East Africa - Two regions of Somalia are suffering from famine, which is not mere hunger, but a formal declaration that hunger now is so severe that more than 30 percent of children are suffering acute malnutrition, more than two people per 100,000 are dying each day, and that food and other basic necessities have become inaccessible to most people. The July 20 declaration came from the U.N. humanitarian coordinator in Somalia, Mark Bowden. "Every day of delay in assistance is literally a matter of life or death for children and their families in the famine-affected areas," he said.

In the Somali regions of southern Bakool and Lower Shabelle, acute malnutrition rates are higher than 30 percent, U.N. aid workers have found. Deaths among young children exceed six per 10,000 per day in some areas. In the last few months, tens of thousands of Somalis, the majority of them children, have died from malnutrition and related hardships, according to the U.N. News Centre.

Secretary of State Hillary Rodham Clinton issued a statement July 20 expressing U.S. concern about the Somali people and the broader humanitarian emergency in the Horn of Africa.

She said the United States has provided $431 million in food and other emergency assistance to help ease suffering in the region. With an additional allocation July 20, U.S. assistance will reach almost $460 million. Clinton urged other donors to increase their actions and contributions to assist the region.

"All donors in the international community must commit to taking additional steps to tackle both immediate assistance needs and strengthen capacity in the region to respond to future crises," Clinton said.

Clinton's statement came less than 24 hours after top officials in U.S. humanitarian activities briefed the press on the growing urgency of the problems through the Horn of Africa, estimating that 11 million people in Ethiopia, Djibouti and Kenya will be affected along with the Somalis. People of these nations have also experienced drought, loss of crops and livestock, and food insecurity.

But Somalia's problems have been further exacerbated by the actions of the insurgent group al-Shabaab, Clinton said.

"In Somalia, 20 years without a central government and the relentless terrorism by al-Shabaab against its own people has turned an already severe situation into a dire one that is only expected to get worse," Clinton said.

The World Health Organization (WHO) unveiled an assessment of health problems in the region July 20 that suggests the situation will grow even more severe. "Reduced food intake and lack of varied diet have led to malnutrition and micronutrient deficiencies, resulting in increased morbidity and mortality, particularly from communicable disease."

While many humanitarian agencies are focusing on food shortages, WHO pledged to keep its focus on disease, especially among the very young who are weakened by malnutrition. The Geneva-based health agency will also be setting up disease surveillance systems and improving primary health care services already in place.

U.S. officials also recognize that acute hunger and malnutrition can be the precursor for disease outbreaks. At the July 19 U.S. briefing, U.S. Agency for International Development Assistant Administrator for the Bureau for Democracy, Conflict and Humanitarian Assistance Nancy Lindborg said her agency has studied the history of earlier famine periods in East Africa and elsewhere, finding that ignoring the early signs of disease in these populations can be a huge mistake.

"So it's cholera, it's measles, it's diarrhea, it's all these diseases that we need to effectively address and very quickly enable vaccinations and health treatments to reach," Lindborg said.

The WHO report estimates 710,000 refugees in the region with 1.9 million internally displaced people. These strains have "exhausted the regular coping mechanisms of affected communities," according to WHO. The water and sanitation shortages that frequently arise among populations of this kind are another factor threatening the health of the people of East Africa, WHO said.

Charlene Porter

United States Department of State/21/07/2011