Nutritional situation

Malnutrition level in Eritrea had been high to very high even at the time of general food aid and supplementary food distributions. This shows the seriousness of the humanitarian crisis which is a combination of chronic (poverty) and acute (short term) shortage of adequate and nutritious food combined with the scarcity of sufficient health care and sanitation. From 2000 onwards, there were intensive and extensive humanitarian activities which mainly focused on emergency health and sanitation programs, food aid distribution, supplementary food distribution to children under five years and pregnant and lactating women and feeding programs in elementary schools. As information on nutritional status of the population is the basis for designing the appropriate programs for both humanitarian and developmental purposes, NGOs and multilateral organizations had worked hard to build the capacity of the nutrition unit of the Ministry of Health (MOH) and institutionalize the nutritional survey and information system. As the result, the national nutrition surveillance system was set up with the responsibility of assessing, analysing and disseminating standardized nutritional information through carrying out regular nutrition surveys twice per year.

Technical and financial supports were provided to the MOH nutrition unit and its capacity was strengthened. The nutrition unit was carrying out regular nutrition surveys until the end of 2005 and its findings served as bases for the planning and designing of food aid, supplementary feeding, nutrition and health and sanitation programs and projects. The nutrition surveys results were particularly useful in identifying geographical areas that are affected most and in targeting the beneficiaries in need. Nevertheless, the government has dissolved the national nutritional surveillance system in 2005, with its announcement of the banning direct food aid. From 2006 onwards no nutrition surveys have been conducted; and ever since, it has been difficult to assess the scale and seriousness of the humanitarian food crisis in general and the level of malnutrition in particular. Although it is still possible to judge from the observing the conditions on the ground and from personal experiences, it is not possible to give statistical data that supports such an anecdotal observation.

Until recently, there were 3-4 NGOs that were distributing supplementary food to children under five years, lactating and pregnant women. The distribution of supplementary food program is often accompanied with health and growth monitoring activities in order to measure the impact of the intervention on the nutritional and health situation of the target communities. The methodology used in growth monitoring data collection is that a baseline survey of the target community as carried out before the start of the intervention, during the intervention and after completion of the intervention on a monthly or quarterly basis. Growth monitoring data of children under five years and in some instances BMI (Body mass index) of lactating women are collected and analysed to measure the nutritional trends and situation. Thus the results of the growth monitoring data collected as part of the supplementary feeding programs can be used as a proxy to indicate the level of malnutrition. Most of the findings of the growth monitoring data show an alarming level of malnutrition. Most of the findings show from very high to extremely high malnutrition level.

For example, growth monitoring data of one of the NGOs engaged in supplementary food distribution in August 2006 show a prevalence of malnutrition level of 69.5%(under weight) among under five years children aggregated from their distributions sites. Similarly, the analyses of growth monitoring data collected in August 2007 in Northern and southern Red Sea zones show malnutrition level (under weight) 45% and 43% respectively among children under five years. According to the WHO standards these finding represent from very high to extremely high level of malnutrition which requires both general food aid and supplementary food programs.

One way to judge the deterioration of the nutritional situation is also through the observation of the severely malnourished under five years old children admitted to the health facilities for therapeutic feedings. Even before the current drought, as a result of the abrupt end of the food aid programs, the humanitarian situation in the Northern and Southern Red Sea zones and in large part of Anseba zone was already getting worse and worse. This was manifested by the big numbers of severely malnourished children admitted to the health facilities for therapeutic feedings (the therapeutic feeding programs are funded by UNICEF). UNICEF is also the biggest supplier of supplementary food program which is distributed through the MOH. UNICEF, as it is a UN agency has the permission to import supplementary food while NGOs are not allowed to import. Even supplementary feeding programs which were under implementation phase when the new regulation governing the operations of NGOs came into effect in 2005 had run into problem because of the unbearable delays in implementation of the supplementary feeding projects as a result of shortage of sufficient supply of supplementary food. NGOs are banned from importing supplementary food thus they fully depend on the sole local government producer: the Red General mills which has very limited capacity to meet the combined demand of the NGOs and sells its products at higher prices than the global markets (in 2006 at global markets the price of one tone of UNIMIX was at about USD 360 -400 per ton while the Red Sea general Mills’ product was selling at USD 650 per ton).

The target beneficiaries of Northern and southern Red Sea zones described the supplementary food as life saviour because in the absence of other food source and food aid, the monthly 6 kg supplementary food distributed to children under five years and lactating and pregnant women was shared among all the household members as it is the only food available for the whole household.

Currently except for the two NGOs that are distributing a negligible amount of supplementary food by purchasing from the local producer, UNICEF is the only supplier of supplementary food. Efforts were exerted in the past by UNICEF and other organizations and NGOS to expand the production capacity of the Red Sea General Mills through financial and technical support. Despite these efforts, the Red sea general Mills did not improve because of mismanagement and it is unreliable source of supply because it enters multiple contracts beyond its capacity at one time. Another private producer had started production of supplementary food in 2004 which gave a relief to the donor community but was banned from production because the RSGM wanted to monopolize the market and later as the result of restriction on importation of raw materials such as cereals, pulses and vitamin mixes. Now there is no supplementary food available in the market and the coverage of the UNICEF supplementary feeding program is extremely limited to meet the huge challenges that the malnutrition level prevalent in the country present. This means even those few people who can afford to provide baby food to their children can no longer get the required food in the market to feed their children.

Disaster preparedness, prevention and response .

There is no institution that is assigned to deal with disaster preparedness, prevention and response in the country that can handle any disaster, be it natural or man made. Nor is there an early warning information system in the country. In the past the Eritrean Relief ad Rehabilitation commission (ERREC) was responsible for making appeals for humanitarian assistance and it was well organized in managing the food aid storage, delivery and distribution. The commission was dismantled in 2005 (again, with the expulsion of NGOs); and the responsibility is said to have been transferred to the ministry of labour and human welfare (MOLHW). The MOLHW has no structure and departments similar to that of ERREC that could handle the programs and activities ERREC was handling. Of the various departments that existed in ERREC, only the one that deals with NGOs affairs is operating within the MOLHW. Most of ERREC staff have been sacked, with only a few employed in other ministries. Further the MOLHW is creating difficulties and obstacles by interfering in the activities of other Ministries such as the nutrition unit of MOH, Ministry of agriculture, and Ministry of health. Particularly the programs that are linked to the funds from NGOS are hindered or delayed.

Operating environment for civil societies or NGOs

The PFDJ regime is known for its boasting of self reliance both during the struggle era and post independence period while the fact happens to be just the opposite. The government never acknowledges that it has been receiving foreign assistance. This claim is absolutely false because it is common knowledge that, starting from the launching of the Eritrean revolution to the current time, Eritrea has received a lot of foreign assistance in different forms and ways. The Eritrean Revolution was almost funded by the Arab countries at the early stages and later many countries both from the West and communist countries supported it. It is sufficient to read the note outlined below to have the insight of the types and scale of the assistances that the Eritrean revolution and the government received and continued to receive:

During the struggle Era

  • Logistical, financial and material support as well as arms, ammunitions and weaponry. The Smret transportation company that was owned by the EPLF and had hundreds of trucks under its administration was licensed in Sudan to raise fund for the EPLF.
  • Protection and military bases, office facilities to the Eritrean revolution. The Eritrean revolution was based in Sudan and Egypt in the early years; the Eritrean peoples’ liberation Front (EPLF) the forerunner of the PFDJ main garages, offices, the disabled care centres were based in Sudan.
  • Health facilities and medical services. For example the Sudanese health facilities were providing health services to the Eritrean fighters.
  • Providing and funding Military and other trainings
  • Transit routes and facilitation for supplies such as fuel, weaponry, arms and ammunition
  • Travelling services such as providing fake passports and visas to facilitate when there were needs for the fighters to travel outside Sudan.
  • Political, diplomatic and moral support

Post independence era

NGOS, multilateral organizations, governments have been providing different types of assistances to Eritrea, ranging from military to development and humanitarian assistances. Still some of the Arab countries provided and continue provide unconditional financial and material supports mostly going to the military budgets or security expenditures. These include food, medicines, fuel and money. As the government is suffering from extreme budget deficit, it can not stay in power without these supports. Usually these assistances are kept secret, except the items such as food that can not be hidden. The assistance provided to Eritrea be it bilateral, multilateral or by NGOs is substantial and big proportion of these funds were provided to contribute to the rehabilitation and reconstruction and poverty reduction objectives through different programs including health, education, water and sanitation, nutrition and food security, agriculture, roads, ports, energy, etc.

While this are the facts, the government denies them, claiming the government has never received assistance and further claims that Eritrea is different from the other African developing countries in that Eritrea is self reliant. The government has a record of hostile attitude towards civil societies including NGOs and community based organizations. In Eritrea, there are almost no civil societies – no human rights organizations or independent unions, for instance. Permission for setting up an organization is given only to those who serve the government’s political agenda. Typical examples are National Union of Eritrean women and the National Union of Eritrean Youth and students which are the arms of the government and work against the interests of the women and youth and students.

In 1997, the government expelled all NGOs confiscating their properties in a humiliating way. The NGOs were invited again to work in Eritrea in 2000 to address the humanitarian crisis created as the result of the border conflict between Eritrea and Ethiopia. Also a couple of local NGOs were established during this period. The NGOs together with the UN and other agencies contributed a great deal in alleviating the suffering of the victims of the war and drought during and after the war.

However, in May 2005, the government issued a new proclamation concerning the operation of NGOs. According to this proclamation:

NGOs are required to apply for registration to get permission to operate in Eritrea and thereafter they need to apply every year for renewal of their registration.

  • To qualify for the initial registration and subsequent renewal for working permission, INGOs (international NGOs) are required to have USD 2 million at their disposal and LNGOs (local NGOs) 1 million.
  • LNGOs are not allowed to receive funding from INGOs operating either in Eritrea or multilateral organizations or UN agencies, whereas INGOs are restricted not to receive funding from UN agencies.
  • NGOs are only allowed to be involved in rehabilitation and relief programs and if they wish to be engaged in developmental programs they have to apply to the Ministry of Labour and Human Welfare to get permission for such types of activities and must have a government ministry as an implementing partner. This means they can only implement through the government ministries or departments denying them freedom and flexibility to work independent of government interference.
  • NGOs are not allowed to recruit local staff who are within the national service age group; national staff must be exempted from the national service to be considered for employment in the NGOs; and even when they are exempted, they must have a release document from government authorities to be able to work for NGOs. NGOs are also not allowed to employ more than one expatriate unless there is no local capacity to undertake the job such as a high technical post. This has constrained and denied the NGOs from accessing to the relevant and qualified and skilled labour force, creating difficulties in the operation of their activities.
  • NGOs are required to pay import taxes for food aid and other humanitarian goods they import into the country.

In practice, the proclamation was aimed at systematically expelling the NGOs or to make them bow to the government’s demand to fund the government departments or ministries. Following the registration applications, only few NGOS out of a total of 36 NGOs were granted working permission. The decision of rejecting or accepting a registration application was a political decision and this was manifested by the fact that most of the NGOs that were most likely to succeed in the registration process in terms of the criteria set out were rejected.

The annual registration or renewal requirements became an obstacle to long commitment, planning, program, project design and funding because of the uncertainties associated with it. Funding agencies to NGOs programs/projects were reluctant to fund projects beyond one year being unaware what the future holds. Contrary to the substance of the proclamation, the government in September 2005 announced suddenly a shift in policy from direct food aid distribution (which contradicts the proclamation content that restricts the NGOs to operate in rehabilitation and relief programs) to development programs. It called NGOs and the UN agencies and other financiers to support its new policy – the cash for work policy but with no clear strategy developed to undertake cash for work programs. The change in policy; i.e. from direct food aid to “cash for work”, came all at a sudden and with no transition period and exit strategy. Following the change in policy, huge food aid stocks, including supplementary food, that were in the warehouses were confiscated by the government. The biggest amount confiscated were from WFP, European commission and Mercy corps. The food commodities that were confiscated were fed to the army. Some food commodities were left in the stores until they were expired. Those expired food were either fed to the army or to the people. For example the expired high protein food CSB (corn soya blend) were transported by military trucks and handed over to the health facilities in 2006. When the health personnel opposed its distribution because of its health risks they were ordered to distribute it. And the result was many children were poisoned and infected with severe diarrhoea.

Following this shift in policy, the remaining few NGOs focused on development programs and other emergency programs such as water and sanitation and nutrition and food security programs. However, almost all applications for launching new projects were either outright rejected or given no response at all. This has left the NGOs with no effective projects under implementation. With no new projects approved for implementation and with the phasing out of the ones that started before 2005, combined with other obstacles and constraints such as long and tedious process of getting work permit for the expatriates and restricting their travel to field sites, shortage or lack of fuel and restrictions on recruiting of local staff and their movements, have created working conditions that are unacceptable and difficult to cope with. Moreover, although the proclamation allows NGOs to import goods paying importation duties, in practice they are banned from importing goods even if they pay import taxes; all goods that have to enter to Eritrea have to get prior approval from the Ministry of Trade and Industries. And this ministry has been blocking almost all planned imports by the NGOS. In addition, the government has imposed restrictions on travel of expatriates within the country. According to these restrictions, foreigners are confined to travel only within ten kilometre of their own area of residence; and if they plan to travel out side their area of residence, they have to apply 10 days in advance to the concerned government authorities for travel permit. But the travel applications rarely get response from the government authorities and those applications that get responses are either delayed or rejected. Many NGO country representatives and senior officials who come for country visit from the head offices were/are denied visiting field sites to the areas of their activities.

Fuel shortage or lack of fuel is one of the most impeding factors to the operation of the NGOs. From 2005 until October 2007, NGOs were rationed only a small fraction of their requirement fuel. But from November 2007 onwards, NGOs were not supplied even a single litre of fuel.

In August 2008 all the offices of the NGOs were raided by the army within one day and all the staffs were arrested while in their duties and taken to the military camp where they screened them. Following the screening, those people who committed crimes (according to the government’s definition crime, people who are believed in to be evading the national service programs) are languishing in the Adi-Abeito military prison held incommunicado. In the subsequent years after the initial registration of 2005, many NGOs’ working permits have been made to expire and as the result of the above outlined difficulties some NGOs were forced to terminate their operations in Eritrea. Now there are only 8 NGOs (both local and international NGOs) operating in the countries and yet these NGOS are limited in their operations due to the different restrictions imposed on them.

With regards to LNGOs, they are further constrained by the restrictions of access to funding sources as well as by the requirement to have USD 1million at their disposal for initial registration and renewal. For the LNGOs USD 1 million dollars is not easy amount because most of them cannot afford it.

In general, the May 2005 NGOs proclamation and the subsequent actions that followed can be viewed as having been introduced to create a hostile operating environment to the NGOs and civil societies. This was accompanied by intensive and extensive smear campaigns against NGOs in the government media outlets describing:

  • NGOs as the source of corruption and that NGOS work to undermine the cultural and traditional value systems of developing countries;
  • NGOs as nurturing a culture of laziness and selfishness;
  • NGOs as ineffective and inefficient in the management of the programs and projects they undertake as well as competing for donor funding with the state;
  • NGOs as intelligence agencies for the western countries describing them as agencies that have come with neo-colonial mission; and
  • NGOs as agencies that help nationals to evade national service and other national duties.

Any of the program that have been funded by the NGOs and other organizations, such as water supply, seed distribution, micro-dams and others, has never been acknowledged by the government. If we take a close look at the activities that the government claims to have carried out most of them happen to be achieved through the funding and direct involvement of NGOs in their implementation. However, the government spreads propaganda through its media outlet that it has solely done them. Usually, after the completion of the projects, inauguration ceremonies are held where government officials, the local communities, the funding agencies and the government media outlets are invited. Speeches are made by the representatives of the NGOs, the local government officials and the local communities’ representatives and the events are recorded and reported by the media. But in the media reports the speeches of the NGOs’ representatives are purposely deleted. This is done to give credit entirely to the government for the work done.