In Burkina Faso, an innovative concept launched in mid-January will make it possible to offer better healthcare to more than half a million children under five, thus reducing child mortality.

Just imagine a primary health care centre in Burkina Faso: we are out in the bush, the small one-storey building is pervaded by the red dust brought in from the nearby desert. Wrapped in bright garments, mothers are patiently waiting for their consultations in the shade of a shed, babies on their backs. The place is open to the winds; goats and fowls wander around. No electricity, running water or tarmac has yet reached this village.

The male nurse calls the next patient. White coat, stethoscope, assured air, he gets out his touchpad and starts to question the mother and examine the child. In a few moments he enters the information on his device and instantly receives the right diagnosis and treatment with its dosage. The nurse writes a prescription for the mother and ‘pushes’ the Electronic Medical Record of the child into Cloud Storage. The stock of the pharmacy is immediately up-dated and the health district management team registers the consultation.

That evening, the nurse turns on his tablet again, peruses the day’s results, replies to questions from the district medical officer and starts his half-hour of continuing online education. In 2016, this scenario will become reality...

A daring challenge

In this country, one of the world’s poorest, one child in six does not reach the age of five, mainly due to badly-diagnosed minor conditions. Burkina Faso Burkina Faso is desperately lacking in qualified medical personnel. There is but one doctor for ten thousand inhabitants (compared with Switzerland, where there are 41 doctors for the same number of people), and this is the reason why children are usually examined by a nurse or health agent in rural areas.

Today, however, we should be able to prevent at least 80% of these deaths caused by malnutrition, malaria, diarrhoea, parasitosis and respiratory infections. For this reason, Tdh, in collaboration with the Burkina Faso Ministry of Health and with the support of the Bill & Melinda Gates Foundation, has launched the IeDA (Integrated e-Diagnostic Approach). This innovative project will make it possible to improve the country’s healthcare system by computerizing the data from healthcare centres for children under five.

The approach is built on four hundred electronic tablets equipped with a SIM card and software, with the aim of improving the diagnoses made by nurses out in the brush.

Exemption from payment for universal access to treatment

In advance of this technological innovation, a third-party payer system has been tried out by Tdh in the same two health districts since 2008. This allows exemption from payment for healthcare for all children under five, as well as for pregnant and breastfeeding women. Free healthcare has in particular multiplied by seven the number of consultations for children, generating over three contacts per year per child, and 100% of the births are assisted by qualified personnel.

One of the essential factors needed to ensure the success of implementing exemption of payment has been the establishment of an inspection system to avoid abuses. This has made it possible to reduce the cost of consultation and treatment of childish ailments treated in the healthcare centres by 40%.
The results speak for themselves

The situation is gradually improving, thanks to the combined actions of supporting the healthcare systems, the integrated treatment of childish ailments, the free treatment and its good quality. The Head of Tdh’s delegation in Burkina Faso, David Kerespars, is very satisfied with the progress made in the six years of the project. “In the Boucle du Mouhoun region, for example, the rate of acute malnutrition has gone down from 15% to 5%!” He added that screening coverage is now estimated to be 100%.

Au Burkina Faso, un concept innovant lancé mi-janvier, va permettre chaque année d’offrir de meilleurs soins à plus d’un demi-million d’enfants de moins de cinq ans et ainsi de faire reculer la mortalité infantile.

Il faut se représenter un centre de santé primaire au Burkina Faso: nous sommes en brousse, le petit bâtiment de plein pied est envahi de cette poussière rouge que ramène le désert tout proche. Des mamans, enrubannées dans leurs pagnes chatoyants, attendent patiemment la consultation, à l’ombre d’un hangar, leurs bébés apaisés sur leurs dos. Le lieu est ouvert aux quatre vents, chèvres et pintades s’y promènent librement. Ni l’électricité, ni l’eau courante, ni le goudron n’ont encore atteint le village. Soudain l’infirmier appelle le prochain patient. Blouse blanche, stéthoscope, mine assurée, il sort sa tablette tactile, commence à questionner la maman, ausculte l’enfant. En quelques secondes, il entre les informations sur son appareil qui instantanément lui propose un diagnostic juste et un traitement avec posologie. L’infirmier griffonne alors une ordonnance qu’il remet à la maman et «pousse» le dossier médical électronique de l’enfant dans le «Cloud». Immédiatement, le stock de la pharmacie est mis à jour et l’équipe cadre du district sanitaire enregistre la consultation.

Le soir, l’infirmier rallume sa tablette, consulte le bilan de sa journée, répond aux questions que le médecin du district lui a adressées et entame sa demi-heure de formation continue en ligne. En 2016, ce scénario ne sera plus de la fiction…

Un défi audacieux

Dans ce pays parmi les plus pauvres, un enfant sur six n’atteint pas l’âge de cinq ans, principalement à cause de pathologies bénignes mal diagnostiquées. Le Burkina Faso manque cruellement de personnel médical qualifié. Il n’y a qu’un médecin pour dix mille habitants (à titre de comparaison la Suisse dispose de 41 médecins pour le même nombre de personnes), c’est pourquoi les enfants sont la plupart du temps examinés par des infirmiers ou des agents de santé dans les zones rurales. Pourtant, nous serions aujourd'hui capables de prévenir au moins 80% de ces décès dus à la malnutrition, au paludisme, aux diarrhées, parasitoses et affections respiratoires. C’est pourquoi Tdh, en collaboration avec le Ministère de la Santé du Burkina Faso et avec le soutien de la Bill & Melinda Gates Foundation, a lancé le IeDA (Integrated e-Diagnostic Approach). Ce projet innovant va permettre d’améliorer le système de santé du pays, en informatisant les données des centres de soins pour les enfants de moins de cinq ans.

L’approche repose sur quatre cents tablettes électroniques équipées d’une carte SIM et d’un logiciel ayant pour objectif d’améliorer les diagnostics posés par les infirmiers en brousse.

Exemption de paiement pour un accès universel aux soins

En amont à l’innovation technologique, un système de tiers payant a été expérimenté par Tdh dans les deux mêmes districts sanitaires depuis 2008. Ceci a permis d’exempter de paiement des soins de santé tous les enfants de moins de cinq ans, ainsi que les femmes enceintes et allaitantes. La gratuité des soins a notamment permis de multiplier par sept le taux d’utilisation des services de consultations des enfants en générant plus de trois contacts par an et par enfants et 100% d’accouchement assistés par du personnel qualifié.

L’un des facteurs essentiels pour garantir le succès de la mise en œuvre de l’exemption de paiement a été la mise en place d’un système de contrôle performant, indispensable pour éviter les abus. Ce dernier a permis de réduire de 40% les coûts de consultation et de traitement des maladies infantiles traitées dans les centres de santé.

Et les résultats sont au rendez-vous

La situation s’améliore graduellement grâce à l’action combinée de l’appui aux systèmes de santé, la prise en charge intégrée des maladies de l’enfance, la gratuité des soins et leur qualité. Le chef de délégation de Tdh au Burkina Faso, David Kerespars, est très satisfait des progrès accomplis durant les six années du projet. «Dans la Boucle du Mouhoun, par exemple, le taux de malnutrition aiguë est passé de 15 à 5%!» Et d’ajouter que le taux de couverture des dépistages est estimé à 100%.

L’essentiel

• La situation de sécurité alimentaire se dégrade dans certaines régions du Mali, de Mauritanie, du Niger, du Sénégal et du Tchad suite à une période de soudure pastorale précoce

• Résultats d’enquête d’insécurité alimentaire inquiétants pour les zones à risque du Sénégal et de la Mauritanie

• Stabilité des prix des céréales sur l’ensemble de la région depuis décembre 2013 à des ni-veaux généralement élevés par rapport à la moyenne des cinq dernières années

MARADI/DIFFA, 5 mars 2014 (IRIN) - Au Niger, les agriculteurs des régions frappées par la sécheresse sont confrontés à une dangereuse combinaison de défis - sécheresse chronique, dégradation de la terre, nuisibles et semences de piètre qualité - qui menacent de les enfoncer davantage dans la faim et la pauvreté.

James Litzinger, un expert agronome étudiant l'usage des pesticides et des engrais que font les agriculteurs de la région centrale de Maradi au Niger, a expliqué qu'une baisse exponentielle du rendement était observée lorsque les cultivateurs étaient confrontés à une telle combinaison de problèmes. « [En matière de pertes,] un plus un égal trois », a-t-il à IRIN.

Dans un article de la revue Comptes Rendus Geoscience publié en 2009, les scientifiques Gil Mahe et Jean-Emmanuel Paturel ont attiré l'attention sur le fait que l'Afrique de l'Ouest expérimentait depuis 1970 l'un des changements climatiques les plus violents depuis l'apparition des archives météorologiques. Au nombre des agressions environnementales frappant le Niger figurent l'érosion des sols, la désertification, la dégradation des pâturages, la diminution des ressources en eau et un déclin de la couverture végétale et de la biodiversité, indique le Programme des Nations Unies pour le développement (PNUD).

Les agriculteurs du village de Malfaroua, dans la région de Maradi, rapportent que les pluies sont arrivées tardivement et ont cessé de manière précoce en 2013, ce qui a ruiné leurs récoltes. Bon nombre des 400 familles que compte le village ont déjà épuisé leurs réserves, a dit le chef de village Moussa Ibrahim. La survie de 75 pour cent des foyers du village dépend de transferts de fonds émis par des membres de la famille ayant émigré - souvent en Libye, au Nigeria ou à Agadez, dans le nord du Niger.

Les sols sont dégradés, les engrais qu'ils utilisent sont peu efficaces, et les semences sont de piètre qualité, a dit Sountalma Ousseini, coordinateur de projet auprès de l'ONG Services de secours catholique (Catholic Relief Services, CRS) au Niger.

« Ces agriculteurs sont pris dans un cercle vicieux, qu'il leur faut briser », a dit M. Litzinger.

Affections chroniques

Cette année, jusqu'à 3 millions de Nigériens souffriront d'insécurité alimentaire, selon les estimations du Bureau des Nations Unies pour la coordination des affaires humanitaires (OCHA).

De nombreuses initiatives sont en cours pour aider les agriculteurs à réhabiliter les sols appauvris et à optimiser les revenus que leur rapporte le peu qu'ils produisent.

À Malfoura, CRS a aidé les agriculteurs à mettre sur pied de meilleures installations d'entreposage pour leurs céréales. Des sacs en plastique ont également été distribués pour tenir les nuisibles à distance et éviter que les stocks ne pourrissent. Grâce à ces mesures, les agricultures peuvent vendre leur millet à 22 000 francs CFA les 50 kg (44 dollars US) pendant la période de soudure, plutôt que de le vendre 16 000 francs CFA (32 dollars US) immédiatement après la récolte.

CRS a également encouragé les femmes à économiser collectivement de façon à développer leurs activités rémunératrices.

Menées à travers toute la région, ces initiatives ont un impact. Mais compte tenu de la sécheresse chronique - le Niger a traversé trois terribles sécheresses entre 2005 et 2013 - et de la pression démographique, il est peu probable que cela suffise à mettre les villageois à l'abri du problème persistant de la vulnérabilité et de la faim.

« Le problème est en grande partie démographique », a dit M. Ibrahim en expliquant que les familles les plus nombreuses devaient survivre avec la récolte de parcelles au sol toujours plus pauvre, dont la taille ne varie pas. « L'espace dont nous disposons est surexploité, alors nous produisons moins. »

Dans le village de Guidan Sani, dans la région de Maradi, Sekina Oumarou - une mère de six enfants - a dit qu'il lui arrivait souvent de devoir attendre six heures par jour pour puiser de l'eau à l'unique puits du village. La nappe phréatique se trouve à 40 m de profondeur, et en l'absence de pompe, il n'y a qu'un bouf pour remonter les seaux.

Le niveau de l'eau baisse d'année en année, ont dit les villageois, ce qui les a contraints à abandonner l'irrigation et le maraîchage, les privant du même coup d'une précieuse source de revenus supplémentaires pour acheter de la nourriture.

Guidan Sani est entouré de dunes de sable, mais il n'en a pas toujours été ainsi. « Avant il pleuvait ici. On pouvait cultiver assez pour s'en sortir », a dit Mme Oumarou.

Tentatives et échecs

CRS a introduit dans le village une technique de maraîchage adaptée à la sécheresse importée de Madagascar. Le concept est simple : une structure en bois - habillée de plastique et remplie de couches de sable, de cendres et de fumier - capture toute l'eau que l'on y déverse, créant un microclimat humide qui filtre également les impuretés. Grâce à cela, les eaux usées domestiques - même l'urine - peuvent servir à arroser les plantes.

Avec cette technique, les familles devraient être en mesure de récolter trois fois l'an, a dit M. Ousseini.

Pour l'heure, deux structures de ce type ont été construites à Guidan Sani. Carottes, choux rouges et laitues n'étaient encore qu'à l'état de pousses lorsque les journalistes d'IRIN se sont rendus sur place début février, mais les habitants avaient bon espoir que les structures fonctionnent.

Dans le village voisin de Doukou Doukou, les familles n'ont « presque rien » récolté l'année dernière, a dit Rahat Amadou, le dirigeant d'une coopérative de femmes. Ici aussi, le sol est sec, sablonneux et stérile.

CRS a aidé les coopératives à réhabiliter les sols appauvris en créant des digues et en creusant des trous en forme de lune pour y planter des jujubiers, dont les fruits - connus localement sous le nom de « pommes du Sahel » - sont très nutritifs. Des moringas ont également été plantés, dont les feuilles nutritives servent à l'élaboration de sauces locales, et qui nécessitent très peu d'eau pour survivre.

Ici, comme en de nombreux endroits du pays, le sol est latéritique, et donc très acide, si bien que des engrais sont nécessaires pour neutraliser la terre, a expliqué M. Litzinger. La plupart des membres de coopératives avec lesquels il s'est entretenu ont dit utiliser du fumier pour fertiliser leurs moringas, mais il s'agit d'un engrais trop puissant. Il doit être associé à des branchages secs - et, idéalement, du phosphore - pour créer un compost plus efficace.

Davantage d'essais sont nécessaires pour déterminer quels engrais rechargent le plus efficacement les sols, a-t-il dit, en rappelant qu'une solution agricole destinée à une région exposée à la sécheresse ne conviendrait pas nécessairement à une autre région.

« Tout ce qu'ils font est vain », a-t-il dit. « Pour bien faire, il faut de bonnes semences au départ, des engrais corrects pour que les plantes puissent tolérer les nuisibles et un système de conservation de l'eau quel qu'il soit. Aucun de ces problèmes n'est insurmontable, mais ça demande de la planification et de l'investissement. »

Mais les habitants de Doukou Doukou n'ont pas vraiment le droit à l'erreur. « Ici, la plupart des familles disposent d'à peine un mois de réserves », a dit le chef de village Issofou Kader à IRIN. « C'est très, très difficile de faire pousser quoique ce soit dans ce sol. »

Ensablement du sol

Plus à l'est, dans les régions de Zinder et de Diffa, des bassins fertiles connus sous le nom de « cuvettes » aident les villageois à cultiver des céréales et des légumes depuis des siècles. Mais avec l'avancée du désert, des centaines d'entre eux ont été ensablés.

Entre 1986 et 2005, les secteurs de Gouré (à Zinder) et de Mainé-Soroa (à Diffa) ont perdu 34 000 hectares de cuvettes du fait de l'ensablement, et depuis la dégradation s'est très nettement accélérée, selon des études citées par le PNUD dont le responsable au Niger, Fodé Ndiaye, a qualifié la situation de « franchement alarmante ».

Les cours d'eau, y compris le Niger et le Goulbi de Maradi, de même que de vastes bassins et vallées, sont également victimes de l'ensablement. Dans certains cas, des barrages construits pour favoriser l'irrigation des cultures ont entraîné une hausse du niveau de l'ensablement dans les départements voisins, a dit M. Ndiaye.

Pratiquement toutes les municipalités du département de Gouré accusent une grave dégradation des sols, révèle le PNUD.

Le PNUD appuie le projet gouvernemental de lutte contre l'ensablement des cuvettes, connu sous l'acronyme PLECO. Il a aidé les villageois à reconquérir 7 000 acres de terres cultivables en renforçant les dunes de sable entourant les bassins de faible altitude à l'aide de tiges de millet et de matériaux locaux, et en y plantant de l'herbe et des arbustes pour ralentir l'érosion du sol. En outre, les agriculteurs reçoivent une formation portant sur des techniques agricoles durables et une gestion raisonnée de l'eau.

Il ne s'agit cependant que de projets pilotes, et une importante mise à l'échelle s'impose pour récupérer les 300 000 hectares de terrain ensablé.

Mise à l'échelle

La mise à l'échelle nationale de tels projets demanderait non seulement une forte augmentation des financements, mais également une meilleure formation et davantage d'organisation de la part des coopératives agricoles, afin qu'elles puissent tester de nouvelles méthodes d'irrigation, de conservation de l'eau et de fertilisation, a dit M. Litzinger.

« Les agriculteurs doivent s'organiser et prendre part aux essais. Il leur faudrait un peu d'entraînement, mais ce ne serait pas si compliqué », a-t-il dit.

Cela favoriserait le renforcement des liens avec les instituts de recherche scientifique et le gouvernement, et une approche gouvernementale plus proactive pour ce qui est de la formation des agriculteurs. « Il n'existe pas d'alternative pour le gouvernement hôte, si ce n'est d'aller à la rencontre de la population et lui apprendre comment surmonter ces problèmes », a dit M. Litzinger.

Lorsque les agriculteurs et les maraîchers s'organisent, même à une toute petite échelle, l'impact est considérable, selon CRS.

Dans toute la région de Maradi, des associations d'une trentaine de femmes se sont formées avec l'aide du CRS. Elles économisent collectivement pour louer des carrioles tirées par des ânes, qui leur servent à apporter leurs produits au marché, acheter de l'engrais, acheter et vendre des animaux et, dans certains cas, transformer certains aliments comme l'huile d'arachide.

L'argent économisé sert également pour des soins de santé et des articles ménagers, mais les femmes s'en servent essentiellement pour acheter de la nourriture, a dit à IRIN Uma Abdu, qui est membre de la coopérative du village de Guilglije.

Selon l'OCHA, le Niger a besoin de 390 millions de dollars pour financer la réponse d'urgence, la réduction de la vulnérabilité et des risques et les efforts visant au renforcement de la résilience en 2014. Jusqu'à présent, seuls 419 589 dollars ont été récoltés.

Des initiatives gouvernementales et locales sont également en cours pour favoriser une agriculture durable, notamment le programme « Les Nigériens nourrissent les Nigériens », mais la plupart d'entre elles souffrent d'un sérieux manque de financements.

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L’essentiel

• La situation de sécurité alimentaire se dégrade dans certaines régions du Mali, de Mauritanie, du Niger, du Sénégal et du Tchad suite à une période de soudure pastorale précoce

• Résultats d’enquête d’insécurité alimentaire inquiétants pour les zones à risque du Sénégal et de la Mauritanie

• Stabilité des prix des céréales sur l’ensemble de la région depuis décembre 2013 à des ni-veaux généralement élevés par rapport à la moyenne des cinq dernières années

Ce nombre devrait atteindre les 150 000

N'Djamena/Dakar, le 4 mars 2014 – La crise humanitaire en République centrafricaine continue de se propager aux pays voisins et l’UNICEF avertit que plus de 76 000 personnes, principalement des femmes et des enfants, ayant fui la violence en République centrafricaine pour le Tchad, ont besoin de toute urgence d’une assistance supplémentaire.

« Dans les sites de déplacement le long de la frontière, j'ai vu des personnes déplacées, pour la plupart des mères et des enfants, qui ont tout laissé derrière elles en République centrafricaine lorsqu’elles ont fui pour ne pas se faire tuer », a déclaré Manuel Fontaine, Directeur régional de l'UNICEF pour l'Afrique de l’Ouest et du Centre, qui est en visite au Tchad.

« Chaque semaine, nos équipes sur le terrain observent encore des personnes traversant la frontière vers le Tchad. Beaucoup d'entre elles, en particulier les enfants, ont été exposées à d’horribles formes de violence. »

Au cours des deux derniers mois, l'UNICEF a déployé du personnel médical supplémentaire et intensifié la distribution de fournitures vitales et d'abris dans les « centres de transit » où les personnes déplacées arrivent, en collaboration avec le Gouvernement et d'autres partenaires, y compris le HCR, l'OIM, le PAM et des organisations non gouvernementales.

Au total, quelque 30 000 personnes déplacées ont reçu des kits d'eau et d'hygiène de base, des kits médicaux et ont maintenant accès à des dizaines de forages et 300 latrines d'urgence construits par l'UNICEF. Dans le sud du Tchad, avec l'appui de l'UNICEF, plus de 12 500 enfants ont été vaccinés dans le cadre de campagnes de vaccination de masse.

Jusqu’à présent, 1 062 enfants ont été enregistrés comme étant non accompagnés ou séparés de leurs familles. Près de la moitié d'entre eux ont été réunis avec leur famille. De concert avec les autorités et l'OIM, l'UNICEF s'emploie à assurer des soins immédiats, un soutien psychosocial et la protection de ces enfants déplacés qui ont souvent vécu une expérience très traumatisante en République centrafricaine.

« Mettre fin à la crise en République centrafricaine est la priorité pour placer tout le monde en sécurité, a souligné M. Fontaine. Les besoins humanitaires énormes vont augmenter au Tchad dans les prochaines semaines. La saison des pluies approche rapidement, et de nombreux sites de déplacement sont situés dans des zones sujettes à des inondations récurrentes et des maladies d'origine hydrique. A la veille de la saison des pluies, on doit éviter une détérioration de la situation humanitaire. Nous devons nous préparer non seulement pour les nouvelles arrivées, mais aussi pour le choléra, la rougeole, le paludisme, la poliomyélite, les épidémies de méningite et les inondations. »

Le nombre de personnes traversant la frontière de la RCA au Tchad a plus que doublé en un mois.

Cependant, le manque de financement compromet les capacités de l'UNICEF et des autres organisations à fournir une assistance et un soutien aux efforts d’urgence déployés par les autorités gouvernementales et les organismes humanitaires. L’UNICEF n’a levé que 2 des 14 millions de dollars É.-U nécessaires pour répondre aux besoins immédiats.

La communauté humanitaire au Tchad estime que 33 millions de dollars sont nécessaires pour fournir une assistance d'urgence à environ 150 000 personnes déplacées au cours des six prochains mois. Outre le Tchad, d'autres pays voisins comme le Cameroun, la République démocratique du Congo (RDC) et, dans une moindre mesure, la République du Congo, sont également de plus en plus affectés par les effets de la crise humanitaire en République centrafricaine.

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Notes aux rédactions : On estime également qu’en 2014, plus de 500 000 enfants de moins de cinq ans souffriront de malnutrition aiguë dans la région sahélienne du Tchad, dont environ 126 000 enfants souffriront de malnutrition aiguë sévère.

Le manque de pluies en 2013 a considérablement affecté la production agricole, e particulier dans la région du Sahel. Cela signifie que la « saison de la faim » – d’avril à septembre – commencera tôt et que 2,3 millions de personnes, d’après les estimations, vivront dans l’insécurité alimentaire.

À propos de l’UNICEF

L’UNICEF promeut les droits et le bien-être de chaque enfant, dans tout ce que nous faisons. Nous travaillons dans 190 pays et territoires du monde entier avec nos partenaires pour faire de cet engagement une réalité, avec un effort particulier pour atteindre les enfants les plus vulnérables et marginalisés, dans l’intérêt de tous les enfants, où qu’ils soient.

Pour en savoir davantage sur l’UNICEF et ses activités : http://www.unicef.org/french

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Pour plus d’informations, veuillez contacter :

Lalaina Fatratra Andriamasinoro, UNICEF N’Djamena tél. : +235 66 36 00 42 courriel : lfandriamasinoro@unicef.org

Laurent Duvillier, UNICEF Dakar tél. : +221 77 637 66 04 courriel : lduvillier@unicef.org,

Kate Donovan, UNICEF New York tél. : 1-212-326-7452; mobile : 1-917-378-2128 courriel : kdonovan@unicef.org

HIGHLIGHTS

• FAO’s forecasts for global cereal production, consumption, trade and stocks in 2013/14 have all been raised since February, with overall supply conditions significantly improved compared to the previous season.

• Export prices of wheat rose in February mainly on concerns about the 2014 winter wheat crop in the United States. Prices of maize also increased, supported by strong domestic and export demand for feed and industrial use. Overall, however, cereal export prices remained below their year-earlier levels.

• Aggregate cereal imports in LIFDCs in 2013/14 are estimated at a near-record level mainly due to reduced harvests in Africa, overall stagnant domestic production and rising demand.

• In the Central African Republic, continued widespread conflict has displaced large numbers of people and sharply increased the dire food security situation.

• In Eastern Africa, food security conditions have deteriorated sharply in South Sudan since the conflict erupted in mid-December, and about 3.7 million people are estimated to be in need of emergency assistance.

• In Western Africa, the overall food security situation has remained stable following an above average 2013 cereal harvest. However, over 20 million people are estimated to be in need of food assistance due to insecurity and reduced crops in parts of the Sahel.

• In Southern Africa, tighter maize supplies and high food prices have affected access to food, mainly to vulnerable groups; however, conditions are expected to improve with a favourable production outlook in 2014.

• In North Africa, early prospects for the 2014 winter wheat and coarse grains crops, to be harvested from May, are favourable.

• In the Far East, overall early prospects for the subregion’s 2014 wheat crop are favourable, with record outputs expected in India and China. . However, more than 4 million people still remain displaced in the Philippines by Typhoon Haiyan.

• Conflict in the Syrian Arab Republic continues to affect agricultural production, trade and humanitarian aid distribution. The number of people in need of urgent food and livelihood assistance is estimated at about 6.3 million. In Yemen, some 43 percent of the population is estimated to be food insecure.

• In South America, overall prospects for the first season 2014 maize crop remain favourable despite dry spells in parts, as improved rainfall in early 2014 prevented significant yield reductions in the main producing countries - Argentina and Brazil. In Bolivia severe floods hit the northern El Beni department affecting the livestock sector and causing localized crop losses.

• FAO estimates that globally 33 countries, including 26 countries in Africa, are in need of external assistance for food due to or a combination of conflict, crop failures, and high domestic food prices.

Peter Clottey March 06, 2014

An African Union official says the organization’s Mission to Mali and the Sahel (MISAHEL) has launched a cooperation initiative with countries in the Sahel to combat terrorism as part of efforts to stabilize the region.

The special adviser to African Union (AU) special representative for Mali and the Sahel Pierre Buyoya says the AU is implementing the Nouakchott Agreement. Special adviser Issaka Souare says the accord between countries in the region enables security agencies to cooperate with their colleagues in neighboring countries to combat terrorism as well as investigate transnational crimes.

Souare says, “The aim of the agreement is to bring together security agents, those organs and structures that work in the security realm, so that they can work together to mutualize their efforts and their resources to fight against terrorism, and other forms of transnational criminality.”

Not much success in the past

Previous regional anti-terrorism efforts enjoyed only limited success before signing the agreement, says Souare. He says MISAHEL has been encouraging countries in the region to unite to combat armed groups who aim to destabilize the region.

“What we needed to do was to break the ice. It was the first time that heads of security intelligence services of the region came together - regularly and openly and frankly, one could argue – to discuss security challenges in the region,” said Souare.

“What we are trying is to really move now to have secure communication channels between these [security] services, and then move to have joint patrols.”

Souare says it is unlikely that individual countries in the region can separately combat cross boarder crimes and terrorism without the support and cooperation from their neighbors. The Sahel includes portions of Gambia, Senegal, southern Mauritania, central Mali, Burkina Faso, southern Algeria and Niger, northern Nigeria and Cameroon, central Chad, southern Sudan, northern South Sudan and Eritrea.

Joint security has a better chance fo success

“We are departing from the observation that most of the security challenges in the region cannot be faced by one single country,” said Souare. “You must collaborate regionally, in order to be able to defeat these challenges.”

Souare also says MISAHEL wants to start joint security patrols to combat any upsurge in cross-border crime and terrorism. He says they will consider the initiative successful if the countries themselves take the initiative to fight terrorism at the regional level.

“A good sign of the success of an initiative is when it is actually taken over by the targeted countries, when there is national ownership. Appropriation by the countries of the region is our ultimate aim,” said Souare.

“We are trying to spur this cooperation. But slowly and gradually, countries in the Sahel would take over the initiative and will no longer need the direct involvement of the African Union.”

New IFAD report shows rural women are key to unlocking economic and social benefits of adaptation

Rome, March 2014 – In advance of International Women’s Day, the International Fund for Agricultural Development (IFAD) launched a report today that highlights the vital role women smallholder farmers play in delivering both economic and social benefits when provided the right tools for adapting to climate change.

The report, The Gender Advantage: Women on the front line of climate change, shows that successful adaptation to climate change means recognizing the role of women smallholder farmers. It describes the lives of millions of women around the world who have been able to better support their families and communities because on gender-sensitive adaptation. "At IFAD, we believe in people-centered solutions that include solutions for climate change," said Kanayo F. Nwanze, President of IFAD. "We need adaptation solutions that build on the diverse knowledge, priorities and capacities of women and men."

The theme of this year’s International Women’s Day is ‘Equality for women is progress for all’, which will be commemorated by IFAD, the Food and Agriculture Organization of the United Nations (FAO) and the World Food Programme at an event at FAO’s Rome-based headquarters on 7 March. IFAD Vice-President Michel Mordasini will give remarks at the event, which will also highlight issues around the post-2015 development agenda and activities of the International Year of Family Farming 2014.

IFAD recognizes that rural women are on the front line of climate change impacts. Experience shows that women are central to improving the lives of their families and communities, playing a pivotal role in adaptation initiatives. In Nigeria, for example, women are at the heart of the IFAD-supported Climate Change Adaptation and Agribusiness Support Programme, which provides credit and seed capital for income-generating activities, specifically targeting women. It also promotes women in decision-making roles. “I am one of the first that benefitted from the IFAD project,” said Hajia Nafisa, community leader, Jigawa State, Nigeria. “I received goats, seed support and improved technologies. I have six goats now for myself, after selling seven and giving one to my daughter . I bought a motorcycle for my son to run a taxi service, and my last daughter is in private secondary school. I supported my husband with N20,000 for his business and I bought a bicycle for myself."

In Swaziland, women in the Vikizijula area came together and built water harvesting tanks to provide potable water for their families, adapting to climate change impacts ,while also learning new and profitable skills. "I want to start a vegetable garden so I can grow vegetables for sale," said Gertrude Gadlela, a single parent of seven. "With the money I get I will buy a few basic commodities and build another tank, because my aim is to have at least three of them."

In 2012, IFAD launched the Adaptation for Smallholder Agriculture Programme (ASAP), which draws on the Fund’s own policy on gender equality and women’s empowerment. The policy states that strengthening gender equality makes a major contribution to improving food security, reducing child malnutrition and promoting inclusive economic growth that can lift rural people out of poverty. ASAP puts gender equality and women’s empowerment at its heart because, as the report demonstrates, full participation of women means greater resilience for the whole community.

The case studies in the report outline how, when adaptation is geared toward specific challenges faced by women smallholder farmers, it creates a virtuous cycle that improves economic options, incomes and yields, and reduces workloads for women and their families. "We know from experience that we will never achieve true food security and poverty eradication unless we promote gender equality and empower women,” Nwanze said. “This is true for those trying to solve the climate crisis. I hope that on International Women's Day, IFAD's work will inspire others to ensure that partnerships in all areas of development include partnerships with women."

Note to Editors:

Download a copy of the report The Gender Advantage: Women on the front line of climate change report.

Read more information on IFAD’s climate resilience work through the Adaptation for Smallholder Agriculture Programme.

Take a look at our photo story on working with women farmers in Nepal in partnership with SNV Netherlands Development Organisation. Read about the women’s personal experiences of receiving support and training and the difference it makes to their families and their communities.

B-Roll is available from James Heer, Manager, Broadcast Communications, TEL +39 06 5459 2550, Email j.heer@ifad.org.

Highlights

A rapid food security monitoring exercise conducted by the Malawi Vulnerability Assessment Committee (MVAC) towards the end of January 2014 dispelled earlier concerns that the food insecurity situation was deteriorating especially in areas that are not part of the current humanitarian aid response. The number of food insecure people remains at 1,894,782.

Army-worms attacks disrupt crop production in some parts of the country. A total of 10,903 ha reported destroyed in 16 districts. However, crop stand looking promising with a high likelihood of higher food crop production than last year.

As of 28th February 2014, a total of 10,727 households (53,635 people) affected by floods and storms since the onset of the rainy season in November 2013.

Three years ago, a bad drought had millions in Niger and other countries in the Sahel region of West Africa in desperate straits. In spite of decent rainfall in 2012, many Nigeriens live so close to the edge that last year’s combination of floods and a short rainy season has plunged millions into crisis while they have to wait until this year’s harvest.

Catholic Relief Services is responding with food and seed distributions, cash for work projects, farming training and livestock distributions.

“We are now approaching the ‘lean season’ which are the final months before crops are harvested,” says Bill Rastetter, CRS country representative in Niger. “Last year was a good year for rain and crops, so many families had enough food to last until the next harvest. This year, though, was unfortunately more typical, with significant pockets where the harvest was not good, and food supplies for many will be depleted before the next harvest.”

Floods hit several areas of the country and washed away crops, homes and property. Then, those rains stopped early, leaving crops that survived the floods dried out before they could mature. As over 90 percent of the population relies on traditional crop farming, experts predict that about 11 million people in Niger will face serious food insecurity this year.

Even in a year of good rains, up to a quarter of Niger’s 17 million people need humanitarian assistance.

“For some, there is never a good year,” Rastetter says. “CRS is always looking to help the most vulnerable families, identified by their own communities. Many are simply too poor to have the means to grow a crop. The challenge is to meet their short term needs, as well as to help them gain the knowledge and resources they need to become more self-sufficient.”

CRS has been supporting the most vulnerable families in Niger for years, and by stepping up its response now, hopes to avoid an even bigger disaster.

“These people are already hungry. We can’t wait until they’re really hungry,” Rastetter explains, saying more funding is necessary to help all who need it. “An earlier response means less work later to rectify things when the situation is worse. This has been done successfully in the past, and we can do it again. It is not futile, because at the same time progress is being made in making people less vulnerable to these crises.

We are focused on improving people’s lives, one person, one family, one village at a time,” he says.

Read more about CRS’ work in Niger.

ROME – Chaque année, le Programme Alimentaire Mondial des Nations Unies fournit de la nourriture à plus de 11 millions d’écolières afin de les aider à rester scolarisées, ainsi qu’un soutien nutritionnel spécialisé à environ 3 millions de femmes vulnérables. Cette année, à l’occasion de la journée de la femme (8 mars), le PAM célèbre le fait que l’émancipation des femmes puisse stimuler les efforts mondiaux pour mettre un terme à la faim.

« Donner aux femmes le pouvoir de faire des choix est l’un des premiers pas vers un monde sans faim » a déclaré la directrice exécutive du PAM Ertharin Cousin. « Partout où travaille le PAM, les femmes sont au centre des programmes qui s’attaquent à l’insécurité alimentaire et la malnutrition. Nous travaillons avec des fermières, des commerçantes, des femmes nutritionnistes, des cuisinières scolaires, et nous servons à manger à des millions d’écolières, de femmes enceintes, et de mères allaitantes ».

Cette année, le thème des Nations Unies pour la journée de la femme souligne que « l’égalité pour les femmes est un progrès pour tous ». Le programme « Achat au service du Progrès », ou P4P (Purchase for Progress), est un exemple d’un programme du PAM qui met l’accent sur l’avancement des femmes. Cette initiative aide les petits agriculteurs, et notamment les femmes, à devenir des acteurs compétitifs sur le marché en produisant et vendant des aliments pour les programmes du PAM.

Lors de la consultation annuelle du P4P, Mazouma Sanou, une fermière de 43 ans originaire du Burkina Faso et membre d’une coopérative soutenue par ce programme, a expliqué comment elle cultivait du maïs, du sorgho, et du niébé. Mazouma travaille comme moniteur de terrain, et est payée par le PAM et Oxfam pour encadrer 25 groupes ruraux de femmes et leur enseigner comment augmenter leur production et gagner plus.

En tant que mère de trois enfants, elle a également évoqué la façon d’augmenter le poids de la voix des femmes dans la famille. « Les femmes doivent participer à l’éducation de leurs maris » a-t-elle déclaré. « Si le dialogue peut changer les comportements, on ne peut pas forcer quelqu’un à faire quelque chose ».

Quelques 200 000 femmes ont été formées à différentes capacités durant le stade pilote du programme P4P, et la participation des femmes a triplé depuis le début de cette initiative. Cependant, des défis perdurent. Alors que plus de la moitié des membres du groupe d’agriculteurs de Mazouma sont des femmes, seulement 22% de l’argent issu des ventes au PAM est allé directement dans les poches des femmes.

Un rapport de la FAO (Organisation des Nations Unies pour l’Alimentation et l’Agriculture), l’agence sœur du PAM, estime que la réduction des écarts de genre dans l’agriculture grâce à davantage de ressources disponibles pour les femmes permettrait de faire baisser le nombre de personnes qui ont faim dans le monde à environ 100 millions. Le rapport sur la Situation Mondiale de l’Alimentation et de l’Agriculture 2010-2011 indique que les femmes n’ont pas accès aux terres, au crédit, aux outils, et aux graines qui pourraient stimuler la production agricole.

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Le PAM est la plus grande agence humanitaire au monde pour la lutte contre la faim dans le monde. L’année dernière, l’aide alimentaire du PAM a atteint plus de 90 millions de personnes dans 80 pays.

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Pour plus d’informations, veuillez contacter (adresse email: prénom.nom@wfp.org) :

Emilia Casella, WFP/Rome, Tel. +39 06 6513 3854, Mob. +39 347 9450634 Gregory Barrow, WFP/Londres, Tel. +44 20 72409001, Mob. +44 7968 008474 Elisabeth Byrs, WFP/Genève, Tel. +41 22 917 8564, Mob. +41 79 473 4570 Bettina Luescher, WFP/New York, Tel. +1-646-5566909, Mob. +1-646-8241112

Cash or food in exchange for work promotes resilience

“There is nothing left in our granaries. The harvest was very bad and we could not feed our children. I can only thank those who are helping us to have food on our plate.”

Karimou Karidjo, a 29-year-old farmer from the Tillabéri region of Niger, has had difficulty supporting his wife and four children due to poor harvests.

“I have to find food for my children. To do so, I collect and sell wood, but even then it is difficult to put food on the table,” he says.

Karidjo and others are often forced to leave their village and migrate in search of food for their families, abandoning their fields at the very time they should be planting. They are among the more than 2 million chronically food insecure in Niger, a country in West Africa where recurring drought, floods and high poverty rates make food security crises all too frequent.

2012 was a particularly bad year for Karidjo and others. The “lean season”—the period before harvest when food is scarcer—stretched from the normal four months to more than nine.

That year, USAID supported the U.N. World Food Program (WFP) with an innovative program to deliver relief assistance differently, using approaches based on seasonality and functioning markets to reinforce livelihoods while saving lives. These efforts are increasingly part of the international community’s efforts to build resilience of communities to recurrent crises.

Hadija* was one of the 2.2 million beneficiaries along with Karidjo who received food assistance from WFP in Niger thanks to support from USAID. She explains that, for her family, rations provided a huge boost during the lean season.

"I’m extremely happy to receive the food at this difficult moment. There is nothing left in our granaries. The harvest was very bad [and] we could not feed our children. I can only thank those who are helping us to have food on our plate. I hope for a better future,” said Hadija.

Severely food-insecure households received food or cash assistance, depending on food availability in their local markets. Where markets were working well, families received funds sufficient to buy a standard food basket in local markets. Recipients can access a more diverse food basket—including fruits, vegetables and dairy—when buying locally, and the relief assistance reinforces the local economy. Where markets were not robust, or too remote, families received food rations instead.

USAID, through WFP, also provided supplementary fortified and blended nutritious foods for children six to 23 months as well as pregnant and lactating women to treat and prevent malnutrition.

When community members were not working their fields, WFP made food and cash transfers conditional for many, providing them in exchange for work that developed shared resources, such as rehabilitating farmland that yields more food for the community. Village members learned simple agricultural techniques like banquettes and half-moons by digging simple shapes into the land to maintain topsoil and improve land quality and food production. Those who worked earned food to feed their families, or cash to buy food.

These conditional transfers, known as “food assistance for assets” programs, can be the most appropriate response following poor harvests and until the start of the planting season, as community labor can mitigate against drought, improve harvest prospects, and prevent untimely migration and other negative coping mechanisms.

The ability of USAID to program both cash and commodities in these situations is critical to the program’s design and impact, and is part of a longer term strategy to strengthen resilience of the most vulnerable. Delivering lifesaving aid in a way that helps communities help themselves aims to promote self-reliance and reduce the need for future food assistance.

*Full name not available.

Mothers improve diets of underweight children

“Before the [program], Katouma was always sick and crying and didn’t have energy. Now look at her!” Katouma, 48 months, is amongst the cleanest, happiest and most active children of the many gathered with their mothers in Tion, the Ségou region of Mali. The mothers discuss a newly introduced approach to nutrition and the benefits it has brought to their households.

“Before the [program], Katouma was always sick and crying and didn’t have energy,” said Katouma's mother, Kadija Konta. “Now look at her!”

This community-based approach, called Positive Deviance/Hearth, identifies "positive deviances," or practices, that allow women to improve and maintain their children’s nutritional status by using locally available foods and good household practices at the “hearth,” or home. In 2013 alone, 88 percent of the 847 children identified as underweight gained weight as a result of these practices.

Katouma lives in the Ségou region, plagued with the highest prevalence of acute malnutrition in southern Mali. In 2013, an estimated 11.9 percent of children under 5 suffered from acute malnutrition. To address these challenges, USAID supports this development food assistance program implemented by Catholic Relief Services to improve nutrition and reduce food insecurity.

After attending Hearth training in April and May 2013, Konta put into practice improved household hygiene practices such as keeping kitchen utensils and eating areas clean, and washing hands prior to food preparation, eating or feeding young children, and after using the latrine. Konta also learned how to prepare nutritious recipes including enriched porridge and soup with meat to improve and maintain the nutritional status of Katouma and her other young children. Katouma is one of dozens of children in Tion who participated in USAID-supported Hearth activities in addition to more traditional malnutrition screening and treatment activities delivered through local health centers.

Five months after Hearth activities ended, it was clear that all of the mothers continued to take the advice to heart. “We can’t even compare the difference in our children before and after the Hearth,” said one mother.

Female community leaders are encouraging others to make positive daily changes even after the project ends. Fathers were also briefed on the approach before the activities began and have noticed the benefits. The mothers noted that their husbands are happy and have more affection for their children. Improving family nutrition practices will also lead to less household health costs and result in greater food security.

Other project activities are designed to allow mothers to continue to provide good nutrition to their children from locally available foods, even during the lean season. A community safety net was in place prior to the start of the project. It was comprised of community contributions of staple grains following the harvest and designed to provide food to families of undernourished children in Tion, but contributions were not sufficient.

Following Hearth activities in the community, however, members were more aware of the positive results of their contributions and the community safety net was revitalized. Men provide local products and small monetary donations for ingredients such as meat and spices so the Hearth groups have the resources they need. Crop sales from a project-supported garden plot allows community members to increase their revenue to purchase other healthy ingredients. A portion of the improved millet production from these community plots also goes back to the Hearth groups to create nutritious recipes.

The Hearth approach was implemented in over 21 communities most affected by malnutrition in 2013 and helped rehabilitate 746 underweight children. It continues to be introduced in a growing number of communities in 2014. Thanks to USAID support, this program, which started in 2008 and ends in late 2014, contributes to the improved food security and nutritional status of over 203,000 people in 205 Malian communities.

By Fred Oluoch

Somali refugees began voluntarily going home recently after an agreement between the government of Kenya, Somalia and UNHCR. Fred Oluoch talked with the country representative Raouf Mazou about their resettlement in Somalia.

Do you think the tripartite agreement between the governments of Kenya and Somalia; and the UNHCR to repatriate Somali refugees was timely?

The tripartite agreement was to provide a legal framework for the parties to play their role in supporting the return of these refugees. The best solution for those who had fled their countries is to return home.

After over 20 years, we hope that some of them will return. It is not going to be easy because the situation in south central Somalia is not uniformly safe. But we believe that a significant number of refugees have already returned, especially those who arrived in Kenya in 2011 due to drought.

What is the progress of the repatriation of Somali refugees since the signing of tripartite agreement last year?

We will be carrying out a pilot programme in the coming weeks. The programme will be the best way to test what needs to be improved on. We are looking at 10,000 initial returnees, but if we have 20,000 coming forward, we will make the necessary arrangements.

We are focusing on three places; Luuq, Baidoa and Kismayu. These are the places that we have confirmed as safe. We need to be present in these areas as UNHCR and, secondly, the returnees have to have access to services.

Is there anything like voluntary return?

Nobody is coercing the refugees to return home. Kenya has been receiving refugees since independence from Rwanda, Uganda, Burundi, Sudan and DRC.

I don’t think it is in the interest of anybody to coerce Somali refugees to return when they are not ready. The challenge is to make sure that when they return they have access to basic services and security, which are the responsibility of the international community. But we want to make sure that the returnees are fully informed about the security situation in the places they are going to.

What is the number of those who have so far returned voluntarily?

It is difficult to come up with an exact number, but we have seen a reduction in the number of refugees in recent years. From 2012, the number peaked 480,000, but when we did verification in 2013, the number went down to about 405,000. Today, we have about 316,000.

Does it mean that all these people have returned to Somalia?

Not necessarily. Maybe there were discrepancies in registration, like double registration, but what we hear from our colleagues in Somalia is that a significant number of people have been returning.

It is very difficult to give exact figures when it comes to random returns. Those who have returned could still come back because they still have their cards, but we are hoping that they will continue to stay in their places of origin. Last year, for instance, figures showed that 30,000 had returned randomly.

Who should ensure that there is security in areas they are returning to?

The government of Somalia and Amisom are providing support. Beyond that we have regional authorities like Somaliland, Puntland and Jubbaland.

As is the case everywhere, the number one responsibility for security lies with oneself. Refugees will only return to places where they feel secure. People should not say that they want to return if they are unsure of security.

Kenya repatriated the refugees largely because it is believed they are responsible for increased insecurity and proliferation of small arms in the country, and that there is need to move the camp inside Somalia. What is the position of UNHCR?

Relocation is out of question because there are already one million internally displaced people inside Somalia and the idea is not to increase this number. The international community can only protect the IDPs. But branding refugees as terrorists is not fair.

Refugees are victims of terrorists, they flee because of terrorism. There are Kenyan refugees in Uganda, Ethiopia and other countries; can they be termed as terrorists? Terrorism is a problem of the entire region.

There are some people who were born in Dadaab. Where do they go?

Even if you were born there, your parents must have come from somewhere. For instance, there are some South Sudanese who were born here but when the country got Independence in 2011, they returned. Again, Rwandan refugees had taken citizenship of countries they were living in such as Uganda, Kenya and Tanzania, but when the time came, they returned.

Is the Dadaab camp likely to be closed?

That is something that no one can say at this moment. For instance, Lockichoggio was once a booming and bustling town during the civil war in Sudan and nobody could have imagined 10 years ago that it could become a dead town. Dadaab could also die out should Somalia find lasting peace.

What are some of the challenges in dealing with refugees in eastern Africa?

One of the challenges is that this is a very volatile region that has seen a number of conflicts in recent years. Right now we are facing an influx of South Sudanese to Kenya. From mid-December, we have received close to 17,000 who arrived in Turkana West, where there were 120,000 refugees already.

What support do you get from host governments?

Access to land is the first issue to ensure that they are accommodated. We were allocated additional land but we still need more land from the host community and the government as more refugees arrive.

We have to consult with local authorities because they are the ones who receive refugees and live with them.

Once we have an agreement, it has to be formalised by the governor and by central authorities. Management of refugees has not been devolved and it remains the responsibility of the central authorities.

But it is clear that you cannot ensure that the refugees are fully protected if the local communities are not in favour.

KEY POINTS

• The food security situation is deteriorating in certain regions of Mali, Mauritania, Niger, Senegal and Chad due to an early start of the lean season

• Results of the latest food security surveys in Senegal and Mauritania indicate a critical situation for poor households in the Zones-at-Risk

• Since December 2013, cereal prices are relatively stable throughout the region but remain above their five year averages

Without Wider Consultation, Commission Risks Being Ineffective

(Nairobi, March 11, 2014) – The Malian government should seek broad-based consultation to ensure a credible and independent truth commission to examine abuses since the country’s independence in 1960, Human Rights Watch said. Two executive orders – one decree and one ordinance – establishing the Truth, Justice and Reconciliation Commission will be debated this week in Mali’s National Assembly.

The decree and ordinance places the proposed commission under the Ministry of National Reconciliation and Development of the North, which would select the commissioners, and does not require public consultation on the commission’s members, mandate, and powers. For the commission to be effective and considered legitimate, there should be a structured, consultative process with groups broadly representative of Malian society, Human Rights Watch said.

“The Malian people will greatly benefit from a truth-telling process to address the persistent violence, poverty, and conflict that has ravaged the lives and hopes of Malians for decades,” said Corinne Dufka, senior West Africa researcher at Human Rights Watch. “However, for the process to be credible and effective, it needs participation and buy-in from a broad cross-section of society.”

An effective truth, justice, and reconciliation mechanism in Mali could have an important impact on the country’s future, Human Rights Watch said. First, it could illuminate underreported atrocities committed during past armed conflicts, notably those suffered by populations in the north. Second, it could explore the factors that gave rise to and prolonged Mali’s multi-faceted crises including state neglect, weak rule of law, poor governance, and endemic corruption. Third, it could explore the dynamics leading to communal and ethnic tensions that have worsened in recent years and could erupt again. Lastly, it could make recommendations aimed at preventing a repetition of past abuses and improving respect for human rights.

A reconciliation commission was first created in March 2013 by the then-interim government. But it was widely rejected by various Malian groups because of the lack of broader consultation on its membership and mandate. Many Malians wanted a commission that could also address impunity for abuses, including permitting the commission to recommend individuals for prosecution.

After assuming office in September 2013, President Ibrahim Boubacar Keita pledged to create a commission that would address more than just the recent conflict and that incorporated justice as well as truth. The proposed commission has a mandate of three years, will cover the period from 1960 to 2013, and will be composed of 15 members and seven working groups.

In order to create a credible, independent, and effective commission, the National Assembly should propose measures to ensure:

• That the commission is independent from other branches of government. Placing the commission under the Ministry of National Reconciliation and Northern Development, makes it subject to political interference and impacts the perception of neutrality;
• A wide consultation process on mandate and membership involving activist and human rights groups, women’s groups, youth groups, political parties, labor unions, victims’ groups, the diaspora, religious denominations, security forces, and warring factions, among others;
• Clear, objective criteria for appointing commissioners, including their moral and professional record, impartiality, and commitment to international human rights standards;
• That all proposed commissioners are subject to public confirmation hearings;
• The implementation of regulations that clarify the commission’s mandate within a human rights framework;
• The implementation of regulations that provide for investigative powers including to subpoena witnesses, public hearings, and a final public report that makes recommendations for accountability, including reparations and cases to be criminally investigated, as well as for other institutional reforms; and
• That the commission is part of broader efforts toward truth-telling and accountability that include justice for serious crimes. While truth commissions can respond to victim and community needs, justice mechanisms are necessary to fully respond to grave human rights abuses.

“The National Assembly should ensure the proposed truth commission reflects all of Malian society, and not the perceived arm of special interests,” Dufka said. “The task at hand is too important to get wrong.”

For more Human Rights Watch reporting on Mali, please visit: http://www.hrw.org/africa/mali

Moki Edwin Kindzeka

YAOUNDE — Some 100,000 children, including Nigerian refugees fleeing attacks from the extremist sect Boko Haram, are suffering from acute malnutrition in northern Cameroon. Hospitals are overwhelmed. Health officials and United Nations agencies have been visiting the children and are promising assistance.

Badyne Mansto cries as her five-year-old child is buried near her house in Maroua, northern Cameroon. She told VOA the child lost weight and died at a private hospital two hours after she was admitted. She blamed the staff for not attending to her immediately when she arrived.

Hospital staff say they are overwhelmed. Mamha Catherine is one of them.

"As you can see, there are so many patients than we can attend to. We lack infrastructure, we lack staff, so what is certain is that some of the children whose lives may have been saved will end up dying," she said.

Dire situation

Aiida Maimonatou, who is at the hospital with her baby, is getting impatient. She said when her first child was not well, she took him to a traditional healer and he died. Now she has brought her second child to the hospital because the government is asking people not to go for traditional treatment. But, she says, "since I came here, nobody has attended to me."

Among the malnourished children are Nigerian refugees fleeing from the Islamist militant sect Boko Haram. At their camp in Menowo in Mayo Tsanaga Division where 7,000 refugees live, more than 300 children are suffering.

Comfort Manda, who said she fled Borno State, said she has lost a child to malnutrition.

"My brother, it is very difficult. I don't know what to tell you, but the situation that I met here is so deplorable that I don't know what to do now," said Manda. "I came in from Nigeria and my two children are sick, I have taken them to the hospital and find it difficult to provide their medicine. One of them already died and I am still struggling with one of them. I do not know what will happen at the end. Added to this, there is no food, there is no water and when children are sick they drink a lot of water. We are not able to have even water to give our children. It is very difficult."

Food scarcity

Dr. Ndansi Elvis said the crisis is aggravated because refugees have to compete with the local population for food and water.

"These people come and there is competition for food. And when there is competition for food, there is also limited supply and the prices go up. And there is the problem of early marriages. You will not expect that a 17-year-old who has a child actually understands the nutritional needs of a child as much as a mature woman," said Elvis.

"It's astonishing that this is a public health problem but little attention is given to it. I go through the budget of the Ministry of Public Health for this year and I don't think that even up to 500 million CFA franc [$1 million] has been allocated for any program as far as malnutrition is concerned," Elvis continued.

Jean Mark Eding of Doctors Without Borders said a number of factors are contributing to the increasing number of malnourished children this year.

"The first thing is the absence or insufficient food for the children," he said. "There are also environmental factors, like droughts, floods, dykes that give way, insects that destroy crops and reduce food production."

UNICEF says large sectors of Cameroon's population lack access to basic health services, safe water, sanitation facilities and basic education. The agency is appealing for funds to prevent and combat malnutrition. Its officials and other United Nations agencies have been visiting the malnourished children and promising to help as soon as they get the funds.