Christian Mission Aid CMA - Action Against Hunger

21The most relevant factors seen to have contributed to the current nutritional state among the under 5 years ofage population are the low access to food and to health services.The long dry spell and erratic rains of 2004 widely affected farming produce in many parts of the Upper Nileregion did not spare this area. Worsened by crops destruction from pests and strong winds, the householdsinterviewed reported minimal harvest of maize in October, which has been exhausted by the 1 st quarter of thisyear. During the time of survey, majority of the communities have been depending on limited sorghum stocksfrom the November harvest, and on wild foods. The Rivers Magol Bior and Nile are a source of fish, however,access is constrained by lack of tools and means for fishing – NGO’s such as FAO and CRS deliver programsand activities related to fishing, but its full potential is yet to be realized. Similarly, milk or meat from livestock ismeager, with majority of families owning maximum of 15 cattle to none. Moreover, although no significantmovement was observed during the time of survey, more than 5000 returnees were recorded in December2004, accordingly depleting the available food among the host families even more. WFP last carried out generalfood distribution in April, providing 50% ration for resident households and 100% ration for returnees; thesehave lasted for only a month.Health records show rising incidence of these conditions in the current period, but utilization of health servicesfrom the existing primary health care facilities is not practiced among the majority of the households surveyed.The health-seeking practices, especially on drinking safe water, hygiene and sanitation are unimproved.A retrospective mortality survey has been implemented alongside the nutritional survey. Unfortunately, the datacollected were not satisfying, which can be attributed to the methodology that was used. As a result, thisindicator is reported in this the present survey..VIII. RECOMMENDATIONSACF-USA recommends the following:Programmatic recommendations:• A therapeutic feeding program should be immediately implemented to cover South Bor County, to treat andreduce the risk of mortality among the severely malnourished children. Co-ordination with and amonghumanitarian agencies on ground should be initiated; technical support should be offered by ACF-USA.• Deeper analysis of the health situation should be undertaken by CMA while enhancing the coverage of itsprimary health care services in the area, ensuring increased access and utilization by the population. ThePHCU’s in Kuei, Yolmuchel and Jalle II should be re-established.• Further assessment and monitoring of the food security situation should be carried out; meanwhile, generalfood aid must be promptly delivered by WFP. Existing food security programs and initiatives should becontinued while further developing its impact potentials.• Capable agencies should support South Bor with projects to increase safe water source (such as boreholeinstallation) and basic sanitary facilities.Methodological recommendation:• To implement in the future surveys the SMART methodology for the collection of data and the analysisof the retrospective mortality rate.