acceptability and use of cereal-based foods in refugee camps: case-studies from nepal, ethiopia, and...

8/7/2019 Acceptability and Use of Cereal-Based Foods in Refugee Camps: Case-studies from Nepal, Ethiopia, and Tanzania

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Acceptability and use of cereal-based foods in refugee camps

During 1989, nutrition-survey report formsincluded sections for reporting bleeding gumsand sore join ts, but these sections were notincluded after this year. The main commun-icable disease of concern at this time, apa rt fromacute diarrhoeal disease, acute respiratoryinfections, and TB, was an outb reak of hepatitis.In 1989, there were 5,185 cases and 96 deathsfrom hepatitis according to records (Toole andBhatia 1991).

Cases of scurvy were first identified in thefirst few months of 1989. According to a keyinformant (Tsegaye), it was mostly childrenbelow 12 years of age who were affected. It maybe that adult cases were less likely to present athealth cen tres, while many children were beingfed daily and screened in the wet feedingprogrammes. It could also be that adult menwere less susceptible because they regularlychewed quad, and, as the most mobile sector ofthe po pulation , they had access to a wider rangeof food. According to Tsegaye, the women werevery anaem ic, but n ot scorbic. Th ere seemed tobe a higher incidence in Hartisheikh A than inHartisheikh B.

A team was organised and trained to screenthe ch ildren for clinical signs. In th e wet feedingcentres, vitamin C powder was mixed withDSM, which was given twice daily.3 Th e area in

which the camps were situatedis poor in sourcesof vitamin C, and was until then pastoralistgrazing land. However, during this yearbusiness and trading centres were beingestablished and vegetables were coming fromHarar 2-3 times weekly at prices which manycould afford (Tsegaye 1997).

1990: In this year an anaemia survey wasconducted, using a questionnaire andcalculating the mean HB levels of adults andchildren


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Somali refugees in eastern Ethiopia

2.5% were reported among those in the feedingcentres, and many of the new arrivals lostweight after time in the camps. This could havebeen due to disease resulting from the use ofdam water by people who had been used toclean water, and also the privations of the cam pin terms of inadequate shelter material andblankets (Tsegaye, pers.comm.). One directeffect of the influx was tha t effectively therepatriation initiatives were now 'on hold'.

1994-1996: During this time, SCF-UK handedover nutrition activities in the camp to ARRA(March 1995), which became the lead implem-enting partner of UNHCR. The only inter-national NGOs left in the camps were CARE(water tankering) and Handicap International.Cam p residents continu ed to move in and out of

the camps all the time, visiting relatives andengaging in business and trading.According to the UNHCR Health Sector

Annual Report of 1995, malnutritionprevalence rates in the camps were


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The FAM report was critical of the food-distribution system in the cam ps, identifying thefact that the family group system was open toabuse, because only the head of the group oftwenty families needed to be identified; photo-graphic proof of identity was not required, andcards were easily forged o r boug ht. In ad dition,there were no indepen dent monitors present atthe time of distribution, UNHCR had not beenallowed to be present regularly, there was anabsence of distribution reports, and physicalchecks or 'food basket monitoring' had neverbeen carried out.

July 1996: Blanket supplementary feeding ofall children


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included. Most of the time was spent in KB.W here respon ses differed noticeably, the sourceis placed in pa ren thes es (i.e. HA or KB).

2.1.1 Food acquisition

General ration/SFP/BFP/repatriation package:Du ring the first five months of 1997, KB campreceived wheat five times, each month, but atdifferent times of the month. No sugar wasreceived. Oil was distributed in Jan uar y, March,April and May, but not in February. Not all ofthe camp residents are entitled to receive thegeneral ration. Ther e are return ees living therewho received a resettlemen t packag e some timeago but have not moved on (1.2), and they arenot entitled to the general ration. Allregistration had been stopped in 1995, but inKB a registration of those previously excludedhad been carried out in 1996 and should havepicked up an d included all those entitled bu t upto then excluded. Nevertheless some womenclaimed not to have a ration card; but theirexplanation for this was unclear.

During the study period in KB camp, theMay ration was received. It arrived on Saturday24 May and distribution was completed by latemorning on the 26th. WFP had informed theCam p Co -ordinato r a few days before. Th e onlycommodities for distribution were wheat grainand oil. According to the ARRA storekeeper,121.9MT wheat were received, and the officialration was 12kg per person for the month (i.e.400 gm /ppd). Th e grain was off-loaded from thetrucks into the compound of the ARRA CampCo-ordinator. The distribution system is basedon groups of 20 families, who are groupedacco rding to familysize, so that in each grou p of20 the family sizeis the same. Th e sacks are the ntaken by the group leader, sub-divided on thespot, and given to the families. Individualkilograms are not weighed, but measured outwith a large tin cup which all say holds theequivalent of lkg. As oil is more time-consu ming to divide up , it is usually distributedon a separate day.

When asked, women said that they had noproblem with the group system of distribution.Most, if not all, of the group leaders are men,but it can be men or women within the groupwho collect the ration. The sacks of grain aretaken away by the family, often on awheelbarrow, rented out by people from thetown, at a ren t quo ted variously as lkg of grainor 1-2EB, depending on the distance. When

asked why they did not carry suppliesthemselves, they said they were too weak. The

men supported the use of the wheelbarrow,especially as they might be away working anddoing other business. One woman said thatwomen were the ones to collect, because, if themen did it, they would waste the food in buyingluxuries; but another woman said that not allmen were like that. Where the amounts aresmall, they may carry them themselves or splitthe load between two of them ; but the use of thewheelbarrow was very common.

The previous distribution had been on 9April, constituting a 44-day interval betweendistributions . Most women interviewed gave theimpression th at they knew how much they wereentitled to on the day, but seemed unable toquote their entitlement. Those askedindividua lly h ad received from 10kg to 12 kgper p erson, according to them ; but, when askedagain during the feedback session in KB, theysaid they thought it was 9kg. Certainly thecommodities they could expect differed some-times.Th ey knew they should receive the ration(or 'gift' as it was translated to the researcher),but they did not know on which day of themo nth it would com e; as one w oman said, 'untilwe see the truck we can't know the time it willarrive'. Some women said that, when the 50kgsack of grain was measured out with their tin-cup measures of lkg, then there was only 40kgin the sack, but no scales were used to confirm this.

One group of women (KB), found dividingup their oil in one of the sections, were using a0.5-litre cup. They said each person receivedthree of these (which is double the officialration). They had not received sugar in recentyears, but one woman thought they hadreceived it twice about three years ago. Theyhad received Famix in the general ration onlytwice, and that was in February and March1997; each time the amount was the same (3kgor 4kg each time among those interviewed for

the study). During the feedback session withagencies in Jijiga at the end of the field-workperiod, agency staff replied to queries aboutpublic information on entitlements that theyassumed tha t after ARRA had been informed bythem abo ut any changes in the food basket, andabout delivery schedules, this informationwould be passed on to the refugees through theRefugee Committee. The last formal sessionheld had been a workshop in 1995 todisseminate information about administrativeaspects of food distribution, bu t no thing similar

had been done with regard to changes in thefood basket or en titlements of different gro ups.

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Eligibility to be included as a beneficiary ofthe SFP and BFP does not depe nd on holding aration card. The criteria are nutritional for SFP(


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baby. When asked why she bought dried milkinstead of fresh, she said that she could not keepmilk fresh in the house for mo re than a day, butdid not h ave money available each day to buy itfresh. Th e 400gm tin had cost her 15EB.

Another commodity routinely purchased asan essential food item is sugar. Heavily sugaredtea is taken as part of the meal, for example,poured over the enjera at breakfast to make itmore satisfying, or consume d in place of lunch ifnecessary.

A number of women said that they boughtFamix in the market; others said they did not.Wh en o ne wom an was asked why she might usethe little money she had to buy Famix and notwheat or even m eat, she replied, 'I don 't know ifit is good nutrition or n ot, but I buy it because itis cheap'. Others mentioned buying Famix tomake shurbad for women who had newlydelivered.

One woman (KB), asked about prioritychoices when shopping, said that it dependedon how much money she had at the time. Forexam ple, if you had only 50 cents, you mig ht aswell buy tom atoes to go withenjera, because thatsum would not buy you enough sugar for anypurpose. For one large thermos full of tea, shesaid she would use aroun d 1EB worth of sugarand 200ml of milk.

One woman (KB) said she bought a tin oftomato paste only if there was a sick child or apreg nan t woman, both of whom tended to havedifficulty digesting shuuro with oil. Other foodpurchases reported and observed werejejeb,which were on the market then following theirdistribution in HA as part of the repatriationpackage; white bread in HA (same price as inJijiga at 1EB for a long stick); and deep-friedwheat-flour snacks from th e camp m arket (HA).Non-food items were many and varied,including soap, cooking utensils, plates andcups, paraffin, charcoal, and firewood. Menparticularly bought qaad, which was readilyavailable in large q uantities.

Food exchange/sale/reciprocal arrangements/gifts: A major finding of the HFEAwas that onlyin KB has the price of wheat consistently beenhigh er th an the prices of locally produce d maizeand sorghum. On average over the one yearfrom mid-1995 to mid-1996 , refugees could selltheir wheat ration and purchase 34% moremaize. 'Therefore, in KB only, it makeseconomic (and nutritional) sense to see relief

wheat in the mark et, as this is a key element inthe coping mechanisms of the poorer refugees.

Both the "poor" and "middle" groups sell aportion of the ration' (SCF-UK 1996). It isimportant to note that this price differential isseasonal; at the time that this field study wasbeing conducted, the market prices of wheat,sorghum, and maize were about equal(Appendix 3(e)). Nevertheless, the HFEAestimates that the poor in KB spend a higherproportion of their cash on food purchase toobtain calories and improve palatability than dothe poor in other camps, because those in KBneed to make u p for their highe r levels of rationsales.

This field study confirmed that most peopleseemed to be selling wheat, rathe r than directlyexchanging it for other commodities. Theproximity of markets makes this easy. Mostpeople admitted to selling a proportion of thewheat ration in order to buy other food, andnon-food items. Quite often women said thatthey sold a whole 50kg sack for 35EB. A fewdenie d selling, saying that they consum ed it all.

No one admitted selling Famix, saying thatthe children needed it, and the amount they gotwas not worth selling. However, there was aplentiful supply of Famix pre-mix in themarkets in both field-study sites. When askedwhere it was coming from, the vendors in KBsaid it was from HA, and som e of the women inHA said it was taken from the feeding centre tobe sold. A camp official in KB said that thewomen sold it after receiving it in the SFP/BFP.As most of the Famix on sale is pre-m ix (oil andsugar already add ed) , most of itis coming eitherfrom SFP/BFP beneficiaries or from the campfeeding centre where the pre-mix is made.

Many people in Kebribeyah spoke ofborrowing from relatives when the food wasfinished. Others mentioned that neighboursgave them food, especially where there wereyoung children in the family. If the food is

requested by a neighbour, it is given on a loanbasis; but if it is freely given, repayment is notexpected. A number of commentators on thecamps have noted the role of gift-giving in theSomali community. It is of course difficult toquantify. One example of this was a family ofsiblings whose parents had died, and a teenagebrother had become mentally disturbed. Theteenage girl who was interviewed for the studywas effectively head of the ho usehold because ofher brother's incapacity. She said she sold herwheat to buy special food for the boy, and the

neigh bou rs then helped o ut, not only with foodbut with tending him.

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Several women talked of obtaining credit(qarde) from one of the town stores for g roceries.Th rou gh the month they would buy tea, sugar,rice and such comm odities on credit, then repaywith the money from the sale of wheat. Anumber of women use this credit facility to buyjejeb to make samosas for sale in the m arke t eachday. A key informant at camp level said that inKebribeyah there had been an income-generation scheme in 1996, involving tenrefugees, who were each given a lump sum tostart up a grocery and a butchery business.However, the businesses had not materialisedby the time of the study. It was not clear howstart-up was progressin g. A key informa nt saidthat liakbet schemes existed informally betweenwomen (2.4), but a group involved in thecooking demonstration, when asked aboutliakbet, denied any involvement.

Food production: All the camps are situated atthe edge of the Ogaden in areas where, with alack of groundwater sources and rocky soil,vegetation is scarce. The absence of wildlife,forests, and rivers limits the possibilities ofcollecting foods in the wild. The rains hadbegun by the time the study began, and thesurrou nding areas looked green. Between Jijigaand the two camps there was considerableagricultural production, the main crop beingmaize.

In bo th cam ps, maize was growing as well assmaller amou nts of sorghum , some beans, sweetpotatoes and tomatoes. Mostly women said themaize was primarily for the children, whowould roast and eat it asxasiid, or else the xasiidwas sold. Later the older maize would beground in the mill and shuuro made from it.When asked why she was growing maize ra therthan sorghum when in Somalia she had mostlygrown sorghum, one woman replied that it waseasier to grow than sorghum, that the gardenwas not large, and that the children could eatthe new maize after roasting it(i.e. in that sense,it requires less preparation than sorghum).The y expect two harvests per year of maize, butone of sorghum . One woman who was growingbeans said she had not grown them before inSomalia, but had bought and ate themregularly. Here that type of bean was notavailable in the m arke t. In HA one w oman saidshe had grown maize over the years, bu t had nocrop now, as she was waiting to be repatriated .

Although women, when asked, tended toknow the nam es of the chief wild foods availablein some locations, they said that the area in

which the camps were and whe re m any of themwent collecting firewood for sale was very poorfor fruits; only one was local (gob), and others,such as hohob and uneho, were found only deepin the Ogaden. Sometimes they were broug ht tothe m arket for sale.

In many of the small compounds within thecamp, there were small hen houses andenclosures for goats.

2.1.2 Food processing

Storage: Normally when not in the refugeecamps, pastoralists and agro-pastoralists storeharvested food underground for up to twoyears. However, the food they have preparedfor consumption, or purchased, is stored in theaqal. In the local village, one half of theaqal is araised platform for sleeping and storing food,but in the camps, sleeping and storage are atfloor level. In most aqals visited in the camps,there did not appear to be large amounts offood sto red, apa rt from whole sacks piled up insome. Th e aqals vary in size; many are in a stateof disrepair, and the wall and roof coveringsconsist of traditional matting, UNHCR plastic,relief-grain sacks, pieces of cardboard, pieces ofcloth and other sund ry m aterial.

It seemed that most women were m illing onlysmall amounts of whole grain at one time, no

more than 5kg. One reason for this is thatstorage of flour in the^ a/s is problematic, sincedust and debris can pollute flour easily. Onewoman kept her wheat flour in a tin coveredwith a cloth; she said it could be stored like thatfor up to ten days. Wh eat flour a nd Famix wereoften kept in plastic bags, suspended from theinside wall of the aqal away from the floor dustand rats; others store Famix (usually kept foronly a few days at the most) in a saucepan with alid. The plastic bags are multi-purpose, andsmall twists of pink and blue plastic are used tosell, buy, and carry hom e small amou nts of milk,tomato paste, and oil. Small twists contain alsospices of different kinds. The whole plastic bagis used to carry lkg or so of grain or sugar.Unfortunately it is not bio-degradable, andremnants of this plastic adorn thorn bushes formiles aro un d and litter the fringes of the townsand camps.

Five-litre oil tins with ropes threadedthrough at the top are very comm on. They areused for collecting Famix and flour from themill, and also storage in the hou se.

Whole grain is stored inside theaqals in sacks,and other commodities in cardboard boxesfrom ration distributions. A few traditional

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Somali refugees in eastern E thiopia

storage containers were also seen, includinggourds for small amounts of grain, and, in onelarge aqal, the woven wooden baskets which areslung from the sides of the camel fortransporting bulk items.

The prepared enjera dough is usually storedovernight in the aqal, not in the alawaat, whichwould be too warm. It seemed to be mostlymixed and keptin a small plastic bucket with a lid.

Small amounts of fresh milk are carried inblue plastic bags, and stored in tin cups whichmost women appeared to have for drinking teaand milk and for measurement purposes, therebeing three sizes (see below). For storage formo re than a few hours , cow milk is boiled, whilecamel and goat milk is heated but not boiled.

Water is collected and stored mostly in 20-litre jerr y cans. Distances to water points are nota problem, and the rewas no sign of congestion orlong queues arou nd water points in either site.

Measurement: It proved difficult to work outhow much was being prepared per person, forthree main reasons. Firstly most women wereclaiming to be eating only grain with oil formeals, and not adding meat and vegetables.This may or may not have been true; butobviously, if meat and vegetables are prep aredalongside the staple dish, the latter portion willbe less than if it is the sole item of the meal.

Secondly, a num ber of women claimed that th esize of househ old for which she was cooking waslarger than that on the ration card, one reasonpresumably be ing that invalidation of cards hadnot been carried out since 1994 (1.2). Lastly, anumber of women in KB made reference to'visitors' staying with them temporarily fromOga den. (It was not clear what was the status orpurpose of these 'visitors' and whatcontribution was being made by them to thehousehold food supply.) Certainly measuringadeq uate qu antities is not a problem for womenused to cooking for their families, unlessunexpected visitors turn up (2.1.3).

It is the person who is to cook who decideshow much to pre pa re. This is always a woman,usually the oldest woman or the eldestdaughter. Many people used tin cups tomeasure out grain and flour. There are foursizes; the largest, a galaan, is used to measure1 kg of grain, and just over one litre of fluid. Th enext sizes hold approximately 450ml, 300ml,and 200ml.

For enjera the amount measured out was

usually equivalent to 200gm per perso n. For 8-10 people, one woman said she bought and

prepared 1.5kg, whether it was for enjera orshuuro (the weight of flour being less than theamount of whole grain before processing).Ano ther, cooking for8 people, used 1 kg of flourplus a handful of Famix to make the enjeradough. Others quoted similar proportions forenjera, one woman saying she needed 0.5kgmo re flour to makeshuuro.

It was interesting that, when the women wereasked what proportion of Famix was added towhat proportion of water, their answers rangedwidely (from 1:2 to 1:10), despite the fact thatthe cooking method and end product wereconsistently similar. This lack of accuracyperhaps reflects the easy and casual cookingmethod, where either water or Famix can beadded incrementally without detriment to theoutcom e (3.1.2).

Preparation: The most commonly prepareddishes included those which req uired milling ofthe grain to flour and those which requ ired onlypounding to dehusk the grain.

Dishes requiring milling to flour: Enjera (o rcanjeero, kimis or laxoox) is m ad e from finelymilled white wheat flour, either machine-milledor hand-milled. When hand -milled, the wheatiscleaned, pounded with the vwoye,and thenwinnowed with the masaf. T he enjera flour canbe mixed with a smaller proportion of maize,

sorghum flour, or Famix (as in the case of thecooking demonstration for the study); but,according to the women interviewed, it cannotbe made from maize or sorghum flour alone.Wheat is the essential major ingredient,according to these women. However, in thelocal village, and according to key informants,enjera can be made from sorghum alone (but itshould be eaten straight away, not kept for anylength of time once cooked ). T he flour forenjerais mixed with water to make a smooth, liquiddough. To the dough is added a starter

(dhananis) of already fermented enjera. Thismixing takes only 10 minutes or so. Themixture is then covered and left overnight inthe house, which is cooler than the kitchen;when fermented in the morning, it is ready tocook.

Shuuro can be made from wheat, sorghum ormaize. It can be machine-milled or hand-milled.When hand-milled, the grainis cleaned with th emasaf, rinsed with water, and then poundedwith amooye. It is then dried for a few m inutes inthe sun and then gr oun d by hand with the stone

grinder (shiide). It is then winnowed, the coarserwheat grain being used forshuuro; the separated

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finer flour is the enjera flour, which is lateradd ed to make the m ixture thicker (see below).The shuuro f lour s then ready to cook.

In HA most women were taking their wheatfor grinding to one of the commercial grindingmills in the ca mp , not to the free g rind ing m ill.It seemed that, while women inKB also used thecommercial mills, more of them were poundingand grinding theirown flour than w ere doingsoin HA. A nu mb er of factors seemed to influencewhe ther wom en used the mills or not (2.2.1).

Dishes requiring de-husking only: Garo can bemade from wheat, sorghum, or maize. Thegrain is not milled to a flour. To preparegaro,the grain is first winnowed with the masaf toremove the chaff, then rinsed with water toclean, If garo is made from sorghum or maize,

the grain is then poun ded to remove the 'eyes',but this is not necessary for wheat, sopreparation time with wheatis less.

Karis can be made from wheat or sorghum,but not maize. Th e grain is not milled to a flour.To prepare the grain forkaris, it is first cleane dwith the masaf, then rinsed in water. The wetgrain is then put into themooye and pounded.The moist pounded grain is then dried in thesun for a few minutes and then winnowed toremove the husks or buushe, which are thengiven to thechickens. Th e grain is then added to

boiling water (about 0.5kg grain to one litre ofwater),covered and left to boil.No preparation is required for Famix, and

the cooking m ethod is simple.

Cooking: The main methods of cooking areboiling and baking in the'enjera oven' (see below).

The most common daily fare was said to beenjera. According to the woman interviewed inthe local village, enjera was more commonlymade in the dry season than the rainy season,because it can be eaten without milk, whileslmuro should be taken with milk, which is morereadily available in the rainy season.

The enjera. dough is prepa red the evening orafternoon before and left to ferment. T hedaawais wiped with oil and placed on the fire. When itis spitting hot, a cup of the mix tureis poured onto it in a circle, starting at the middle andsprea ding it outw ards. Th e diam eter is jus t lessthan the lid of the daawa, which is then put onand left for about two minutes, after which timethe enjera is removed and the next cup pouredon the daawa. In the cookery demonstration,about 1.25kg of enjera flour was mixed with

water to make the runny d oug h. The cooking ofth e enjera took just over one ho ur. Th e women

cooking said that in the camp it would feedabout four people for breakfast, because in thecamp they did not have lunch, whereas in thetown it would feed m ore than this, because theyhad other foods to go with it and they tooklunch. When it is about to be eaten, if the re is nosauce or m eat to go with it, eitheroil or sweet teais poured over it. If meat is available, it is friedand mixed with vegetables such as potato andred tomatoes to make a stew(sugo).

A less common dish made similarly isbur, atype of bread made from dough which is notfermented, but thiswas not observed d urin g thestudy, and women did not mention itspontaneously.

Another favoured dishisshuuro. Theshuuro isgradually added to boiling water and stirred

continuously at the beginning of the process;then it is covered and left to boil. The cookingtime depends on the amount. For the studydemonstration, only 0.25kgshuuro was added.After about 25 minutes, a relatively smallamount of enjera, f lour was added and stirred into make the consistency thicker. The cookingtime in all was about 40 minutes; the womensaid that when cooking for the family it usuallytakes twice as long. Apart from theenjera,nothing was added during the cooking process,but butterfat or oil is usually added and stirred

in after it has been taken off the fire. Likeenjera,shuuro is preferably eaten with meat andvegetables or with m ilk. An alternative additionis one small tin of tomato paste. Shuuro isconsidered 'heavier' thanenjera, which m eans itis less easily digestible .

Karis an d garo take different times to prep are ,but abo ut the same am oun t of time to cook(garomight be slightly less). After preparation of thegrain, it is placed in hot water, brought to theboil, and covered with a lid. While these werecooking, the women could go away and d o their

chores, returning before it was ready. For thestudy demonstration, 0.5kg of grain wasprepared and cooked for each dish. Thecooking time was about two hours. Before thecooking process was completed for thekaris,when all the water was absorbed, salt and spices(geedo) were ground together and added, andabou t 20ml of oil also. Salt and spices are add edto the garo after any excess water has beendrained off, and then it is ready to be served.Karis can be eaten with meat and vegetables, orwith milk which is poured over it.Garo can be

eaten with milk or with oil or mixed with beans,but is not eaten with m eat and veg etables.

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Famix was cooked similarly by all womenwho were asked and observed. They heat somewater, and when it is hot but not boiling theyadd the Famix slowly, sprinkling it into thewater and mixing all the time. Onc e it comes tothe boil, it is boiled for 2-5 minutesapproximately (one woman said she boiled for15 minutes, because it did not taste good ifcooked for less; but she was the exception).Many women were adding sugar because they(or more commonly their children) complainedthat it was not sweet enough. Also one or twowomen expressed the belief that the sugar wasboiled away durin g cooking,so that more had tobe added before eating. Some also added moreoil and, occasionally, salt. The resultingboorashwas of a thin, gruel-type consistency oftenlikened by women to 'milk' or 'tea', which isdru nk from a cup . It was said th at for the plainFamix (not the pre-mix) m ore wateris required.On e woman who said she used on e pa rt water tothree parts Famix (similar to the ratio recom-mended by the manufacturers) said she cookedit thick and gave to the children from a spoo n.

The cooking method of Famix is similar tothat for making shurbad, a porridge-type dishwhich many referred to having cookedpreviously when in Somalia. Forshurbad, whiteflour or sorghum flour might be used, or tinne dwhite oats (which were favoured). The flour oroats were added to hot water, stirred an d mixedin with milk and butterfat, possibly sugar. Thiswas traditionally made for young children,newly delivered women, and the sick; and alsodurin g the Ramadan fasting period. Somethingsimilar but m ade to a much thicker consistencythan shurbad was cassiset, which was mostly forthe newly delivered wom en.

Mostly cooking takes place in a smalleraqal(alawaat) next to the home aqal, with very littleventilation. Charcoal is used by some, in asquare tin or round clay stove, but it is moreexpensive than firewood. Itis more convenient,especially in the rainy season and also if cookinginside the living aqal, to avoid wood-smokepollution. However, particularly in KB,firewood was used for cooking, and thecollection of firewood for use and/or sale is amajor activity for many women.

2.13 Intra-household food distributionThe most important meals of the day arebreakfast and lunch, so that lunch is usuallyheavier than supper. If something heavy is

taken at lunch, then supper will be lighter, andvice versa. Most of the women interviewed in KB

said that they were not cooking lunch that day,because they had not enough food, whereas inHA this was not thecase. It was difficult to verifythis, because much of the cookingis done insidethe alawaat, and wood smoke may denote a mealbeing prepared, or samosas for sale, or thepreparation of tea. The use of 'in-between'snacks was rarely mentioned. In KB smallchildren were observed nibbling sweet potatoesin the middle of the morning (from the gardenof that hous ehold), and in HA deep-fried wheatsnacks had been bought from the camp marketfor the children of one of the interviewees.How ever, for adults, it ap pea red that teawas th emain 'in-between' sustenan ce, as well as being ameal substitute on occasion, according to someinterviewees.

The breakfast was almost invariably said to beenjera, cooked and eaten soon after sunrise, thedough having been prepared the evening orafternoon before. The amounts prepared areusually for one meal only. It is not stored formuch later meals, because it becomes bitter,though a few women spoke of saving thebreakfast enjera for lunch an d taking it with tea.Famix can be a substitute for breakfast, but m ostpeople said they had prepared enjera thatmorning, and almost always they had eaten theenjera. with tea, either taking the tea separately

or pouring it over the enjera, and some hadpou red oil on to theenjera prior to eating it. Saltand onion are sometimes added. One or twowomen admitted eating enjera with spices,onion, and tomato for breakfast. Other disheslike karis andgaro an d bur can be taken, but werenot often mentioned during the study as thatday's breakfast.

Women said that, if they had something toprepare for lunch, they began preparationaround 11 a.m. for midday eating, but it couldbe later than that if the woman had been to

collect firewood first in the morning.Shuuro is eaten for lunch or supper, and isconsidered a heavy food, even if taken 'dry' that is without meat and vegetables, or milk. Itwas often referred to in connection with su ppe r.Supper is eaten around sunset, so preparationwould start aroun d 5.00 p.m . at the latest.

Garo an d karis may be taken for lunch orsupper. In HA, women also mentionedspaghetti and rice, eaten with a sauce forsuppe r, and admitted to eating meat sometimeswith the staple dish.

Famix was taken mostly as lunch or supper,according to most women, and notas a between-

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meals snack, except sometimes for smallchildren. It appeared that people generallywould substitute Famix for lunch or supperrather than for breakfast. It was not consideredequal to wheat flour by most, but in the absenceof flour it was an acceptable second choice as alight food to balance heavy food taken at theother mealtime. One woman (KB) said whenshe had received 4kg in the genera l ration somemonths ago, she cooked it for one week, everyday for lunch for everyone: 'It is not good forlunch, but we were forced by circumstances'.Tho se receiving one ration of pre-mix thro ughthe SFP /BFP tende d to use the week's ration allat once or twice, to give to everyone in thehou seho ld, so that the week's ration lasted onlyone or two days, or as ano ther woman said

it was eno ugh for two meals for four peo ple eachtime.Famix was used for infants as a weaning food,

women saying that they gave it with a cup andspoon. However, it was also eaten by allmembers of the household, and did not at allseem to be considered as only a food forchildren. Sometimes a small amo unt was addedto the wheat flour in preparing theenjeradough. It was commonly described as 'likemilk', and it was mad e to a thin consistency anddrunk from cups like milk and milky tea. The

tea made in the camps is extremely sweet(reportedly around 0.25kg of sugar for oneThe rmo s) and fresh milkis preferably added, sothat tea is more than a drink .

All members of the household liked to drinkmilk, either cold by itself, heated with sugar ormixed with tea, or as yogu rt, togeth er withkarisor garo or shuuro. For young children it wasusually heated a little and sugar added. At thetime of the study it was cow's milk which was inevidence (not camel's), and the price wasrelatively low, because the rains had begun.However, women said that at the moment cowand camel milk were the same price. Goat milk,they said, which was even better than cow orcamel, was also around the same price, but theyield of the goat was far less than that of cow orcamel. They said children tended to prefer cowmilk; if camel milkwas given to small child ren , ithad to be hea ted a little first or taken in tea.

In one small aqal (HA), there was a youngwidow and her 7-month-old baby. She wasbreastfeeding and giving reconstituted driedwhole-cream milk (tinned) from a feedingbottle. She was adding c.3 teaspoons of milkpowder to 115ml of boiled water, and adding

some sugar. Use of the bottle was said to becommon in HA, but the bottles are hiddenbecause they are discouraged at the clinic(according to a camp-based key inform ant).

Commensality: Members of the household tryto take meals at the same time, butcircumstances of camp life make this difficultsometimes, because various members of thehousehold are out doing business or chores ortaking leisure time.

Asked if all members of the household men, women and children eat together, thewomen laughed on more than one occasion,presumably because for them it wasunth inkab le that all should take 'from the sameplate'. The men eat from a separate plate andpreferably in a different space from the womenand children. Food is eaten inside theaqal,either in the entrance section, which is often acooking space where charcoal is being used, orin the main living/sleeping section. It may bethat the older sons have a separate sleepingaqaland they would eat there. Plates and pans arewashed o utside, and refuse is given to chickensand goats and/or thrown into a pit. When theresearcher and interpreter were invited tolunch in HA by a woman from the Committee,they were served first, then her husband andadu lt sons, before she sat down to eat.

Thus the woman usually makes sure that allare satisfied before she takes food. Some womensaid th at sometimes they missed ou t because th efood was not enough. This was most likely tohappen if unexpected visitors appeared; thesewould take precedence over the woman andolder d aug hters , not the small children (male orfemale). When asked why women did not keepsome aside for themselves to prevent missingout, one wom an said, 'You cannot do tha t whileyour child is suffering. You are the responsibleone cooking,so you have to make sure everyon eis satisfied'. One woman said that 'in the Somalicommunity to eat alone is not good, and eatingtoge ther is a sign of peace'.

One woman said that if there was enoughfood, and the children took some, went away toplay and then returne d wanting more, she gaveit to them, but this was applicable only to thechildren of the household.

As further illustration, one woman in HA whoseemed to be well off (and had certainly been sopreviously in Hargeisa town) explained that inHargeisa she and her husband and childrenused to eat seated at the table together, buttaking from separate plates; this happened

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when it was just the close family and there wasfood in plenty, so she knew there would beenoug h. If therewas not much food, the womenwould wait until the others were satisfied; or ifvisitors came, the women would retire toanother space and wait until all had receivedenou gh food, before they themselves partook. Ifthe food was not enough for the women, theywould cook again, or buy from the h otel.

The same woman went on to explain that,before coming to the camp (in her experience),family members would be sitting down to eat atthe same time, because they were living inhouses with a spacious compound and goodfences, so that the children stayed in thecompound. In contrast, she said, in the campthere were no fences, and children wererunning all over the place, and the adults wereout 'run ning after money', so that people wereretu rnin g hom e at all different times.

2.1.4 Food preferencesA number of women seemed to favour wheatover sorghum and maize, because they said itwas more versatile, in that it could begaro orkaris (pounded, boiled, but not milled),enjera,shuuro or bur (requiring milling). Whea t flour isalso used by several wom en to m ake samosas forsale each day in the market areas. Anotherreason, which they did not state, but was

explored in the SCF-UK HFEA, was that in KB,at least, for certain periods of the year, the priceof wheat is higher than that of sorghum andmaize, so wheat grain represents potentiallymo re cash available to buy oth er food, an d non-food items. In fact, asking abo ut p references ininterview was not easy, because the womenmade a distinction, understandably, betweenwhat they preferred before when they were inSomalia and what they preferred now, becausenow the choice was so limited and heavilydep end ent on what was given in the 'gift'. T hey

may have feared that expressing preferenceother than wheat to the researcher mightprejudice future supply in some way.

In terms of choice between wheat, sorghum,and maize, now that they were in the cam p mostsaid they preferred wheat first, then sorghum,then maize. When asked why, in that case, theywere growing so much maize in their gardens,they replied that it was easier to grow thansorghum, and that when it was ready thechildren could take and eatasxasiid.

Most interviewees were asked what kinds of

food they commonly prepared before theybecame residents in the camps. The former

town-dwellers, from both northern andsouthern Somalia, tended to mention first riceand spaghetti, and 'white flour'. This whiteflour was wheat flour, but several claimed theydid not know from what it was made and werenot familiar with wheat grain before they cameto the camps. With the white Hour they wouldmake enjera sometimes for breakfast, eating itwith oil and tea, or with meat stew(faxfax). Thiswhite flour was also made into white bread inbakeries; this was bought and eaten forbreakfast by many in the towns. One womansaid the flour was sweeter than that obtainedfrom milling the ration wheat, and the breadtasted sweet also. Some said they had usedsorghum in the towns, but it was factory-milledsorghum, unlike whole-grain sorghum, whichyou have to mill and which is too coarse by itselfto be enjera. A number of people talked ofmixing beans with sorghum for a main meal.Among former town-dwellers and thewell-off,spaghetti and rice were highly favoured,spaghetti probably more so than rice. Bothcommodities were on sale even in KB, but theprice of both was much higher than the otherstaples.

Those from a pastoralist or agro-pastoralistbackground tended to favour sorghum over theother grains, and placed great emphasis onmeat, and particularly on milk and butterfat.Cow's milk was generally preferred overcamel's, but they said that children could takeeither. One reason why cow's might bepreferred (as explained by the local villagerinterviewed) is that cow's milk can m ake y ogurtand butterfat, but camel's milk cannot. Whenthey sold an animal, explained one w oman, theywould buy rice or wheat, but they would notmake enjera with the wheat. Rather, with thewheat she would make shuuro an d garo mostregularly. Th e ricewas expensive,so they wouldbuy it only for special occasions.

There were some contradictory replies inrelation to whether it was pastoralists or urbandwellers who had most commonly eatenenjerabefore in Somalia. One woman said that somepastoralists did and some did not, that itdepended whether they could afford to buy thewheat flour. Generally it seemed thatenjera waseaten more by former urban residents, andshuuro more often by nomadic households. Onewoman from an agro-pastoralist background inthe sou th of Somalia said tha t they used to grow

sorghum and maize and preferred sorghum,because with it they made shuuro an d garo

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mostly, and because they considered it morenutritious than maize. She said (as did someothers, though it was disputed by one or two)that they did not ea t enjera then, and that someof the nomadic peoples did not eatenjera at all,that it was mostly town dwellers who did. Herein the camp she was growing maize, however,because the children could eatxasiid and alsobecause the ga rden was not very large.

Another woman from a pastoralistbackgroun d said that she preferred sorghum towheat, but sorghum alone cannot beenjera(according to local villagers and key informants,it can), and when the children sawenjera beingcooked by othe rs, they asked her to make it forthem. She said there was white and redsorghum, of which she preferred the red, but

only because of the colour, as the taste andtexture were the same. Another womanexpressed preference for the red sorghum andsaid that the one supplied as 'gift' last year wasgood, even though it was not the same as shehad grow n herself before in Kismayo. However,this same woman said that now she was in thecamp she preferred wheat to sorghum , becauseshe could make more things from it (likesamosas, which she was selling in thetown). Alsoshe said that before becoming a refugee therewere many things she was not familiar with: for

exam ple, she used to wear one set of clothes allthe year when in the rural are a, but now she hadgot used to being in town and wearing differentsets of clothes. This woman (previouslypastoralist) said she had seenenjera before in thetowns, but did not know how to cook it until shecame to the camp, while another woman(previously living in Hargeisa) said she had noteaten shuuro before comingto the camp and hadsubsequently learned how to make it.

Virtually all of them exp ressed preferencefor enjera an d shuuro over the boorash made from

Famix, though one woman said she preferredFamix because it was easy to prepare. Whenasked, they said they did not know what it wasmade from, but had an idea it was 'nutritious'and co ntained 'pro tein', and had accep ted it in away as a milk substitute. Several were buying inthe market; one woman, when asked why sheboug ht Famix and notwheat, said because it waseasy to cook, and she had only enough moneyfor Fam ix, which was much che aper than meat,implying its perceived value as a source ofprotein.

Some mentioned that, while most people ofall ages liked the Famix, sometimes the small

children refused it, because it was not sweetenough. Asked why they did not reject otherfoods like enjera. on that basis, one womanexplained that enjera was not expected to besweet, but boorash was. For this reason, theFamix was often served with extra sug ar a dd ed ,as was milk. Many said they did not know thistype of boorash before in Somalia, but many hadmade shurbad; and those from towns had oftenused the tinned white oats for this andperceived them to be sweeter and morenutritious than the Famixboorash. However, theFamix boorash, said some, tasted better thanwheat-flour boorash without milk and sugar.

2.1.5 Local factors influencing foodpracticesUnderstanding of health and nutrition issue s:Women in interviews did not make anyreference to specific micronutrient deficienciessuch as scurvy; in a discussion of the scurvyoutbreak of many years ago, they did not seemto distinguish it from the problems of diarrh oea ldisease and wasting and hepatitis, which theyremem bered from those days.

When asked about special foods duringpregnancy, women would speak ofa 'balanceddiet', by which they meant milk, meat, fruits,vegetables, eggs, and liver. They said thatpregnant women particularly should eat moremeat and vegetables. There seemed to be nofood avoidances or taboos for women duringpregn ancy and delivery, but some said that foodlike shuuro with oil was less appetising and no t soeasily digested when pregnant, and foods likemeat and vegetables were preferable for thatreason also. Cassisel an d shurbad made fromsorghum (for pastoralists sometimes fromwhite oats for the town dwellers) were pre pa redcustomarily for newly delivered wom en, and soFamix could also be used for this purpose,although itis probably no t thoug ht of as quite so'nutritious'.

The feeding of children was of course apreoccupation with many of the women. Theyoften referred to the value of milk for ch ildren .It was considered the most imp ortan t food itemfor their nutrition. In terms of commensality,childre n w ere given priority over older girls andadult women. In both camps, a few childrenwere observed eating m id-morning snacks, butthe F amix, said the wo men,was not used for thispurpose.

The 'camp' situation: Th e camps are not in anyway 'closed': on the contrary, they are anintegral part of the regional 'economic and

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cultural co ntinu um ' (1.2). Th us the availabilityof markets containing a wide range of food andnon-food items influences what foods areprepared, and the scope of food preferences.Recent repatriation initiatives too will have hadan effect, with many refugees effectively havingrepatriated themselves but having kept apresence also in the c am p, and with oth ers nowtaking up the repatriation package on offerfrom the agencies. This will influence foodproduction, food trading, and food-securitystrategies of the camp residents.

To meet the study proposal criteria, most ofthe interviews were conducted in KB, becauseof its status as the poo rest cam p and because, assuch, it was the most dependent on the ration.However, HA was also visited, to ensu re that th eIsaaq clan was included in the study (the mostnumerous clan in North-Western Somalia andmany of them formerly town-dwellers), in casefood practices and preferences were differentfrom those of the KB camp. The highereconomic status of the HA residents appearedto have an impact on types of food regularlypurch ased , but not on choice of milling metho d,except that rice and pasta, the more high-costfoods, do not re quire milling anyway.

The Famix, on sale in both places, was said tooriginate in HA. This could reflect the highereconomic status of its residents, who relied lesson the ration food. Ho wever, it could equally bedue to the fact that the population figures onwhich food distribution is based are moreinflated in HA, which is visibly smaller th an KB.

Opportunities for work and incomegeneration: Many women, particularly in KB,spoke of collecting firewood to sell in th e town tobuy food. A morning of collecting firewoodcould earn about 4EB. Women were seenmaking mats to sell for covering aqals, an dseveral were making samosas. This was not

necessarily something they had done before inSomalia. Some men tioned men ou t working, forexample one spoke of her husband outcollecting large pieces of timber to sell tobuilding contractors.

Credit arrangements were mentioned byman y, often to ma intain a small business such assamosa sales. Several women had run smallbusinesses before becom ing refugees, so skills inborrowing and managing credit are wides-pread. The visible income-generating initiat-ives, and those accessible to a visiting research-

er, tended to be those operated by the poorerrefugees. The prolific and large-scale trading

and business ventures were no t so accessible no rso relevant for this study, because thoseinvolved do not depend on the general rationfor nu tritional reasons. Th ere a ppe ar to be widevariations in socio-economic status in thesepopulations. Those in KB have fewer supportnetworks, because they do not live in their ownclan areas, unlike the residents of the o ther cam ps.

One woman (nomadic background), whenasked whether she worked harder in the campthan she had in her home place, said it washa rde r in the cam p, as she was collecting waterand firewood, gardening, making samosas, andtending the children. Her older dau ghters werenot helping, because they were alreadymarried, and the husband sp ent his time goingto the town and talking with the othe r m en.

2.2 Opportunities for cereal fortification

2.2.1 Household-level millingHousehold-level milling of cereals isundertaken by women. The milling process ispounding, winnowing, and stone grinding byhand. Th e equipm ent used is theviooye an d tip,the shiide and the masaf. The mooye an d tip aremade from particular trees which do not growlocally, so the refugees either bro ug ht their ownwith them when they came or bought frompeople living in the Ogaden (they said the cost

was around 20-25EB). Most women said thatthey shared the equipment with theirneigh bou rs: up to ten wom en a day could use it.Mostly if the grain is pou nd ed at ho me , itis thenhand-ground, but one woman reported thatfirst she pounded the grain at home to clean it,then took it to the commercialmill, because, shesaid, the commercial mill could no t clean it wellenough. One woman who was using the mill inHA said she used it most times, but it was notquite fine enou gh, so she sieved it afterwards athome with the masaf. So in some cases the

milling process is a combination of householdand mill, either before the grinding orafterwards.

For several women it seemed that, if they hadno money for the commercial mill, thealternative was hand-grinding with the stone,rather than the free camp mill (2.2.2). Some saidthey would hand-grind if they were makingshuuro, but take it to the commercial mill forenjera. For sorghum and maize when they hadit, they were more likely to use the stone thanthey would for wheat, although, of the three

cereals, maize is considered the most difficult tohand-mill with the stone.

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Because of the difficulties encountered incamp-level milling and those anticipated inregional-level milling (2.2.2), WFP recentlyinvestigated the possibility of providing hand-grinding mills which would be used by groupsof women from 5-10 households on a co-operative basis and/or for income generation.The maximum capacity of these mills would be4kg/hour. The investigations into appropriatetypes of mill found that the type availablethrough a NGO in Addis was not good forsorghum and was probably not durableenough. Alternative sources in Kenya weresought, but the investigation itself was time-consuming and expensive, and the procure-ment and importation of the large quantityrequired would also be expensive, and it wasunlikely that the supplier could meet thedemand.

2.2.2 Camp-level millingMilling at camp levelis available. In all camps atleast one mill is provided free of charge, bu t themaximum daily capacity of each is 50-750kg.UN HCR was responsible for camp-level m illinguntil 1996, when W FP took over. WFP pays forfuel, maintenance, guards, and any otherrunning costs incurred , but the imp lementationof the service is the responsibility of ARRA.According to one agency key informan t, th e KBmill broke down several weeks ago but wasworking only intermittently before that, eventhough itwas relatively new. In other ca mps notincluded in the study, new mills have beeninstalled, but they too have functioned belowtheir capacity, partly because it was severalweeks before they began operating after thenew installation (this may have been related toopposition from local commercial mill-ope rators) . Durin g the agency feedback sessionfor the study, it was clear that opin ions differedamong key agency staff over how well the mills

were functioning and the reasons forinadequ ate functioning. A monthly r epo rt ofmill-output is supposed to be produ ced, b ut noone present had seen such a report recently. Afield-level analysis by implementing andfunding agencies is probably required.

Th ere are num erous commercial mills in andaround the camps. An attempt by theresearcher to enter one in HA for the purposesof the study was firmly repelled. Itwas not clearwhy the mill operators appeared so hostile tovisitors. In KB the mills were busy on the day ofthe researcher's visit. People hand over theirgrain and are given a numbered receipt, which

they submit to obtain the flour. The operationlooked speedy and efficient. The cost wasaro un d 200Ssh (0.17EB) for about 1kg.

There were no overt complaints during theinterview about the milling capacity available inand around thecamp. Wheat was usually said tobe the pre ferred staple, even though itis not theeasiest to hand-mill (sorghu m being the easiest,then wheat, then maize). The reasons for thiswere p robably a combination of a desire to givethe answ er they tho ugh t would be most likely toinfluence the food basket in the way theywanted, the higher market value of wheat overother cereals (at least seasonally), and the factthat wheat is a little more versatile (suitable formaking samosas and bread). The availability ofmilling facilities was not raised by women as an

issue or major co nstraint.In both camps some women said they weretoo busy to go to the free camp mill, which wasfar from their section, and the free camp mill inKB was working only sometimes. InKB, womentend ed to say that when it was working it mad ethe flour too co arse, while in HA they said it didnot spoil the g rain. It m ay be that those who liveneare st to the mill tend to use it most, bu t in HAmany were choosing the commercial mill forreasons which were not clear. Some spoke ofcertain ca mp res idents not being eligible; others

said the quality of the flour was poor, b ut o therssaid it was good. In both cam ps peop le said thefree mills were busy for the first few days after adistribution, because that was when the wheatwas available. This implies tha t the free m ills donot operate until or unless they have a lot ofcustom ers at one time, as milling small amo untssporadically is not economical in terms of thefuel. However, if it was the case that the millsoperated only around distribution time, thatdoes not explain why in both places the smallcomm ercial mills were doing plenty of business

every day of the researcher's visit, irrespectiveof when th e distribution had taken place.

In KB the operator of the non-functioningmill said on the rese archer 's first visit that it wasnot working that day because the people werewaiting for the next wheat distribution, whichwas already late. He said tha t if the re was at least25kg to be milled, they could start the ma chine;but if it was smaller amounts, they had to waitfor several people to turn up. However, on asubsequent visit, immediately after a wheatdistributio n, it was still not in use and the re wasno sign even of prospective customers. Thistime, he said the mill was not used because it

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spoiled the grain: it milled too coarsely if lessthan 50kg was entered. He also said that therewas a prob lem of fuel.A number of women saidthat the mill worked only sometimes, and whenit did, it did not grind finely enough forsamosas, which a num ber of them were mak ingfor sale. Some said it did no t makeenjera, othersthat it did n ot makeshuuro.

In HA one of the free cam p mills was visited.It looked in good condition and there wasevidence of wheat flour which looked quitefinely g roun d. T he mill was locked up when theresearcher arrived. The operator said that therewere no customers because wheat had no t beendelivered recently. However, there was acontinuous sound of commercial millsoperating around the camp, and the womeninterviewed all said that they used thecommercial mills.

2.2.3 Regional-level, millingThe nearest large mill is in Dire Dawa. Thecapacity was quoted variously from 260MT/month if working only8-hour days (morethan double with 24-hour shifts) to as much asl,200MT/month. In any case, even with 24-hour operation, the current monthly require-ment of WFP for the Eastern camps(3,500MT/month) would not be met. Eventhou gh there a re oth er mills in Dire Dawa, their

capacity is less than that of the large mill. WFPhas considered milling at the national orregional levels in the past, but found it was notfeasible with this level of capacity. Ther e is morecapacity in Addis Ababa, bu t this would increasethe internal trans port costs considerably, as thegrain from the ports to the Eastern camps doesnot pass thro ugh Addis.

Another constraint in addition to millcapacity is that, for the last year at least,WFP hasnever had more than a two-month advancesupply of grain in-country for the Eastern

camps. There is a problem of supply due todonors' inadequate commitments to thisprogramme. In recent months, WFP has beenfunctioning in a 'hand to mouth' fashion,borrowing from other organisations who havegrain available; but loans can be agreed onlyagainst the shipping information number (i.e.proof that the WFP supply to repay the loan isalready on the high seas). Thus most of thegrain going to the Eastern camps is truckedstraigh t from the p orts (Assab or Djibouti) to thecamps; or, if borrow ed, it comes from Nazrat (c.

one hour east of Addis Ababa) to Dire Dawa.There is no buffer stock in Dire Dawa or Jijiga.

This makes the feasibility of milling regionallyextremely problematic, even if there wereadequate milling capacity, because milling andfortification would involve off-loading, de-bagging, monitoring of the whole process andthen re-bagging and re-loading. This wouldrequire more time, and so adequate advancesupplies of grain in-country would need to beguaranteed to avoid serious delays indistribution to the camp s. It would also increasethe cost of internal transp ortation considerably,as would a similar optio n of milling in Addis.

2.2.4 Blended-food production and fortification'The blended food distributed to this populationis Famix, a pro duct of the Faffa factory in AddisAbaba, established since the mid-1970s toproduce blended fortified food for relief and

commercial purposes. For most of that time, itwas subsidised by government and supportedby UNICEF and WHO, among others. Fiveyears ago, with the change in government inEthiopia, the factory had to plan to become aprofit-making comp any, with no mo re subsidiesor tax exemptions.

The maximum capacity was said to be 50-70M T/24-hour day (i.e. working 24-h our shifts)for the roasting process, and up to 30MT/24-hour day for the extrusion process. In theorythis represents a maximum capacity of

lOOMT/day, but this is not being realised. Onereason given by the man agemen tis that the nextstage of the process, involving the sole ham me rmill, cannot match that capacity, so actualou tpu t will be less. They are not sure how muchless, as the extruders are still new, and thecommissioning period had just en ded. Accord-ing to oth er sources, a less specific reason is tha tmana geme nt capacity at presentis weak. Therehave been problems in meeting the schedule fordelivery of blended food to WFP, and thisresulted in only sporadic distributions in 1997

at camp level.During the tour and interviews with the

management for the study, there seemed to besome confusion about the vitamin/mineral pre-mix. The management said that they used tobuy in their own vitamins and mineralsindividually and store them in a speciallyventilated ro om . However, WFP specified 2-3years ago that for its orders the La Rochevitamin pre-mix should be used. In interview,the acting manager said that as this did notinclude minerals, these were bought separately

from a La Roche agent and mixed in with thevitamin mix. There appeared to be some

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confusion when trying to ascertain proportionsfor mixing. Howev er, thereis no way in-cou ntrythat the product can be checked against thesespecifications.

Another source of fortified blended food is

HCFM (Health Care Food Manufacturers),established six years ago by a former GeneralManager of the Faffa factory. It does use avitamin/mineral pre-mix direct from La Roche,containing all specified requisite items exceptcalcium, which is acquired and mixedseparately (because of its bulk). Unfortunatelythere is no capacity anywhere in Ethiopia toanalyse samples in terms of their micronutrientcontent, so quality control in-country in thisrespec t is not feasible.

The capacity of HCFM, which produces

'Tenamix', a blended food like Famix, is atpresent 20MT/24-hour day. However, capacitywill soon increase to 35MT/24-hour day, withthe acquisition of one more hammer mill androaster. Currently they have no extruder, but anew plant is being planned in another part oftown.

WFP's most recent order of C.800MT hasbeen split between the two companies, 50:50.WFP's monthly requirement for the Easterncamps is 260MT for the general ration and90MT for the T FP/SFP/BFP, making a monthly

total of 350MT .Specifications of Famix and Tenamix areincluded in the appendices of the main rep ort.

ConclusionUse and acceptability of blended food asprovided in the general ration was in one sensedifficult to ascertain, since it had been suppliedonly twice. The camp residents were used toreceiving it only through the selective feeding

programmes. In 1996 blended food wasintroduced into the planned ration, but notprimarily to add ress m icron utrien t deficiencies.On e of the main reasons for its introduction wasnutritional, as part of a revised food basketwhich aimed to meet more of the nutritionalneeds of the camp population, given theapparently poor nutritional status in some ofthe camps in mid-1996. It was also part of theplan to diversify the food basket to reduce theamount of grain ration being sold to obtainother items. There seems to have been little orno public information around that time todistinguish blended food from the staple grain,

to give advice on how to cook it, or how todistribute within the family all of which isimportant if refugees are to understand thepurpose of blended food as a strategy forpreventing micronutrient deficiencies in thewhole populatio n, as distinct from a therap euticnutritional intervention for malnourishedchildren. Once the blended food is beingdistributed regularly to this population, theywill be receiving a plain Famix, which issupposed to be eaten by all the family, and aFamix pre-mix, which is targeted at childrenunder 5 years. It is unlikely that those distinc-tions will be m ade either by the refugees or bythe agencies and camp officials.

Th e mixed messages abou t food preferences,particularly with reference to cereal foods, that

were received from interviewees and keyinformants reflect the factors which act to shapepreference and shifts in preference. Theyinclude resale value, perception of nutritionalvalue, and recognition of, familiarity with, andconfidence in cooking the food item. Blendedfood in this context appears to have hadintrinsically no features which would lead to itsrejection by refugees, except if it were perceivedas a substitute for an item (or a part-substitutefor an item) which they would value mo re.

The political complexity of this refugee

situation inhibited the study in a number ofways. There was the wider political context ofSomali region 5, whichis considered by some tohave potentially secessionist aspirations, withinthe relatively new Ethiopian federal state,meanwhile being supported (strongly ifindirectly) by the food aid to the refugee camps.

At the camp level, ther ewas mu tual suspicionand resentment between the remaining aidagencies and camp residents. There is a longand complex history concerning issues ofregistration, repatriation, and resettlement of

returnees. Many camp residents seem toperceive the agencies as neglectful of theirneeds and offering inadequate support, whilethe agencies perceive the refugees as milkingthe system and enjoying a prolongeddependency which for many is no longerappropriate, given that return to northernSomalia is now possible.

There was particularly a considerable senseof grievance related to the am oun ts in the foodbasket and its unpredictability from month tomonth, although, as Farah (1994b) points out,

in terms of food security, compared withunreliable and supp leme ntary activities such as

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petty trad ing , selling firewood etc., 'its reliabilityaffords it special significance'. It has beensupplied to this population now for nine years.

The many commercial and business-vestedinterests in and around the camps in the regionare a major factor in all programming. Theexistence of these powerful interests probablymeant that three issues arising from the fieldwork were very difficult to elucidate at the time,namely the monitoring of distribution andrefugees' knowledge of entitlement; the sale ofFamix in large quantities; and the poorperformance of the free camp mills in contrastto the functioning of the commercial mills.

Notes1 'Somaliland' in this textis used to denote the

bord ers of the former British Somaliland a ndof the subsequent North-West region ofindep ende nt Somalia. Itis used in the tex t for

convenience, and its use does not imply anyopinion about the legal status of the ter ritory.The term 'Somali' is used to denote those ofethnic Somali origin, whe ther their residenceis Ethiopia or Somalia.

2 The GOE/UNHCR 'cross-mandate approach',c.l 992, was an atte mp t to combine vo luntaryrepatriation of refugees, resettlement of return-ees, and development aid to the Ogadenregion. It had only limited success, and theinflux of refugees in 1994 disrupted plans.

3 A film for L WT, m ade in early 1990, includesa short discussion about the possible additionof vitamin C to the water supply which wastankered in to the camps and then stored inand distributed from rubber-lined tanks.However, this was not done. The reasonswere not make clear in the film and are notmentioned in secondary sources consultedfor this study.

4 At the time of the study , 1EB = 1,200 SomaliShillings (and 500 new Somaliland Shillings).

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Append ix 3(b): Location of camp s, Somali R egion

km 0 50 100 150

D a r w o n a j i A \ j -e f e r i b e r

Jijiga \ Hargelsa

KebribeyahA.^Hartisheik

Harshin

C a m a b o k e r ^ *Rabasso

ETHIOPIA

Refugee camps

Main towns

International boundaries

SOMALIA

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acceptability and use of cereal-based foods in refugee camps: case-studies from nepal, ethiopia, and...

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