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High mortality and malnutrition rates among settlers in northwestern Ethiopia alarms MSF

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Addis Ababa - The international medical relief organization Médecins Sans Frontières (MSF) has discovered very high rates of mortality and malnutrition among the settler population in Tach Armachaho, situated in the Amhara region of Ethiopia.

A nutritional survey carried out by MSF in late October has revealed that, in the remote area of Abrihigira, at least 69 people have died over the last 6 months. Thirty-two of these were children under the age of five. This equates to an under-five mortality rate of 5.5 per 10,000 per day - a catastrophe against any benchmark indicator. MSF has opened a therapeutic feeding center, which currently hosts more than 63 children.

The severe acute malnutrition (SAM) for the under-five population in Abrihigira is 13.2 per cent and in Abdurafi, further north, it is 6.8 per cent. The global acute malnutrition (GAM) is 23.8 per cent and 15 per cent for the same respective areas. Children aged one to three years have been affected primarily - which increases the likelihood that the poor nutritional status is disease related.

MSF has been working in Tach Armachaho for the past year treating Kala Azar, a little known disease that is endemic in this area. An initial analysis in Abdurafi and Abrihigira shows that the trigger for the current crisis is likely to have been the lack of access by road to these areas in combination with a lack of monitoring by the Ethiopian government for a relatively small population of 3,000 settlers the majority of which are adults.

Over the next three-year period the Ethiopian government intends to resettle 2.2 million people in an attempt to address food insecurity in the country by providing settlers with available land. Despite preparations made by the authorities in Abrihigira, the health situation in the region has deteriorated and resulted in very high mortality and malnutrition rates. The lack of year round access to the area, especially in the rainy season, has exacerbated an already dire situation.

Poor access to drinking water due to water pumps breaking down and not being fixed has forced the population to rely on river water, resulting in high rates of diarrhea.

The inaccessibility of the area has caused ruptures in the drug supply, no monitoring and reporting of morbidity or mortality data, and a total inability of the health services to refer and treat emergency cases. In recent days there have been three confirmed cases of Kala Azar among the non-immune settler population.

This is a worrying sign given the high fatality rate of the disease if not treated and the lack of preparation by the government to treat and diagnose the disease.

MSF has alerted the government to the nutritional problem, which has resulted in promises to send blended food and oil to both resettlement sites that will cover the needed rations for the next two months. MSF is also carrying out blanket supplementary feeding to all under fives and lactating mothers in an attempt to stem a further deterioration in the health status of the population.