When they worked as a volunteer in the Greece Mission, a missionary of Fraternity – International Humanitarian Federation (FIHF) watched in disbelief as refugee mothers offered their babies the same food that was for the adults. It was a typical North African dish, consumed by adults in their country of origin: lentils cooked with a strong seasoning and strong spices. The scene took place in a cafeteria run by humanitarian organizations in Athens. Greece has become Europe’s gateway for those coming from Asia, Africa and the Middle East, and welcomed immigrants and refugees of various nationalities, mainly Syrians and Turks.
It is because of stories like this, which are repeated all over the world, that the Sphere Handbook emphasizes the importance of the issue of Food and Nutritional Security. The theme is like a piece of a great puzzle represented by the humanitarian aid to populations and communities at risk. Like the other pieces, this is vital. Without it, the picture is not complete. By itself, it means nothing. For this reason, food and nutrition fit perfectly with the other technical themes, joining the theme of Water and Hygiene (which we saw in the report on WASH actions) and also with the themes of Lodging and Camping, and Health, the subjects of our next reports.
In order to achieve good results, responses to the food and nutrition problems need to be coordinated with the WASH, shelter, and health actions. For example, it is necessary to have water in sufficient quantity and quality to prepare nutritious food and adopt safe eating practices. Access to sanitary and hygienic facilities reduces the risk of outbreaks of diseases, as well as adequate accommodation allowing the use of kitchen facilities and offering protection from extreme weather conditions, decreasing the risk of illnesses. When there is access to good health care, the nutritional situation is likely to be better.
The refugee mother in Greece was not offering the adult’s food to the baby because she lacked options. She was simply reproducing a common practice in her community of origin, where despair because of hunger causes people to consume the food that is available, whatever it may be, either for children or for adults. Through a lack of guidance and education, the mother could not comprehend how harmful such spicy food would be to a still developing organism.
It is bad nutrition that precisely leads to lack of nutrition, one of the serious worldwide problems frequently found in humanitarian shelters. Bad nutrition is like the tip of an iceberg. The true reality of the problem is submerged, and most of the time, we don’t see or perceive it; the ingestion of inadequate food, the uncertainty of enough food in the home and insecurity in the family environs, illnesses and lack of attention to health.
The Sphere Handbook has seven rules that guide the food security work of the organizations in humanitarian aid (see chart). In addition, the handbook established metrics so that the helpers involved can assess – from internationally accepted data and parameters – the severity of the issues related to nutrition. One of these is the CMB evaluation tape. The tool is used to determine the average circumference of the upper arm of babies and children, and from these numbers, establish whether it is a case of Severe Acute Malnutrition (SAM) – which can be treated, provided it includes hospital care; Moderate Acute Malnutrition (MAM) – which can be controlled with food supplementing; or Global Malnutrition (GM) – the care of which includes distributing food or the money to purchase it.
The Challenge in Practice
The last of the seven rules, but not the least, is about Means of Subsistence. It is a set of measures that aims to give people in the shelters access to ways of obtaining income and employment. In this way, through their own resources, they are able to acquire the products that are going to sustain their food supply. But even so, these people – as in the case of the refugee mothers in Greece – need guidance. In the Roraima Mission, missionaries experienced attitudes that illustrate this concern.
The missionary Anderson says that after a long work, some of the Venezuelan refugees given shelter through the Roraima Mission began to have an income and purchased part of the food that they consumed. And it was astonishing that they found many families spent much of the money on items that did not generate food security. There was, for example, a high consumption of soft drinks. Instead of offering healthy foods that guaranteed minimum calories, the parents gave their children Coca-Cola. “They had no information about the damage that high sugar consumption could cause in children’s development,” says Anderson. “We had to put the health and education sectors into action to not only bring this information to them, but also to develop campaigns and activities to positively change the behavior of these families,” says the missionary.
The Sphere Handbook teaches that the right of citizens to not go hungry and to have adequate food is safeguarded by international laws. It is up to the State to guarantee access to adequate food for everyone, including groups of refugees. Likewise, withholding the access of food to deprive the civilian population, as a method of war, is prohibited by the Geneva Conventions. It is also prohibited to attack or destroy crops, livestock, irrigation works, drinking water facilities and reserves, food items and agricultural areas. In the event of an occupation, international humanitarian law obliges the occupying power to guarantee adequate food to the population.
Food Security for groups at risk, besides guaranteeing people’s survival, serves to maintain their dignity and prevents the goods collected by individuals and families from being lost in a crisis situation or from being completely consumed. By preventing the loss of assets and guaranteeing dignity, humanitarian actions generate resilience in people. Generating resilience means helping the individual to rebuild their ability to deal with problems, overcome obstacles, and resist pressure in adverse situations.
The 7 rules of Food and Nutritional Security
1. Food and Nutritional Security Assessments.
These are necessary because they follow the evolution of the response and allow adaptations. Standard 1: Determine the degree and extent of food security, identify who are the people most affected, and define the most appropriate response.
Standard 2: Use accepted methods to determine the type, degree, and extent of malnutrition, the people most at risk, and the appropriate response.
2. Treatment of the Malnutrition
Chronic malnutrition can be avoided, but there is little evidence that it can be reversed or treated. On the other hand, acute malnutrition – which can arise during a crisis – can be prevented and treated with adequate nutritional responses.
Standard 1: Moderate acute malnutrition is an object of prevention and care.
Standard 2: Severe acute malnutrition can be treated.
3. Deficiency of micronutrients
These have important effects on people’s health and their ability to learn. These deficiencies contribute to creating a vicious circle of malnutrition, underdevelopment, and poverty that affects already disadvantaged groups. There are three approaches to controlling micronutrient deficiencies: supplements, providing micronutrients in a format that is very easily absorbed; enrichment, adding food products with micronutrients to control deficiencies; diet, with vitamins and minerals present in various foods.
Standard 1: Micronutrient deficiencies are correctable.
4. Feeding of infants and small children
Adequate feeding of infants and small children in emergencies saves lives and protects the nutrition, the health, and the development of minors. Some infants and children are especially vulnerable: underweight at birth; unaccompanied minors; children of mothers with depression; non-milk drinking children under two years of age; disabled minors; those with acute malnutrition, stunted growth; or with micronutrient deficiencies.
Standard 1: Policy guidance and coordination ensure the safety, the punctuality and adequacy of the feeding of infants and small children.
Standard 2: Mothers and caregivers have access to timely, appropriate food support that is sensitive to cultural uniqueness.
5. Food Security
It exists when all people have access to safe and nutritional food of an adequate amount. In a humanitarian crisis, responses must address short-term needs.
Standard 1: People must receive food assistance that guarantees their survival, maintains their dignity, stops their assets from being drained, and creates resilience.
6. Food Assistance
This is necessary when the quality and the quantity of available food or access to it are not sufficient to prevent excessive deaths, morbidity or malnutrition. Various tools can be used: food distributions (in kind or cash for purchasing); comprehensive and selective supplementary feeding programs.
Standard 1: Basic nutritional needs of people are taken care of, including the most vulnerable.
Standard 2: The food provided is of adequate quality, is acceptable and can be used effectively and efficiently.
Standard 3: The selection of those receiving it and distribution are governed by criteria of flexibility, punctuality, transparency, and security.
Standard 4: Food storage, preparation, and consumption are safe and appropriate, both in homes and in the community.
7. Means of Subsistence
People’s ability to protect sources of income is directly related to their vulnerability to lifestyle disruptions. They may lose their jobs or be forced to abandon their land or water supplies, as well as having their resources destroyed, contaminated, or stolen.
Standard 1: The mechanisms for primary production receive protection and support.
Standard 2: Men and women have equal access to income and job creation opportunities.
