Horn of Africa Drought and Famine


Severely malnourished child from southern Somalia is being held in a makeshift shelter in a refugee camp in Mogadishu, Somalia, Tuesday, Sept. 20, 2011.

Severely malnourished child from southern Somalia is being held in a makeshift shelter in a refugee camp in Mogadishu, Somalia, Tuesday, Sept. 20, 2011.
(AP Photo/Farah Abdi Warsameh)


The Horn of Africa, named for its resemblance to a rhinoceros horn, has long been prone to cyclical drought, sometimes accompanied by famine. Approximately 80% of the region is classified as arid or semiarid. The 2011 drought was forecast in August 2010, because of the climatic effects of La Niña on the region. The Famine Early Warning Systems Network also anticipated the coming crisis. During the short rainy season of October–December 2010, accumulations were well below the long-term average. The U.S. ambassador to Kenya declared a disaster in January 2011 and called for aid. The shortfalls of the long rainy season of March–June 2011 were much more widespread and severe. Food prices, which had begun rising in 2010, skyrocketed, and crops and livestock were decimated, creating the worst food crisis that the poverty-stricken region had experienced in two decades. However, it was not until July 2011, when the international media began covering the crisis, that a major humanitarian response was launched. By then, the emergency was well underway. A report by the international aid agencies, Oxfam and Save the Children, concluded that there were thousands of needless deaths and millions of wasted dollars because of the international community's failure to respond decisively to early warnings.


Somalia, one of the poorest countries in the world, had been in a state of political turmoil and armed conflict, without a stable central government, since a 1991 civil war, which had also led to famine. Ongoing conflict among warlords and clans, a corrupt and ineffectual transitional government, and al-Shabaab, an Islamic extremist militia, had rendered Somalia a failed state. By 2009, al-Shabaab controlled most of southern Somalia and began expelling aid agencies, including the United Nations World Food Program (WFP). The United States—the world's largest donor of emergency aid—cut funding to Somalia because of al-Shabaab's terrorist links. Although more than two million Somalis faced starvation in the rebel-held territories, al-Shabaab refused to allow foreign groups to deliver aid.

With the drought ushering in famine and disease, more than 500,000 displaced Somalis arrived at the capital of Mogadishu, and nearly 135,000 Somalis fled to refugee camps in Kenya and Ethiopia. The Afgooye Corridor outside Mogadishu, with the world's highest concentration of displaced persons, was then hit with torrential rains. On July 20, 2011, the United Nations (UN) declared famine in two regions of Somalia. On September 5, the UN announced that the famine had reached six regions and was continuing to spread. The UN defines famine as a triple failure of food production, access to food, and failed political response by governments and international donors. The UN and other major aid agencies use a five-stage scale to classify food security. Stage five, a famine/humanitarian catastrophe, requires the following:

In February 2012, a new military offensive in the Afgooye Corridor forced thousands of civilians to flee yet again, just as the region was beginning to recover. Toward the end of 2012, Somalia was no longer in a state of famine, but it remained in crisis because of continuing poor rainfall and armed conflict. Somalis in Kenyan and Ethiopian refugee camps were showing no signs of returning home.


By July 2011, some 2,000 malnourished and starving Somali refugees were arriving daily in southeast Ethiopia, crowding together in areas with few or no facilities. This second crisis required a response suitable for rural and nomadic populations. The situation eased at the end of 2011, following good rains in the lowlands and a good harvest in the highlands.


In Kenya, as in Ethiopia, it was the northern poverty-stricken pastoral regions that were the worst hit by drought. The Kenyan government declared an official emergency in May 2011. The livestock market had collapsed, and people were walking long distances to find water. Although Kenya has a safety net for the poorest of the poor, some local markets had very little food available. Some families even crossed into wartorn Somalia in search of food.

The Kenyan refugee camps at Dadaab, 50 miles (80 km) from the Somali border, were constructed 19 years earlier to house a maximum of 90,000 displaced Somalis. From 1994 until the end of 2006, the camps accommodated about 177,000 refuges. By 2012, more than 465,000 refugees were living at Dadaab, making it the world's largest camp and the third largest city in Kenya. Although the communities surrounding the camps were less affected by drought, the camps put tremendous pressure on available water and fuel for water pumps. Tensions between the camps and nearby communities increased, and threats of violence and kidnapping restricted humanitarian efforts.

Risk factors

The Horn of Africa is severely affected by weather patterns. Recurrent drought is the most widespread and longest-lasting natural hazard, and droughts are expected to become more frequent and more severe with climate change. Drought, crop failures, and persistent poverty make the region vulnerable to famine, but famine only occurs when these factors are coupled with political failure. For example, although Somalia had good rainy seasons in 2010, it took only two failed seasons to usher in famine in some conflict-ridden areas. Ethiopia and Eritrea have also suffered from long-term civil wars and internal conflicts. In the Ogaden, the Ethiopian government has used famine as a weapon against secessionists. Similarly, the most drought-affected region of Kenya has traditionally received the least government support. Thus, political instability, armed conflict, ethnic strife, and religious extremism are major risk factors for famine. Centuriesold hostilities among the countries of the Horn of Africa, and interference from outside interests, also contribute to the risk of food insecurity and famine. Blocking of humanitarian aid, as in Somalia, inappropriate aid, or the siphoning off of aid to militant groups, and the logistical difficulties in getting aid to remote areas and nomadic populations are additional risk factors for famine. Flooding from too much rain at the wrong time, deforestation, misuse of land and resources, and population growth all contribute to the risk of famine.


An estimated 70 million people live in arid regions of the Horn of Africa. The 2011 drought and famine affected people who had been entrenched in poverty for decades. Pastoralists were particularly affected, since settlements and government policies had severely restricted access to traditional grazing areas. It has been estimated that the drought resulted in 50,000–100,000 deaths between April and August 2011, more than half of these among children under five.

Some 300,000 Somalis died in the 1992 famine. The 2011 drought and famine affected more than four million Somalis—almost half of the population. In August 2011, a U.S. aid official announced that 29,000 Somali children had starved to death in the previous three months. In July 2011, it was estimated that almost 20% of the Somali population—1.5 million people—were displaced within Somalia, and at least 250,000 had fled the country. The majority of those who survived the journey settled in the three Dadaab refugee camps, forming an artificial city-state. Long-term camp residents had established businesses that undercut those of local host communities and rented out refugee shelters to new arrivals, as well as to members of surrounding communities, who themselves often registered as refugees to obtain rations and better health care.

Causes and symptoms

Although the Horn of Africa has always been subject to periodic droughts, studies suggest that the African continent is warming faster than the rest of the planet, and droughts are expected to become more frequent and severe. The Somali famine was caused by drought, high food and fuel prices, and lack of humanitarian aid, coupled with 20 years of war that prevented Somalis from growing crops or otherwise earning income. Although there was food available in Ethiopia, Kenya, and many parts of Somalia, poverty rendered it unaffordable. By July 2011, the Kenyan government had supplied only about half the food assistance requested for the northern district of Wajir, and the Ethiopian government was reported to have misused emergency aid for political purposes.

Common diseases and disorders

Children died from malnutrition across the Horn of Africa. Malnutrition also puts children at risk for permanent stunting of development and weakens the immune system. Refugees in Mogadishu may have been as likely to die of disease as of starvation. The main government hospital in Mogadishu had thousands of confirmed cases of cholera. Acute water diarrhea (AWD) killed hundreds of children. Many more children died of measles.


Where possible, nongovernmental organizations (NGOs) and their in-country partners established health centers. Malnourished children were assessed, admitted to outpatient therapy or supplementary feeding programs, and monitored. Children with medical complications were sent to stabilization centers run by medical NGOs. Mothers and children were vaccinated against measles, whooping cough, tetanus, and other contagious diseases.

Public health role and response

Despite early warnings, response to food crises and famine in the Horn of Africa was seriously delayed. Lack of coverage by international media meant that NGOs and the WFP had difficulty finding donors. Delivering aid to conflict-ridden southern Somalia was an even bigger problem. As of July of 2012, an additional $25 million was required for Dadaab alone, where 130,000 refugees lacked adequate shelter, and another 50,000 lacked safe water and sanitation, increasing the threat of cholera.

Acute water diarrhea (AWD)—
Acute diarrhea and vomiting from consuming contaminated water; especially common in children in refugee camps and disaster areas.
Abacterial infection of the small intestine that spreads through feces-contaminated water and food and is often fatal in young children and the elderly; cholera vaccinations are essential in the overcrowded, unsanitary conditions of many refugee camps.
Ahumanitarian crisis defined as the most severe stage of food insecurity.
Food security—
Access for all people at all times to the food required to lead a healthy and active life.
La Niña—
Unusually cold temperatures in the Equatorial Pacific that can contribute to drought in the Horn of Africa.
Inadequate or unbalanced intake of nutrients that affects health.
An acute, highly contagious viral disease marked by distinct red spots followed by a rash; occurring primarily in children and often epidemic in refugee camps.
Nongovernmental organizations (NGOs)—
Relief and development nonprofit organizations that work independently of governments.

Millions of people did receive international aid, including therapeutic feeding for children, water systems, cash transfers, and farm support. Mobile phone networks helped workers mitigate the spread of cholera. Hygiene promotion was adapted to the drought, keeping water use to an absolute minimum.


As the world's atttention turned to humanitarian crises elsewhere, Dadaab was threatened with severe shortages of food, water, sanitary facilities, shelter, and health care. A high percentage of children remained malnourished. Water systems were inadequate for a region where daytime temperatures often exceeded 104°F (40°C). More than 70% of the 221,000 children were out of school. There were thousands of separated and unaccompanied children, and abuse and sexual and gender-based violence were rampant.


Droughts are inevitable in the Horn of Africa, but malnutrition and famine are not. Implementation of drought-cycle management and adaptations for climate change are essential, as is overcoming the region's extreme poverty. Although early-warning systems can accurately predict droughts, they are of little use without early action. The ability of governments and aid agencies to save lives has improved in recent years, but the number of disasters and people at risk has increased greatly. Funding is required for prevention, development, education, training, and building local infrastructure and capacity. Investments in water sources and management, roads, and agricultural planning are essential. Many experts believe that leadership must come from the African Union, especially for resolving the conflicts in Somalia. The European Union's SHARE (Supporting Horn of Africa Resilience) initiation aims to transition from emergency assistance to long-term development aid, strengthen food security, and increase disaster resilience.

See also Cholera ; Climate change ; Drought ; Famine ; Humanitarian aid ; Sanitation ; Whooping cough .



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CARE International Secretariat, Chemin de Balexert 7–9, Chatelaine, Switzerland, 1219, 41 22 795 10 20, Fax: 41 22 795 10 29, (800) 521-CARE (2273), http://www.care-international.org .

International Rescue Committee, 122 E 42nd St., New York, NY, 10168-1289, (212) 551-3000, Fax: (212) 551-3179, http://www.rescue.org .

Oxfam International Secretariat, 266 Banbury Rd., Ste. 20, Oxford, UK, OX2 7DL, 44 865 339 100, Fax: 44 865 339 101, http://www.oxfam.org .

Save the Children, US Headquarters, 54 Wilton Rd., Westport, CT, 06880, (203) 221-4030, (800) 728-3843, http://www.savethechildren.org .

World Food Program, Via C.G.Viola 68, Parco dei Medici, Rome, Italy, 00148, 39 06 65131, Fax: 39 06 6590632, http://www.wfp.org .

Margaret Alic, PhD

  This information is not a tool for self-diagnosis or a substitute for professional care.