Malnutrition in Ethiopia

Nowadays, the food problem is justly referred to the so-called global problems of mankind. Ethiopia has faced such a problem that already continues for more than 30 years. In Ethiopia malnutrition flourishes. Especially, this issue has affected mothers and children. Their nutrition is very poor what reflects in the widespread diseases, underweight, undersize, and many deaths annually. It is necessary to find the origins of this social phenomenon to study its specificity in all its complexity and identify implications. During all these years, the world community provided foreign aid to the country but it did not change the situation. For this reason, it is ineffective and there must be found other solutions to the problem. Thus, in the past, interventions for malnutrition have mainly focused on treatment and emergency relief aid in Ethiopia, but a more effective and sustainable solution would be to focus on prevention that encompasses a multi-sectoral approach.

Background

The main cause of the malnutrition in Ethiopia is often called a drought. In fact, the climatic causes do play a role in the tragedy, however, there are also other, more important factors. Military conflicts, government policy, economic conditions, constant poverty, dishonesty of the developed countries, and the geographical factors – all this has contributed to the fact that millions of people in Ethiopia need urgent humanitarian assistance.

The problem started from the war, government policies and specific strategies of action used against the guerrillas, and the so-called social transformations in the areas where there was no insurgency in 1983-1985 (Binet, 2013). The Ethiopian government carried out a policy of genocide, using hunger. From 1982 to 1984 in northern Ethiopia there was neither rain nor water for crops and even for drinking. The government was aware of the situation but did not do any action because it did not want Eritrean army to receive food and other reserves (Binet, 2013). In 1983-1986, practically the Marxist government of Ethiopia used $ 200 million for the celebration of the 10th anniversary of coming to power while millions of poor Ethiopians lived under the threat of starvation, and hundreds died daily (Binet, 2013). 30 years ago, part of the financial aid allocated to Ethiopia Western states had been used by the Popular Liberation Front Tigray to finance their military objectives. Besides, all money was used for military purposes, so the country became poor (Binet, 2013). The same situation repeated in the Ethiopian-Eritrean war in 1998-2000. 60% of the national budget was being spent on war. Thus, the Ethiopian government never cared about its population; it was only acting for its own purposes (Binet, 2013).

Moreover, the used agricultural practices are outdated and often cause the opposite effects. According to the Ethiopian system of land possessiveness, the government owns all land and provides it in a long-term lease to the tenants. This system continues to hamper growth in the industrial sector as entrepreneurs are unable to use land as collateral for loans. In Ethiopia, thousands of hectares of land are planted with corn and grain, but residents are still starving. It is the result of the wrong agricultural policy, mismanagement, and tyranny. These lands were bought or leased by foreign investors to produce biofuels. This situation is characterized by experts as agricultural imperialism. It is one of the malnutrition causes because the Ethiopian people cannot consume food produced in their own land (“Global Nutrition Report 2015,” 2015).

In addition, the agricultural policies of developed countries increase the poverty of Ethiopian people. Thus, subvention import of agricultural products from the industrialized countries, especially from the EU, destroys local food markets. Artificially reduced price of corn and wheat import from EU countries to Africa has created a glut of these products on local markets. Therefore, corn exempted from customs duty is 55% cheaper than that grown in Ethiopia (“Global Nutrition Report 2015,” 2015). Moreover, there are shortcomings of the existing distribution system in the world. The slowdown in food production, which is observed in recent years, is mainly due to a voluntary restriction of production by developed countries to prevent price reductions (“Global Nutrition Report 2015,” 2015)..

Additionally, the current distressful situation reveals the fragility of the economic successes, which Ethiopia made over the last decade. In 2005-2015, Ethiopia has implemented a rapid economic growth, on average by 10.6% per year. Nevertheless, taking into account the significant population growth (2.5% per year), the number of which now amounts to 96.5 million, many economic achievements are neutralized, and their immediate effect on people’s lives is erased (Symaco, 2014). The more people – the less food.

In addition to economical causes, the cost of food in some areas of Africa, particularly Ethiopia, has increased three times. As a result, people who already suffer from continuous drought are literally in poverty. Some roads are littered with dead livestock. There is almost no pasture or water for the animals left, on which people could rely (“Global Nutrition Report 2015,” 2015).

Due to the poverty, Ethiopia is not able to buy products on the world market. Moreover, funding and logistical problems are major obstacles in the fight against the emergency in Ethiopia. In December 2015, the Government of Ethiopia stated that it takes at least $ 1.5 billion to address humanitarian catastrophe. The United States has provided only $ 97 million. In 2014, Russia donated 66 million dollars, but now, it does not react to the aid request (“U.S. Response to The Ethiopian Drought 2015-2016,” 2016). The logistic cause consists in the fact that the food is imported through neighboring Djibouti, where the ships usually wait a few days for the berth (Symaco, 2014). The products are then passing thousands of kilometers, often on winding mountain roads, to get to the people who need them. After such a trip, the products can be often spoiled or damaged. Besides, Ethiopia borders with Somali, what contributes to the fact that convoys of food are often attacked by Somali pirates (Symaco, 2014). However, the inaction of the government also plays a huge role here.

The last and one of the most important backgrounds of the problem is an environmental effect. Ethiopia is constantly suffering from the drought that alternates with floods. The drought that is nowadays in the country is the most intensive since several decades. It has led to a decline in the harvest by 50-90% in some regions and to almost complete loss of harvest in the northeastern part of Ethiopia. Besides, 80% of the population is involved in Ethiopian agriculture (“Global Nutrition Report 2015,” 2015). Thus, a large-scale drought adversely affects the living conditions of millions of people and contributes to the malnutrition. People and animals are forced to drink dirty water, which remains in the region. However, the government also plays a key role. It did not even provide a system of water reservoirs that would be very effective considering the heavy rains.

Thus, all this has contributed to the four basic forms of malnutrition in Ethiopia: acute and chronic malnutrition, iron deficiency anemia, a deficit in vitamin A, and iodine deficiency disorder. In Ethiopia, iron deficiency anemia is found in 53.5 % of children under five years old and in 26.6 % of women (Gebremichael, 2015). 4.5 millions of people in Ethiopia are in need of emergency food assistance (Ababa, 2011). Especially strongly this problem has reached children and women. 47% of children under five years old are undersized. It is the fourth highest rate in Africa after Zambia, Madagascar, and Malawi (“Nutrition: 6. Common Nutritional Problems in Ethiopia,” n.d.). 10% are wasted, and 29% are underweight. In 2011, the mortality rate of children under five years was 88 individuals per 1,000. The infant mortality rate was 59 individuals per 1,000 live births (“Ethiopia: situation analysis for Transform Nutrition,” 2011). 20 million of children under five years old are subjected to the severe acute malnutrition.

The malnutrition rate is also very high among women. 27 % of women are thin. Their body mass index is less than 18.5. The malnutrition of women makes them sick mothers and leads to suffering of their children. 17% of women between 15 and 49 years old have anemia. Moreover, near 50 thousand infants die annually due to the poor breast-feeding; it is 18 % of all infant deaths. Approximately every third baby is not breast-fed within one hour after birth, and many children continue to be exclusively breast-fed without additional food after six months. At that age, breast-feeding is not able to provide needed calories, proteins, vitamins, and minerals. Moreover, due to the anemia, mothers lack in milk (Rajkumar, et al., 2012).

The scale of the effects of drought and famine is horrendous – according to the UN, 400,000 children and 700,000 pregnant or new mothers experience extreme malnutrition. More than 10 million people are directly affected by the drought, and 100 000 people are forced to flee from disasters by internal displacement. The drought leads to the loss of hundreds of thousands of cattle, and the lack of prompt response in the near future can cause an increase in parasitic diseases of animals and diseases transmitted by food.

Since the second part of the twentieth century, the world community has not learned how to prevent such disasters. All these years, the world developed companies and organizations have been providing humanitarian aid, and focused only on treatment and emergency relief, but it has not changed the situation. Providing emergency relief exclusively is ineffective. The depletion of land in the normal amount of precipitation is not able to feed the people processing it, and in a drought almost does not give the harvest. Social problems, low level of farming, and lack of investment turn the threat of hunger in a permanent phenomenon. Thus, it is necessary to take systematic measures, but not to look at the problem from one side.

Supporting Arguments

There are many arguments that support the multi-sectoral approach to the malnutrition issue in Ethiopia. The most important of them are improvement of nutrition practices and mother education, agricultural interventions, economic strengthening, strengthening of political will and advocacy, and strengthening of WASH.

Improvement of Nutrition Practices and Mother Education

Women usually are the last who eat and in the smallest amounts. Education can change this. According to the studies, mothers who did not attend a school are more likely to have an underweight child than those who did attend (“Tackling child malnutrition,” 2012). There is evidence showing that when women are empowered and educated, the infant mortality declines, the child health and nutrition improve (Reinhardt & Fanzo, 2014). Thus, it is important to educate Ethiopian women. Moreover, it is significant to establish social transfer programs. Such programs can promote correct nutrition and stimulate mothers to attend prenatal care and participate in nutrition education for remuneration (“Multi-sectoral Approaches to Nutrition,” n.d.). Nutrition education programs combining with money transfers communicate the importance of consumption of food rich in nutrients to mothers, what contributes to the fact that they select better foods and what, thereby, improves the nutrition results and facilitates the malnutrition (“Multi-sectoral Approaches to Nutrition,” n.d.).

Agricultural Interventions

In the world, there is such a tendency that investments in agricultural sphere decrease poverty, food insecurity, and malnutrition (“Multi-Sectoral Nutrition Strategy,” 2014). Proper agriculture means increased and improved diversity of landscapes and available products grown on those lands, what contributes to the dietary diversity; they just need investments. The research proved that proper agriculture improves dietary patterns and some micronutrient intakes, particularly vitamin A. Other studies, particularly dairy goat project in Ethiopia, have shown reductions in children stunting due to the agricultural strategies (Masset, et al., 2012). Another review has shown that home garden programs made people consume more fruit and vegetables, fish, milk, what has improved the dietary diversity. Besides, the consumption of milk and animal food, in general, lowers the risk of stunting because of their micronutrients and a large amount of high-quality elements. Moreover, when consuming meat, the risk of children anemia decreases (Reinhardt & Fanzo, 2014). Additionally, the effective implementation of agricultural technology interventions can lead to the reduced food prices because of increased production (“Improving nutrition through multi-sectoral approaches,” 2013). For this reason, it is important to approach the problem also from the side of investments in agriculture.

Economic Strengthening

According to the USAID research, poverty, food insecurity, and good nutrition are directly connected (“Multi-Sectoral Nutrition Strategy,” 2014). Groups of poor people usually have no access to nutritious food, good education, and proper health services. Economic strengthening and linking to the social factors can promote people’s resistibility to the disasters that have led to the issue, improve food security, and cope with malnutrition through employment generation, professional education, micro-credits etc. (“Multi-Sectoral Nutrition Strategy,” 2014). Moreover, the economic strengthening leads to the higher purchasing power and the reduced prices. Thus, people will be able to buy products.

Strengthening of Political Will and Advocacy

According to the USAID research, political will plays a key role in creating the environment that contributes to the right nutrition. The government issues laws, makes arrangements, controls finance and does many other things that directly influence the malnutrition (“Multi-Sectoral Nutrition Strategy,” 2014). The culture and policy play an important role in the advocacy efficiency (Pelletier, et al., 2013). Advocacy partly unites and coordinates all interested parties, particularly governments, international organizations, and benefactors. Appropriate data collection is a part of efficient advocacy. Because of the versatility of malnutrition, the data about nutrition should reflect all involved spheres, including level of population, particular nutrition data, such as dietary, water, and sanitation hygiene indicators (WASH). Without the diversity of information, advocates cannot determine the volume of the program (Reinhardt & Fanzo, 2014). A great example of the necessity and importance of proper advocacy is the creation of emergency nutrition coordination unit in several regions of Africa. It has been monitoring the nutritional situation and properly collecting data, and thereby, it increased the harmonization of nutrition-related programs that helped to manage the malnutrition (Rajkumar, et al., 2012).

Strengthening of WASH

The ability to use clear water, sanitation facilities, and a proper hygiene can influence the nutritional situation by reducing the causes of malnutrition. Such important things as washing hands utilizing soap, processing and proper preservation of drinking water, and sanitary removal of excrements lead to the reduction of diarrhea spread that is the main cause of low child nutrition (Reinhardt & Fanzo, 2014). The absence of appropriate sanitary conditions is directly connected with undersize of children. The environment polluted with excrements leads to the chronic intestinal diseases, even when diarrhea is not observed. Thus, it is important to maintain the area where the food is prepared in clean conditions, separated from raw and subjected to heat treatment. It is also carefully and thoroughly cooked, and properly stored. Additionally, it is important to use covering for the prepared food, as well as clean places where children play to prevent them from contacts with excrements (Reinhardt & Fanzo, 2014).

Opposing Arguments

Population of Donor Countries is Against

According to the survey made by Debate, 56% of people do not want the US to help other countries (“Should the United States help other countries?,” 2013). People are against any foreign help. They want the US to fix its own economy before anything else. They think that in the US there are lots of people that need help from their home country, and they are more important than others. This fact also confirms the article in the Daily American (Scribner, 2009). Such thoughts and opinions can lead to the rebellion in the country or even to the civil war between people whose views have divided. The multi-sectoral approach leads higher investments, so it can sharpen the problem. Thus, the US, or any other helping country, is compromised to the social adversity.

Not Economically Beneficial for Donor Countries

According to the Global Humanitarian Assistance, only in 2013, the US has provided foreign aid to Ethiopia in the amount of 235.5 million dollars (“Ethiopia,” n.d.). The total amount is more than 3 billion dollars. And it is only the official humanitarian assistance. The official developed assistance that involves the multi-sectoral approach is three times higher (“Ethiopia,” n.d.). Thus, the multi-sectoral approach involves higher expenses that devastate the budget of the donor country. The money could be spent on the development of own economy and betterment of the financial condition of the own population. It is also the cause of the previous argument.

Dependency on the Foreign Aid or Losing the Independence

According to the BBC, undeveloped countries, like Ethiopia, can become too much depended on the foreign aid (“Advantages and disadvantages of aid,” n.d.). Confucius said: “Give a man a fish, and you feed him for a day; teach a man to fish, and you got rid of feeding him for a lifetime.” When a country receives millions of dollars of foreign aid, it loses the competitiveness of its economy on the world market due to the rapid growth of exchange rate. The countries can deeply poach into debt because usually foreign aid is not given for granted, but in the form of loans. In addition, Sophal Ear confirms this fact in his book, providing Cambodia as an example (Ear, 2012). Thus, multi-sectoral approach, requiring even more investments, can lead to the Ethiopian dependency on the foreign aid.

Undermining of Other Agriculture

One of the most important things in the multi-sectoral approach is to focus on the health nutrition and consumption of foods with enough quantity of necessary vitamins, microelements, etc. The focus on nutritious food can undermine the production and export of coffee that is widespread in Ethiopia, and, thereby, even worsen the economic condition of the country.