More than a million people are at risk of starvation in Uganda's semi-arid and remote northeastern regions and over 40,000 children are suffering acute to moderate malnutrition, a government official said.

Musa Ecweru, Uganda's state minister in charge of refugees and disaster preparedness, said prolonged dry conditions after flooding in the region last year had led to a 90 percent crop failure. Plants had failed to germinate under very hot conditions.

"We had expected a problem after the floods that attacked the very survival of the people by destroying staple food in Karamoja and Teso regions," the minister told IRIN in the capital, Kampala. "Sorghum has been destroyed in Karamoja while cassava has been destroyed in Teso.

"Now the situation is becoming very bad. Up to one million people are at risk of starvation in Karamoja, Teso and some areas of Lango District," Ecweru said, adding that livestock, an integral part of food security in the region, had been decimated by disease.

Karamoja, along Uganda's borders with Sudan and Kenya, is a chronically food-insecure region that has suffered three consecutive years of drought. With an estimated population of just over 1.1 million people, most Karamojong subsist on agro-pastoral or purely pastoral livelihoods.

"More resources are needed to feed all these people and provide them with planting materials," the minister added. "We plan to launch a flash appeal so that donors can help us. In some areas food is being rationed and the women and children are the victims in this episode of survival of the fittest. There is a high incidence of acute malnutrition among children."

The exact amounts of money needed to address the situation, he said, were being worked out.

According to a recent assessment by the UN Office for the Coordination of Humanitarian Affairs (OCHA), an estimated 35,000 children in Karamoja are targeted for supplementary feeding to combat moderate malnutrition. Another 7,500 require immediate medical treatment for severe acute malnutrition.
Late and reduced planting, OCHA said, with a growing toll of animal losses, meant general relief food distribution would be extended by three months through October 2008, targeting more than 700,000 people.

"Karamoja is approaching a period of humanitarian crisis that will be characterised by elevated levels of household food insecurity, heightened rates of gross acute and severe acute malnutrition and rising morbidity and loss of livestock and other livelihood capital," OCHA said.

"Without increased donor support, the urgent action required to address these increasing needs will not be achieved. Certainly, negative coping mechanisms, such as out-migration, asset stripping and early marriage among others, will be reinforced," the assessment added.

Poor health facilities

Humanitarian agencies note that the situation has been aggravated by inadequate health facilities in the region, which has some of the worst health indicators in the country.

Among the causes, according to OCHA, is extremely low access to and utilisation of basic health services due to poor health-seeking behaviour, insecurity, long distances and the highly mobile pastoralist lifestyle.

Uganda's health ministry recently piloted two nomadic health units to travel with one community for a year. One of the units was deployed in Kotido District, the other in Moroto, to enhance community access to health services through adaptation to the pastoralist lifestyle, Paul Kaggwa, the ministry spokesman, said.

However, the health statistics still show serious gaps in capacity. There are only two doctors on active duty in Obim district and only 56 percent of health posts in the district are filled (151 of 272 posts). Of 42 midwives required in the district, 11 posts are filled.

Only one vehicle was allocated to the district health office while 24 health staff have not received their salaries since October 2007. In Kaabong, only 45 percent of health posts are filled and in Kotido, only 51 percent. The regional referral hospital in Moroto has no physician at all.

IRIN