An Internal UNICEF Malnutrition Report on Sudan and Darfur: Why have these data been withheld?
Eric Reeves, 5 September 2014 | http://wp.me/p45rOG-1pL
New York Times journalist Nicholas Kristof, one of the first to sound the alarm about genocide in Darfur, has today posted a scanned UN document with his commentary. [This link has been allowed to go “dead” by the NYT, even as it appears in a search of the newspaper’s site:
It comes from UNICEF, one of the organizations most responsible for the UN’s refusal to release critical malnutrition data for Darfur. The document is a compilation of various charts and graphs, key points of definition, as well as a vague sketch of something called “The Strategic Response Plan.” But the actual data presented are shocking, utterly shocking, and I will largely let them speak for themselves.
What I have done below is transcribe the data from Kristof’s posting of the imperfectly scanned document. Except for straightforward descriptions of format, all comments and figures are taken directly from the UNICEF report; any editorial clarification or additional remarks are indicated with [italics in brackets], with my initials [—ER] following.
The report was evidently prepared in 2013 or 2014; the date on the document Kristof has posted is 9 June 2014 and has as its title:
“Malnutrition Defined”
• Sudan has very high numbers of malnourished children; malnutrition exists in both acute and chronic form
Under-nutrition
Acute (wasting) Chronic (stunting)
Severe
Moderate
• (Global Acute Malnutrition) [GAM]
Arm muscle wasted to a circumference < 11.5cm
[A graph is presented at this point, bisected by the World Health Organization emergency threshold for acute malnutrition: > =15 percent [the report indicates in a subsequent section that this threshold figure drops to a 10 percent threshold in areas of armed conflict such as Darfur; particular results for Darfur include—ER]:
Acute malnutrition rates for children in Sudan among the highest in the world:
North Darfur: 28 percent acute malnutrition among children
South Darfur: 18 percent acute malnutrition among children
East Darfur: 15 percent acute malnutrition among children
South Darfur: 13 percent acute malnutrition among children
West Darfur: 8 percent acute malnutrition among children
Other notable acute malnutrition rates among children:
Red Sea State: 20 percent
Blue Nile: 19 percent
Kassala: 15 percent
South Kordofan: 10 percent
Source: S3m Survey, 2013 [This date suggests that much of the malnutrition that has developed since the violence began in South Kordofan and Blue Nile is not reflected in these numbers—ER]
• Chronic malnutrition among children is widespread and pervasive
A second graph reports the following figures for chronic malnutrition among children in Sudan:
Central Darfur: 45 percent
East Darfur: 40 percent
West Darfur: 35 percent
North Darfur: 35 percent
South Darfur: 26 percent
The report indicates that the World Health Organization cutoff point for “high” prevalence of chronic malnutrition is 30 percent, and for “very high” prevalence > = 40 percent.
Source: S3m Survey, 2013] [See also Save the Children’s Acute Malnutrition Summary Sheet—ER]
• A third chart indicates:
“% of under-fives moderately or severely wasted in the 10 most affected countries”
(Sudan ranked 4th from the bottom in this category in 2010—ER]:
Wasting prevalence for country population under five:
Moderate or severe wasting: 16 percent
Severe wasting: 5 percent
[Emphasis added here: two percent is the “emergency” threshold for Severe Acute Malnutrition (SAM) among children; in developing countries, even in hospital settings, some 20 – 30 percent of all children suffering from SAM die—ER]
Number of wasted children, 2011 (moderate and severe): 817,000
Source: UNICEF Global Nutrition Database, 2012, based on MICS, DHS, and other national surveys 2007 – 2011 (except for India)]
• The next graph shows Sudan as far “off track for meeting the MDG1 target” (the first phase of the Millennium Development Goals has as its Target 1.C: “Halve, between 1990 and 2015, the proportion of people who suffer from hunger”—ER] The MDG1 benchmark is 10 percent; various surveys included in the report show Sudan at 32 percent, 33 percent, 43 percent, 35 percent, and 35 percent;
• The next chart represents:
“Total number [of] malnourished [children]”
Total number malnourished children over a year = prevalence x incidence
Prevalence = measure at a single point in time
Incidence = expected new cases over a year (2.6 percent incidence rate)
2013 S3M prevalence = 773,438 children x 2.6 (incidence rate) =
Total malnourished annually: 2,010,939
Moderate: 1,455,735
Severe: 555, 203
Global total: 2,010,939
• [The rest of the UNICEF document is given over to “The Strategic Response Plan,” which has only one statistic of significance for present purposes—ER]:
“Criteria for prioritization of the target localities” should include “Severe Acute Malnutrition (SAM) rates greater than 3 percent.” [Again, the emergency threshold for SAM is usually regarded as 2 percent—ER]
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What should we take away from this unreleased document with such shocking and extraordinarily telling data? It must be said first that these data comport all too well with reports we have received for a number of years now from Radio Dabanga, and that there is good reason to continue using their dispatches in assessing humanitarian conditions in Darfur.
Second, we should take away a question that must be forced upon the UN humanitarian agencies at every opportunity: how can you refuse to release data showing such horrific malnutrition rates? Among the many possible examples that might be instanced:
[1] In North Darfur 28 percent of children suffer from acute malnutrition—almost twice the UN’s “emergency” level;
[2] Moderate or severe wasting affects some 817,000 children in Sudan;
[3] More than 2 million Sudanese children are malnourished.
[4] The report indicates that “ Severe wasting” affects five percent of the under-five population in Sudan as a whole. Given that two percent is the “emergency” threshold for Severe Acute Malnutrition (SAM) among children, we need to know why more isn’t being done for this large and extremely vulnerable population.
[5] Finally, we need to ask what else the UN is refusing to disclose in the way of data bearing on our understanding of malnutrition in Darfur. There are serious questions—and clearly considerable incentives on the part of the UN to obfuscate. But given the number of lives at risk, particularly children, concealment seems a disastrous strategy, however much it may please Khartoum to have this UN self-censorship perpetuated.
Eric Reeves
Smith College
Northampton, MA 01063
413-585-3326
ereeves@smith.edu
Skype: ReevesSudan
Website: www.sudanreeves.org
Eric Reeves’ new book-length study of greater Sudan (Compromising With Evil: An archival history of greater Sudan, 2007 – 2012; www.CompromisingWithEvil.org; review commentary at: http://wp.me/p45rOG-15S)