points.

  • Inappropriate household water management, excreta disposal, and personal hygiene practices contribute considerably to unhygienic risk conditions, creating a breeding ground for disease and the possibility of diarrhea, dysentery, and cholera. Repeated diarrhea is a major cause of malnutrition and underweight, leading to susceptibility to other illnesses. Diarrhea causes 13 percent of under-five deaths. UNICEF will Identify and promote hygiene education and the promotion of suitable hygiene coping mechanisms under the drought conditions. UNICEF will also procure supplies and equipment, including family hygiene kits, chlorine and other supplies, to ensure safe water supplies and appropriate hygiene practices.

  • There are currently over 420,000 primary school pupils enrolled in the 43 drought affected districts. It is estimated that the drought could prevent many of these pupils from going regularly to their schools. This is mainly due to an increased reliance on children's participation in household activities such as collecting water, searching for wild fruits, carrying out small jobs for food or money, or caring for sick family members. However, it may also result from reduced energy levels, as children become more malnourished or sick. The likelihood of children been withdrawn from school in families living with HIV/AIDS is likely to be intensified. Support will be aimed at providing key education materials to pupils, teachers and schools. This will reduce the need for families to make a choice between using scarce household resources for food or for education, and should help encourage families to keep their children in school, thereby minimising the rates of absenteeism.


In Swaziland, the total cereal requirement is over twice as much as 2001. As with Lesotho, high rates of HIV/AIDS and increasing unemployment are reducing household purchasing power. A recent multi-sectoral assessment in Swaziland has highlighted the deteriorating coping mechanisms of the affected population. It showed the reduced number of meals available to households (80% of families on less than three meals per day), and over 10% school drop-outs in the first term as more families were forced to use school-fees to pay for increasingly expensive staple foods. Families, unable to feed their own children are increasingly refusing to take in orphans and vulnerable children, thus breaking the "extended family" bonds. Approximately 10 per cent of households in Swaziland are now headed by children.

  • To address acute malnutrition particularly among children, UNICEF will support school feeding programmes with the aim of providing at least one meal a day to 36,000 children enrolled in these schools in communities most affected by the drought. The feeding programmes are being supported through the provision of kitchen equipment and materials to build storage facilities, training of the staff managing the programme and provision of basic foodstuffs for preparation of a daily hot meal for students. UNICEF is also working to establish school farms and gardens.

  • In response to burgeoning numbers of orphans and vulnerable children, methodologies have been developed to mobilise communities to assess their own situation and to plan and implement self-reliant actions. UNICEF is working with communities to establish child monitoring systems in the affected communities, and to put in place the structures for supporting current assistance and sustaining community action to protect vulnerable children beyond the term of food aid.


The combined effects of grinding poverty and HIV/AIDS leave Zambia with a large population of vulnerable people at risk of serious health problems and malnutrition if there is an extended period of food shortage. Base line malnutrition rates for under fives are high with 53% stunting, 24% underweight and 5% wasting nationwide. Zambian children have a very narrow margin of tolerance for any disruption in the supply of food and water. HIV/AIDS is ravishing Zambia. Like other countries in the region, it has lost large numbers of its young, productive people.. The extended family, the heart of traditional coping mechanisms in times of stress, has been tested to the breaking point. It is estimated that 13% of all Zambian children are orphaned as a result HIV -- one of the highest proportions on the continent.

  • UNICEF is addressing the nutritional needs of the affected population, especially of children through the provision of therapeutic feeding supplies, and the vitamin and mineral supplements to women of child-bearing age. These interventions will benefit some 50,000 children and their caregivers. Rehabilitation of severely malnourished children will be further supported through training and capacity building of government institutions and NGOs. UNICEF is working with Ministry of Health, WFP, WHO and partner NGOs to establish a nutrition surveillance system to monitor the nutritional status of the affected population and to use the collected information to better target food as well as other assistance.

  • UNICEF plans to construct new water points and rehabilitate boreholes and wells in the eighteen most affected districts in eastern, southern and western provinces. Moreover, in an effort to prevent waterborne disease outbreaks and mitigate the effects of drought, UNICEF plans to provide water trucking where necessary.. Water purification tablets for treating water and water jerry cans will be procured and distributed among the affected population. Hygiene and health education campaigns will also be carried out.

  • In education, UNICEF is supporting the Ministry of Education and other partners to ensure that children affected by the current crisis continue to go to school. To this end, UNICEF is providing basic school supplies to compensate for community shortfalls and to ensure that education activities continue. In addition, the water and sanitation programme will support primary education by the repair of water and sanitation facilities in schools. UNICEF will also collaborate with WFP to support community based school feeding programmes. These interventions will benefit close to 160,000 children, including 90,000 girls.


To address health threats to children and women, all more acute in the present context, UNICEF, in collaboration with WHO and the Government, is supporting interventions to control and prevent the spread of vaccine-preventable diseases such as measles, polio and neonatal tetanus by launching accelerated immunization campaigns for children aged 6 months to 6 years in the affected areas and providing additional training to health staff in the planning and management of immunization programmes.

  • Sixty-six percent of the population of Zimbabwe is affected by food shortages. A recent nutritional survey conducted by UNICEF and the Government of Zimbabwe found that acute malnutrition earlier this year had increased by 8 times from the 1999 average. UNICEF is targeting close to 620,000 children and some 100,000 women for nutritional assistance in the 19 worst-affected districts.

  • UNICEF will conduct additional assessments, mapping and monitoring of children and families living with HIV/AIDS to ensure current data for effective programme response. The collected information will be used to further enhance the response activities of all implementing partners working in the area, which will benefit some 600,000 children and their families.

  • In the education sector, UNICEF will expand activities to ensure that a target population of 58,000 school age children among the affected population have uninterrupted access to education. In addition to the obvious long-term benefits of primary education, arresting school drop out rates makes children less susceptible to sexual violence outside the classroom. The quality of education will be enhanced through the provision of appropriate teaching and learning materials, particularly school-in-a-box kits, to learning centres. Professional guidance and supervision to the learning centres will be provided.

  • Malaria is a major killer in Zimbabwe with an estimated three million people in the country experiencing at least one episode of the disease each year. Together with its partners, UNICEF will distribute insecticide-treated bed nets and support the training of health staff and communities in their use. UNICEF will also continue to provide anti-malarial drugs to health centers. People weakened by malnutrition are more likely to succumb to malaria.

  • To control and prevent further outbreaks of cholera and other diarrhea-related illnesses, UNICEF is working with the Government, UN agencies and NGOs to launch expanded social mobilization campaigns to promote improved hygiene practices and to pre-position emergency supplies to endure rapid response to future outbreaks. In addition, training programmes will be conducted for health staff on early case detection, management and reporting of cholera.

  • UNICEF assessments in water and sanitation found that some 1,700,000 people, including 408,000 women and 935,000 children did not have access to safe water or sanitation facilities. UNICEF will respond to the immediate needs of some 450,000 vulnerable people in the seven most affected provinces by constructing and rehabilitating hand-dug wells and boreholes and continuing to provide technical support and training to communities and local authorities in the management of water and sanitation facilities.


In response to the humanitarian crisis in Southern Africa, UNICEF, together with other UN agencies, will present its funding requirements to the donor community on 18 July. As part of this framework, UNICEF is requesting US$ 26.8 million to provide humanitarian assistance to the affected children and women in the six affected countries. The table below gives the sectoral as well as country breakdown of the appeal:

Country/ Sector

Further details of the emergency programme can be obtained from:

David S. Bassiouni
Tel: + 41 22 909 5503
Fax: + 41 22 909 5902
E-mail: dbassiouni@unicef.org

Dan Rohrmann
New York
Tel: + 1 212 326 7009
Fax: + 1 212 326 7165
E-mail: drohrmann@unicef.org

Urban Jonsson
UNICEF Nairobi
E-mail: ujonsson@unicef.org