Under-resourced aid agencies struggle to raise nutrition levels

Despite efforts by relief agencies to stabilise alarming malnutrition levels in southeastern Madagascar, the nutritional situation remains fragile. "The nutrition problem was being dealt with by the World Food Programme (WFP), the United Nations Children's Fund (UNICEF) and cooperating partners, but there are still critical challenges that need to be addressed," WFP programme coordinator Soava Rakotaorisoa told IRIN. According to the most recent nutritional assessment by government agencies and UNICEF, 20.4 percent of the children surveyed suffered from global acute malnutrition (GAM), and rates were higher in more remote areas. "The rapid assessment conducted in November had GAM levels at 38 percent - a rough indication, but it allowed us to mobilise immediately. This more accurate assessment confirms the need for action - there is no question that there is a need for an emergency response," Barbara Bentein, UNICEF's resident representative, told IRIN. Rakotaorisoa said the WFP had already distributed 942 mt of food in the Manantenia and Vangaindrano regions near the southeastern coast, targeting 7,800 families with moderately to severely malnourished children. "In November we established there was a need to treat 2,400 children in the Nutritional Rehabilitation Centres (NRC) in Manantenia but we are now treating 800; in the Vangaindrano region we expected 5,000 and now treat 3,000," he noted. The drop in the number of children in need was attributed to gradual improvement in the situation over the past two months but Rakotaorisoa said other factors, such as emigration to other regions, had also played a role. He mentioned more serious concerns in Vangandriano: "It is very inaccessible, so it is difficult for people to reach the NRCs - that means maybe only 3,000 are making it [to the NRCs]," he explained. "Two big challenges remain: first of all, WFP resources in Madagascar have reached critical levels and we are still waiting for additional contributions from donors; second, reaching people in inaccessible areas, where there are no bridges to cross rivers, is still a problem," Rakotaorisoa said. Southern Madagascar is plagued by chronic food insecurity. In 2005 repeated flooding, insect infestation and drought affected the region's rice and sweet potato crops, while the lack of a clove harvest due to its biannual production cycle affected coping mechanisms and exacerbated an already precarious situation.