In the aftermath of all emergencies, undernutrition runs rampant, exponentially increasing children’s risk of disease and death. In most situations, children’s baseline nutrition is poor even before the crisis exacerbates such underlying factors as food insecurity, limited access to essential health services, unhealthy environments, and poor feeding and care practices. Consequently, the limited nutritional stores of young children are soon depleted after emergencies. Micronutrient deficiencies, particularly of iron, vitamin A and iodine, are frequently a major public health threat.
To promote access to essential, quality health and nutrition services in the immediate onset of acute emergencies and beyond, UNICEF has agreed on an essential set of interventions, the Core Commitments for Children. These include rapid nutrition assessments; measles immunization accompanied by vitamin A supplementation; fortified foods and micronutrient supplements; support for breastfeeding and complementary feeding for infants and young children; therapeutic and supplementary feeding in collaboration with the World Food Programme and non-governmental organizations; support for nutrition monitoring and surveillance; and provision of nutrition education and counselling, including messages on the importance of breastfeeding.
Major advances have been made during the past decade in the way the international community responds to the health and nutrition consequences of complex emergencies. The public health and clinical response to diseases of acute epidemic potential has improved, especially in camps, and fatality rates for severely undernourished children have plummeted.
A Humanitarian Response Review commissioned by the UN Office for the Coordination of Humanitarian Affairs in August 2005 recommended assigning responsibilities by sector to lead organizations and the clustering of partners for improved emergency preparedness and response. UNICEF has been asked to lead the nutrition cluster.
Amid the human drama of conflict and natural disasters, public attention and relief efforts tend to focus – rightly – on children. But the number of children who succumb in emergencies is small compared with the millions of undernourished children each year who fall ill and die in a ‘silent’ emergency of undernutrition, outside the focus of international concern.8
8 Gross, Rainer, and Patrick Webb, ‘Wasting Time for Wasted Children: Severe child undernutrition must be resolved in non-emergency settings’, The Lancet (forthcoming in 2006).