WFP, in the first survey of internally displaced people (IDPs) and residents across western Sudan, said today that almost 22 percent of children under the age of five are malnourished and almost half of all families do not have enough food.
The nutrition and food security assessment found almost half the households in Darfur are not consuming enough food to sustain an active and healthy life. IDPs are markedly worse off than local residents - with 6 percent of people in camps able to obtain sufficient food by their own means and not relying on food assistance, in contrast to 46 percent of local residents.
"While much has been done for months now to feed as many people as possible in Darfur, the survey underlines how much remains to be done," said Ramiro Lopes da Silva, WFP Country Director in Sudan. "But food alone is not enough - the response also has to be significantly stronger on water, sanitation and health."
"This survey gives us a key baseline to refine our response and to press our donors for much-needed support," he added.
The survey, conducted in all three Darfur states during August and September, reveals a serious situation - especially among IDPs. However, the survey report says increasing food aid alone cannot reduce malnutrition. A basic minimum public health package, including adequate supplies of clean water and medicine, should accompany food and nutrition aid.
WFP collected data on more than 5,000 people at 56 sites in collaboration with the UN Food and Agriculture Organisation, the UN Children's Fund, the Atlanta-based Centers for Disease Control and Prevention, the United States and United Kingdom branches of Save the Children and with the support of Sudan's Ministries of Health and Agriculture and its Humanitarian Aid Commission.
The survey found food aid played a critical role by already reaching 70 percent of households among 1.45 million IDPs at the time of the survey and 20 percent of resident households in conflict-affected areas.
But the report also said the malnutrition rate for children in Darfur under the age of five was still 21.8 percent - a figure well beyond the 15 percent rate regarded as indicating a serious situation - and that a total of 3.9 percent of children suffered from severe acute malnutrition.
Alarmingly, the survey found that only 18 percent of the identified malnourished children in need of supplementary feeding were being reached, and that none of the seriously malnourished children in the sample of families surveyed received the therapeutic care they needed at special feeding centres.
"There was a problem of capacity," said WFP Country Director da Silva. "There were so many people who went hungry that we first had to give food to everyone. Only now can we start expanding to give special additional rations to every child under five and pregnant women. We also found that many women with sick children simply did not know that these centres exist."
The survey found "unacceptably low rates" of coverage for supplementary feeding and recommended a move to blanket supplementary feeding for all IDP children between the ages of six months to 59 months and pregnant and lactating IDP women as soon as possible.
Non-Governmental Organisations have supplementary and therapeutic feeding programmes, many supplied by WFP, in Darfur. But the feeding programmes are still not operational in some areas. The report recommended an immediate and comprehensive review of feeding programmes to identify gaps and improve their coverage.
It said protocols for feeding, the capacity of partners, outreach strategies, coordination, the food used, elevated defaulting rates and protection issues should be included in the review.
The survey found nearly a quarter of IDPs were critically short of food, with aid not reaching 16 percent in adequate amounts. Eight percent did not receive any food assistance at all.
Health problems are widespread with more than 40 percent of children having diarrhoea and 18 percent acute respiratory infections. These are the major causes of death for young children in developing countries. The survey also found a need to improve child immunisation against measles - one-third of children between nine months and 59 months were left out of a recent vaccination campaign.
Large numbers of children, women and pregnant women in Darfur were found to be deficient in minerals and vitamins. More than half of the children and a quarter of the women are suffering from anaemia. The survey found a 25.8 percent prevalence of goitre - an enlargement of the thyroid causes by a lack of iodine - among non-pregnant mothers.
"The situation is very precarious,'' said WFP Senior Nutritionist Rita Bhatia, who co-led the 70 team members in Darfur on the three-week survey. "Humanitarian assistance is going to be required for some time and needs to be increased."
The assessment mission recommends providing life-saving full general food rations for 94 percent of IDPs and in addition supplementary feeding for all children under five and all pregnant and lactating women.
With a poor crop year ahead and the nutrition and livelihoods of the poorest residents already at risk, targeted food assistance will be needed in 2005 for people living in conflict-affected villages.
The joint survey put the crude mortality rate for February to August in Darfur at 0.72 deaths per 10,000 people per day. The under-five mortality rate was 1.03 deaths per 10,000 people per day. Both rates are below the emergency threshold. But the report noted that these figures are for mortality across a population of IDPS and residents over a seven-month period.
This survey therefore is not comparable with other surveys taken among different population sub-groups or different geographic areas, where mortality rates might well be higher.
In September, WFP fed more than 1.3 million people in Darfur, representing 78 percent of conflict-affected people in areas accessible to UN agencies at the time. The International Committee of the Red Cross fed approximately 100,000 other people in areas of Darfur rated as "No-Go" by UN Security.
The survey indicates that WFP should be feeding at least 1.7 million people in Darfur by the end of the year. This number may increase further once the results of a FAO/WFP crop and food supply assessment mission to the Darfur states are collected by the end of the year.