A mother gives her child water out of her hand as they arrive at a reception center in Ifo camp in Dadaab.

In a blog post marking the first year anniversary of 2011's declaration of famine in Somalia, USAID Assistant Administrator for the Bureau for Democracy Nancy Lindborg reminds readers of three very important points.

1. Famine is not a word to throw around lightly.

Famine is a very specific technical term to describe only those most severe food crises that reach three clear sets of conditions. In famine, more than 30 percent of children are acutely malnourished; at least 20 percent of the population consumes fewer than 2,100 calories of food a day; and the mortality rate exceeds two deaths or four child deaths per 10,000 people on a daily basis.

2. Famine is not a natural disaster.

So as the worst drought in 60 years gripped the Horn of Africa last year, it was only in Somalia, racked by 20 years of conflict and instability, and with limited access for humanitarian action, that famine was declared.

3. Aid to the region saved lives, even in very difficult to reach parts of Somalia.

Our disaster experts from the Office of U.S. Foreign Disaster Assistance and Food for Peace used market prices and nutritional data to chart a strategy that focused on highly targeted cash and vouchers, attention to market dynamics. We also kept a focus on health programs, knowing that the leading cause of death for children in famines is preventable disease. USAID worked around the clock in the region and in Washington to ensure strategies, supplies and partners were in place, including creative approaches to address the limited humanitarian access in many parts of Somalia.

Although the situation has improved since its nadir last year, the Horn of Africa is still struggling with food security. In the past year CARE reached 2.8 million people in the region with critical humanitarian assistance.

To learn more about our work in the Horn of Africa and how you can help, visit our Horn of Africa page.

Photo. © 2012 CARE

CARE International: Cash relief for drought affected families in Somalia
Rahma is a 14 year old orphan girl with three siblings. Between them, the parentless family has one cow and twenty shoats remaining from a herd already decimated by previous droughts. The few livestock they have are not enough to support the whole family, so she and her older brother Muuse have had to find other ways to earn extra money.

Despite its negative impact on the environment, the only way they have been able to earn money for food has been to cut trees and produce charcoal. Together, the brother and sister look out for suitable trees that can be cut for burning. 16 year old brother Muuse, cuts the wood into pieces, digs a hole and sets fire to the wood to produce charcoal. He also then transports the charcoal into town for selling at the local market. This was their way of life, until CARE started working in their village.

CARE worked with the local elders to identify families in need and Rahma and her brothers and sisters were enrolled as cash relief beneficiaries, enabling them to earn around USD$120 a month from two projects managed by the organization.

Because of these earnings they were able to stop cutting the trees for charcoal, they also bought two extra cows, and can now produce extra milk to sell in the market. They also decided to join a village savings and loans group. They took a loan and bought fodder for their cows, this has helped increase their milk production. From the proceeds of milk sales, they managed to repay their loan.
They strongly believe that with their increased income they will be able to cope better in future droughts. The extra money has even enabled them to send their two younger siblings to school.

Rahma said " Since the death of my parents we both gave up our dream towards development, our thoughts were focused on how to find food and water, but our God sent this wonderful agency to support us, make us change our attitude, let us protect our forest. It was cutting trees as a coping mechanism during the drought that made us lose our animals. Now we have good dreams; I want to learn and become teacher, and my brother wants to be doctor. Many thanks to CARE, and its staff".

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Rick Perera, Horn of Africa Communications Coordinator

Overflow classes at the crowded Illeys Primary School, run by CARE, meet in tents in the courtyard. Most new students are recent refugees from Somalia.

It's a typical day at the CARE-managed Illeys Primary School at Dagahaley refugee camp in Dadaab, Kenya. Fifty parents are lined up outside the gates, desperate to enroll their children. They're drawn not just by the prospect of an education, but by the daily meal CARE provides, in partnership with the World Food Program. The student body is swelling astronomically with the children of new refugees, mostly fleeing drought and hunger in Somalia.

This modest compound of cement-block classrooms, designed for 1,500 students, packs in more than 4,000 children in two daily shifts. Spillover classes are housed in tents, bright voices echoing in song and recitation through the sandy courtyard.

"Every child who wants to come to school here is welcome, though of course it's a strain," says principal Ahmed Hassan in his cluttered office, where a whiteboard overflows with statistics about his ever-growing student population.

Illeys school is close to the influx area for refugees, and most of the new youngsters filling the school have recently arrived from Somalia with their families. In one of the tents, Farah Ali Abdi gives a basic English lesson to a remedial class. The group encompasses children ranging from 4 to 15 years old, all of them struggling to catch up enough to enroll in regular primary grades. "The cup is on the table!" they shout gleefully – more or less in unison.

Principal Ahmed Hassan struggles to accommodate 4,000 students, in two shifts, in a facility designed for 1,500.

Most teachers here, like Farah, are refugees themselves, hired and trained by CARE. They work with patience and skill, but with as many as 130 children in one classroom it is next to impossible to give all of them the attention they deserve. The five primary schools managed by CARE in Dagahaley camp are massively overburdened, with over 15,000 students. To cope with the influx, and help those who lag behind catch up to their peers, CARE operates special accelerated learning centers during school vacation. Yet, far too many refugee children receive no education: more than 60 percent of kids in the Dadaab camps do not attend school at all.Girls face special roadblocks in the quest to learn. Only 39 percent of students at the camp schools are girls. By tradition, girls are expected to take on the bulk of chores at home. "If a family has two girls and two boys, they will send the boys and one girl to school and keep the other girl home to work," says Principal Hassan. "Even the girls who attend will have little time to do homework – unlike their brothers." Puberty brings an additional challenge. Girls may miss class for a week every month during their period, out of fear of embarrassment – and many drop out entirely. A girl is traditionally considered marriage-ready at 14, and dropout rates soar at that age.

CARE's work to improve educational opportunity starts at the grassroots. Staffers hold community orientations and go door to door in the camp's residential blocks, advising families about the benefits of learning. Teachers live among the refugees, constantly reinforcing those messages. CARE helps adolescent girls stay in school, distributing sanitary napkins and training communities in how to dispose of them safely.

Sahara Hussein Abanoor, age 17, is an eighth-grader at Illeys, and aspires to be a lawyer.

Over time, teachers say, families see the benefits their neighbors reap when daughters become educated, get jobs and help support their parents. Bit by bit, the old attitudes are changing.

Sahara Hussein Abanoor, age 17, has an exceptionally eager face, but her ambition is not unusual among the students here. She loves learning and wants to become a lawyer and help refugees like her family. "My parents see what I'm achieving and they believe that my future life will be better," she says in confident English, beaming beneath a pumpkin-colored hijab that billows in the stiff breeze. "My mother did not go to school because there was no possibility of that in Somalia. Nowadays the world has changed very much. Even my brothers say it's good that girls go to school."

Shukri Ali Khalif, a member CARE’s Gender and Development team, is a passionate advocate for girls.

Indeed, some of the most effective advocates for girls' education in Dadaab are men. One of them is Shukri Ali Khalif, a tall, skinny 29-year-old who joined CARE's Gender and Development team in 2007. Previously, he says, he had no idea of the difficulties girls face or why they are more likely to drop out. Today he is an enthusiastic spokesman for their equal access to school. "I facilitate mentoring groups for girls, and encourage them to speak out in class and ask questions, instead of sitting on the back bench and letting boys take the lead."

And how do the boys feel about all this? Shukri – who was himself a refugee boy not so long ago – grins. "They feel great!"

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Niki Clark, Dadaab Emergency Media Officer
August, 2011

CARE's goal is to provide sufficient quantities of water to the existing and new refugee populations. This includes the maintenance of 20 existing boreholes and over 170 km of pipes.

Fardosa Muse is a much fiercer woman than her small stature implies. As a CARE sexual and gender-based violence officer in the world's largest refugee camp, she has to be. She spends her day listening to other people's nightmares.

Born in Dadaab, Fardosa, 26, grew up in a polygamous family; her father married multiple wives, and had 40 children. A fluent English speaker, Fardosa studied social science in college. Upon returning to her hometown, she came to work for CARE, where she has spent the past two and a half years in the Dadaab refugee camps.

She is passionate about her work and the people she serves. "Can you imagine being gang-raped in the middle of nowhere?" she says, a steady gaze in her eyes. "This is what women and children are experiencing on their journey from Somalia. Violence against women is a profound health problem for women across the globe."

Today she visits Sultana,* a 53-year-old grandmother, who Fardoza met when she first arrived at the camps. She wants to see how Sultana is settling in.
Sultana greets Fardosa upon her arrival and, after a few minutes, she asks the six children in her care (five grandchildren and one other child relative) to go and play. She wants to speak to Fardoza alone. She doesn't want them to have to relive her story.

Sultana gestures to her tent for Fardosa to come in. With Fardosa's help, Sultana was fast-tracked through registration so as to get a more permanent shelter than the initial reception process provides. There is a thin mattress on the floor, also given to her by CARE as part of her intake process. Other than a piece of tattered fabric covering her bed, and a thin cover of red dust, the rest of the tent is bare.

Sultana was living in Dadaab when she heard that the husband of her mentally-challenged daughter had been violently killed in Mogadishu. Knowing the struggle her daughter would have raising the children alone, she traveled to Somalia. Once there, she turned back, determined to take the six children to a safer, more stable environment. Midway through her journey, Sultana was raped by seven armed men.  When sharing her story with Fardosa, Sultana's eyes squint in pain as her hands gesture how she was gagged and bound. She says that she continued her journey back to Dadaab once the men were done. She had to keep going. 

Rape affects survivors in many ways. Because of the severe social stigma here associated with rape, many cases go unreported. Women who are violated are often shunned by their neighbors and families, divorced by their husbands. For unwed women and girls, rape can mean a solitary life with no chance for marriage. There is the risk of HIV infection, too. In Somali communities, Fardosa says, there is no sense of confidentiality. With thin tent walls separating neighbors, it seems the case is the same in Dadaab. So Sultana tells her story in soft whispers. Having others know what happened to her "would be a whole set of other problems."

"It's a challenge just operating in this environment," Fardosa says. "A lot of the shame survivors feel comes from the community. Here, women are ‘the lesser sex.' Only women that are circumcised are considered marriage worthy. Marital rape is a big concern. The work that CARE is doing in Dadaab focuses on providing psychological and social support and rights education, as well as outreach to men and boys so we can start changing what is considered the social norm."

CARE is supporting newly-arrived survivors through counseling and referrals to emergency medical facilities at the reception centers and by providing psychological counseling services in the camps. Weekly sessions are conducted at settlement sites, including education on services available within the camps. To date, CARE reached approximately 8,200 new arrivals with information on violence prevention and where and how to get help. CARE also provides information through "road shows" put on by Community Participatory Education Theatre groups. Unfortunately, reported cases of gender-based violence in the camps have significantly increased since the onset of the crisis, although most violations still remain unreported.

Fardosa's visit with Sultana comes to an end. "I still have horrific nightmares," Sultana tells Fardosa. "But because of counseling provided by CARE, I am healing."
Fardosa stands and brushes off the red dirt from her clothes. She steps outside and once the children see their grandmother's meeting is over, they run back from a neighbor's tent, laughing and chasing each other. 

"Rape is not only a violation of the law," Fardosa says as she walks back towards the car. "It's also a violation of humanity."

She is on to her next client. There are many more waiting.

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*Identifying characteristics have been changed to ensure confidentiality.

Mohamed Maalim Gedi sits cross-legged on a floor of dusty red dirt, aimlessly fiddling with his bare, well-traveled toes. His gaze is towards the ground, but his thoughts are obviously elsewhere. He occasionally reaches out to swipe an insistent fly from the face of one of his young children, five boys. The wooden benches, set in a half circle around him, are filled with other weary travelers. They just arrived in Dadaab, a place of both hope and uncertainty. A large bus, smoke still sputtering from its tail pipe, is parked a few yards away. It is the one that transported him from the border, another group of Somali refugees escaping drought and insecurity. There have been more than 132,000 refugees who have come just since January.

Like so many of his fellow refugees, Mohamed is a pastoralist. His entire livelihood depended on his cattle. When the last one died, he decided it was finally time to escape. "I have lived like this for 20 years," Mohamed says, referring to the frequent drought and worsening security in his home country. "Enough is enough."

So, with his wife and mother, he traveled 500 kilometers via foot and donkey cart from his village of Bu'aale, Somalia to the border town of Dif, Kenya. From there, he arranged for a bus to transport his family for the rest of the journey to Dadaab. Because of limited space, he had to leave behind two of his children, his youngest, 2, and his eldest, 14, with cousins. "I hope the bus that just brought us is going back to get them," Mohamed says. "But I can't be sure."

The reception center is the first safe haven after a long and arduous journey for refugees. In the background, one can hear the shrill, high cry of children. But their cries come not from the hunger but vaccinations against polio, measles, diphtheria and pneumonia. Such vaccinations are unheard of luxuries back in Somalia, and are part of the reason Mohamed made the trip here. He hopes his sick children will get the medical attention they need.

Waiting outside the UNHCR registration tent. Once a refugee is registered, they are entitled to the regular food distribution cycle that CARE manages with food procured by the World Food Programme.

Here at the reception center, Mohamed also has access to clean water and a supply of high-energy biscuits. Because of increased efficiencies in registration, Mohamed and his family will now be registered within a three-day time period, down significantly from previous waiting times when the crisis first hit. After he registers, CARE will provide him with a plastic tarpaulin, kitchen set, soap, blankets, plastic mats and jerry cans and an initial food ration to last until the next regular food distribution cycle. As registered refugees, Mohamed's family will be entitled to a tent from UNHCR an a food ration card so they can join the bi-monthly food distribution cycle run by CARE.

On the fence surrounding the area where CARE distributes initial food rations —servings of wheat flour, Corn Soy Blend (CSB), vegetable oil, corn meal, beans, salt and sugar — hangs a sign in English and Somali. It states: "Services from Agencies are Free; Help Stop Sexual Exploitation and Abuse." CARE and other agencies that work here are continuously working to ensure refugees are aware of services and where to access them. A CARE counselor stands next to the area where new arrivals gather their high energy biscuits. "How was your journey?" she asks a fatigued family of five. She's looking to identify vulnerable populations, such as survivors of gender-based violence, widows, lactating mothers and the ill. She's help "fast-track" them so they can get to immediate help, including medical services and counseling.

As he waits to be called, Mohamed sits with uncertainty weighing on his mind. He has no relatives or friends in the camps, and is unsure of what to expect. "There is a fear of the unknown," he says. "Will I have a place to sleep tonight? Will my children get food and medicine?"

In spite of these reservations, Mohamed says he remains optimistic. "I am hopeful. Hopeful that I will get help for the first time. That, finally, we will have some relief."

He pauses for a few minutes, lost in his thoughts. "A larger question lingers, though," he finally admits. His question is one that countless others have asked, continue to wonder, even after the physical part of their journey is complete. "What's next?"

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Niki Clark
September 20, 2011

Everyone knows that water is necessary to sustain human life. People have survived for weeks, even months, without food, yet even a day without water causes the human body to suffer. Even with its critical importance, water isn't typically something that gets most people excited. That is, unless you're talking to any of the CARE staff working on water and sanitation (WASH) in Kenya at the Dadaab refugee camps. Just hold a 10 minute conversation and you'll understand how easy finding a passion for the subject can be. 

CARE's goal is to provide sufficient quantities of water to the existing and new refugee populations. This includes the maintenance of 20 existing boreholes and over 170 km of pipes.

As the main implementing partner for water production and distribution in Dadaab's three camps and two outlying areas, CARE pumps and distributes approximately 7.5 million liters of water a day, enough to provide all residents with 15 liters of water a day. With almost 500,000 refugees in and around the camps, providing water for the entire population remains a daunting task and extending services to keep up with demand is a constant challenge.

"Dadaab is the third largest city in Kenya," says Timothy Mwangi who helps with CARE's water management. "The coordination and logistics involved in making sure that many people have enough to drink would be difficult in a normal setting. But within the context of a refugee camp, it is even more of a challenge."

CARE is meeting that challenge through a combination of boreholes and water tanks. Currently, CARE maintains 20 boreholes and over 172 kilometers of pipes throughout the camps. These boreholes tap into the reserve of groundwater that sits below Dadaab's surface. In addition, CARE provides potable water through trucking services and water tanks. Each influx area has between one and three tanks, each serving 2,500 people.  CARE also is increasing the number of water points and tap stands in the influx areas and extending water pipes from the existing camp systems.

Resources are tight. Amina Akdi Hassa is the chair of the Dagahaley camp. She serves as a refugee representative and is consulted when decisions regarding Dagahaley services are made. She has lived in Dadaab for nearly 20 years. "Share our problems," she tells visitors. 

One of those problems is storage. While CARE distributes jerry cans to all new arrivals, there often are not enough to transport and store all the water needed. The task of collecting water is time consuming, and often keeps those charged with less time to collect firewood and cook, for example. Community mobilizers employed by CARE spend their days talking with residents like Amina to assess the problems and offer solutions.

In addition to our water production and distribution work, CARE manages all hygiene and sanitation promotion programs in the three main camps — Hagadera, Ifo and Dagahaley — including each camp's influx areas, markets, schools and water points. Refugee "incentive" workers raise awareness around various hygiene issues, including reducing the spread of waterborne diseases through handwashing. These workers go door to door, demonstrating safe hygiene practices and distributing soap.  

Water trucking in camp Dagahaley. Refugees here receive an average of 19 liters of water per day.

To the outside world, it may not seem like the most glamorous of jobs, but the response of the refugees is quite different. When CARE's Public Health Promotion Officer Raphael Muli visits the influx area of Dagahaley, he is immediately surrounded by residents of all ages. Young children crowd, raising their hands, anxious to volunteer for the handwashing demonstration. Raphael flips through a "how-to" picture book walking the children through each step. Then, he hands out bars of soaps, reminding refugees that handwashing is a simple way to reduce the risk of disease. In fact, some studies show that this simple act can decrease diarrheal disease by up to 47 percent in a community. All day long Raphael will repeat this drill, one person in a CARE team of public health officers and community mobilizers. He is greeted enthusiastically everywhere he goes.

Raphael and his colleagues have reached nearly 31,500 refugees living in the influx areas with their public health promotion messaging this year alone. Their goal is to reach 60,000 by the end of the year. With each demonstration and each conversation he holds, his message about the important of water and good hygience becomes clearer to everyone.

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The Borana region of Ethiopia is known for its deep traditional wells that are the main water source for livestock and household consumption in the dry season and in times of drought. These wells are known as the "singing wells" -- because when people fetch water they form a long line up a ladder and sing as the water container is passed from one person to another, until it reaches the last person waiting above ground. The traditional wells have kept the people and livestock safe for generations – until this current drought, when they stopped giving water. "There was never a drought like this one that made the traditional singing wells of Borana run dry. Never in history," said an elderly man from the community, with an expression of disbelief. 

Due to the greater number of deaths of livestock recently, and migration of the remaining animals, it was normal to expect that there would at least be less pressure on the wells now, as they would serve only for human consumption. But their natural capacity to produce water has dropped precipitously, making the situation increasingly dire. 

Previously both animals and humans took water from the same source – but in the recent past CARE, through our Resilience Enhancement Against Drought in Ethiopia (READ) project, rehabilitated these 12- to 15-meter-deep traditional wells for better and more hygienic accessibility and quality of water during dry seasons and droughts. But even these improvements cannot make the wells give water when nature does not cooperate.

Currently, rationing is in place in five woredas (districts) at water points served by different NGOs. CARE has continued rehabilitating water points and providing water purification solution.

After the great number of deaths of livestock, the lifeblood of Borana pastoralists, it has become normal to hear people saying, "We have stopped thinking about our animals now. We are worried only about lives." Cereals are in short supply in markets, and prices are out of reach for many. Malnutrition for nursing mothers and children under 5 is another serious issue that is getting worse day by day. 

More and more cattle can be seen for sale at the market, but their selling price is lower than ever and few buyers can afford them. The rate of deaths has been slowing lately, but as rains fail and drought conditions persist, the situation is again deteriorating – precious herds are dying.

CARE is actively involved in preventing the loss of livestock, by providing feed and helping herders manage their herd size, culling animals while they still have some value for meat, rather than letting them starve. We are also providing supplementary feeding for malnourished children in three woredas and scaling up to reach two more, as the number of new cases soars.

The songs may not come back to the wells anytime soon, but CARE is determined to bring a note of optimism to the herders of Borana in these difficult times.

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Adulkadir Adbullahi Muya—known by his colleagues simply as Muya—is in a hurry. He hardly has time for a handshake greeting before he is off, his long stride forcing the occasional sprint in attempts to keep up.

Muya is a paracounselor with CARE in the Dagahaley camp of Dadaab Refugee camp. He identifies people in his community who have experience trauma, loss or violence and handles initial consultations.

Paracounselors like Muya are specially trained, identifying the violated and vulnerable within the community and handling initial consultations. He walks this route several times a day, going back and forth between the CARE Counseling office and the drop-in center.

Right now he is headed to meet a new client, someone a CARE community mobilizer told him about. A bus was hijacked on the journey from Somalia to Dadaab. Women were raped; people were burned. The details are fuzzy but he knows it's serious. His pace quickens, his fingers furiously texting, always working, even as he walks. He briefly turns, "Dagahaley is growing and growing," outstretched arms for emphasis. Indeed, it is. The population of Dadaab has more than doubled in just three years.  

We rush past Unity, a primary school CARE runs in Dagahaley, the sing-song chorus of children echoing from the classrooms. Past a lone donkey, munching his way through a burned refuse pile, searching for anything edible. Through shouts of "How are you?," a charming acknowledgement by refugee children of Muya's obviously English-speaking companion. By mud bricks in a yard, past a naked toddler beating an empty jerry liter, applauding himself for the rat-a-tat noise his impromptu drum makes.

A resident of Dadaab since 1991, Muya went back to Somalia in 1997 and after nearly a decade, returned once again, this time bringing his mother. He works with an unceasing determination, often working through lunch breaks in order to squeeze in just one more visit. The pride he holds in serving his neighbors in this way is evident; it comes through in his stance, the way he speaks of his "clients." The sweat beads that form on his brow in this ungodly heat remind me of a musician, just finished with a high-energy performance. It's an accurate impression. In many ways, Muya is a rock star.  

On the way to the drop-in center, Muya walks past the home of one of his current clients. A quick change of plans and Muya walks in the yard, greetings all around. An elderly refugee woman sits on a mat outside her mud hut. I smile softly in her direction but notice her blank eyes, she is blind. A lump grows in her neck glands; multiple hospital visits have answered none of her questions. Muya asks how she's doing, is she in pain, does she need him to make any calls?

"Sometimes I just stop by to say hello," Muya says about his visits. One man he stops to see has a cancerous tumor that is enveloping the back of his head, creating constant pain. His only option is chemotherapy, which he can't afford. But Muya stops by every day, every two days. "I don't want him to lose hope. Maybe one of these days, if I keep referring him to different doctors, reaching out to different people, then maybe someone can intervene and help him. Until then, I'll keep listening, searching for help. I want him to know he hasn't been forgotten." 

As he speaks, another woman walks up, complaining of constant headaches and vision problems. Can he help her? She heard he could. "New clients," Muya says with a smile. "Every day, you get a new client." He jots down her information and refers her to the medical center before he is off again. Muya has his fill of new clients today. He is stopped no less than six times on his way to the drop-in center.

One is a woman who has lived with her condition for six years, four of them in Dadaab. She, too, spends her days sitting outside on a woven mat, not walking except to the latrine, which is fortunately just a couple of feet away. Her arms and legs are thin like twigs, breakable, yet her abdomen is swollen like the belly of a mother on the brink of birth. But this woman isn't pregnant, her eldest is eight. And no one can seem to tell her what's wrong. She asks Muya to photograph her; that maybe he can show the picture to another doctor, one she hasn't seen before, and this one could help. Muya promises to follow up and then heads out.

There are more people to see.

Because the sun is fading, and the drop-in center is still far, Muya calls the daughter of the woman he originally set out to see and asks if he can meet her at the block instead. It is in fact, right next to Muya's block in Dagahaley, so he knows exactly where to go.

Muya with the some of the refugees (including a client, bottom left) with whom he interacts with regularly, not only as a paracounselor for CARE, but as their neighbor and fellow refugee.

The woman's family surrounds her as he makes his way to her house. She lifts her dress, revealing a painful and hideous wound, where the men covered her with paraffin and firewood and set her on fire. It was her punishment for resisting rape. After her bus was hijacked, women were brought into a nearby forest and raped. When she fought back, she was burned. The hijackers stole the bus, and so the woman had to be carried by the other refugees to Dadaab. Luckily—if you could call anything in Dadaab that—her daughter was here and had a mud house to offer. She visited the hospital with her husband, who could just watch as she was attacked, but they couldn't afford the recommended procedure so they returned back to her daughter's home with just pain pills and topical cream. That was two weeks ago. Yesterday, CARE had met with the men on the bus, today the women survivors. They needed to talk through the horror they had witness.

"I still feel the pain," she said, "Like my skin is on fire." When Muya asks her about her other pain, the pain that's will remain after her leg heal, she tells him, "I've accepted what has happened to me. What is disturbing me is my wound, my physical pain. If I can get treatment, and I can't see the scar, I will be able to forget about it."

In a world where violence, loss and death are an everyday norm, this may be true. But Muya will not forget. He gets her details; promising CARE counselors will follow up and ensure that the woman receives both the physical and psychological care she desperately needs. She is not alone, she will not be forgotten.

Muya and the woman part ways, nightfall is approaching quickly and he wants to get in one more visit. He shouts his goodbyes from over his shoulder; like always, he is in a hurry.

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by Niki Clark, CARE Emergency Media Officer in Kenya
September 2011

One of my "duties" as an emergency media officer here in the refugee camps in Dadaab, Kenya, is to share my perspective of CARE's work and beneficiaries through social networks such as Facebook and Twitter. And being the dutiful employee I am, I often Twitter-follow recent Dadaab visitors so that I can in turn share their perspectives of the camps.

One such recent visitor was Somalian-born, Canadian-raised singer K'naan. Although K'naan found worldwide fame only recently through his 2010 FIFA World Cup theme-song Wavin' Flag, he has been amassing fans for more than 10 years, when a spoken word performance before the United Nations High Commission on Refugees caught the ear of famed Senegalese singer Youssou N'Dour (another recent Dadaab visitor). After K'naan visited Dadaab with a World Food Programme-CARE joint delegation, which included friends of CARE Cindy McCain and retired NBA superstar Dikembe Mutombo, @Knaan became my latest Twitter-follow.

For the past week or so, I have been struggling with the two very different Dadaabs I have experienced. Then, yesterday, I read a tweet that perfectly captured what I have been trying to express:

"Somalia is overflowing with beauty." @knaan reflects on his Somalia, not necessarily the one you see on the nightly news.

In midst of the strife and turmoil, hidden between the heartache and uncertainty, and tucked away behind the dire poverty and desperation of a homeless people, the people of Somalia – the refugees of Dadaabb – are an overflowing vessel of beauty. Because the unexpected truth is: there is beauty everywhere, even in the world's largest refugee camp, where I see:

The luminous glow of a fading sun, moments before dusk, as we head back to the compound to meet our curfew.

The joy of a widow's eyes and the firm grip of her hand as I tell her about CARE's livelihoods program; that she too could learn how to operate a business of her own, to educate and feed her four young children.

The gentle touch of a small child, no older than 3, when she reaches out to shake my hand in greeting and decides, instead, to kiss my hand.

The pride and confidence of a recent graduate of CARE's Community Tailoring School as she displays the bags she made with her own two hands, which she sells in the Hagadera market, allowing her some independence in a culture of dependency.

The lines of an elderly man's face, and the stories the lines tell of loss beyond description, and of a determination that guides him forward day byday in spite of it.

The toothless grin on a 5-day-old baby girl, born on the journey from Somalia, her 10 perfect fingers, 10 perfect toes.

When I was an art student in college, I did a photography project on raw beauty – the beauty of accomplishment, the beauty of the everyday, of the unintentional. I have seen incredible poverty in Dadaab, things that people should never see, things that should never exist. Back in my Washington, D.C., office, I have CARE's vision tacked to my cubicle walls:

We seek a world of hope, tolerance and social justice, where poverty has been overcome and people live in dignity and security. CARE International will be a global force and a partner of choice within a worldwide movement dedicated to ending poverty. We will be known everywhere for our unshakable commitment to the dignity of people.

It's a constant reminder for me of the essence of CARE's purpose: Defending Dignity. Fighting Poverty. Because dignity is beautiful. People who are able to control their own destinies and raise themselves above the situations into which they are born: this is true beauty. And it's all over Dadaab.

As a native of Somalia, K'naan is able to see something that most people in the world will never see: the beauty of Somalia and its people. Dadaab may never make Travel & Leisure's "Top 10 Most Beautiful Places' but the people of Somalia – who are the refugees of Dadaab – are some of the most beautiful people in the world.

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by Rick Perera, CARE Communications Coordinator, Horn of Africa
September 2011

Janet Ndoti Ndila is a tough lady with a tender heart. She's the lead counselor at CARE's drop-in support center at the Dagahaley refugee camp in Dadaab, Kenya. Here she offers a trained ear, and a map through the maze of camp bureaucracy, to people who have suffered some of the most horrific things imaginable in their flight from hunger and despair.

Janet and her colleagues are the first resort for thousands of weary, dejected Somalis pouring out of their famine-stricken homeland into this complex of camps, the largest of its kind in the world, now sheltering nearly 430,000 people. She doesn't let the experience dampen her upbeat, take-charge personality. But there are days when it can get overwhelming.

"I've worked in worse places – places where there's immediate, ongoing bloodshed. That's not the case here, but the things people have lived through…" Her voice trails off.

Providing Physical and Emotional Rest

Janet leads the way to CARE's distribution center for new arrivals, a large tent where refugees collect initial rations to tide them over until they are registered as camp residents. An efficient operation whisks them through as they collect plastic mats, jerry cans, cornmeal, beans, salt, oil and other essentials. Nearby, a set of taps offers plenty of safe water for washing and drinking.

More than physical hunger and thirst are looked after. Janet and her staff usher in group after group of tired, bewildered families and sit them down on rough-hewn benches in the shade of a canvas tent. Janet – a native of Kangalu in eastern Kenya – speaks to them reassuringly through a Somali interpreter. Here they get their first orientation to Dadaab: how to negotiate the labyrinth of services available, register for food distributions and shelter, and gain access to medical care for the weak, the malnourished, the sick and those injured during the harsh journey.

There are wounds to the spirit, too, and these are Janet's most important responsibility. Most of the refugees have seen and experienced terrible things before arriving here. Not just the suffering of poverty, hunger and warfare back in Somalia, but the trauma of being uprooted from home and family, and the loss of loved ones: the elderly, frail and children who did not survive the trip. Many fell prey to bandits along the way, robbed of everything when they were at their most vulnerable. And in every group of new arrivals there are women bearing terrible secrets, of brutal violence and rape suffered in the lawless wilds they were forced to cross in search of safety.

Refugees Counseling Refugees

CARE's paracounselors are a team of 18, as energetic and outspoken as their boss. They are all refugees themselves, recruited in the camps by CARE and specially trained to handle initial consultations. They are familiar, compassionate faces, fellow Somalis who understand what their compatriots have been through. The paracounselors quickly identify survivors of sexual violence and other particularly vulnerable people, "fast-track" them for special assistance including food and essential household items, and refer them if needed for medical attention. Women who are in immediate danger from domestic violence can take shelter in a community-based "safe haven" until they have somewhere safe to go.

Nearly 4,700 refugees have come to CARE for counseling and support in just over three months – 1,111 during the week of Aug. 28-Sept. 3 alone. The women who seek Janet's help have suffered more in a few weeks than anyone should bear in a lifetime.

Responding to the Different Needs of Men and Women

Today Janet met a client, who arrived two months ago and set up housekeeping on the outskirts of Dahagaley camp, in a crude hut made of cardboard boxes on a frame of bundled sticks. Before leaving Somalia, as her family's meager farm shriveled to nothing, the woman watched two of her three children die of hunger and disease. Crossing the desert on foot, she was robbed of everything – even her precious supply of water – then gang-raped. It is a horrifying story, but the woman speaks with a steady tone. She wants to give voice to the terror, to speak out on behalf of those who must remain silent in fear.

Men, too, suffer their own nightmares. Initially many stayed behind in Somalia to watch over homesteads and herds. But as famine continues to spread, crops have been decimated. When their last cattle starve, men are forced to make the trek to Dadaab in search of help. For those from proud, ancient pastoralist traditions, who measure wealth in terms of how many cattle a person owns, the loss of a sense of identity is devastating.

"Not quite as many men come as women, for cultural reasons, but they do come," said Sharif Ahmed Abdulahi, a CARE paracounselor trained in community development, life skills and counseling. He and his colleagues are careful to respect tradition and work in harmony with community norms. "Sometimes people ask me to tell them what to do. I say: I can counsel you, but I can't advise you. If you want advice, you should go to an elder."

Janet is busy recruiting additional staff to reach more people in need. She wants to hire and train more female counselors – just under half of the current refugee workers are women – but it's hard to find candidates who are literate, and many young girls are married off at age 14 or so.

But Janet is not someone who gives up easily. She thrives on challenge, and finds this work incredibly rewarding. One thing is clear: she's not going anywhere soon. "I plan to stay as long as I still like it. It will be a few years."

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When I told my family and friends that I was leaving for six weeks to work with CARE on temporary assignment in Dadaab, the world's largest refugee camp, I was immediately bombarded with Facebook messages, e-mails and calls along the lines of "I'm so proud of you. You're going to save the world!" and "You're making such a difference!"

To be honest, besides being a bit exaggerated, it makes me a bit uncomfortable. Now, don't get me wrong, I cannot emphasize how much I appreciate the good wishes and thoughts of my loved ones. Their support has allowed me to take this journey. But nothing — absolutely nothing — compares with the dedication and passion of CARE's employees in the field. And to even be put in the same category as these colleagues seems more than a bit ludicrous.

This past weekend, for example, I took part in my first real Dadaab celebration —complete with grilled goat (a rather tasty treat, if you're curious) — a send off for long-time CARE employee, Julius. Julius is leaving Dadaab for a new CARE post in Nairobi after nearly 19 years in Dadaab. Nineteen years! That's the equivalent of 133 years in a normal career, as I'm convinced Dadaab years should be counted like dog years. He joined CARE when the refugee population in the camps was around 35,000. Today, nearly 400,000 additional people have been added to that number.

For 19 years he has lived here away from his family. He most likely has shared a room and used a communal bathroom and shower. Because space is at a premium, when a staff member goes on leave, people exchange rooms, some moving every few weeks. There are no hanging photographs, no personal mementos. In many ways, the staff is unsettled as the new arrivals. They are nomads without a home. They work for hours on end in the unforgiveable combination of heat and dust.

I am here for six weeks, and even in that relatively brief time, I have succumbed to heartache and homesickness. I assumed that unlike me, the devoted staff in Dadaab must have solitary lives, free of the commitment of relationships. Until I met Maureen, a new coworker who casually mentioned her three-year-old son and husband back in Nairobi. Or another colleague who mentioned how he was planning some quality time with his wife during his next break. CARE staff work eight weeks on, two weeks off. Because of limited resources, sometimes even those brief breaks get shortened. But I have yet to hear a complaint. I have yet to see a frown. There is a Jewish proverb that says, "I ask not for a lighter burden, but for broader shoulders." CARE staff in Dadaab are star athletes in that regard.

In addition to the tough environment in which they work, the actual work they carry out is difficult. Imagine feeding 427,000 people. Getting clean water to them. Educating them. Training them. These jobs are difficult no matter the circumstances – but in these conditions, accomplishment is an amazing feat. Many that have made the long trek from Somalia have experienced personal violence or loss, each tale of tragedy and horror more unfathomable than the one before. CARE's sexual and gender-based violence officers have the colossal task of helping the survivors heal, start their lives anew. Day after day after day.

I asked a colleague why staff that work so hard, so tirelessly. And why are the people that CARE serves, people who have been through the most of trying of times, always smiling? Why despite everything that surrounds them, do they always greet me with a handshake, with a sense of joy? He answered, "Because we are Africans. We have been through so much and we survive. We have hope now."

No individual is saving the world. But here among CARE's dedicated staff, I have met a lot of people who are doing their part.

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by Niki Clark, Emergency Media Officer in Kenya
September 2011

I’ve been in Dadaab for nearly two weeks now. I have seen mothers and daughters, fathers and sons. They have been old and weak, young and weak, their faces lined with struggle. I have seen the faces of children who have eaten their first meal in weeks and the resulting transformation back to childhood, full of giggles and smiles and impromptu games of tag. When people think of Dadaab – now with its three camps considered the third largest city in Kenya – they think crisis. They think emergency. Humanitarian efforts and funding tend to focus on the immediate, looking ahead no more than a year. As soon as another emergency hits, the spotlight will move on. But, as they have for the past 20 years, the refugees of Dadaab will remain.

This thought particularly struck me during a visit to the reception center, the first place where refugees find help after a long and arduous journey. Here they receive medical assistance, and aid workers identify the most vulnerable for immediate attention. A chorus of wails echoes from the vaccination room: the occasional child slipping from the grips of the nurse, running to the dirt yard in tears. Each family collects a 21-day ration of food and supplies (cooking pots, mats, a tarp, soap, jerry cans) to tide them over until they can register.

Today, I see a young mother waiting for her high energy B-5 biscuits, a box of which is given out to new arrivals. Tucked under her garbasaar – a traditional shawl – a set of tiny toes poked out into the sunlight. I approached her gently, and she pulled back her wrap so I could see his miniature features. He is 10 days old, she tells me with a smile. She gave birth to him halfway through her journey to Dadaab. Most likely, I thought to myself, he will become part of the second generation that has spent their entire lives within this camp.

CARE has worked in Dadaab since 1991. Refugees who were educated as children here are now teaching refugee children themselves. That’s why the long-term investment that CARE is making here is so critical. It’s not just an investment in immediate needs, although we’re doing that, too. On an average day of food distribution, CARE passes out 389 metric tons of food to 45,000 people. And every single day, CARE pumps and distributes approximately 7.5 million liters of water, enough to provide more than 446,000 people with 15 liters of water every day.

But we’re also working toward long-term solutions. We’re investing in people. In Dadaab there is a thriving economy – butchers and bakers and, yes, probably candlestick makers. They own restaurants and bookstores and barber shops. People are being trained by CARE in trades from dressmaking and tailoring to computer technology. CARE directly employs 1,600 refugees, who serve as counselors, food distributors, chefs, teachers and drivers. They grow up in Dadaab, are educated in Dadaab and work in Dadaab.

After the “emergency” has passed, hundreds of thousands of people will remain here in the refugee camps. As my colleague told me today, they need more than food, water and shelter. They need a future. CARE is committed to helping them prepare for tomorrow, whether they continue to build their lives here, or one day, return home to start anew.

The drive to the Galbet Farm in Garissa, Kenya, looks strikingly similar to the land around Dadaab, site of the world’s largest complex of refugee camps. It is dry and barren. The bush remains brown and leafless after months upon months without rain. It seems like an unlikely environment for a farm – one that will thrive, anyway.

But thrive is exactly what the farmers at Galbet Farm are doing. While the drought is killing the livestock and destroying people’s livelihoods in neighboring regions, this one small patch of land in Garissa is literally an oasis in the desert. It’s not just through happenstance. The people of Garissa knew a drought was coming so, with CARE’s help, they prepared.

For the past two and a half years, CARE’s Arid and Marginal Lands Recovery Project Consortium (ARC) has worked to promote drought-resilience in the Garissa, Moyale, Wajir and Mandera districts. The three-year project reaches more than 85,000 people, in a region where the drought is affecting half of the population – some 2.4 million people. In a region where 80 percent of the population is dependent on livestock, the death of animals is devastating.

CARE’s objective in launching the project in the aftermath of the 2008-2009 drought was to help vulnerable rural people gain sustained access to food and become more resilient in the face of future crises.

Maka Kassim is one of those people. As a pastoralist, she and her family followed their livestock wherever pastureland and water could be found. After a severe drought five years ago, her herd died and she was left with nothing. “I decided I needed to plan so I could provide for my family – so we could get our daily bread.” she says.

Today, Maka is flourishing. CARE taught her how to farm and diversify her crops to protect against disaster. As part of the Galbet Farm cooperative, she and the other farmers grow fodder grass, bananas, tomatoes and mangos. In addition to providing enough food for her family, including her six children, the farm has been so successful that she is able to supplement her income by selling extra produce at the market.

CARE also is helping improve water canals. Previously, farmers collected water from the Tana River, a time-consuming and dangerous task considering the river’s high population of crocodiles. The old canal cut through loose soil and experienced frequent breakages and high seepage that resulted in a large loss of water. Now, an abundant supply of water comes to the community to irrigate the land and provide fresh drinking water at tap stands.

Galbet Farm is just one of several ARC projects. CARE’s work through the project includes teaching beekeeping, fodder production, milk marketing and basic veterinary skills. We’ve also helped foster a relationship between First Community Bank and the Kenya Meat Commission. Farmers now purchase weakened cattle from drought-stricken districts, bring them back to the farm to fatten them up and then sell them for a profit.

“We want to serve as role models,” Maka says. “Because of CARE’s assistance, I am able to feed my family. I am able to educate my children. I am able to plan for my future.”

Niki Clark, CARE Emergency Media Relations Officer
30 August 2011

Here I sit, 7,500 miles away from home. I’m a week in. Over the course of just a few days, my life has completely changed. On a Monday I reported to work at CARE’s Washington, D.C. office. By Thursday I was on a plane bound for Nairobi where my final destination would be Dadaab Refugee Camp, the world’s largest. I will spend the next six weeks here as CARE’s emergency media officer. It is a position that both thrills and terrifies me. As an employee of one of the most prominent global humanitarian agencies, there is always an excitement that surrounds “going to the field.” But this is different.

Unlike my colleagues who have preceded me in this position, and most likely the ones that will follow, I have not been in a humanitarian emergency crisis situation before. I haven’t seen the devastation of a Haiti or a Pakistan. The closest I’ve come was the fall of 2005, when my grandmother came and lived with us after Hurricane Katrina. Her Biloxi home had been destroyed. But even then, I witnessed the situation only through my constant refreshing of CNN.com, and through my grandmother’s stories, not firsthand. And Dadaab is unlike other emergency situations. It is established. There are second generation refugees that have grown up in the camps. I’m not quite sure what to expect. Or how what I experience, the people I meet, will forever impact me.

CARE has worked in Dadaab since 1991, as the main implementing partner for the distribution of food and water and as well as a lead provider of education and psychosocial support and rights education for sexual and gender-based violence survivors. We’ve been here for decades. But with the recent declaration of famine in five regions of southern Somalia, coupled with ongoing conflict and instability, a surge of new arrivals have flocked to the camp, and a global spotlight has been shone on the region, particularly on Dadaab. Dadaab’s population stood at 423,361 as of August 28th. Every single day, it grows by 1,200.

As we landed—my colleague Michael Adams, the Senior Sector Manager for the Refugee Assistance Program in Dadaab, and I flew in on a small UNHCR humanitarian aid plane—the pilot circled around towards the gravel airstrip. A bird’s eye view of Dadaab and its three main camps became visible below me. It was a breathtaking site, a massive settlement that’s now effectively Kenya’s third largest city. It’s hard to fathom until you’ve seen it. And even then, when it’s right in front of you, and you’re face to face with women and children and families that have traveled 80 kilometers or more to get here, there’s still something surreal about it all. Something that makes putting it into words seem a sort of insurmountable task.

But that’s what I’m here to do. To share the lives of the people I meet, people up against incredible odds, some who have thrived and some who are struggling to survive. To share the stories of the unwaveringly committed CARE staff whose dedication to the people they serve is first and foremost. To share the successes of CARE’s programming, and its far reaching impact. I’m not sure if I’m up to the challenge; if I can accurately portray the scale and struggles or the unexpected hopes and triumphs. But I do know one thing. I’m going to do my best. There are too many lives at stake not to.

For updates on my experience and CARE’s work in Dadaab, follow me at @nclarkCARE. I can also be reached at nclark@care.org

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As a humanitarian worker for the past sixteen years I have seen some pretty shocking scenes. Before this trip to East Africa, I was particularly not looking forward to witnessing suffering children. However, when I saw the dedication and commitment of the CARE staff working on our response in very difficult surroundings, it made me feel proud to work for CARE.

Villagers in Gemechis District, Ethiopia, register for food distribution by CARE. Photo: CARE/Sandra Bulling

Helping pastoralists in Borena
In Borena, Ethiopia, CARE is working with people to reduce cattle herd sizes during droughts to prevent over grazing of the pasture, and to provide the community with an income from their weakened cattle before disease robs them completely of their value.

People in Borena are well known for their strong social bonds. They are also well known for feeding their children first, a practice which is key to ensuring survival of the next generation in this toughest of times. This, along with the monitoring from CARE and the local government, ensures the program reaches those who need it most. But our program is only reaching five per cent of people living in the targeted districts ­­– further funding is desperately needed to extend this highly impactful and timely program.

A health centre in Miyo district
Distances in Miyo district are huge and mothers can travel for a long time to bring their children to the health centre for assistance. The most seriously malnourished children receive help here, accompanied by their mothers.

First they are checked for diseases like diarrhoea and given treatment. Then they start a careful course of therapeutic food, starting with low-strength milk powder. It normally takes four to five days for their weight to stabilise. Then they progress to a more nutritious formula that helps them regain weight fast. Finally, they can be discharged with two month’s ration of oil and corn soya blend to take home.

In Gemechis District, Ethiopia, CARE distributes monthly rations to villagers, who share the food between them. Food distribution benefits more than 66,000 people in East/West Haraghe and Afar. Photo: CARE/Sandra Bulling

Making sustainable change in people’s lives
Along with responding to the current situation, we also have to look at what causes the current situation and how we can prevent it from happening again. We need to understand the underlying causes of poverty and why drought keeps coming, and why children and mothers are severely affected. For example, we have linked many large households in East and West Hararghe to the long-term family-planning project in the area, as large family sizes can contribute to malnutrition.

With CARE Ethiopia already meeting the needs of over 406,000 (as of Aug. 22) people and plans to reach up to a million in the next three months, I am confident CARE is playing its part in reaching the most vulnerable during this drought, the worst in a generation. It’s our job to make things better in a tough situation and that is something I feel positive about. We need help from the Australian public so that we can extend our programs and benefit more people who are suffering from this devastating drought with long-term solutions.

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The green trees, cool mountain climate and well-stocked shopping malls of Nairobi are in sharp contrast to the camps in dusty Dadaab. The warm smiles and healthy faces of the Kenyans I meet are very different from the haggard faces of the new arrivals from Somalia I saw lining up for food just a couple of days ago.

Many Kenyans are also suffering in the terrible drought sweeping across the north and east of the country. Today I met with CARE Kenya senior staff who explained how CARE is working to improve the situation in Kenya by investing in communal management of water and pasture. They told me that most of the people affected by the drought are pastoralists who live and move with their herds. In the drought, lack of water and pasture has seen herds decimated and no rain is in sight until September.

In the north-east of the country CARE is supporting people to renew communal management of grazing lands and water pans. Where there was some local rain in April, the water pans still have water and there is still some pasture, but even they are badly off. That’s why CARE is supporting off-take of weak livestock at a reasonable price and the vaccination of stronger animals so they can withstand the drought. This should help herds to recover and people to bounce back if the rains come.

Stephen Gwynne-Vaughan, CARE’s Country Director in Kenya, visited Gafo in late July and saw the difference these investments have made. Water pans that were rehabilitated last year with community labour through CARE’s support still have water. What’s even more encouraging is that the community have managed them well, collecting small fees from users, which have allowed them to clear out the silt this year. If they continue maintenance, these should last for twenty years.

We have also supported district-level planning so that communities and the local government know when to take emergency measures such as de-stocking of livestock. Pastoralists move across the border with Ethiopia, so CARE has worked on both sides to bring communities together so they can make agreements that allow access to pasture for the animals when times are hard.

Gary McGurk, Assistant Country Director of CARE Kenya, explained why CARE will only consider water trucking and food aid in the most dire situations. “Water trucking is expensive and encourages people to stay in places that cannot sustain them rather than moving on with their herds.” By investing in community management of water and pasture, we can reduce pastoralists facing a crisis and needing expensive food hand-outs or water trucking.

But support for such interventions is hard to get. Even though studies show that a dollar invested in preparedness will save on average seven spent on crisis response like food aid, we find it hard to gain funding. With the situation so bad, we now also need to help the many who are in crisis. Tomorrow I will travel to Ethiopia to see how we are doing that there.

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Today, I spoke to a young woman who had walked for twenty days with her two children. They left their home due to the drought which has dried up all drinking water sources.

She was sitting in a makeshift tent made from rough branches and covered in bits of cardboard and scraps of cloth. She and the other new arrivals have taken refuge outside the established camps.
The influx of new arrivals has put great pressure on services in the camps, not least on the water supply. CARE has been providing water to the camps for over twenty years, but with the recent influx we have been really stretched.

Jason Snuggs, CARE Australia’s Water and Sanitation Adviser, has been working with the local team to ramp up water supply. He says, ‘We have been setting up new water tanks and tapstands so that people can easily access the water that we truck in.’

We are also supplying 19 litres of water per day to people as they arrive in Daghaley camp. We are redrilling seven boreholes so they produce more water, increasing storage capacity, and extending the piped water system out from the main camps to the influx areas next to them. This reduces the need for expensive trucking and ensuring we can meet the needs of the 30,000 new arrivals in this camp.

The ongoing drought and conflict in Somalia – where famine has been declared in several districts in the south – means the influx of refugees will probably continue for several months. CARE estimates that over 500,000 people will be in the camps by Christmas. Clearly this is a big challenge. Jason says, “We are increasing water provision in the influx areas and water in the camps to above UNHCR global standards of 20 litres per person a day, and we will keep going until we are sure we can meet the needs of further new arrivals.”

I ask him what the biggest challenge is and there’s no pause in his reply: “Funding is the biggest challenge.” It’s also a challenge to get skilled water and sanitation professionals to work in Dadaab as conditions are hard, even for the staff working there.

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It’s 6.30am on a crisp Nairobi morning. The dawn chorus has just finished and I am standing in the CARE Kenya compound. Abdi, our driver, has just arrived with a broad smile and wearing a bright cap typical for Somalis. I am joined by Alain Lapierre, Director of Emergencies for CARE Canada who has been overseeing the expansion of our activities in the region this past month.

He says the situation in Dadaab is of great concern. People are still arriving in a terrible state. Although the numbers arriving have reduced slightly in the past few days, he believes this is only temporary. CARE is scaling up to meet the needs of an increasing number of refugees. This includes recruiting more national staff and for long-term planning with existing staff, such as Jason Snuggs, CARE Australia’s global WASH Adviser, working at the strategic level to develop plans to cope with the projected influx of people.

As we reach a rendezvous point, three CARE Kenya staff who work in Dadaab join us. They are highly skilled Kenyans working in the construction team. One of them, Oumari, tells me that he has been working for nine months in the searing heat of Dadaab, providing administrative support to the construction team who build and maintain boreholes, latrines and five schools. I ask him how he feels about working in Dadaab. He replies, ”I feel really motivated. We are giving hope to people who had lost hope in life.”

We are now joined by another CARE vehicle packed with field staff and provisions for the camp. There are also vehicles with staff from UNHCR and other NGOs. It’s 6.45am and time to hit the road!

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Adam Poulter, Emergency Response Manager for CARE Australia
August 2011

As the plane took off from Canberra yesterday I looked down on the dry hills below. My thoughts turned to the dusty plains of Eastern Kenya where CARE is working in the world’s biggest refugee camp, Dadaab. We’ve been working there for twenty years leading the provision of water, food and education. While we and other agencies working in the camps are able to provide assistance to the more than 414,000 [as of Aug. 22] refugees now there, the problem is that the numbers just keep growing. I’ll arrive there on Sunday to work with the team on increasing our capacity to deal with the projected increase to over 500,000 refugees by Christmas.

Newly arrived refugees from Somalia collect water provided by CARE at Dadaab refugee camp in Kenya. Photo: Kate Holt/CARE

Yesterday I spoke with Jason Snuggs, CARE Australia’s global water, sanitation and hygiene (WASH) Adviser who has been working with the team in Dadaab to increase water supply and storage for the new people arriving since early July. He told me how they’ve managed to increase water supply for people on the edges of the three main camps. We are now providing people with up to 12 litres of water each per day. The target is to exceed 15 litres, which we have been able to provide to long-term refugees. Jason is confident we can reach this target in the coming weeks by redrilling bore holes, improving distribution lines and storage capacity for water.

Just as important is public hygiene and we are working with animators from the local community to spread simple hygiene messages like the need to use soap and to wash hands before eating. By doing this we can limit outbreaks of diarrhoea and other infectious diseases which can kill the malnourished, especially young children.

We leave at 6am sharp. I will be accompanied by CARE’s Regional Coordinator, and two global education experts. The road takes a bumpy six hours, but this is a trifle compared to the journeys of several weeks the new refugees arriving have made.

I am standing in front of the borehole well, waiting for the clicking sound of my camera. But there is no sound. The CARE engineer has just explained how ground water is pumped up and then distributed to water stations. We are wandering around Dagahaley, one of the three refugee camps in Dadaab. A photographer working for a newspaper is gathering images of how a refugee camp works. But now as we stand at the borehole I feel yesterday’s long hours creeping up on me: my camera battery has obviously run out, plus I forgot my pencil and notebook on the desk. But there are solutions to these minor problems: The photographer lends me a pen and I use the back of my permission papers for the camp to take notes. In fact, I am starting to like my day without a camera.
The frenzied activity of taking photos, writing stories and organizing your way around Dadaab helps you tune out some of the misery and extent of human suffering. But it also makes you focus on only one part of the story. For the past two weeks in Dadaab, I spent most of my days in the camps, documenting the work of CARE, accompanying journalists or interviewing colleagues. My head is still buzzing with all the information and impressions. Like any humanitarian crisis, Dadaab is fast-paced and loud.

But now, sitting down in the sand near a water tap stand, I am quietly watching the hustle and bustle going on around me. I close my eyes as the wind blows fine-grained sand my way. I gaze around in all directions. The photographer stands on top of a water tank to get a better angle. None of the women or children fetching water pay much attention to us -- water is much more important than the strange sight of a visiting foreigner. I curiously watch two young women leaving with their jerry cans full of water. But they don’t carry them on their heads; instead, they roll them across the sand. This really calls for a picture: Two women in long veils and torn sandals kicking their jerry cans full of water through the desert. But with my camera batteries empty, my eye batteries seem to be more charged than ever.

After a while I move to the side of a latrine. It’s just four walls of corrugated iron, but at least it guarantees some privacy. Standing in the shade I watch a man with his donkey cart. Bit by bit women lift their jerry cans onto the cart, tightening them with ropes and rags. Getting places here in Dadaab takes time. The three camps cover some 56 square kilometers. Owning a donkey cart is a pretty good business. It is so hot that everything here seems to happen in slow motion. Finally the cart starts to move. I wonder how much the women have to pay for their transportation and whether they will still have enough money left to buy food for their children. While I sit in the sand, their skinny legs are at eye level. I can count the children wearing shoes on the fingers of one hand.

Humanitarian aid means reaching as many people as possible with at least minimum needs, given limited resources. In Dadaab, CARE and other agencies provide about 500 grams of food and about 12 litres of water per person and day, some basic medical assistance, some counselling. Every one of these 414,000 refugees is a unique person with a particular history, hopes and sorrows – but the scale of this emergency is so vast, we can’t possibly meet all those individual, specific needs. What we can do is slow things down for a while and pay attention. Observe. Understand. And adapt our programs to what we see. For example, CARE might soon pay the owners of the donkey carts so that weak and poor women don’t have to spend the rest of their money for transportation of water and food.

It is quick and easy to take a picture, upload it to your computer and then store it somewhere in your archives. But the pictures I saved in my head today will linger on for some time before I will be able to store them anywhere.

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CARE's Emergency Communications Officer Sabine Wilke in Dadaab, Aug. 11

How does the situation compare now to the beginning of the year?

The big difference is simply the high number of new arrivals. They have stretched our capacity to deliver the essential services for humanitarian aid, especially because many families are settling in informal, undesignated areas where there is poor access to services. They are scattered around the camps, but it is hard to reach them quickly enough to prevent further suffering. After 20 years of providing humanitarian aid in the camps, CARE and other agencies are now confronted with a new complication: in order to meet the increasing needs,  we have to stretch the resources that we have as much as possible to help all new people arriving in very weak and vulnerable conditions. Another complication is that the refugees are taking up more and more space outside the formal settlements which is having a detrimental effect on the local environment; they need firewood to cook which results in the deforestation of the sparse land which in turn creates conflict with the host communities whose grazing land is being destroyed. In the first five months of 2011, we had weekly registrations of about 2,000 people on average. In July, this number went up to more than 5,000. And this only counts the individuals being registered; we currently have a backlog of about 35,000 people still waiting for registration.

What is the difference between those refugees who have been here for some time and those who are new arrivals?

Most refugees here are quite resourceful, that is natural in any setting. People are not going to sit around for 20 years; they want to get on with their life. There are thriving markets in each of the three camps where you can charge your phone for 25 Kenyan shillings at a shop that has a small generator, you can find tailors and hairdressers and so on. Those who have a little bit of money buy products from the local markets in the area and sell them in the camps. But the newly arrived families, those who have fled drought, poverty and instability in Somalia within the last few weeks, they come here with next to nothing, barely carrying clothes on their backs. So, the provision of basic emergency services such as food, water, health and shelter are very important to sustaining life. As a measure of how serious this crisis is, the refugee community that has been long settled here in Dadaab have come together to compliment the international response. A Muslim charity created from within the camp population is now providing clothes and shoes at the reception areas to help the aid agencies. This is really encouraging for us to see because it demonstrates this crisis affects everyone. And help comes from many directions.

The areas around the camps are also suffering from drought and chronic poverty. How can you balance assistance for refugees and Kenyans?

This is a very important concern. People outside the camps are also in dire need of assistance, and of course they see the services provided in the camps and want to receive similar support. CARE has been working in the region for years, and we are now scaling up our emergency regional response to meet the ever increasing need beyond the Dadaab refugee camps. But we cannot feed and water everyone in and around the camps… we simply don’t have the capacity. The mere existence of the camps, offering relative safety and security and access to basic essential services, that is like a beacon of hope in an otherwise bleak and desolate environment for all those Kenyans who also suffer from the impacts of severe drought. Ready markets and access to trade and business offer alternative livelihoods or income generation opportunities for families no longer able to continue their pastoralist lifestyle. The refugee operations bring jobs, businesses and contracts. The area of Dadaab has grown from 30,000 people to more than 200,000 people over a twenty year period. This said, the camps are stretching the existing resources and the environment to a point where it will be very difficult and slow to recover. CARE has always engaged with the host community, they have always been a part of our response in this region. Our support to the cost community has included activities such as borehole maintenance through repairs of the generators and pumps, chlorination of the boreholes to reduce contamination; we created water pans for livestock watering, built classrooms and trained teachers. And we are currently looking into ways to provide even more support. But we also have to think in terms of how this can be sustainable in some way, because there will always be droughts in this area. We need to find ways to build resilience; boreholes can only be a part of the solution.  The key is to support the communities to help themselves. Let’s say through cash transfers so that they can hire their own water trucking, by training to maintain boreholes, by conflict-resolution forums. But all of this costs money and unless there is a severe humanitarian crisis and people here about it in the news, aid agencies really struggle to obtain funding for these activities.

What role does the Kenyan government play?

Kenya has had its doors open for 20 years, and continues to keep it open. They are not turning people away. The international community has provided some support, but nowhere near enough, and before pointing a finger at the Kenyan authorities we have to remember the impact this refugee population has on both the communities and the environment. And with Somalia still lacking security and governance, there is no solution for the refugees to go home again. Kenya has a right to continue ringing the warning bell, and the country cannot carry the burden by itself for another 20 years.

What are the biggest challenges right now?

As for food distribution, WFP and CARE have done an exceptional job to provide food when and where necessary. Every refugee receives an average of more than 500g of food per day. But it remains a challenge to disseminate information about how much and where food is available for the new arrivals. When so many people are coming in, we don’t know where they are coming from and where they end up. Before, when the number of new arrivals was still manageable, the information focused on reception centers. But now we need to do outreach into the so-called influx areas around the camps, where people settle while waiting for registration.

As I’ve mentioned before, there is also a backlog of people received but not yet officially registered as refugees.  Since there is no screening center at the border, people arrive here and have to go through the registration process, which takes time. People who have been received, but not yet registered, get food for 21 days and some supplies such as water cans, blankets, cooking items, soap etc. But if they have to wait longer than those 21 days to get registered, we have to organize a second round of distributions. Another problem is transport, because many families settle quite far from the reception areas. So many single mothers or people suffering from weakness and malnourishment have to pay someone to carry their food home. This is a big concern for us, so we are working very hard to fill that gap.

And then there is water: CARE has done quite well in providing water to the influx areas to new refugees, where we can we’ve been able to extend piping from the existing water lines out, so that pressured water is provided from boreholes to temporary taps. CARE is also trucking water to temporary tanks and taps. But we still face challenges in that some of the current borehole systems bordering the influx have insufficient pressure to fill up the water tanks more quickly, so in some cases this leads to long queues. We are replacing these low pressure boreholes so we can provide enough water to the refugees. Technically, it is always a challenge to bring in the equipment and set up a structure in the middle of nowhere. But water is such a crucial part of the response that we cannot slow down now.

Protection is also a big issue. The families arriving here, especially single mothers and young children, are often very tired, malnourished and sometimes sick. They are the most vulnerable having traveled many weeks in the sun with little food and or water with barely enough clothing to cover their back. They need to get support as soon as they arrive. The health agencies are trying to keep up but the malnutrition rates are still high. We need to help them settle in a more secure community environment where they are not exposed to sexual violence or banditry and close to essential services. However, we simply don’t have the people-power to reach all of them with the information they need to know to help them. In an effort to address this issue, CARE has set up temporary kiosks at strategic locations in the outskirts of camps where people can come and seek help and information. It also acts as a base from which our community development mobilisers move out on foot into the influx areas to talk with as many new arrivals as possible giving them basic information: where to get food and water and that both are provided for free, where to seek counseling services for those who are survivors of conflict and or violence etc.

What are you most worried about for the months to come?

At current rates of arrival we will still have significant challenges to meet the needs. We have new extension areas where people will relocate to, but if the influx continues, those will be full by the end of the year, so we will not have been able to decongest the current camps as hoped. We also don’t know where all of the refugees are going when they arrive here, some go into the camps so that the density increases, there’s encroachment around schools, youth play areas, community centers and so on. This puts an extra burden on the existing refugee communities. Another thing we are very worried about is the levels of malnutrition seen in the new arrivals. Food needs to have sufficient caloric value to reduce malnutrition rates, but this is also more expensive.

 How do you ensure that women are protected in the camps?

Just as in any city of this size around the world, we cannot fully ensure that women are protected in the camps. There are too little police officers per person and camp, protection remains a major challenge. Women generally don’t go out after dusk, but there is some community patrolling during day time. There are police stations in the camps. Imagine a city of 400,000 people without enough police. But previously settled refugees have been able to form community support networks and work well with the religious and community leaders. The most serious challenge we face now are the new arrivals. They are exhausted, uninformed about where to get help and an easy target for abuse and violence. CARE works directly with the communities and religious centers themselves to prevent violence through information sharing, educational sessions on conflict management, and to support existing community structures, neighbors watching out for each other. For example there are referral systems: if a woman feels threatened, she can come to a CARE office and seek refuge and may be brought to a safe house. We also have helpdesks in the police stations. But we want to extend our services, currently there is about 1 counselor for 30,000 refugees.

It is impressive to see our counselors in action. We have this one very confident young woman, Fardoza, and I recently accompanied her to one of the communities. She goes to one of the camp neighborhoods and sort of holds court, meeting with young men and women who have very set ideas about women’s place in society. And she challenges it in a very positive way and generates discussion. People can connect to her because she is their age, and since she is a Somali Kenyan, she speaks their language.

Do you lobby for the refugees to be granted citizenship or work permits in Kenya?

This is an issue for the Government of Kenya. Our focus is on providing services and working to reduce refugee vulnerability and to maintain their dignity as much as possible. The best case scenario, what we are all hoping for, is of course a return to peace in Somalia. But would all refugees go home then? There is now a second generation born in the camps who have been educated with Kenyan curriculum, and who have never been to their home country. But I still think that many of them would like to go home. And then they will have the unique chance to build their nation with the skills they have acquired here in the camp schools. We are now seeing the same in South Sudan: Refugees who were educated in Dadaab and Kakuma refugee camps as well have now returned home and are a vital part of nation building.

What other issues are important for you to communicate to everyone who is now interested in Dadaab?

I have been saddened by the voices from home who say things like charity begins at home, and that we shouldn’t be helping because there is so much corruption, or that we have already given too much. Every person in the camps of Dadaab is a refugee. But let’s not forget that people don’t want to be here, they want their freedom to move like anyone else, to be free to access higher education, better business opportunities. Even though there is no fence around the camps, they are legally not allowed to work in Kenya and are restricted to the regions of the camps. And what is most heartbreaking is the daily struggle for dignity. Put yourself in their shoes and imagine having to line up for food twice a month, for 20 years now. These are highly proud people, and a man in this culture who cannot provide for his family – well, that is just very hard for everyone. A couple of weeks ago I was introduced to a refugee who was previously a full time employee for CARE in Somalia and now cannot work legally here in Kenya. Though we cannot give them legal jobs, every agency employs workers from among the refugee committee to help with distributions, translations, housekeeping of the compounds etc. They receive a salary and can thus support their families. But like I said, it is not a regular job. He would be very well qualified to be a part of our operation, with all his skills and knowledge of CARE. But all we can do is employ him as an incentive worker. That is one of the many limits they are constantly facing in Dadaab.

Early morning in Dadaab, a nice breeze announces a day that will most likely not be too hot. Outside of the CARE canteen, people are scattered at tables under trees, taking their breakfast. CARE’s 270 members of staff live and work in so-called compounds, one in each of the three refugee camps of Dadaab, one in the main part of town, attached to the compounds of UN agencies and other aid organizations.

I sit down with a group of four colleagues who are having what seems to be a lively discussion in Swahili. As much as we speak the same “language” as part of the CARE family, I sometimes wish for a button I could push to be able to speak the local languages of the countries I am deployed to. But there’s no button, so I just watch and listen before they change into English. As a newcomer, it’s hard to figure out who does what here, with so much buzz and activity everywhere. So I start asking around what their jobs are.

“I work in maintenance of our vehicles, making sure that they function properly”, tells me one the guys. “I’m part of the WASH team”, says another. WASH is one of our most common acronyms and everyone who uses it tends to forget that the outside world needs interpretation for it. WASH sums up all activities in Water, Sanitation and Hygiene promotion, one of the most crucial programs in any emergency to prevent disease outbreaks and ensure that people have sufficient potable water to survive. “We get called when there are problems with the boreholes, pipelines or water stations”, he adds. So is he going out to one of the camps today? “That depends, I am basically on call for any emergency. Otherwise I stay in the office and catch up on paperwork.” Paperwork in a refugee camp? Yes, sure. Quality management, accountability and proper information management are crucial for any successful operation, even more so in the fast-paced environment of a humanitarian crisis. If we don’t document what we are doing and how things are working out, we cannot communicate our needs and plan for the upcoming months. Moving on to the third person at the table: “I work in construction.” Constructing what? “Anything that is needed, whether that be new rooms or sanitation facilities in our compounds, or services for the refugees in the camps. We just rehabilitated some classrooms in a school.”

This conversation gets me thinking as I wander off to the office: There are two faces to the humanitarian work CARE is doing: One face consists of the men and women who appear in the photos and TV images, those who get interviewed by newspapers and radio stations: doctors treating patients, staff distributing food to refugees, and of course the spokespeople of our organizations. But behind the scenes, there is a whole army of workers managing the operation every day. They work from early morning till late at night, lacking private life and comfort, missing their friends and families. Journalists often ask whether we employ Western volunteers who have given up their life of comfort to help people in need. As honorable as this is, humanitarian assistance demands expertise, local knowledge and a long-term presence. All over the world, CARE’s staff is over 95 percent local, speaking the language, understanding the social dynamics, and committing to these difficult working conditions for longer periods of time.

When I leave Dadaab, my colleagues will still be here. And when the cameras leave and the public eye wanders off to the next crisis, they will continue to do their jobs to provide water, food and social assistance to the more than 400,000 refugees here. And I hope they will have many more laughs in Swahili at the breakfast table to start their day with a smile.

The realities of a refugee camp are hard to explain to the outside world. Many people think of Dadaab as a fenced-in area, overcrowded with tents, and people lining up for assistance. Some of this is true, to a certain extent. But Dadaab has grown for over 20 years now, and developed into an almost urban settlement of huge dimensions. There are actually three refugee camps in Dadaab, Dagahaley, Ifo 1 and Haghadera. And we spend about 10 to 20 minutes in the car getting from one camp to another. There are no fences around the camps, so people are generally free to go from one place to the next and into the town of Dadaab. But with long distances to walk in the sand under the blazing sun and no legal rights to actually leave the camps and settle outside, freedom is not the right term to use. Tents can be seen everywhere, but many new arrivals in the outskirts have simply put up wooden sticks and cover the structure with tarps, for now. Those who have been here for decades, who have raised their children here, have grown old in Dadaab and still see no way to return, those families have built more solid houses, constructed of bricks or mud, fenced and well-maintained. When I enter one of those homes, it reminds me of other places I have visited in some countries in Africa. Clothes hang up to dry, children play around in the court, the elders sit together in the shade of a tree.

But whether settled or just arrived, all 400,000 refugees in Dadaab depend on assistance to meet their basic needs. They cannot legally work or leave the camps, and the sandy soil and lack of water make it difficult to plant vegetables or other staples. This is where CARE, the UN Refugee Agency UNHCR, the World Food Program WFP and others come in: Many of us have been here from the start and it is encouraging to see the level of cooperation. I think of critical media coverage about how aid agencies compete for funding and don’t coordinate their work that usually comes up with any emergency. But everyone who has been to Dadaab quickly understands that our humanitarian mandate is a much stronger bond than any talk of money, influence or popularity. Over 400,000 refugees are in need of assistance, there is enough to do for all of us. CARE manages two cycles of food distribution per month and hands out food and relief items to new arrivals; our engineers maintain and extend the water supply systems; counselors and social workers help the most vulnerable, mainly women and children suffering from violence and exhaustion; teachers are trained and schools set up.
Currently everyone here is worried about the bad state of newly arrived families. Exhausted, malnourished, traumatized: When I look into the faces of women, children and men in the reception areas, I can only begin to imagine what they have been through. With the increasing stream of refugees arriving, there is a backlog of around 35,000 people who have not yet been registered. CARE distributes food and other relief items to them, but they cannot settle permanently yet. Much of the first help is information: Many newcomers simply don’t know that the food and water is free, where the next clinic is, some don’t even know where exactly they are.

It’s also hard to describe to the outside world how aid workers cope with the suffering and misery they are confronted with every day. Over the years, I have had many discussions with colleagues, and although it is a very personal affair, I feel like we have a common understanding: Most of the time, you cannot look beyond the crowd to acknowledge the individuals, your work needs to be about quantity: Handing out food to as many people as possible as quickly as we can. Disseminating information about counseling services and support for women victims of gender based violence to a whole area as fast as possible. Hurrying to a bursting pipe to get the water supply going again.

But this line of work would not be called humanitarianism if you would not care deeply for every single person. And every now and then, you cannot blend out one of the faces in the crowd. At the reception center of Dagahaley, I catch the eye of a young father; he sits at the reception area with his three kids, his wife next to him. It is impossible to explain how and why this connection happens, but his smile is so inviting and their relief of arriving here safely, their family intact, is almost palpable. We exchange smiles, I ask for a photo. Then I just sit next to the reception table and watch them for some time. Then something else comes up, I leave. When I turn around again, the family has gone. Back to be a part of the crowd. But I know that they now have food to last them for 21 days, water, and have met people who can assist them with their needs. And that must be enough, for now.

I have just visited Balich Village in Garissa district, North Eastern Province of Kenya. Inhabitants of Balich belong to the Somali-Bantu community, an ethnic minority which is highly marginalized. The region is experiencing a severe drought, as many other areas in the Horn of Africa currently. According to some estimates, 2.4 million people are affected in the North Eastern Province, where Garissa district is located – this is more than 50 percent of the province’s population. But amidst the drought, there is a glimmer of hope, because in Balich villagers were prepared for the drought. They are able to plant and harvest food and animal feed as they have a functioning irrigation system. But let’s start from the beginning:

Some areas of the North East Province are difficult to reach because very bad roads and long distances of up to 1,000 kilometres, and in those far away places, children, pregnant women and lactating mothers and elderly people are mostly affected. I heard of some men who had to migrate in search of pasture for their livestock or for work in the towns. Women and children staying behind depend on assistance from relatives, the Kenyan government and humanitarian organizations.

As the drought goes on water pumps cannot keep up with the demand. People use it during the day, animals at night. People rely on mechanised pumped water more than ever, and because of the over-usage the pumps often break down. Ground water levels are dropping, and some areas that were once sustained by pumped water now have to be served by expensive water trucking, which can only be a short-term solution. In some villages, pastoralists had to wait for three days to get water for their animals. Some had to walk for 30-40 kilometres to reach water points. Many of their livestock died while looking for water – and that means their source of income has perished. Garissa is mostly a pastoralist area; animals mean everything. One colleague said to me: "Animals are meat, milk, and cash. If they are gone, everything is gone”. Prices of livestock have decreased and often pastoralists have to sell their animals for very unfavourable prices. Once they make it to the market they have to sell their animals at any price offered because they do not have the means to transport them back home. Livestock might even die on the way back, because they are too emaciated. Approximately half a million people and 90 percent of all cattle already migrated out of some areas in search of water, pasture and food. And naturally, these movements cause conflicts.

Resilience is key

However, Balich village showed me a picture of strength and perspective. CARE’s long-term support in Balich has helped people to resist the impacts of the drought and to prepare for times of hardship. CARE assisted the community to plant animal feed and crops by erecting water pumps and canals for better irrigation. Before, fetching water was a dangerous job: “My children are safe now when they get water. Before, they were threatened by crocodiles living in the nearby Tana river”, on woman told me. The key is resilience: empowering vulnerable people to overcome drought without losing all assets. With access to credit facilities, market linkages and a sustainable livestock marketing model, people are able to generate an income and save assets.The CARE projects in Balich show how important Disaster Risk Reduction initiatives are. But it has a side effect: Pastoralists from nearby villages are now increasingly bringing their livestock to Balich, putting pressure on the valuable water sources.

My visit to Balich reiterated what we know in theory and what we need more in practice: emergency support and long-term development initiatives that focus on creating resilience need to go hand in hand. This is the only way to break the hunger-cycle in chronic emergencies. However, funding for emergency is often easier accessible than funding for disaster risk reduction. I hope that the example of Balich shows how much we have achieved and how much money we can actually save when we invest in preparedness.

“It is unfortunate that the rains have decided to not fall for the last two years.” The Kenyan man sitting next to me on the plane to Nairobi has a very poetic choice of language, which makes for a rather stark contrast when you consider what he refers to: His country and the whole region are in the middle of a humanitarian crisis triggered by a severe drought, which is affecting almost 11 million people. And yes, some parts of this region have not seen rainfall in two years. My neighbor continues: “It is all about water. If you don’t have water, you cannot raise animals. And without animals… well, that is their life insurance.”

Touching down in Dadaab the next morning, I remember that friendly voice. The refugee camp in the North of Kenya is now home to more than 400,000 mostly Somali refugees. Their numbers have risen immensely in the last weeks, due to the ongoing drought and insecurity in their own country. The landscape is dry and plain up here, and one wonders how any group of people, let alone such a high number of refugees, can survive in these difficult circumstances.

This is my first time to Dadaab, but weirdly enough, everything seemed very familiar. Maybe that’s a CARE thing: The refugee assistance program for Dadaab is one of our longest humanitarian missions, many colleagues have worked here at one time or another. And for years, we have continuously talked about it to the public, launched appeals and tried to get journalists interested. But now, with an average of more than 1,000 new arrivals every day and extremely high numbers of malnutrition, Dadaab has become something like the epicenter of the current humanitarian crisis in the horn of Africa.

But a walk through Dagahaley, one of the three camps, also shows the impressive efforts by all the agencies on the ground to provide basic services to all these people. We pass by the reception area where CARE distributes food and other relief items to new arrivals, we see trucks delivering water, and visit the service tents – all of this I have heard about before, but it is still a whole different story to see the work with your own eyes and listen to the admirably energetic colleagues explaining their work.

And we meet Amina Akdi Hassa, who serves as chairlady for the camp Dagahaley. She has been living here for 20 years and is a leader and an advocate for her community. “I want the world to know that they should please share our problems with us”, she explains. “We have had five schools here since the 1990’s, but now there are so many more children.”

The people of Dadaab are talking. But is the world listening?

By Sandra Bulling

Green plots of land cover the lush mountains of East Haraghe in Ethiopia. Small brown huts dot the landscape, their owners busy working in the fields. Thick grey clouds hang above the peaks as high as 3,000 meters, seemingly bursting with rain any moment. On a first look, East Haraghe looks like postcard idyll, perfectly suited for agriculture that yields enough crops to sustain the farming families. On a second, the area is the scene of a severe drought. Malnutrition cases East and West Haraghe zones increased steeply in the past months. The reasons: insufficient rainy seasons, high food prices, chronic poverty and a weather phenomenon called La Nina.

The large majority of Ethiopian households, 87 percent, relies on agriculture as source of income and nutrition. A good rainy season brings relief, a failed one desperation. The past twelve months were determined by worry; the Meher rains that usually arrive from June to September in East Haraghe ceased prematurely last year. As a consequence, the complete harvest was lost. The following Belg rains which are scheduled by nature from March to May were delayed for about two months, insufficient in amount and erratic in distribution. For many farmers it was impossible to plant; and those who did are still waiting for their maize to ripen. One month ago, in June, farmer would have normally started to harvest. But instead, people have no food left in their homes. Scientists credit the insufficient rains to La Nina, a weather phenomenon that changes weather patterns and causes drier conditions in East Africa.

Maize porridge, twice a day

Kado Kaso came with her son Sabona to a government run health center in Kurf Chele district. “My son was vomiting, he had diarrhea and could not hold any of the food I fed him”, she says. Sabona was diagnosed as severely malnourished. The three year old has lost his appetite. His feet, legs and eye lids are swollen – characteristic signs of edema, a medical complication of severe malnutrition. He stares into the room, there is no energy left in the little body to play or move around. Sabona arrived one day ago and the therapeutic food provided by CARE has not regained his energy yet.

When the Belg rains began this spring, Kado started to plant barley and beans on her small land. But the rains stopped earlier and all her crops withered. “We have barely anything to eat. During normal years, we eat three meals a day. Now we are lucky if we eat twice a day,” the 30 years old mother says. She takes Sabona into her arms. “We only eat maize porridge, I cannot afford anything else.”

On the bed next to Kado sits Abdi Mahommed with his five year old daughter Milkiya. She has been here for one week, has recovered her strength and appetite. Both father and daughter will leave the center the next day. They will continue receiving weekly rations of therapeutic food, to ensure Milkiya’s condition stays stable. But Abdi has sold his ox to buy food for his family of eight. “I don’t know how to plant for the next season, I have no ox and no seeds,” he says. He is glad his daughter has regained her appetite and started playing again. “All that matters is saving my daughter’s life.”

Searching for labor

Kado’s husband has moved to the nearest town in search of work. But he is not alone. Fathers stream into the towns offering their labor – and salaries have dropped by 50 percent. “My husband now earns 10 Birr a day, in normal years he can earn 20 Birr”, says Kado. Ten Birr are USD 0.60; and that is how much a kilo of maize costs. A price, that has risen significantly over the past months. “My husband comes back every four days, giving me money to buy food. My four children and I are dependent on him, we have no other income.” She now stays with Sabona in the health center, until the little boy can eat again and reaches a stable condition.

Kado’s other children are at home, alone. Neighbors look after them, but they have no meals to share either. And the health center has run out of resources to hand out food to mothers like Kado coming to stay with their children. “CARE is now starting to provide food for the mothers in the health centers. Because if they don’t get anything to eat, they might be forced to leave or refrain from coming here with their malnourished children,” says Jundi Ahmed, CARE Ethiopia’s Emergency Nutrition Advisor.

A malnourished generation

Today, almost every tenth pregnant woman or lactating mother in East Haraghe is malnourished due to the insufficient rainy seasons. However, malnutrition is a chronic condition for many Ethiopians. Even during years with normal rainfall, the small plots owned by households in East Haraghe do not yield enough to cater for balanced and sufficient meals. Malnourishment during pregnancy determines the entire life of a child. Sons and daughters, who do not receive sufficient nutrition in the first five years of their life will not fully develop their mental and physical capabilities. “It is a chronic hunger cycle that can last for generations. Malnourished mothers give birth to malnourished children and have no means to feed them with most needed vitamins, iodine and iron. Children are smaller in height than well-fed children their age, they are stunted. And it is very likely that they will also have malnourished children,” says Jundi Ahmed.

CARE started food distributions to reach 66,000 people in the zones of East and West Haraghe and Afar. Kado’s family and others in her district receive monthly rations of sorghum, vegetable oil, supplementary food such as corn-soy-blend and beans whereas pregnant mothers and lactating women get special supplementary food. But CARE also has long term development programs in the area, supporting families to overcome poverty and hunger. Through Village Savings and Loan Associations, for example, women can contract small loans to open shops and small businesses. With an additional income families can save assets that protect them in times of drought.

Drought comes in different shapes in Ethiopia. But whether in the dry areas of Borena in southern Ethiopia or the lush green mountains of East Haraghe – the pain and consequences of drought and hunger are the same throughout.

Muna* is the envy of her friends in Dagahaley camp. She is also a newly arrived refugee, in fact just nine days in the camp, but unlike her friends who have to live in the outskirts, she has what seems like the comfort of a room within the camp. As soon as she arrived, she managed to trace some of her clan members, who let her use the room in their homestead. Muna is 40 years old, and arrived in Dadaab with her seven children.

Her story, however, is nothing to envy.

She left her husband behind because bus fare for all of them was too expensive. They had to pay Ksh 15, 000 each for the journey on a bus, so he let them go ahead, remaining behind to raise more money for his own trip. “I will join you soon,” he said as he waved them goodbye.

Muna’s journey from Somalia took her 18 long days, having to feed her children wild fruits and look out for wild animals and hyenas. Her children are all safe, and they did not come across any wild animals on the way. However, what her friends would not envy about her is that she was raped on her way to Dadaab. It was midway through their journey, bandits (shiftas) stopped their bus and ordered all the women to step out. “We were eight women on total, so they separated the older women from the younger ones, and told them to get back into the bus. The five of us stayed behind, with our children, and the bus driver was ordered to drive off and leave us behind. That is when they raped us,” she said.

They were in the middle of nowhere, with their children, and strange armed men. The children were pushed away behind some bushes and instructed to be quiet by one of the men, as the others went back to the women and raped them. Some of the other women were gang raped.

Although it was in broad daylight, no other vehicle passed by, and even though they all screamed for help and their children were crying in fear, nobody came to help them. “Afterwards they told us to take our children and keep walking,” Muna and the other women ended up walking 17 kilometres before coming to Dif, where they told some village elders what had happened to them, and they raised some money so the women could go on their journey.

Muna and the other ladies finally came to Dadaab, and she is happy to stay away from her fellow newly arrived refugees, in some private space with her children, among her larger clam. She has gone through reception, and her registration date is set for November 11th. “I am glad we arrived here, and all my children are ok. We finally got some food and water and I have a tent. There are so many people here, even those who came with us, but it is still like we are alone, because my husband is not here.”

The most dangerous period for refugees is when they are on the move. Women and girls are especially vulnerable to rape, abduction, illness and even death on the journey. Many women set out on the journey alone with their children, leaving husbands behind and they may walk for weeks in search of safety.

According to UNHCR reports, the numbers of sexual and gender-based violence cases have quadrupled in the last six months in Dadaab: 358 incidents reported from January until June 2011, in comparison with 75 during the same period in 2010.

CARE has set-up a screening tent at reception centers in Ifo and Dagahaley camps in Dadaab to help identify survivors of sexual abuse or other violence on their journey. In the first six months of this year, since the refugee influx began, 136 cases have been documented, compared to 66 in the same period in 2010. Upon identification, counseling and referred emergency medical attention is administered.

“The deep psychological affects that drought, conflict and subsequent movement can have on woman refugees is immense. We have witnessed high levels of anxiety, panic and trauma due to loss of family members along the way and women are sharing stories of rape, violence and hunger,” said Wilson Kisiero, CARE’s Gender and Community Development manager in Dadaab. “CARE is providing immediate psychological support to the newly arrived women and girl refugees and we are doing all we can to ensure follow-up visits.”

Muna was referred to the MSF clinic by the CARE staff that interviewed her, but she has not gone to the clinic yet, she is afraid she may be pregnant from the ordeal, or she may have a disease. She said she would wait a few more days and then go, but not just yet.

*Not her real named

In Hagadera camp, Fatumo Osman Abdi, 50 has just settled into her tent. She is weary from the journey of 20 days from Somalia. She came with her three grandchildren (aged 13, 5 and 4), her son and pregnant daughter-in-law. Back in Somalia they were farmers, in a place called Kurdun where they grew food for her family. The lack of food became a bigger and bigger problem with time, until they decided to leave.

“Every night as we traveled here, we slept out in the open land, under the stars. We were very afraid, we did not know what was out there, or if there were people coming. We had heard many stories of man-eating lions so we could not even sleep,” she said.

The journey was a difficult one, but Fatumo is thankful that they did not meet any robbers. On their way to Dadaab, they were given food by Muslims on the way, just well wishers who decided to lend a helping hand.

“We arrived here so hungry, so tired. My grandchildren were so tired, I was afraid they would die on the way. Even my daughter-in-law. We slept out in the open for many days, we were under the stars again, but we were safe. After so many days I finally have my tent,” she said.

Seventy year old Habibi* came to Kenya as one of 72 people who traveled together from Somalia. That was almost her entire village, she says, and was made up of her family and friends. Her son had heard of Dadaab and told them about it years ago, he had said that they could run to it because of the fighting. Habibi’s husband had declined, opting to stay in Somalia longer.

Back home they were farmers and pastoralists, growing sorghum, and keeping cows, goats and sheep. They left Somalia because of drought, came here with her friends and neighbours, children and grandchildren. She describes the journey to Dadaab as the ‘worst thing she has ever experienced’.

“We were attacked by strange men, they looted all our belongings, women were raped and men were beaten, but we thank God nobody died,”. Habibi was also raped, and manages to talk about it openly, her anger and confusion still evident. “Our husbands and sons were all there to see it happen to us, it was very bad!”

She is still in the influx area of Dagahaley camp, with only 16 other friends and relatives. The others settled in another camp, Hagadera. One of her relatives gave up his tent for her so she could have shelter with her four grandchildren. All they had to eat on the way was maize, and more maize as they traveled the long journey to Dadaab.

“I do not want to go back to Somalia, all our problems are still there! I am here with nothing, but I would rather stay here. Life here is hard, the food they give us is little because now we have to wait for registration, but I would rather stay here than go back,” she said.

*Not her real name.

In Borena in southern Ethiopia the last two rainy seasons have brought no water. The drought took one third of all livestock, leaving families without income.

Little Salad is sleeping soundly. Gamu Kamad, his mother, is very relieved. Just a few days ago, the 11-months old could do nothing but vomit. He could not crawl, he did not play; he was just too weak. In the past weeks, Gamud feed him only water – she had no money to buy milk. Most of her cattle died. In the Borena zone, in southern Ethiopia, the last two rainy seasons did not bring any water and a worrying drought has gripped the region. In the Moyale district, the land is brown and dusty. Bushes and trees have lost their last leaves, their trunks and branches reach naked into the air. A little green is left on thorny shrubberies and acacia trees, both either too dangerous or too high for cattle to reach.

Gamud and Salad have found help in a health center in the town of Moyale, run by the local government. Salad was weighed and screened. His diagnose: severe acute malnutrition. He was brought to the stabilization center, where he now receives therapeutic supplementary food, provided by CARE Ethiopia, until his condition improves and he reaches a normal weight for a boy of his age. His mother stays with him and receives food as well. “I was very worried about Salad,” she explains. “We came here four days ago, but now Salad’s condition is already much better.” She looks at the tiny bundle lying next to her, still sleeping calmly. “Before I brought him here, he could not open his eyes any more. He threw up the water I gave him. But now he gets stronger every day.”

The health centers in the Moyale district have experienced a rise in malnutrition cases for children under five years. Almost 500 severely malnourished children were admitted from January to June. In 2010, this was the rate for the entire year. In the Borena culture, children are given the most food. They eat first, followed by the father and then the mother. Parents give their children the little food they have, but now they have no groceries left and no money to buy some.

Livestock is life
The prices for cattle are the lowest in the past decade in Moyale. At the same time, prices for food have risen sharply. In a pastoralist society such as in Borena, people depend on their livestock. They are their income and source of nutrition – their life. When livestock die, people lose their assets. In the Borena zone, one third of all livestock have starved. “Even goats and camels find no pasture any longer. This very unique, as they are usually drought resistant animals”, says Mandefro Mekete, CARE Ethiopia’s Emergency Operations Coordinator. But it has never happened before that both the Hagaya autumn rains and the Genna spring rains have failed in Borena. Scientists credit this drought to La Nina, a weather phenomenon that changes weather patterns and causes drier conditions in East Africa.

Gamud has lost 36 of her 51 cattle to the drought. The residual cattle are too emaciated to give milk or to sell on the market. Her husband is trying to save the lives of the remaining ones by taking them to areas where pasture is still available. Some people migrate as far as 400 kilometers in search of water and pasture, putting pressure on the remaining grazing grounds. CARE, in close collaboration with the local government, opened 21 slaughter destocking sites to recover some value from emaciated and unproductive animals that would otherwise die and to prevent conflict that might arise from competition around scarce pasture grounds.

The smell of slaughtered meat hangs in the air. The bones of cattle are thrown into a square, deep pit. Bloods seeps away into the brown ground, leaving dark red streams on the earth. Hasalo Duba has come with two cows to the slaughter destocking site in Dima village. “Before the drought I had ten cattle. Six died already and I brought two here today. I have only two left now; only one of them gives milk,” the 25-years old mother of six children says. She will receive 800 Birr (47 USD) per cattle which allows her to buy staple foods on the market. She will also get some hay and supplementary animal feed to save the life of her remaining two cattle. “Eight vulnerable families will receive the meat of the slaughtered cattle,” Mandefro Mekete explains. “The slaughtering takes place with technical assistance from official meat inspectors, who ensure that the meat is safe for consumption.” However, there is not much meat left on the bones of the barren cattle waiting in front of the slaughtering pit.

No rains expected to come soon
Malicha Galgalo has already received her money. The 40-year old wears a long black dress with red applications; she sits on top of a heap of white bags full of hay, surrounded by children. “I have to find a donkey to carry the bag home. I have lost 25 cows, only five survived,” she says. Malicha believes that Moyale is in a very critical situation. “Before the drought, I could sell the milk and I had a steady income. But now I don’t earn any money and I have ten children to feed.” She depends on food distributions from the government. With the 800 Birr she received for her cow Malicha bought one kilo of grain. “I will save the remaining money. I don’t expect the situation to improve, there will be no rain coming soon.”

The next rainy season is supposed to arrive in September or October. Until then, many pastoralists predict most if not all of their remaining cattle will starve. Some elderly already fear that the Hagaya rains, as the autumn rainy season is called, will fail as well. Kofobicha is 55 years old and has lived through several times of hardship. But the drought has never been as bad. “We don’t expect the next rainy season to come. Even if the Hagaya rains come, no cattle will be left by September,” he forebodes. “But we don’t care about our livestock any more. All that counts now is to save human live. We have accepted that we need to fast, but who saves our children?”

Salad from Moyale town was lucky, he has been saved. Life has returned to him, thanks to CARE’s and the government’s interventions. But many more children and their parents will need assistance in the coming months. They need urgent humanitarian support, but they need also a long-term strategy to become more resilient to the impacts of drought. So Salad’s mother is able to buy him food when the next drought hits.

I arrived in Borena Zone, Oromia Region, in the southern part of Ethiopia two days ago. I am here with my CARE colleagues to conduct a deeper assessment on the impact of the current drought on women, men, boys and girls. We have talked to different groups, and even though we just had four basic questions, there was so much to listen to and to learn from. Basically, I could have asked 10,000 questions! Today we visited Moyale woreda (a woreda is the equivalent of a district), that is bordering Kenya. It has not rained there in the past six months, only the last ten days saw some rain. However, these rains were very sparse and did not bring enough water. So some areas look greener now, while others are still very dry.

But a green pasture does not mean there is no drought. The people of Borena are pastoralists and dependent on their cattle, goats, sheep and camels. But so many cattle have died already. Even though pastoralists move them to one place in order to avoid diseases, I could see carcasses lying around, there are just too many of them. Some people told me that this is not the first drought, of course, Ethiopians are used to the cycles of aridity and rain. However, what is really unique now is that it is not only cattle dying, but also sheep and goats. This is really concerning because goats usually resist quite well to drought since they can eat almost anything if needed (shrubs, bushes, branches, etc.).

A whole day to fetch water

There is not enough pasture, there is not enough water. This has a huge impact on women. Women are usually responsible for fetching water and they have to walk much longer distances now than before. One group of women told me that before the drought, it took them 30 minutes to the water point for one way. Now they have to walk three hours – one way. The second group mentioned that they not only need two hours now instead of 15 minutes to fetch water but they also need to queue at the water point for four to six hours. Because there is very little food, they don’t take anything to eat with them. They come back home hungry and exhausted. And they have to go through this ordeal every day.

In addition of spending almost the entire day to get water, women also need to collect pasture for their cattle. They therefore have very little time for their daily household chores. They can’t properly take care of their children and provide them with food. In some cases, I saw elderly people watching small children. But very often parents see no choice but taking their children out of school. School drop outs are already being visible here in Ethiopia, and it is mostly girls who need to stop their education because they have to assist their mothers with household chores and take care of their siblings. One young man of 17 years told me about the drop outs in his school. His 4th grade consisted of 82 students before the drought. Now, just 25 students are attending school – and most of them are boys.

One meal per day

I saw many cattle that are really, really weak. People told me many of them were too weak to stand up without help and how they constantly needed to support them to do it. A minimum of three strong people are needed to do this. I have not had the opportunity to see that myself but one of my colleagues sent the picture he took during one of its field visits. Impressive.

Since there is no pasture, men need to climb trees to cut leaves and use them as fodder for their livestock. People also reduce their food intake. While most families usually had three meals every day, they now can only eat once per day. Children eat first, then the father and the mother is the last one to receive what is left. So it is no surprise that most women told me: “We need food.” Even though there is food to buy at the market, the prices have steeply increased for the last months. In April 2011, the food index increased by 35.5 percent in Oromia Region compared to April 2010. People just cannot afford to buy products any longer.

An important element of a pastoralist diet is milk. Since their cattle are dying and starved, there is a shortage of milk, so people have replaced nutritious milk with tea. Without any nutrients and proteins, people are at high risk of becoming weak and malnourished. In some areas, I heard of conflict that arose due to the scanty resources. When pasture and water is limited and when people see their animals dying, tensions can get high.

These are all very concerning accounts. However, most people expect that the biggest impacts have not even begun. The worse is yet to come. The rains of the past days belong to a short rainy season and after it another dry cycle that will last until September starts. People have huge fears about their future and their ability to cope with the drought. The Ethiopian government is already responding to the drought with different interventions of which food distributions. I saw one of those today, but it is clearly not enough to reach every one who is in need right now.

By Audrée Montpetit, CARE Senior Humanitarian Program Quality Advisor

We traveled ten hours by car from Addis Ababa to reach the CARE Ethiopia Borena Field office based in Yabello. This small town is located some 200 kilometers from the Kenyan border. CARE is scaling up its emergency relief operations rapidly to address the worsening drought situation for this primarily pastoralist population. The Borena pastoralists are known for their hardiness and endurance, as well as for their cultural tradition of ensuring that the children are fed and asleep before the men eat, and finally the women. When malnourishment of children amongst this population becomes a source of concern, it is clear that there is a crisis on hand.

In a presentation at the CARE office, the CARE field staff and government officials jointly painted a very grim picture of the current situation and repeatedly referred to a disaster in the making with the loss of over 200,000 livestock dead in Borana (out of 750,000) as a result of lack of pasture and water. Without cattle, there will be neither income to buy food or milk to feed the children. As the cattle weaken and become emaciated, they no longer produce milk and often reach a stage that by the time they are slaughtered, there is hardly any meat left on the bone to consume.

In one of CARE’s innovative programs in close collaboration with government authorities and community leaders, we aim to recover some value from emaciated and unproductive animals that would otherwise die from the effects of drought. Slaughter destocking decreases the grazing pressure at times of high pasture scarcity. We saw carcass after carcass being thrown into a pit after the animal was killed, and those animals that still yielded some meat were butchered and shared amongst families identified by government authorities as vulnerable. CARE Ethiopia’s program of de-stocking provides an opportunity to pastoralists to sell their cows at a fair price and to receive in addition to nearly USD 50 for each cow, grain to feed two remaining cattle. This project is an excellent effort to help families not only gain some savings from their cattle before they die from weakness, but also to try to save those that they still have.

But their remaining cattle are very few. Of original herd sizes of 15, 30 or 40 in nearly every case, women and men would tell us that they had only two or three cows left. They have lost the majority of their cattle in the past few months with mounds of partially decomposed skeletons scattered throughout the landscape attesting to this fact.

The respected elderly clansmen of Borena have predicted that the next rains will fail as well. Scientists credit the current drought to the La Nina phenomenon which changes weather patterns and causes drier conditions in Eastern Africa. The rains are not even due for another two months yet they are expecting the worse as their situation now is very grim. A dignified elder told us that there was no hope for them: ”We shall pass, but we must help the children.” He told us that they are not able to care for their cattle and that this is not their first priority anymore. The major issue is now the health of their children who are already starting to suffer. His words highlighted the scenes and conversations of the day visiting a local health center where too-thin babies were being treated for malnutrition, to the destocking site, and water provision activities, and later to the amazing clan gathering of around 15,000 Borena who meet every eight years to elect new leaders.

At this gathering, we were told that there were very few cattle and camels. One of the elders gestured to the encampment area and said: ”Look, it is empty. In the past years there were too many cattle and we had no space. This year we have hardly any cattle.” They told us that their fate is not in their own hands, and that they have to pray to God for rain. However, their cultural wisdom of ages past leads them to believe that the rains in September will fail again.

There is a window of opportunity for the Borena: If assistance is able to reach them at this time. They have lost their assets, their source of family insurance has gone, and they now face three months, at the very least, of continued drought. They are sure that without help, they and their families are at extreme risk of losing their lives. The CARE Ethiopia team has worked diligently over the past years to develop an excellent strategy and complementary set of interventions to help mitigate this situation in Borena. But, the complex set of factors created by a catastrophic region wide drought caused by the La Nina phenomenon, the loss of a cattle market in the Middle East, chronic poverty and the dramatic increase in food prices has resulted in a situation where the Borena are on the edge of disaster.

CARE is acting now to scale up and expand our efforts in our current programming areas of CARE Ethiopia -- to save lives that will be at extreme risk in the coming months. But we need more help. We need to prevent people from leaving their homelands in search of refuge, to prevent a further long term catastrophe including complete loss of livelihoods as well as loss of lives.

Story of Shangara Hassan, a Somali woman who traveled to Dadaab refugee camp with her four children.

“I think I am twenty years old. I have four children – two of them are very sick and two of them are OK. The oldest is six years and the youngest is six months.

"I have come to Dadaab from a village in southern Somalia. I came with my children, alone, to save our lives. There was a very bad drought there – it hasn’t rained for four years, and everything was very dry. Nearly all of our animals had died because there was no food for them to eat. We used to keep small animals – goats and sheep. What few we have left my husband has stayed to look after. Once they are dead he will come here too. We used to have nearly sixty but now there are less than ten.

"On our plot in our village we used to grow sorghum and that is what we used to eat. But because there has been no rain, the sorghum hasn’t grown. The ground has become very dry and the seeds don’t even come up anymore.

"Nobody has seen a drought like this for many years. Everyone in our community in Salag is leaving. All of my neighbors left at about the same time as me and they are living around me here in Dadaab. The only people who are remaining are the ones who still have a few animals alive to look after but I think they will all come here soon.

"There was hardly any water left to drink either. We used to get our water from a nearby stream but this had dried up. There was no water point in our village. So when the stream dried up we started to walk to a river that was a long way from our village to collect water to drink, wash and cook. It would take me about two hours to walk there and three to walk back when my container was full. It was very hard work because it was so hot. I can’t remember when it has been that hot in Somalia before.

"My husband decided that we had to leave when we hadn’t eaten for over a week. He said if we didn’t leave we would die.

"We arrived here about two weeks ago now. We walked from our village to the border and then we got a bus along with other people from our village. When we arrived in Dadaab we went to a reception point and were given some maize, sleeping mats and some other things. We had nothing with us. I couldn’t carry anything when we left because I had the four children.

"But now all of that food is gone. We are meant to go and be registered now so that we can get food regularly. But I have been there twice now and each time I have been told that I have to come back another day because there are too many people waiting to be registered.

"My second born child, Habiba, is very sick and my third born is starting to get sick. Because I haven’t registered I don’t think I can go and find them medical help. I don’t know where to go to find them a doctor as this camp is very big.

"Also if I go with one child, I don’t have anyone to leave the other children with. I am also breastfeeding my youngest and if I carry her, I can’t manage to carry Habiba too. Her condition is getting worse every day and I don’t know what to do. I am worried that all of my children may get sick soon because we are only eating once a day as we only have very little maize left.

"But even though it is hard here, it is better than what we left behind.“

Story of Osman Sheikh Hussein, who fled drought and conflict in Somalia to arrive at the Dadaab Refugee Camp in northeastern Kenya.

“My family and I have come from Somalia – from Baidera in the Upper Juba Valley. I took the decision to leave with my family because of drought and violence. The situation had become very bad. There had been no rain and everybody was starving.

"We walked by foot all of the way. It took us 32 days and every night we stayed under the sky. When we reached the border with Kenya some of the women and children were very tired and sick. So I managed to get some money and paid for them to come here in the back of a truck. It was a difficult journey.

"We have been here 29 nights now but still haven’t been able to register to get food aid. When we first arrived, we went to a place with other new arrivals and we got some food and other basic things. Because we had to leave out town quickly we left nearly everything behind. Along with way we lost some things too – the children were so tired that we had to carry them.

"I have been wanting to leave Somalia for a long time – the situation never gets better. There was nothing left in Somalia – it wasn’t like it used to be. There were no schools or health facilities – and I want my children to have an education.

"The security situation was getting worse and the drought has meant that there is now a lot of violence because people are hungry. I don’t know when the conflict is going to end and in our community it hadn’t rained for nearly five years.

"Everybody’s animals have died. We used to have a big herd of goats and sheep and also some camels. All of them have died because of lack of food. It is so dry there now and I don’t think the rains are going to come again.

"Here we only have this shelter that we have made from plastic sheeting and wood. But at least we can get food and water. There is a health center too and for the first time in many years I feel safe and don’t go to sleep worrying my children may die."

We’ve just returned from a visit to Dadaab Refugee camp in northern Kenya, where I was accompanied by the CARE Canada President and CEO Kevin McCort, CARE Australia Head of Fundraising Andrew Buchannan and CARE USA Head of Foundations Liz McLaughlin.

In my more than 20 years of field experience with CARE, I have not seen such widespread levels of the effects of lack of food on so many people.

Every single man, woman and child that we saw and met with of the more than 1,500 people arriving daily do not have a spare ounce of flesh on their bodies. The adults are literally down to the bone; the children are incredibly listless, showing obvious signs of malnutrition and distress.

Single mothers carry one or two children on their backs with others holding tightly onto their ragged wrap. We met groups of over 40 people who had traveled together, leaving behind the elderly whom they knew would not be able to make the walk of 20 or more days to reach Dadaab. They do not know if they will ever see each other again.

Every single person with whom we talked -- from those who had just arrived after a grueling journey to those who have been waiting in small hastily and sparsely constructed shelters, to those working as volunteers with CARE to provide food and some basic essentials -- asked us to help them to tell the world of their plight.

“Please share our message from Dadaab that we need help, that we cannot wait, that we have come this far and we still do not have the food and shelter that we need.”

There are more than 15,000 refugees who have arrived who are still not on the U.N. registration system and are not entitled to receive basic health services or a monthly ration of food. We met many of these people on the outskirts of one camp where CARE is now providing additional water and sanitation services. When I asked to see their vouchers that were provided to them upon arrival to confirm when a date had been set by which they would be officially registered, I was surrounded by many people who dug into their carefully wrapped worn bags and pockets to show me vouchers with dates for as far away as mid September.

One young woman asked, “I am hungry now and I have no shelter, how will I be able to wait this long for food for myself and my children? We thought we would be able to get help here but there is no help.”

Yet, these vouchers are like gold, and each one is carefully wrapped up and tucked back away for safe keeping. Without a voucher, a family does not get into the system, and therefore it is as if they had not walked and risked their lives to reach Dadaab. They do not exist in the system.

Our CARE staff is working many long hours each and every day to help speed up food distribution, to get water and sanitation services out to those who are escaping from the drought plaguing the region, and to increase educational services for the influx of many more young children.

The commitment and dedication of our staff is incredibly impressive, and they are doing this in the face of many challenges and difficult working and living conditions. There is no complaint voiced ever, yet their faces are lined and, at the end of the day, they're almost too tired to talk. We must get them additional help and support and we need to get it to them now.

I am extremely heartened by the great willingness and generosity of the CARE members to offer expertise and personnel as well as hopefully, in the short term future, significant additional funding. Many of the people who we met thanked us -- for the support they are receiving now and for what they truly hope will come.

We meet Asli at the registration centre in IFO sitting under a leafless tree with her four children, one of whom kept crying. When we ask her what the problem is, Asli says that the child is two years old and mentally challenged, and he has had a fever for the past few days. When asked whether she had taken him to hospital, she told us that the registration process was more important at the moment.

“When we get registered, we will be settled enough and we can then seek medical care,” she said.

With nearly 1,500 people arriving in the Dadaab refugee camps in North-eastern Kenya every day, registration is taking nearly three weeks to register new families, and arrange for them to settle into the camps. It used to take just days.

To help people cope with the delay, CARE, in partnership with the World Food Programme, has increased our emergency food distribution to new arrivals. CARE staff provide new arrivals with three weeks of food, instead of a two-week supply. Once families are registered in the camps, they are entitled to receive regular food rations, and critical support such as access to safe drinking water and medical care.

The life Asli led with her family in Somalia took a turn after all the cattle and goats they owned died because of drought and her crops failed due to lack of rain.

“The situation got worse every day. We spent all the little resources we had, until we had nothing more to spend,” said Asli, whose children are aged between four years and three months old.

“The sight of seeing our children crying, and me having no breast milk for my baby, made my husband Abdi Osman Abdi decide to take the little money of our savings and come to Dadaab Refugee Camp which we had been hearing about while we were back at home. Even some of our neighbours had fled to Kenya because they said in Dadaab there are different agencies that give food, medical care and education for free and that’s all we need.”

Their journey from Somalia was long; it took the family five days to reach the Ifo refugee camp in Dadaab. They went to the reception centre after their arrival and they were given wrist bands to prepare for registration and access to safety and support from the many aid groups working in Dadaab.

But in the confusion of arrival, Asli and her family didn’t know to go to the food tent to receive their food rations. According to CARE staff, so many people are arriving, exhausted, traumatized and hungry, they sometimes misunderstand how to access help and get the supplies they are entitled to when they first arrive. That’s how CARE staff found Asli and her family when we were giving information to new arrivals about how to get assistance, and how to report and seek counseling if they had been attacked or sexually assaulted as they fled Somalia. Asli and her family were sheltering at their makeshift structure outside the camp, along with all the other new arrivals – but it had been 13 days since Asli’s family arrived, without food.

“My children are sick and hungry,” she said. “We have been here from six o’clock in the morning. It is now one o’clock, and the sun is hot. We do not have any money with us. We have been seeing women selling tea and mandazi (local donut-like pastry), but we cannot afford it. We will wait to get registered then we can go look for food from any good Samaritan.”

As soon as CARE staff found Asli and her family, we quickly arranged a representative from UNHCR to ensure they received their three-week ration of food, and soon they will be registered and settle into their camp in Dadaab.

But Asli’s relief at arriving in Dadaab – a hot, barren camp in the middle of nowhere – shows how difficult her life was at home in drought-stricken Somalia. It shows how important it is to find long-term solutions to food shortages and drought, to help people stay at home, instead of seeking shelter in overcrowded refugee camps.

Photo: © CARE 2011

I woke up early in the morning and accompanied American and German journalists to a reception center before it had opened for the day. We found people sitting outside in neat rows. Women with their small children made up three lines of about 20 adults each, then two lines were made up of families, fathers and mothers together with their children, and lastly, another three lines of single men, young and old alike. This is the prioritization for access to the reception center – women and children first.

What struck me today were the children and the mothers. I have had the privilege of traveling to many places in this big world of ours. I have found that in places where I spend time with people with whom I don’t share a common language, smiling and nodding hello is a great way to initiate communication. Often, the children I have met along the way find ways to laugh, to play, to joke with me…or the youngest of the children stare and sometimes cry if I get too close.

Here, at the reception center, the children were not laughing, not playing…. The mothers did not really give me a smile back, barely any nodded back at me – rather they just stared at me. The children were sitting, very quietly and others curled on their mothers laps. Not exactly what you think of when you think of a two year-old in line somewhere. Many of these people have just arrived from their long journeys here. And at 7:30 am, they were really only focused on the last few hours before they were to receive their first ration of WFP food.

Later in the afternoon, we arrived at the area where refugees who have been here for about three months had set up their homes. We arrived around 4:30 in the afternoon. Areas with water taps were bustling with activity. Women and men were talking along the side of the dirt road, as women with wood on their heads and a man on bicycle passed by. Goats grazed on mostly barren bushes. And there were children – wow, were there children…they were hard to miss: running, smiling, laughing, playing, and wrestling. I was struck by the contrast of this morning’s scene. Water. Food. Shelter. Latrines. Education - all the services these refugees were now accessing; it gave me hope.

The worst drought in 60 years is spreading across East Africa, creating the most severe food crisis in the world and threatening the lives of 10 million people. Life-saving support is urgently needed. Make a donation |Learn more

La pire sécheresse des 60 dernières années se répand à travers l'Afrique orientale, provoquant la crise alimentaire la plus grave au monde qui menace la vie de 10 millions de personnes. Des secours sont urgemment requis. Faire un don | En savoir plus

Emergency Media Officer Alexandra Lopoukhine describes the situation in Dadaab refugee camp, northern Kenya, where nearly 1,500 people are arriving each day.

When a family arrives:
Outside of the reception centres, crowds of people are waiting. UNHCR has set up a structure that is open on all sides, but has a roof to help shade the burning noon day sun. It is still not big enough for all the people. The people are quiet; they are exhausted and in what seem like shock. They are called into the reception centre in small groups to keep the flow inside moving.

Once they are called up to enter the reception centre (a fenced in compound with various tents, benches, tanks and taps of water CARE provides) , they go to one of the three reception centres being run by UNHCR staff. They first go through an electronic finger printing screening which registers them and their family. They get coloured bracelets based on which camp they are being received in (Blue bracelet in Ifo, Yellow in Dagahaley and Red in Hagadera). They then move to receive non-food items – being distributed by CARE staff (plastic mats to sleep or sit on, blankets, jerry cans). At that point they move to food tent, and receive two weeks’ worth of food. CARE staff gives the food out. There is a medical tent for malnutrition screening and the CARE tent for counselling. The final step is they are given a registration date and time to get to the one UNHCR Registration centre which they then get their WFP ration card, and tents and allocation of land.

Living in the camp:
Because the camps are full, people are setting-up their places to live where they can find land. This has lead to sprawling overflow, haphazardly set up. Deforestation (de-shrubbing) has taken place. This is a real source of tension with the host community- this is the land that typically Kenyan-Somali use as nomadic feeding and living grounds. So, when the wind blows, the wind blows red dusty dirt all around. At time the dust is so thick, you cannot see one foot in front – cars stop, people cover their faces; lack of visibility can last up to a minute. The houses are round stick buildings with any type of covering around. The wind can blow these houses down. The children are generally covered in the dust. Feet are perpetually dirty it seems. The sandy-ground is hot, and many refugees have no shoes. Flip flops from China seem to be the most popular type of footwear.

One woman’s story:
Hawa Aden Hassan, 30 years old with 3 children, her husband stayed in Somalia, she has been here 5 months. She and a friend went out to collect branches to make their houses and they were attacked. They were able to get away and suffered only minor injuries. They are now afraid to go out and collect what is needed; she said they are sleeping in the open air. They generally don’t feel afraid, but they really want schools for the kids.

“The violence (in Somalia) is not good. This place is good as long as there is no fighting and there are schools to go to.” 14-year-old boy

Newly arrived refugees from Somalia wait to be registered at Dagehaley camp, one of three camps that make up the Dadaab refugee camp in Dadaab, Noertheastern Kenya on the 9th July, 2011.

By Alexandra Lopoukhine, Emergency Media Officer
July 6, 2011

The heat is strong and the wind is blowing. The shade provides relief. People are lined-up, orderly and patient. There is an overwhelming sense of calm. This is not exactly what I would have expected in the Dagahaley Registration Center, as today, 1,055 people wait for food and to be brought into the United Nations High Commissioner on Refugees (UNHCR) system.

Then, we spoke to a few of the women and they explained their long and challenging journey that brought them here, to Dadaab, the world's largest refugee camp. They told us of their days of walking, of the challenges they faced in the last few days, and last few hours before they reach here. The hunger they faced at home. The insecurity. One women explained she had heard on the radio in Somalia that here, in Dadaab, they were giving away free food. This was the information she needed to get her kids in order and start the move. People were calm, I realized, because they had arrived.

They arrived to be greeted by staff from UNHCR, World Food Programme, CARE, and so many other organizations here, ready and able to support them. Relief was offered in the tangible supplies water, food and order.Orderly lines, orderly registration points, orderly information given to people reeling from their recently history of chaos. This is today's relief.

Newly-arrived refugees from Somalia wait to be registered at Dagehaley camp, one of three camps that make up the Dadaab Refugee Camps in northeastern Kenya. Photo: 2011 Kate Holt/CARE