Famine in southern Ethiopia 1985-6: population structure, nutritional state, and incidence of death among children.

OBJECTIVE To assess the effects of drought on mortality in children. DESIGN Prospective epidemiological study forming part of nutritional monitoring during famine relief work. SETTING 24 Food distribution sites in Arero and Borana provinces in southern Ethiopia. PATIENTS A monthly average of 14,173 and 5,334 children under 5 were examined in 1985 and 1986, respectively. Altogether 148,966 child months (105,872 for 1985 and 43,094 for 1986) were available for analysis. INTERVENTION The families of all children were supplied with food each month. Basic medical care was also provided. MAIN OUTCOME MEASURE Mortality in children under 5. RESULTS A 40% increase in crude mortality was observed among children living in traditional and stable societies. The severe consequences were observed mainly among children living in relief shelters, where a threefold to fourfold increase in crude mortality was recorded among children. Increased childhood mortality was also associated with high prevalence of malnutrition, living in the most arid areas, and the dry season. A long period of food aid was needed to normalise the nutritional state, especially for children living in relief shelters. CONCLUSIONS The most severe consequences of the widespread famine that occurred in the Arero and Borana provinces of southern Ethiopia during 1985-6 were seen among children living in relief shelters. Early food intervention may decrease the scale of migration and thus also reduce the severe consequences of a famine.