Somalia's Agony Tests Limits of Aid
man/index.html?inline=nyt-per> JEFFREY GETTLEMAN
Published: November 2, 2011
BENADIR HOSPITAL is a chunky block of a building in downtown Mogadishu,
built in the 1970s by the Chinese. It has cracked windows, ceiling fans that
don't turn and long, ghostly hallways that stink of human excrement and
diesel fuel - all that the nurses have to wash the floors. Each morning,
legions of starving people trudge in, the victims of Somalia's spreading
famine. Many have journeyed from hundreds of miles away. They spent every
last dollar and every last calorie to make it here, and when they arrive,
they simply collapse on the floor. Benadir's few doctors and nurses are all
volunteers and all exhausted, and many wear tattered, bloodied smocks. The
minute I walked in, I had a bad feeling I would find what I was looking for.
As the East Africa correspondent for The New York Times, my assignment has
been to chronicle the current famine in Somalia, one of the worst
humanitarian disasters of the last two decades, hitting one of the most
forlorn and troubled countries in modern times. My job is to seek out the
suffering and write about it and to analyze the causes and especially the
response, which has been woefully inadequate by all accounts, though not
In Benadir, there is a room full of old blue cots, one after another, where
the sickest children lie. On each bed, a little life is passing away. Some
children cry, but most are quiet. The skin on their feet and hands is
peeling off. All their bones show, like skeletons covered in parchment. I
was standing just a few feet away from Kufow Ali Abdi, a destitute nomad, as
he looked down on his dying daughter, and when the time came, there was no
mystery, no fuss.
I watched Mr. Kufow carefully unhook the I.V. that was attached to her
shriveled body and then wrap her up in blue cloth. Her name was Kadija and
she was 3 years old and probably not more than 20 pounds. Mr. Kufow walked
out of the room, lightly carrying Kadija's body in his arms.
At least five children died that day in Benadir. At a camp not far away,
where people are housed in twig huts and stare listlessly at the road,
hoping for an aid truck to arrive, I was told that 10 had died. Across
Somalia, it's hundreds a day.
Much of Africa, Somalia in particular, has had a tough time since
independence in the 1960s, becoming synonymous with staggering levels of
misery and leading many people to simply shrug and mutter "here we go again"
when they hear of a new drought or a new war. But this current crisis in
Somalia is on a different order of magnitude than the typical calamity, if
there is such a thing. Tens of thousands of people have already died, and as
many as 750,000 could soon starve to death, the United Nations says, the
equivalent of the entire populations of
-less-likely-to-intervene.html> Miami and Pittsburgh.
One reason the situation has gotten this grim is that most of the big
Western aid agencies and charities, the ones with the technical expertise
and so-called surge capacity to rapidly distribute aid, have been blocked
from working in the famine zones. At a time when Somalia is suffering from
the worst drought in 60 years, a ruthless militant group called the Shabab,
which is essentially a Qaeda franchise, is on such an anti-Western tirade
that it has banned Western music, Western dress, soccer, bras and even
Western food aid. The Shabab are a heavily armed complication that
differentiates this crisis from previous famines in Somalia, Ethiopia or
Sudan and from other recent natural disasters like the tsunami in Indonesia
or Haiti's earthquake, where aid groups were able to rush in and start
saving lives within a matter of hours.
That said, it is not as if American or European aid agencies are simply
giving up on Somalia. It's the opposite. They're stepping up operations and
scrambling to find ways to get around the Shabab restrictions, turning to
new technologies like sending electronic money by cellphone so people in
famine zones can buy food themselves from local markets.
Western charities are also teaming up with the new players on the aid scene,
like Turkish groups and other Muslim organizations that are allowed into
Shabab areas. It all calls for more hustle and definitely more imagination:
in Somalia there are a million impediments to the aid business - the Shabab,
the broken-down state, dilapidated ports and airports, American government
sanctions, a legacy of corruption and the sheer dangers of working in
full-fledged anarchy haunted by militias, warlords, glassy-eyed gunmen and
even 21st-century pirates. But charity groups say they are beginning to turn
this famine around. They just need more resources and more time.
"One thing is clear," said Elhadj AsSy, a Unicef official. "With continued
support from our donors and partners, our combined efforts to save lives,
livelihoods and ways of life will make a difference."
But support - meaning dollars - has been frustratingly scant. While many
more lives are at stake in Somalia's crisis, other recent disasters pulled
in far more money. For instance, Save the Children U.S. has raised a little
more than $5 million in private donations for the Horn of Africa crisis,
which includes Somalia and the drought-inflicted areas of Kenya and
Ethiopia. That contrasts with what Save the Children raised in 2004 for the
Indonesian tsunami ($55.4 million) or the earthquake in Haiti in 2010 ($28.2
million) or even the earthquake in Japan earlier this year ($22.8 million) -
and Japan is a rich country.
"Americans are incredibly generous when they understand that children are in
desperate need," said Carolyn Miles, president of Save the Children. "If
they knew millions of children were facing death in East Africa, I believe
they would give. But I don't think Americans understand the scale of this
Rachel Wolff, a spokeswoman for World Vision, explained that "rapid-onset
disasters," like a sudden earthquake, tend to get more attention and more
donations. And Somalia's crisis was hardly rapid. This was a catastrophe 20
years in the making.
The central government collapsed in 1991, pulled down by clan warlords who
then turned on one another and plunged Somalia into anarchy. The hospitals
are now shot-up wrecks, the roads are abysmal and the airports and ports
barely function, complicating the efforts to bring in life-saving supplies.
Somalia's economy has been so shattered by war that there are few paying
jobs, which leads to the pilfering of humanitarian aid, another serious
problem here, because the black market of stolen food aid has blossomed into
one of the country's few moneymaking industries, along with, of course,
Farms are ruined and much of the food Somalis survive on is imported,
leaving them highly vulnerable to swings in global food prices, which are
near record highs. Somalia is also probably one of the most violent
countries on the planet. Whenever I come, I have to hire my own private
mini-army to guard me, usually 10 to 15 gunmen, who start shadowing me the
minute I step off the plane. Many aid workers have been killed or kidnapped
in Somalia, which has scared aid organizations away.
"We are beyond frustrated to not be able to reach children who are dying,
not be able to fulfill our humanitarian mandate within the worst-hit areas
of the Horn drought crisis," said Mrs. Wolff of World Vision, which the
Shabab has banned. "Since February, when we warned of the drought crisis, we
have been exploring various options but do not have a breakthrough solution
at this point."
In the other crises I've covered, there's a certain routine: check in with
the United Nations upon arrival, get a security briefing, take an aid worker
out for a drink and then, come next morning, hitch a ride to the field in an
aid agency Land Cruiser with the name stenciled on the side.
In refugee camps in Darfur, Sudan or the many besieged Congolese towns I've
worked in, it's hard not to stumble across other Westerners, many wearing
mesh vests emblazoned with the name of their organization or the acronyms -
Save the Children, Doctors Without Borders, Unicef, the United Nations High
Commissioner for Refugees, the International Rescue Committee, War Child -
overseeing food deliveries, taking surveys or slipping a feeding tube up the
nose of a starving child. But in Somalia, these big agencies are virtually
The day a photographer and I visited the Badbaado camp in Mogadishu, many
people thought we were the aid workers. We passed rows of tiny huts built
literally out of sticks and rags, stepping over piles of human waste because
these camps of starving people have sprouted up so fast there are few
latrines, water taps or any real planning, and we met one emaciated person
after another. They stumbled forward, sometimes hugging me for support or
pulling the tight skin at their throats to show they were starving. One man
reached out and jerked my arm.
"Look!" he said, pointing to a small bundle in the corner of his tent. I
peered in. It was the corpse of his 2-year-old son, Suleiman, who had just
I heard many bad stories about the Shabab in these camps. Most people here
fled Shabab zones, often starting out their journey with five or six
children and arriving in Mogadishu with just one or two left. There is
nothing else they can do. They either buried their children along the way or
left them dying under a tree.
People told me the Shabab were trying to prevent anyone from leaving and
that Shabab fighters had even set up special camps where thousands of
exhausted, hungry and sick people were corralled at gunpoint, an ideal
breeding ground for disease, especially because the Shabab have also
immunizations. It's the perfect storm to kill countless children. Measles,
typhoid and cholera are already beginning to sweep through the camps.
Epidemiologists predict that the fatalities will shoot up and thousands of
people will perish when the heavy rains come in November and December,
spreading waterborne diseases.
Ken Menkhaus, a political science professor at Davidson College who has been
working as a consultant on Somalia since the early 1990s, said the Shabab
had pushed Somalia to a tipping point.
"The worst-case scenario is a Khmer Rouge situation where a group with a
twisted ideology presides over the mass death of its own people," he said.
"The numbers are going to be horrifying."
There have been some rumblings by Ethiopia and others of strengthening the
current African Union peace-keeping force in Somalia and trying to blast out
the Shabab so more aid can reach starving people. But the United States and
the other nations with the necessary resources don't want to get dragged
back into Somalia, which was the scene of a botched peace-keeping mission in
But this famine isn't all about the Shabab. Even in the few
government-controlled zones, people are suffering on a shocking scale.
Western donors, including the United States, have poured millions of dollars
into Somalia's Transitional Federal Government, a divided, unpopular
collection of politicians and former warlords based in Mogadishu, Somalia's
bullet-riddled capital. American officials have branded the T.F.G., as it is
known, as the best bulwark against the Shabab. But many analysts say the
T.F.G. has performed dismally in responding to the famine (and to the
Shabab), and in recent weeks, government militias have looted food and shot
The government's weaknesses have spawned the advent of more than 20
independent mini-states seeking to
themselves. Most of these are formed by members of the same clan - the
building block of Somali society - and are loose organizations of a few
politicians and some gunmen. In a time of famine, it's a bit overwhelming
for aid groups to deal with all these new entities.
In August, I flew with World Vision to visit Dolo, a small town on the
Ethiopia-Somalia border controlled by a local militia. We took off from
Nairobi at dawn, cruising over vast tracts of uninhabited, desiccated scrub
brush, and landed on a dirt airstrip three hours later. Stick-thin
militiamen dressed in camouflage uniforms that hung loose off their bony
shoulders squinted at us as we stepped off the plane. We climbed into dusty
trucks and sped off to see the district commissioner, Dolo's boss.
The district commissioner's office was a twig hut with a plastic tarp for a
roof and sand for a floor. I think the man could read, but that was about it
- he told us he had barely gone to school, didn't have any money and was
struggling to handle the ceaseless flood of starving people pouring into his
area. Just a few steps from his office I met a woman sitting on an empty
wooden box along the road, with four very thin children. They had just
arrived from a Shabab area, and the woman said that what little food was
being distributed through the International Committee of the Red Cross was
getting stolen by Shabab fighters.
"They're starving, too," she said.
The World Vision team made a quick survey of conditions in the town, leaving
Chris Smoot, the Somalia country director, almost in tears.
"I see a community that doesn't know how to cope," Mr. Smoot said. "They're
cut off, this little island of whatever."
We landed back in Nairobi by nightfall, proof of another problem: few
foreign aid workers who work on Somalia actually spend much time in Somalia.
Just about all the embassies and aid agencies run their Somali operations by
remote control from Nairobi, relying on local staffs and updates by phone
and e-mail, because it's too dangerous for foreigners to linger in Somalia
for more than a few hours (unless you're a journalist with your own
mini-army). One of the consequences of this arm's-length approach is an
inevitable lack of oversight, which has precipitated scandals like
accusations against the World Food Program that as much as half of the
emergency food intended for needy people in Somalia is being stolen by
corrupt United Nations contractors and sold on the open market; some of the
proceeds are said to be going to the Shabab, who then use the money for
The accusations have never been definitively proved. But just their
possibility prompted the American government to slap heavy restrictions on
aid to Somalia, which remain in place now, even during the famine. American
officials recently indicated that they had relaxed some of the restrictions,
but aid agencies said it was still difficult to determine what was legal and
what was not.
"The uncertainties around what we're allowed to do in southern Somalia, and
with whom, create a chilling effect for aid groups who would otherwise want
to respond," explained Jeremy Konyndyk, a director of policy and advocacy
for Mercy Corps.
All this might easily lead one to conclude that Somalia is beyond hope and
that hundreds of thousands of people are going to die, no matter what. But
that's not true. Aid agencies are making progress, though the situation is
far from ideal. I constantly get e-mails asking: what can I do to help?
I try not to pick favorites, and I give the best picture I can, which is
constantly changing, of who is doing what in response to this famine. The
Shabab are mercurial, letting in some big aid groups but not others.
> Unicef, for example, is one of the few United
Nations agencies able to do some work in Shabab areas, supporting feeding
centers and medical clinics, but all through Somali staff. The World Food
Program is distributing food in the Mogadishu camps, but once again there
are myriad accusations of aid being stolen.
Smaller aid agencies definitely have more flexibility. For instance, the
only Western aid worker I saw during a recent trip to Dhobley, a wild,
militia-controlled town on the Somalia-Kenya border, was a burly Australian
with a white Hemingway-esque beard who was working for the
> American Refugee Committee. It's a private aid
agency that has sent several foreigners into Somalia to oversee sanitation
and cash-for-work projects.
Kenya and Ethiopia host more than 600,000 Somali refugees, and many of the
major aid organizations, like CARE, Doctors Without Borders, the United
Nations High Commissioner for Refugees and Save the Children, are running
programs in camps in these two countries. Inside Somalia, many aid groups
are embracing the approach of cash transfers by cellphone as a way to get
around the Shabab and deliver aid directly - and discreetly - to poor
people. It is early days yet, but it seems to be working.
Muslim charities, like Islamic Relief and several Turkish aid agencies, are
playing an increasingly large role in this crisis, because the Shabab
continue to allow them much more access to drought zones than the Western
groups. Somali organizations, like Saacid, are also helping feed people,
though the local charities are often undermanned and underfinanced.
It is important to remember that however plagued Somalia is, however routine
conflict, drought and disease have become, however many Somalis have already
needlessly died, Somalis are not somehow wired differently from the rest of
us. They are not numb to suffering. They are not grief-proof. I'll never
forget the expression on Mr. Kufow's face as he stumbled out of Benadir
Hospital into the penetrating sunshine with his lifeless little girl in his
arms. He may not have been weeping openly. But he looked as if he could
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Received on Wed Nov 02 2011 - 17:37:42 EDT