Horn of Africa Complex Emergency Fact Sheet #7

July 10, 2017

  • Famine Early Warning System (FEWS) NET expects persistent food security crisis through early 2018.
  • USAID/OFDA staff assess health, nutrition, and water, sanitation, and hygiene (WASH) needs in northern Kenya.
  • US Government (USG) announces nearly $126 million in new humanitarian assistance for Somalia and Somali refugees in the Horn of Africa region.

On July 8, U.S. President Donald J. Trump announced nearly $639 million in new humanitarian funding to support emergency response activities in Nigeria, Somalia, South Sudan, and Yemen—the four conflict-affected countries facing severe food insecurity and malnutrition crises—as well as neighboring countries hosting refugees fleeing those crises. The new funding includes nearly $126 million in new humanitarian assistance for drought- and conflict-affected Somalis, which brings the total U.S. Government (USG) humanitarian assistance for Somalia to nearly $336.7 million to date in FY 2017.

Response stakeholders continue to highlight concerns regarding deteriorating nutrition conditions in Somalia, Ethiopia, and Kenya. Nutrition actors in Somalia have admitted approximately 126,000 severe acute malnutrition (SAM) cases to date in 2017, including approximately 25,000 new cases admitted in June. In addition, nutrition actors in Ethiopia reported nearly 110,700 SAM admissions between January and April—marking a 125 percent increase from the same period in 2016—and nutrition actors in Kenya reported nearly 43,600 SAM admissions between January and May.

Approximately 761,000 people in Somalia were displaced by drought between November 2016 and June 2017, the UN reports. The total includes an estimated 13,500 internally displaced persons (IDPs) who arrived in Bay Region’s Baidoa town between June 1 and 23, primarily from remote villages in Bay and neighboring Bakool Region’s Rabdhure District. Primary needs among the newly arrived IDPs include emergency food and shelter assistance and access to safe drinking water, according to the UN.

Between June 19 and 23, USAID/OFDA staff traveled to northern Kenya’s Marsabit and Turkana counties—where nutrition actors have identified pockets of malnutrition exceeding 30 percent, more than twice the UN World Health Organization (WHO) emergency threshold—to evaluate humanitarian response activities and remaining needs.

Numbers At A Glance

6.7 million

People in Somalia Experiencing Acute Food Insecurity

7.8 million

People in Ethiopia Experiencing Acute Food Insecurity

2.6 million

People in Kenya Experiencing Acute Food Insecurity

3.2 million

People in Somalia Experiencing Crisis or Emergency Levels of Acute Food Insecurity


Somali Refugees in Neighboring Countries

Humanitarian Funding

For the South Sudan Response

USAID/OFDA $269,168,262
USAID/FFP $874,969,480
State/PRM $346,392,670
Total $1,490,530,412

Following the poor performance of March-to-June seasonal rains in the Horn of Africa region, most areas have remained seasonally dry in recent weeks, the USAID-funded Famine Early Warning Systems Network (FEWS NET) reports. Satellite-based surface water monitoring indicates decreased water availability in southern Somalia, southeastern Ethiopia, and northeastern Kenya, likely resulting in deteriorating pasture conditions during the July-to-September dry season, according to FEWS NET. Kenya’s Isiolo, Kajiado, Laikipia, and Turkana counties will also likely be negatively affected by deteriorating rangeland conditions, FEWS NET reports. FEWS NET expects the food security crisis in the Horn of Africa region to persist into early 2018, with vulnerable populations in Somalia and southeastern Ethiopia likely facing Emergency—IPC 4—levels of acute food insecurity through early 2018 and the persistent risk of Famine—IPC 5—in areas of Somalia.

Despite some improvements in drought conditions in localized areas following April-to-June gu rains, overall below-average gu rainfall was insufficient to end Somalia’s ongoing drought, which is expected to continue until at least the onset of the deyr rainy season in October, according to the UN Food and Agriculture Organization (FAO)-supported Somalia Water and Land Information Management (SWALIM). The gu rains sufficiently recharged only 20–40 percent of ground water sources, primarily in northern parts of the country, according to SWALIM. The rains also resulted in pasture regeneration in some areas, which has provided grazing lands for livestock. However, rainfall amounts and vegetation conditions remain significantly below the long-term average in many areas, particularly in southern Galgadud, Gedo, Lower Shabelle, and Mudug regions and parts of northern Sanaag and Sool regions.

FAO reports that poor livestock body conditions, causing low productivity and birth rates, persist across Somalia due to pasture and water shortages. In severely drought-affected areas, FAO estimates 40–60 percent herd reductions since December 2016 due to livestock deaths and the forced sale of livestock assets. FAO anticipates an unfavorable 2017 gu harvest due to the poor and erratic rains, which would further compound an already dire food security situation. FEWS NET estimates that the gu harvest will be up to 60 percent below average, resulting in continued Emergency—IPC 4 —levels of acute food insecurity through at least September.4

Internal displacement continues to drive humanitarian needs in Somalia, with approximately 761,000 people displaced due to drought since November 2016, the UN reports. Despite a downward trend in new displacement between mid-April and mid-June, relief actors recorded a recent spike in new IDP arrivals to Baidoa, with approximately 13,500 new IDP arrivals in Baidoa between June 1 and 23. The majority of the newly displaced households are from remote villages in Bay and Rabdhure and include a significant number of vulnerable individuals, including children, the elderly, and pregnant and lactating women, the UN reports. Given limited capacity at existing IDP sites in Baidoa, most recent IDPs have sought shelter on the outskirts of the town, with approximately 8,160 of the new arrivals sheltering at two new IDP settlements west of Baidoa. Relief agencies have provided some food and medical assistance at the two sites; however, newly displaced populations continue to require emergency food and shelter assistance and safe drinking water, the UN reports.

The Federal Government of Somalia (FGoS) Ministry of Health (MoH) and WHO reported approximately 1,980 new suspected cholera cases and 13 related deaths between June 12 and 18. During the same period, the semi-autonomous region of Somaliland MoH reported nearly 1,160 cholera cases and two related deaths, including more than 700 cases—nearly 61 percent of the Somaliland total—in Togdheer Region. As of June 18, the FGoS MoH and WHO had recorded more than 53,000 suspected cholera cases and 795 related deaths since January; relief actors are seeking clarification on whether the countrywide total includes Somaliland.

On June 27, the Somalia Water, Sanitation, and Hygiene (WASH) Cluster—the coordinating body for humanitarian WASH activities, comprising UN agencies, non-governmental organizations (NGOs), and other stakeholders—released an advocacy note highlighting the continued widespread transmission of cholera in Somalia and urging the international community to support WASH agencies to scale up the response. Despite significant WASH support in most districts of Somalia, with cluster partners facilitating access to safe drinking water for an estimated 706,900 people in May, relief agencies require additional resources to meet the increasing need. As of June 19, the WASH Cluster reported receiving only $30.3 million—approximately 27 percent—of the $111.6 million requested in the Revised 2017 Somalia Humanitarian Response Plan (HRP), released in May. The cluster warns that, without urgent action to increase WASH services, including the continued provision of safe water; an increase in emergency latrines, especially in new IDP settlements; and extended hygiene promotion activities, the cholera outbreak will continue to threaten the most vulnerable populations in Somalia. The Somalia Humanitarian Fund (SHF)—a country-based pooled fund managed by the UN Office for the Coordination of Humanitarian Affairs (OCHA)—recently allocated an additional $6.5 million to address IDP needs in Somalia’s Banadir and Bay regions, including in Baidoa and Mogadishu, and prevent further cholera transmission in Somaliland.

International media report that more than 20,000 children residing in areas of Somalia controlled by armed groups are experiencing SAM, according to preliminary results from a recent survey conducted by Action Against Hunger, Concern Worldwide, and Save the Children. In Hiraan Region’s Mataban District, one of nine assessed districts, the survey indicates a SAM prevalence of 9.5 percent, significantly higher than the WHO emergency threshold of 2 percent. An estimated 275,000 individuals are projected to experience SAM by the end of 2017, according to the revised 2017 HRP.

On July 8, the USG announced nearly $126 million in new humanitarian assistance for conflict- and drought-affected people in Somalia. The total includes more than $4.8 million from USAID/OFDA—including $3.5 million to an implementing partner for agriculture, livelihoods, logistics, protection, and WASH support in Somalia’s Bay, Lower Shabelle, Middle Shabelle, Nugal, and Woqooyi Galbeed regions—as well as $30 million from State/PRM for assistance to Somali refugees, IDPs, and conflict-affected people in Somalia. In addition, USAID/FFP contributed more than $91.1 million in emergency food assistance for the Somalia crisis, including $67.6 million to the UN World Food Program (WFP) and $23.5 million to NGO partners. The funding includes 19,580 metric tons (MT) of U.S. in-kind food aid—valued at $34.6 million—and support for food vouchers and cash transfers for food.

As of June 18, health workers had recorded more than 37,500 acute watery diarrhea (AWD) cases and 780 related deaths in Ethiopia’s Afar, Amhara, Oromiya, Somali, and Southern Nations, Nationalities, and Peoples (SNNP) regions, WHO reports. Of the total, more than 33,460 cases and nearly 750 related deaths—89 percent and 96 percent, respectively—occurred in Somali. During the week of June 12, health actors reported more than 660 new cases countrywide, including more than 430 cases in Somali, 160 cases in Oromiya, and nearly 70 cases in Amhara. In each of the regions reporting active transmission, the number of cases decreased as compared to the previous week. However, the number of AWD cases reported to date in 2017 remains significantly higher than the number of cases reported in 2016, according to WHO.

USAID/OFDA supports NGO partner the International Rescue Committee (IRC) to provide emergency WASH assistance in AWD-affected areas of Oromiya and Somali. With USAID/OFDA assistance, IRC is conducting AWD case management trainings and providing AWD treatment supplies, such as chlorine sprayers, sanitary materials, and soap, at local treatment facilities; facilitating access to safe drinking water by chlorinating water sources and conducting outreach campaigns on water treatment techniques; and training community health volunteers and community and religious leaders on AWD prevention and control practices. In addition, through $4.8 million in ongoing FY 2016 assistance, USAID/OFDA has supported IRC to reach more than 1.9 million people countrywide with emergency WASH assistance, such as hygiene promotion campaigns and trainings on household water quality testing and safe handwashing practices.

Nutrition actors in Ethiopia admitted approximately 110,700 new SAM cases to therapeutic feeding programs (TFPs) between January and April, according to the Ethiopia Nutrition Cluster. The total includes approximately 27,700 SAM cases admitted in April—an 11 percent decrease from March admissions. However, the April total remains 125 percent higher than the number of TFP admissions during the same month in 2016, the UN reports. Ethiopia’s acutely drought-affected Somali Region continues to report the highest SAM admission rates, with nearly 6,800 new admissions—25 percent of the national total—in April.

USAID/OFDA is supporting NGO partners to provide multi-sector assistance, including critical nutrition support, in Somali. With USAID/OFDA support, Save the Children/U.S. (SC/US) is providing livestock support and managing cash-for-work projects to strengthen community assets; providing training, surveillance, and logistics support at malnutrition treatment sites to bolster malnutrition treatment; and implementing WASH interventions, including distributing water purification supplies, conducting hygiene promotion training, and rehabilitating water supply infrastructure to help drought-affected communities cope with water shortages and associated spikes in waterborne disease outbreaks. In addition, Mercy Corps is bolstering community management of acute malnutrition, promoting safe hygiene practices among drought-affected communities, and supporting improved sanitation infrastructure at health facilities across ten Somali districts

On June 21, USAID/OFDA staff, including technical advisors specializing in health, nutrition, and WASH, traveled to acutely drought-affected Turkana to assess ongoing drought conditions and observe SC/US response activities. SC/US is conducting nutrition and WASH interventions, including improving water access at health facilities and supporting outreach activities to identify and treat acute malnutrition, in Turkana’s Kibish, Turkana Central, and Turkana North sub-counties. During the site visit, USAID/OFDA staff confirmed increased health, livelihoods, nutrition, and WASH needs in Turkana. At an integrated health and nutrition outreach site in Turkana Central, for example, community members reported walking up to 6 miles to seek treatment. Additionally, the outreach site was crowded, demonstrating a high demand for health and nutrition services in rural areas. USAID/OFDA staff also observed severely restricted water access in Turkana Central, including dry and low-yielding wells and boreholes, and community members collecting water from holes dug in dry river beds.

From June 19–23, USAID/OFDA staff traveled to Marsabit to evaluate ongoing drought conditions and observe response activities conducted by NGO Food for the Hungry (FH). FH is implementing nutrition and WASH programs, including supporting outreach activities to identify and treat acute malnutrition and improving water access for drought-affected communities, in Marsabit. In North Horr sub-county, which has reported global acute malnutrition levels exceeding 30 percent—at least twice the WHO emergency threshold of 15 percent— USAID/OFDA staff observed local health officials, supported by FH staff, screening children and pregnant and lactating women for acute malnutrition and providing nutrition commodities at a community outreach site.

USAID/FFP partner WFP reached approximately 594,500 people in Kenya with in-kind food and cash-based transfers under its livelihood assistance program in May. WFP also provided emergency food assistance to drought-affected households in Mandera and Marsabit counties and plans to continue relief distributions in additional drought-affected counties in the coming weeks. In addition, WFP reached approximately 35,700 children younger than five years of age with moderate acute malnutrition (MAM) treatment. WFP also commenced distributions of SuperCereal Plus, a specialized nutrition commodity to prevent acute malnutrition, reaching 35,600 children younger than five years of age and pregnant and lactating women in Marsabit and Turkana. In July, WFP plans to provide approximately 545,000 children younger than five years of age and pregnant and lactating women in the two counties with interventions to prevent acute malnutrition.

Recurrent natural disasters and ongoing complex emergencies remain major contributors to vulnerability across the Horn of Africa, negatively affecting the lives and livelihoods of populations across the region. Somalia has experienced a persistent complex emergency since 1991 due to chronic food insecurity, widespread violence, and recurring droughts and floods. The 2011 drought severely reduced food security among Somali pastoralists and populations in marginal farming areas, resulting in Famine levels of food insecurity in areas of Bakool, Bay, Lower Shabelle, and Middle Shabelle regions, as well as among IDPs in Mogadishu and the nearby Afgooye corridor.

Despite modest improvements in recent years, malnutrition rates in Somalia remain among the highest in the world, and ongoing insecurity in the country—particularly in areas that lack established local authorities and where al-Shabaab is present—contributes to the complex emergency. Sustained life-saving assistance, coupled with interventions aimed at building resilience, is critical to help vulnerable households meet basic needs, reduce malnutrition, and protect livelihoods. An estimated 6.7 million people require humanitarian assistance between January and December 2017.

Since the Horn of Africa drought crisis of 2011, USAID has scaled up efforts to build resilience in drought prone areas, and the governments of Ethiopia and Kenya are leading current response efforts in their respective countries, with support from the USG, other donors, and relief actors.

Multiple consecutive seasons of below-normal rainfall and the effects of the 2015/2016 El Niño climatic event resulted in deteriorating agricultural, livestock, food security, and nutrition conditions in northeastern and central Ethiopia. By December 2015, the GoE estimated that 10.2 million people required relief food assistance and other humanitarian interventions during 2016, in addition to nearly 8 million chronically food-insecure people requiring Productive Safety Net Program support.

In response to the drought in Ethiopia, USAID activated a Disaster Assistance Response Team (DART) and Washington, D.C.,-based Response Management Team (RMT) in March 2016; the DART and RMT stood down in November 2016 as humanitarian conditions improved. In April 2017, the GoE estimated that 7.8 million people will require humanitarian assistance in Ethiopia through December, primarily due to newer drought-related needs in southern and southeastern parts of the country.

In addition to drought, populations across Ethiopia confront other challenges—including seasonal flooding, localized intercommunal conflict, above-average food prices, disease outbreaks, and limited access to health and WASH services—that contribute to sustained humanitarian needs and an ongoing complex emergency.

In Kenya, drought conditions have exacerbated chronic stressors, including food insecurity and malnutrition. Through ongoing FY 2015 and 2016 programs, USAID/OFDA and USAID/FFP are supporting efforts to strengthen health and nutrition systems in drought-affected areas in coordination with USAID/Kenya resilience initiatives to mitigate the effects of recurrent natural hazards.

On October 6, 2016, U.S. Ambassador Stephen M. Schwartz renewed the disaster declaration for the complex emergency in Somalia for FY 2017. On March 28, 2017, Ambassador Schwartz declared a separate disaster due to drought and food insecurity in Somalia for FY 2017.

On October 18, 2016, U.S. Chargé d’Affaires, a.i., Peter H. Vrooman redeclared a disaster for Ethiopia in FY 2017 in response to the ongoing complex emergency.

On February 17, 2017, U.S. Ambassador Robert F. Godec declared a disaster for Kenya due to the effects of drought and increasing food insecurity and malnutrition.