It is recognized that numerous recipients <strong>of</strong> <strong>food</strong> aid will compla<strong>in</strong> about <strong>food</strong> . One district<strong>of</strong>ficial from Gulu claimed that: “<strong>food</strong> is like money, and however much you provide IDPs with<strong>food</strong> there will never be enough”. Nevertheless some key stakeholders criticise WFP as wellas NRC for not provid<strong>in</strong>g the IDPs with thorough, targeted and repeated explanations as towhy <strong>food</strong> baskets are composed <strong>in</strong> a certa<strong>in</strong> way, and why rations have been reduced, andwhat the expectations are from the IDPs to do <strong>in</strong> return. Many IDPs deny that they have beenthoroughly <strong>in</strong>volved <strong>in</strong> the dietary composition <strong>of</strong> the <strong>food</strong> basket or even the <strong>food</strong> reductions,and that these decisions were <strong>in</strong> most cases ‘just presented to them’ through radioannouncements or by the camp leaders 71 . More <strong>in</strong>volvement could perhaps have reducedcompla<strong>in</strong>ts. NRC acknowledges this <strong>in</strong> so me <strong>of</strong> its monitor<strong>in</strong>g reports.7.1.6 But People Have Been Kept AliveDespite the reductions <strong>in</strong> rations and <strong>food</strong> basket, pipel<strong>in</strong>e breakages, uniform diet andmiss<strong>in</strong>g <strong>food</strong> items health <strong>in</strong>dicators 72 from the past three years show that malnutrition rateshave been kept relatively manageable, under the emergency threshold <strong>of</strong> 10%. The GlobalAcute Malnutrition (GAM) rates <strong>of</strong> 2005 showed: 4,7% <strong>in</strong> Gulu and 11,8% <strong>in</strong> Kitgum 73 . In2008 these figures have reduced even further to 3,1% <strong>in</strong> Gulu and approximately 8% <strong>in</strong>Kitgum. It is argued that the number <strong>of</strong> admissions to therapeutic feed<strong>in</strong>g centres <strong>in</strong> thisperiod has reduced. The <strong>in</strong>cidences <strong>of</strong> deaths due to hunger <strong>in</strong> camps have reduced br<strong>in</strong>g<strong>in</strong>gthe crude mortality and the under 5 mortality rate down to or less than 1/10.00 0 persons perday 74 .Many IDPs <strong>in</strong>terviewed did express their appreciation and satisfaction with <strong>food</strong> aid, qualifiedwith statements such as: “it susta<strong>in</strong>ed our lives”… or more literally “it kept us breath<strong>in</strong>g”… or<strong>in</strong> terms <strong>of</strong> nourishment “it kept our children healthy”. Or as a group <strong>of</strong> people <strong>in</strong> Pawiditransit site <strong>in</strong> Kitgum district said: “we ran from our villages, and moved with noth<strong>in</strong>g… atleast we found <strong>food</strong> <strong>in</strong> the camps”. This was followed by a more sad consideration: “wewished we could dig, but security didn’t allow us… so we depended on the <strong>food</strong>”. 75 . Severalmothers appreciatively also added that <strong>food</strong> aid had kept their children <strong>in</strong> school. The factthat <strong>food</strong> <strong>distribution</strong> <strong>in</strong> camps had lead to a safer life without the threat <strong>of</strong> or reality <strong>of</strong>abductions and kill<strong>in</strong>gs, which all IDPs had faced <strong>in</strong> the home gardens was humblyacknowledged. However had there been alternative options and possibilities <strong>of</strong> fend<strong>in</strong>g foroneself, most IDPs would have opted for these.In sum, the quantitative <strong>in</strong>dicators show that the GFD project through difficult times hascontributed to household <strong>food</strong> security and the ma<strong>in</strong>tenance <strong>of</strong> m<strong>in</strong>imum nutritional anddietary standards, and brought down high GAM rates and saved lives.However, research, beneficiaries’ voices, observations on the ground, op<strong>in</strong>ions <strong>of</strong>humanitarian actors and donors pa<strong>in</strong>t a more cloudy picture <strong>of</strong> the fulfilment <strong>of</strong> the objective.Multiple factors contribute to positive nutritional rates, not only <strong>food</strong>, but also good sanitation,clean dr<strong>in</strong>k<strong>in</strong>g water and proper hygiene practices and a clean environment. Hence, thepositive developments <strong>in</strong> the quantitative <strong>in</strong>dicators are not just a reflection <strong>of</strong> <strong>food</strong> aid.Moreover, the reality – and maybe the more qualitative signs - is that pipel<strong>in</strong>e breakages,delays, shortages <strong>in</strong> <strong>food</strong> items, reduced rations and few alternative <strong>food</strong> options, littlediversity <strong>in</strong> <strong>food</strong> supplies and weak cop<strong>in</strong>g strategies on behalf <strong>of</strong> the IDPs (also <strong>in</strong> newtransit sites where support<strong>in</strong>g services are not available) have meant that IDPs havestruggled to ma<strong>in</strong>ta<strong>in</strong> their m<strong>in</strong>imum nutritional dietary standards <strong>of</strong> 2.100 kcal per person perday and accord<strong>in</strong>g to several stakeholders, many have not managed at all. A closer look atsome <strong>of</strong> the issues is taken <strong>in</strong> the follow<strong>in</strong>g chapter.71Focus group discussions with IDPs <strong>in</strong> camps and transit sites.72NRC Quarterly reports, EFSA <strong>of</strong> 2007, WFP PRRO, ACF nutritional report 200773GAM rates before this period were even higher, close to 20%74 Nutritional Surveys for Gulu district <strong>in</strong> 2005 and 2006, WFP75Interviews and focus group discussions <strong>in</strong> Camps and transit sites <strong>in</strong> Gulu and Kitgum28
7.1.7 Lesson Learned♦ Food aid has been vital to fight<strong>in</strong>g (acute) malnutrition and sav<strong>in</strong>g peoples lives dur<strong>in</strong>gthe protracted crisis <strong>in</strong> Northern Uganda. Compos<strong>in</strong>g a <strong>food</strong> basket with the correctamount and type is essential to meet<strong>in</strong>g the m<strong>in</strong>imum nutritional dietary standards. Butwith ration reductions, cuts <strong>in</strong> the <strong>food</strong> basket and few alternative options thema<strong>in</strong>tenance <strong>of</strong> m<strong>in</strong>imum standards <strong>of</strong> 2.100 kcal per person per day is seriouslychallenged.♦♦♦The <strong>food</strong> aid has not been provided accord<strong>in</strong>g to preferred dietary needs and demands <strong>of</strong>the Acholi people and has <strong>in</strong> several cases also been <strong>of</strong> <strong>in</strong>ferior quality. The traditionalAcholi diet is rich and diverse. The uniform <strong>food</strong> basket given over many years haschanged diet habits and nutrition <strong>of</strong> the IDPs. Be<strong>in</strong>g aware <strong>of</strong> needs and <strong>in</strong>volv<strong>in</strong>gbeneficiaries <strong>in</strong> f<strong>in</strong>d<strong>in</strong>g alternative or complimentary solutions to <strong>food</strong> aid can boost thediet and nutrition and respond to some <strong>of</strong> their preferences.Changes <strong>in</strong> <strong>food</strong> rations, problems with quality, miss<strong>in</strong>g <strong>food</strong> items etc may require more<strong>in</strong>tensive and repeated explanation to the IDPs so as to fully answer compla<strong>in</strong>ts.Adjust<strong>in</strong>g <strong>distribution</strong> mechanisms to the family size system with an emphasis <strong>of</strong>beneficiary <strong>in</strong>volvement can prove effective <strong>in</strong> as much as reach<strong>in</strong>g the target populationswith <strong>food</strong> <strong>in</strong> a fair way and controll<strong>in</strong>g crowds <strong>in</strong>to an orderly <strong>distribution</strong>.7.1.8 Recommendations♦ With the ration reduction, changes <strong>in</strong> <strong>food</strong> basket and <strong>in</strong>consistencies <strong>in</strong> supplies, NRCshould <strong>in</strong>corporate alternative strategies to <strong>food</strong> aid programmes <strong>in</strong> a protracted situation.IDPs, with a wealth <strong>of</strong> dietary knowledge, can be brought more actively on board toidentify ideas or solutions to meet their own needs. Based on this, NRC should source forthe most feasible operational solution (e.g. topp<strong>in</strong>g up <strong>food</strong> aid, implement<strong>in</strong>g small scalelivelihood activities, <strong>in</strong>itiat<strong>in</strong>g cash programmes and stimulate market forces). See alsorecommendations and qualifications under Section 5.4.♦♦♦NRC should <strong>in</strong>clude qualitative <strong>in</strong>dicators <strong>in</strong> the project design to compl iment the exist<strong>in</strong>gquantitative health <strong>in</strong>dicators, which may not always provide a complete picture.Qualitative <strong>in</strong>dicators could be def<strong>in</strong>ed around ‘beneficiary satisfaction’, which NRC hasalready been report<strong>in</strong>g on <strong>in</strong> Post Distribution Monitor<strong>in</strong>g Reports.Tak<strong>in</strong>g IDPs compla<strong>in</strong>ts seriously through actions and recourse <strong>in</strong>creases the feel<strong>in</strong>g <strong>of</strong> adignified process. In this connection NRC and WFP should reassess the functions andpurpose <strong>of</strong> the compla<strong>in</strong>t desk with a view to improve the use <strong>of</strong> them and reach a moreeffective compla<strong>in</strong>t handl<strong>in</strong>g process.NRC should take other/alternative measures to push for actions and recourse <strong>in</strong> someareas with persist<strong>in</strong>g compla<strong>in</strong>ts (rations cards, verification/pr<strong>in</strong>t list failures/pipel<strong>in</strong>eshortages etc). For example more direct communication/advocacy can be made to WFPmanagement.29