Mortality rates in Ajiep began to rise early in 1998 and by August, despite a large amount of food and NGO inputs, were still very high. World Food Programme (WFP) had scaled up its food distribution in July, while other large-scale interventions included a blanket supplementary feeding programme, wet supplementary feeding and a therapeutic feeding programme. However, no nutrition interventions targeted any group other than children less than 130cm in height.

Logistical constraints in Ajiep meant that most food had to be delivered through 'food drops'. Other deliveries were frequently interrupted when the unpaved air-strip became flooded. Humanitarian efforts were co-ordinated under the umbrella of Operation Lifeline Sudan (OLS). UNICEF was the lead agency, which aimed to co-ordinate operations with their main local and United Nations (UN) counterparts, Sudan Relief and Rehabilitation Association (SRRA) and WFP respectively.

The problem

In Ajiep the crude mortality rates and prevalence rates for acute global malnutrition in children under five remained high. An assessment carried out In August 1998 revealed that an outbreak of shigella was one of the main causes of the high rates of mortality and malnutrition, while a large number of adolescents and adults were severely malnourished and suffering from dysentery. The low-lying surrounding area had become flooded, many adults were in a critical state and were unable to reach central service facilities.

As of August 1998, the response was unable to address adequately the needs of the affected population. While significant efforts were being made by the agencies operating in Ajiep, there were fundamental shortcomings in the analysis of the problem, and a poor use of information to advocate for a more effective and integrated response. The poor quality of existing services and the lack of technical co-ordination mechanisms were also significant problems.

SRRA requested the assistance of two consultants in the assessment of needs in August 1998. The Sphere minimum standards and indicators were used as part of this assessment. The analysis, technical and capacity-building standards for nutrition were used in particular. For example, Analysis Standard 1 ('a demonstrated understanding of the conditions which may create risk of malnutrition'), Targeted Nutritional Support standard 1 ('the public health risks associated with moderate malnutrition are reduced') and the indicators associated with the Targeted Nutritional Support standard 2 ('mortality and morbidity associated with severe malnutrition are reduced'), were the main focus of the assessment.

The assessment report focused on some technical issues, but it also highlighted a significant gap in efforts to implement a coherent strategy for best practice for humanitarian response in southern Sudan. A lack of accountability and of shared responsibility as well as the 'territorial' nature of agencies' response were raised as barriers for an effective response.

As a result of the assessment, additional resources were allocated to address the needs in Ajiep: adult and adolescent nutrition programmes were implemented with a community-based health education programme and efforts to decentralise services were made. In addition, the local communities were consulted to a much larger extent in the design and implementation of the programme.

At the policy level, efforts were made to develop a strategy for monitoring and evaluating emergency nutrition responses. For example, mechanisms were identified to ensure that agencies were both more aware of best practice and were more accountable. A strategy of decentralisation in planning a response became a central element of future responses in southern Sudan.

If specific minimum standards cannot be achieved, agencies need to identify why this is the case. Instead of seeing shortcomings as an absolute measure of 'failure', such information can be used constructively to advocate for more resources or assistance in a given context.

The perception that the Sphere minimum standards can be used to undermine agencies' credibility still exists among some of those involved. This view limits the considerable potential of the Sphere handbook for describing a shared understanding of good practice in humanitarian assistance.

While the technical (quantitative) sector standards are useful, the indicators relating to the approach used are more important, and should be applied more systematically. These include: the importance of a sound analysis of the problem, ongoing monitoring, developing human resource capacity, co-ordination and consultation with the community.

The Sphere minimum standards provide a common framework for co-ordination which may be invaluable in the absence of a formal and competent co-ordination body.

Contact: Annalies Borrel. Email: This email address is being protected from spam bots, you need Javascript enabled to view it