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The 10 Most Underreported Humanitarian Crises of 2020

A woman stands in a field of plans with a hoe on her shoulder.

10.1 million Zambians are in need of humanitarian assistance as a result of severe drought and flooding. Photo: Karin Schermbrucker/CARE

10.1 million Zambians are in need of humanitarian assistance as a result of severe drought and flooding. Photo: Karin Schermbrucker/CARE


2020 was a year no one predicted. With the mother-of-all crises rocking every corner of the world, affecting virtually every country and city on earth, COVID-19 up-ended life as we knew it. Over a million lives have been lost, millions of jobs have been wiped out, extreme poverty has risen and economies have stalled.

As governments in the West struggled with high death tolls, numbers of infections began to rise elsewhere on the globe. When spring came around, the Black Lives Matter protests reverberated around the world, a global call for justice, equality and decency. The inequalities of countries traditionally deemed ‘developed’ were exposed. We learned that we are all interdependent; our lives and wellbeing are intertwined with the lives and wellbeing of others.

But some things remained the same in 2020. Now in its fifth year, our report continues to highlight the world’s most under-reported humanitarian crises. Although there are new entries on the list, the ranking continues to be dominated by crises in Africa. The Central African Republic, Madagascar, Mali and Burundi have appeared on the list across multiple years, yet the people in these countries don’t get sufficient media attention. The combined news coverage on these 10 crises was less than that of entertainer Kanye West’s bid for the US Presidency, or the Eurovision Song Contest. Further to this, these 10 crises received 26 times less attention – in terms of online news articles – than the launch of PlayStation 5.

For millions of individuals, COVID-19 has simply made a bad situation worse.

In mainstream news reporting, it is the global pandemic that has dominated headlines. Once its potential for widespread infection and health system chaos was understood, countries – and their media – turned their focus inwards; on protecting citizens and prevent
ing the virus from spreading. But as we’ve learned in 2020, humanitarian crises don’t respect borders, race, religion or global pandemics. For the people surviving in these crises, COVID-19 is simply an additional threat to a host of others – from the global climate crisis; to deadly diseases such as tuberculosis, malaria, and HIV; to the unavailability of food and clean water; to conflict, violence and abuse. For millions of individuals, COVID-19 has simply made a bad situation worse.

A wan standing outside carries a bundle of firewood on her head.

At the end of 2020, the United Nations (UN) estimated that at least 235.4 million people would need humanitarian assistance in 2021.[3] The effects of COVID-19, coupled with the growing impacts of climate change have increased the number of people in need by 40 percent [4] – the single largest increase ever recorded in one year. This historic level is challenged by a marked decrease in bilateral development aid as donor governments attend to the economic and social fallout of COVID-19 in their own countries. As of December 2020, UN OCHA states that the humanitarian response plans and appeals for the past year were only 44.7 percent funded [5]  and adds a new estimation of around USD 35.1 billion needed for 2021. [6] Unless these neglected and forgotten crises are attended to, every country on earth is vulnerable – because no one is safe until everyone is safe. To quote UN Secretary-General Antonio Guterres: “We are only as strong as the weakest health system in our interconnected world.” [7]

Let’s be clear: The quoted “silence” is very much due to the limited perspective of the Global North. While figures outlined in this report may be staggering, in every crisis quoted, there is humanity and strength

We acknowledge, and must bear witness to, the suffering. But we should also all pay tribute to those who survive the silence, fight injustice and overcome the biggest obstacles.

A woman holds her chin in her hand while standing outside.
Photo: Irenee Nduwayezu/CARE

1. Burundi

Scarcity of arable land and natural disasters drive hunger

A relatively peaceful transfer of power following years of political turmoil is seeing an influx of Burundian refugees returning home from Rwanda and Tanzania. [8] In May 2020, Burundi held general elections, marking
a major step towards ending the socio-political crisis that had gripped the country since 2015. However, the situation remains fragile as substantive social and political challenges in Burundi and the region remain unaddressed. UNHCR expects at least 50,000 Burundian refugees will return home in 2020. [9] But Burundi, the fifth poorest nation in the world, [10] is having a hard time absorbing returnees. With a surface area of 27,834 km2, Burundi is one of the most densely populated countries in Sub-Saharan Africa. [11] Being resource-poor with an underdeveloped manufacturing sector, Burundi’s economy is predominantly agricultural. Over 90 percent of the population depends on subsistence small- holder farming. [12]

Extreme weather events, combined with political instability and insecurity since 2015 have uprooted over 135,000 people within Burundi’s borders [13] (of this figure, 83 percent were displaced due to natural disasters). [14] Displacement, high population density, large numbers of returnees, and close to 80,000 refugees from the Democratic Republic of Congo (DRC), [15] are contributing to competition and disputes over land. [16] As a result, the poorest and most vulnerable sections of the population, mainly women, are pushed to marginal land. [17]

Given that Burundi is ill-prepared for major emergencies, the country has the highest rates of chronic malnourishment in the world. Pre-COVID (2016/2017), the national average stunting rate was 56 percent – well above the emergency threshold of 40 percent. [18]

2.3 million Burundians are in need of humanitarian aid

In 2020, landslides and floods caused by torrential rains and border closures brought on by the pandemic have corroded livelihoods and led to intense hunger among the poorest Burundians, especially those dis- placed. [19] As of December 2020, over 2.3 million Burundians are in need of immediate humanitarian assistance, including food aid. [20]

The global pandemic has disrupted trade, especially informal commerce, in border areas and urban centers, and has restricted cross-border movements. This has led to loss of jobs and remittances to rural areas that could finance agricultural production and other commercial activities. Malaria epidemics and the risk of Ebola from neighboring DRC compound an already precarious situation. [21] As in all emergencies, women and girls are the most affected. Not only do they bear additional financial and domestic responsibilities, but many also endure daily violence and insecurity. Pre-COVID, women played a major role in Burundi’s national economy, representing 55.2 percent of the workforce, with the majority working in the agricultural sector. [22]

CARE Burundi has developed a Women’s Empowerment Program focused on rural areas, but with a nationwide advocacy platform for women’s rights. Additionally, CARE hosts youth programs to improve Sexual and Reproductive Health and to reinforce economic empowerment and gender equality. CARE is supporting youth-led locally-focused innovations for COVID-19. They include: working with community-based women groups to deliver cash assistance, using art to build COVID-19 awareness and prevention behavior practices, as well as working with internally displaced communities to introduce the construction of public showers using recycled plastics. CARE Burundi also promotes social cohesion and initiatives to end gender-based violence and gender inequalities through its ‘model men and model couples’ program interventions.

Two girls look up directly ahead.
Photo: Nancy Farese/CARE

2. Guatemala

Raising the flag of desperation

In Guatemala, whole communities are waving the white flag. [23] Since April 2020, thousands of Guatemalans across the country have begun flying white flags in the streets and from their windows; signaling their dire need for food. For the 10 million people living below the poverty line in this Central American country, COVID-19 has made a serious food crisis worse. [24]

When the pandemic occurred, it was estimated that some 3.3 million people within a population of 14.9 million were in need of humanitarian aid. [25] The Humanitarian Needs Overview, published in March 2020, showed that high levels of poverty, and several consecutive years of drought, had led to high levels of food insecurity, especially along the so-called Dry Corridor [26] – a tropical dry forest region on the Pacific Coast of Central America. According to the 2019 World Risk Report, Guatemala is among the top ten most vulnerable countries prone to natural hazards. [27] Since 2015, protracted droughts and sparse, yet torrential rains have battered the country, resulting in continual crop failures and the death of livestock. [28] And now, at the time of writing, Guatemala is reeling from the aftermath of two back-to-back category four storms, Iota and Eta. [29]

Guatemala – considered a middle-income country by the World Bank – has had continued, moderate (3.5 percent) growth over the last five years. This economic stability, however, has not made much of a dent in poverty and inequality. [30] Even before COVID-19, Guatemala had the sixth highest rate of chronic malnutrition in the world with close to half (47 percent) of all Guatemalan children chronically malnourished and at risk for stunting. [31] Also worrisome is the national maternal mortality rate which stood at 108 deaths per every 100,000 live births pre-COVID. [32] Around thirty-five children out of every 1,000 born in Guatemala die before the age of five. [33]

10 million people live below the poverty line

In April 2020, the UN warned that COVID-19 lockdown measures were aggravating the seasonal hunger in eastern Guatemala. Among the most affected households, many have lost all or part of their incomes as a result of curfews and business closures. Most Guatemalans work in the informal sector without any social protection. [34] The decrease in remittances from family members working abroad has been an additional blow for many vulnerable families. Remittances are a lifeline, particularly for women, who make up 69 percent of the recipients. [35] In desperation, migrants continue to seek a way to the United States, [36] despite the pandemic, and despite American law which in effect bars their entry. Pervasive poverty, high homicide rates driven by gang violence, and corruption – factors that pushed migrants to flee Central America pre-COVID – have not eased during the pandemic. Despite COVID-related blockades, it is reported that criminal groups are using confinement to strengthen their control; intensifying extortion, drug trafficking, and violence. [37] Violence against women and girls has also increased during the pandemic, with 319 women killed, and over 5,600 reports of sexual violence between January and October 2020. [38]

Women and girls typically suffer the most in emergencies, yet they are often at the frontline, providing humanitarian support to their communities. In Guatemala, local women’s organizations have partnered with civil society organizations to identify families in need, collect donations and distribute basic food items to marginalized communities. [39] CARE Guatemala is implementing its COVID-19 response plan and is providing necessary support in the areas of food security, economic recovery, and gender-based violence. Together with partners such as Movimiento de Mujeres Tz’ununija and CICAM, CARE Guatemala is also supporting communities affected by the tropical storms Eta and Iota with food, water, hygiene items including personal protection equipment to prevent COVID-19, and protection services.

A woman sits outside.
Photo: Sebastian Wells/CARE

3. Central African Republic

The world’s forgotten crisis

The Central African Republic (CAR) marked a milestone in 2020: Sixty years of independence, but there was little to celebrate in this thinly populated country of 4.9 million people. [40] A perennial entry on the Suffering in Silence list, CAR remains in the throes of one of the deepest, most damaging humanitarian crises in the world.

Despite its significant mineral deposits that include gold, diamonds and uranium, as well as rich arable land, CAR sits at second last on the 2019 Human Development Index. [41] Pre-COVID, more than 71 percent of its population lived under the international poverty line of USD 1.90 per day. [42] Basic services are lacking throughout CAR, and, in many areas, people depend entirely on humanitarian assistance. [43]

Ravaged by decades of armed conflict, rampant poverty, an unending spate of natural disasters, and a global pandemic, CAR today stands on a precipice. The UN warns that in 2021, 2.8 million Central Africans – more than half of the population – will need humanitarian assistance and protection. Of these, the survival of 1.93 million people is at risk. [44]

Since 2012, the country has been held in the grip of a civil war. Human rights violations are a daily occurrence, including assassinations, torture and rape. The humanitarian situation is further impacted by fragile governance, poverty, and the plundering of natural resources. In February 2019, under the auspices of the African Union, the government and 14 armed groups signed a historic peace deal to bring an end to armed conflict. Despite this, violence is ongoing, with attacks even on UN peacekeepers and civilians. [45]

One in four Central Africans is displaced in country or in a neighboring country

Conflict continues to force many families to abandon their fields. [46] One in four Central Africans is displaced either within the country or in a neighboring country, and the numbers of returnees have dwindled. [47] These displacements, combined with poor rains during planting season, and along with invasions of fall army- worms and locusts, have put 1.93 million people at risk of starvation. Additionally, difficulties in supplying markets as a result of COVID-19 containment measures, and numerous border controls on goods from Cameroon have driven up the prices of basic foods like rice, oil and sugar. [48]

The pandemic has also exacerbated protection issues. Pre-COVID, the humanitarian alert system – which covers just 42 percent of the country – would receive hourly reports of violence against women and girls. Since the introduction of COVID-19 containment measures, the number of cases has nearly doubled. Children also continue to be at risk of abuse. A quarter of all families fear their children may fall prey to sexual violence, forced labor or recruitment by armed groups. [49] CAR is also one of the most dangerous countries for humanitarians in the world. Between January and the end of September 2020, humanitarian workers were affect- ed by about one incident per day, with two aid workers killed and 21 injured. [50]

Frustrated by continuing violence, groups of women are coming together across the country to forge peace and collective healing at a community level. One group, Femme Debout (Woman Standing), brings together women of all religious and ethnic backgrounds. The group fosters a spirit of entrepreneurship and independence by helping members develop new livelihoods and new lives. [51]

an elderly women walks on the street while holding a cane.
Photo: ©OCHA/ M. Levin

4. Ukraine

Elderly left to fend for themselves

In mid-2020, videos of newborns ‘stranded’ in a Ukrainian hotel made world headlines. The babies, children of foreign couples born to Ukrainian surrogate mothers, couldn’t join their parents because of a COVID-19 lockdown. [52] Ukraine is one of the poorest countries in Europe, and while the story highlighted the plight of impoverished Ukrainian women willing to give birth for pay, the larger humanitarian crisis affecting more than five million in the eastern part of the country remained largely ignored this year.

Even before the COVID-19 pandemic, the UN estimated that 3.4 million Ukrainians in the Donbas region would need humanitarian assistance in 2020. [53] Already enduring so much, the COVID-19 pandemic has only intensified the challenges faced by the affected populations. The situation is especially dire along the ‘contact line’ that divides Ukrainian government-controlled land from separatist-run areas. In spite of repeated ceasefire agreements, critical civilian infrastructure, such as water and electricity systems, is frequently damaged. [54] The more than 420-kilometer-long contact line – equivalent to the length of the French-German border – is one of the most mine-contaminated areas in the world. [55]

Civilians, and in particular the elderly and disabled, bear the brunt of the conflict. Many younger and able-bodied people have moved to other parts of the country, leaving more vulnerable groups behind. Senior citizens and people with disabilities make up 30 percent of people living in the conflict areas and account for more than 40 percent of the 70,000 people living in government-controlled settlements. There they are isolated due to insecurity and damage to road infrastructure, and rely on humanitarian aid such as mobile medical care. [56]

3.4 million people in need of humanitarian assistance

Fear of shelling, violent clashes, and the threat of landmines and explosive remnants of war are the daily reality for those living on either side of the contact line. Many people are increasingly affected by mental health issues, both due to the fear of violence as well as the long-term socio-economic impacts of the conflict. Once considered the industrial heartland of Ukraine, Donbas has experienced a sharp decline in economic activities since 2014. The stress associated with the conflict has been further exacerbated by the COVID-19 pandemic and restrictions, which have limited people’s ability to cross the contact line, access basic services and markets, and receive the humanitarian aid they normally rely on. [57]

In late September, wildfires raged for a week in the government-controlled areas of Luhanska. Over 32 settlements along the contact line were affected. About 500 homes went up in flames, nine people were killed, and 19 injured. [58] It is feared that those who lost their homes will have to spend the winter in temporary shelters. [59]

Gender-based violence is a serious problem in Ukraine with about three-quarters of Ukrainian women hav- ing experienced some form of violence since age 15. [60] According to UNFPA, the situation worsened during the pandemic with the national hotline on domestic violence reporting a 72 percent increase in the second month of quarantine compared to the pre-quarantine period. [61] The government, however, is committed to supporting programs that aid and protect survivors of violence. During the pandemic, many of these services moved to new platforms. For instance, survivors of violence can now get help through mobile apps and other silent channels. [62]

A girl stands in front of a river with a small island visible behind her.
Photo: Lucy Beck/CARE

5. Madagascar

Battered and bruised by climate change

Geologists believe that 165 million years ago, Madagascar was connected to Africa, but began to drift over time. As a result, it evolved in isolation as evidenced by its unique fauna and flora. The Indian Ocean island appears on the Suffering in Silence list for a third year in a row.

Every year, thousands of Malagasy people are affected by natural disasters but their situation is rarely report- ed in the international media. In this country, where three quarters of the population (or around 20 million people) live under the poverty line, [63] it would seem deprivation is the norm. Yet the grave challenges faced by the island nation hardly ever make world headlines.

Madagascar is blessed with a wealth of natural resources including vanilla, cloves, titanium, cobalt and nickel, and a tourism industry driven by its unique environment. Over 90 percent of its wildlife is found nowhere else on earth. However, the country is also severely affected by climate change; experiencing recurrent, protracted droughts, and an average of 1.5 cyclones per year – the highest rate in Africa. [64] An estimated one fifth of Malagasy people – around five million people – are directly affected by recurring natural disasters, including cyclones, floods and droughts. [65] Additionally, due to its low vaccination rates and poor sanitation and hygiene, Madagascar is regularly hit by epidemics. Malaria as well as bubonic and pneumonic plague are endemic to the country. [66]

Almost every second child suffers from stunting in Madagascar

In 2020 alone, the Malagasy people faced several emergencies: COVID-19 across the country; [67] flooding in 13 districts [68] that killed 35 people; [69] malaria in the southern regions that killed 398 people; [70] dengue in the central west; and the return of severe drought in the south. [71] While the measles epidemic of 2019 is mostly under control, there is high possibility that a new epidemic could begin again.[72]

In the south of the country, the effects of prolonged drought and COVID-19 have worsened food insecurity, putting close to 120,000 children under the age of five at risk of acute malnutrition, with close to 20,000 at risk of starvation. [73] Pre-pandemic, Malagasy children had the fourth highest rate of chronic malnutrition in the world, with almost every other child under the age of five suffering from stunting. [74] Maternal mortality rates were also among the highest in the world, while Madagascar ranks in the bottom four countries on the African continent in terms of access to clean drinking water. [75] With trade and tourism having been disrupted by the COVID-19 crisis, economic growth is expected to fall to 1.2 percent, compared to the rate of 5.2 percent predicted prior to the outbreak. [76]

In Madagascar, CARE helps the most vulnerable communities in several regions to prepare and face natural disasters. With its local partner SAF/FJKM, CARE supports innovative financing and insurance solutions against climate risks and disasters. To address the effects of the COVID-19 pandemic, CARE supports public services and helps the most vulnerable populations through a cash transfer program, rehabilitations of infrastructures in health centers, access to water and hygiene promotion, especially for school children. In 2020, CARE also provided emergency aid to communities affected by flooding earlier in the year by building or rehabilitating their houses and strengthening their capacities to resume agricultural activities.

A woman stands underneath an open air evacuation center while holding an object wrapped in fabric.
Photo: Joseph Scott/CARE

6. Malawi

Suicides and child marriages on the rise

In this small, peaceful country in Southern Africa, there is growing concern about the rising numbers of suicides. Natural disasters, pest outbreaks, extreme poverty and now COVID-19 are pushing an already highly stressed population to the brink. According to reports from the Malawi police service, there has been a steep (57 percent) increase in suicide rates in 2020. [77]

The UN estimates that 8.3 million Malawians require humanitarian assistance in the wake of the COVID-19 pandemic. [78] In this, one of Africa’s most densely populated countries, seven out of ten people live below the poverty line. [79] With slightly over half the population (51 percent) under the age of 18, [80] Malawi also has one of the lowest per capita Gross National Incomes in the world, at just USD 320 (2018). [81] Its economy – which is heavily reliant on rain-fed agriculture – is extremely vulnerable to shocks. [82]

Malawians are still recovering from the effects of Cyclone Idai, which in March 2019 submerged vast areas of farmland, just a few weeks before the start of the main harvest season. [83] In recent years, the country had made significant progress bringing acute malnutrition rates from 4.1 percent in 2016 down to less than 1 percent in 2019. [84] COVID-19’s disruption of supply chains is threatening these gains by exacerbating the food crisis. [85] The World Food Programme (WFP) estimates that about 2.6 million people need food aid as of November 2020. [86] Further aggravating the situation are Malawi’s HIV/AIDS infection rates (at 9.6 percent), [87] low primary school completion rates (at 51 percent), [88] high levels of stunting (at 37 percent for children under five), [89] and more than 75,000 refugees from the Democratic Republic of Congo (DRC) and other neighboring countries. [90]

2.6 million people need food aid,

The closure of schools during the COVID-19 lockdown has led to rising rates of child marriage and abuse. Between March and July 2020, there were 13,000 cases of child marriages and over 40,000 cases of teen pregnancies according to a government-led rapid assessment. The figure suggests an 11 percent increase in underage pregnancies since 2019. [91]

In Malawi, CARE is providing gender-based violence training to service providers across victim support units as well as supplying them with mattresses and bedding, and equipping staff with COVID-19 personal protective equipment, including masks and sanitation supplies. Additionally, CARE is leading a group of international aid organizations on gender and food security programming, and there is continued advocacy on women’s leadership and participation in COVID-19 decision-making bodies. Together with the Ministry of Education, CARE targets out-of-school adolescents via radio programs. CARE Malawi also supports village savings groups to empower women and youth economically. During the pandemic, these groups have begun working with CARE to sensitize the larger community about COVID-19.

Three women sit on a bed. The young women in the foreground studies a book.
Photo: ©Shaista Chishty/FotoDocument/CARE

7. Pakistan

Conflict, violence and the ‘triple threat’ of 2020

In the world’s fifth most populous country, disasters stem from temporary displacement due to conflict, the effects of climate change, and pervasive poverty. Pakistan is highly prone to natural hazards, including flooding, avalanches, and earthquakes. Each year, at least three million people are affected by natural disasters. [92] Weak infrastructure, ineffective warning systems, and remote terrain exacerbate the damage and hinder the humanitarian response.

In 2020, the country faced a triple disaster with COVID-19, locust swarms and unprecedented levels 
of urban flooding. While in the grips of the pandemic, Pakistan suffered its worst locust plague in history, forcing the government to import wheat for the first time in six years. [93] Further decimation of crops and livelihoods occurred when the August monsoon rains submerged large parts of the country, including Karachi, Pakistan’s most populous city and economic hub. [94] The floods killed over 400 people and displaced 68,000 others. [95]

The provinces of Baluchistan and Sindh, which are particularly prone to droughts, floods, cyclones and locust infestations were already highly vulnerable before the floods. Sindh has the highest rate of rural poverty in the country. [96] Crops, food supplies and livestock destroyed in 2020’s extreme flooding will take many years to recover. The triple disaster has left approximately 6.7 million Pakistanis in need of food and agricultural assistance. [97] A WFP-FAO joint analysis conducted during the pandemic found 25 percent of households (around 49 million people) are food insecure and 10 percent (21 million people) are in urgent need of food aid. [98] Even before this, malnutrition was prevalent across Pakistan, with four out of every ten children under the age of five suffering from stunting. [99]

49 million people – 25% of the households – are food insecur

For vulnerable communities food insecurity is heightened by pervasive poverty and an overburdened health system. [100] And there are nearly 1.4 million Afghan refugees in the country [101] – one of the largest displaced populations in the entire world – adding pressure to already strained public infrastructure such as schools and hospitals. In 2019, an HIV outbreak was declared in the district of Larkana in Sindh province but according to UNFPA, Pakistan does not have sufficient supplies of anti-retroviral medications; making the spread of the disease a continued threat. [102]

Pre-COVID, Pakistan was among Asia’s five fastest emerging economies according to World Bank statistics. But COVID containment measures have contributed to a decline in Pakistan’s real GDP in 2020. The virus is also widening the gender imbalances in the country, raising concern that some of the gains that women have fought to achieve will be lost. [103] Pre-COVID, Pakistan ranked 136 out of 162 countries on the Gender In- equality Index. [104] Many Pakistani women cannot easily access basic health, legal and social support services. And although Pakistan has enacted legislation against gender-based violence, implementation of these laws is a challenge. [105] According to the 2017-2018 Pakistan Demographic and Health Survey, more than a quarter (28 percent) of Pakistani women have experienced some form of physical or sexual violence. [106]

CARE Pakistan works in some of the most remote and logistically-challenging areas to address the underlying causes of poverty, with special focus on women, children and the most marginalized. CARE and its local partners responded to the locust infestation in Pishin, Baluchistan province. CARE has also supported the government’s response to the COVID-19 pandemic to strengthen the public health sector and to improve water and sanitation facilities. Over 40,000 people have been reached with radio messages on virus prevention in Peshawar city and newly merged districts. In Khyber Pakhtunkhwa province, CARE provided food and hygiene kits to over 13,000 of the most vulnerable individuals. CARE Pakistan’s regular programming supports health care, sanitation and clean water for vulnerable populations.

A woman stands in a field with a farming tool.
Photo: Makmende Media

8. Mali

Violence and COVID-19 fuel the humanitarian crisis

Renowned for being the land of the legendary city of Timbuktu, and several pre-colonial empires, the ancient West African country of Mali is in crisis today. Even before the pandemic, years of conflict, insecurity and poor governance, along with climate shocks and natural disasters had left a mark on this vast Sahelian country.

Eight years ago, an insurgency began in Mali’s north and has since spread to the country’s fragile center. Today, it even rattles neighboring Burkina Faso and Niger. The Central Sahel is under extreme stress. Violence, natural disasters and widespread poverty have pushed a record 13.4 million people in Mali, Burkina Faso and Niger in need of urgent humanitarian assistance. Of these, 7.4 million people are facing starvation and 1.6 million have been uprooted from their homes. [107]

The pandemic has worsened the humanitarian situation in Mali. Pre-COVID-19, close to half (42.7 percent) of nearly 20 million Malians lived in extreme poverty. [108] Mali’s social indicators were among the lowest in the world, ranking it 184 out of 189 countries on UNDP’s 2019 Human Development Index. [109] Security, which is critical for economic recovery and poverty reduction, remains fragile. Mali is currently in the aftermath of a military coup that toppled President Ibrahim Boubacar Keita in August 2020. The new transitional government has renewed hopes for peace, [110] but years of conflict and violence in the central and northern areas have displaced thousands of people and livestock, and in the rural areas of the south, where population density is highest, nine out of ten people live below the poverty line. [111]

live below the poverty line

live below the poverty line

Almost two-thirds of Malians are employed in the agricultural sector. With farming and cattle rearing severely disrupted by violence, natural hazards, and COVID-19 prevention measures, the number of people in need of emergency aid spiked from 4.3 million to 6.8 million between January and August 2020. In other words, according to the UN, one in three people in Mali need humanitarian assistance. [112] This includes 1.3 million people on the verge of starvation. [113]

The pandemic has also aggravated the situation for women and children. Mali is one of the most unequal countries in the world for women. It ranked 158 out of 162 on the Global Gender Equality Index pre-COVID. [114] Given that Mali is a landlocked country, COVID-19 prevention measures such as border closures are severely hampering regional trade, reducing women’s opportunities to earn money for themselves. Social distancing and movement restrictions in country add to the burden.

The pandemic is also aggravating the situation for children. The UN in Mali recorded 745 serious violations against minors in 2019 – the highest number since 2017. The violations included killing, maiming, rape and other sexual violence, as well as recruitment by armed groups. The total for the first three months of 2020 alone was 228 incidents. The UN also noted a sharp increase in forced displacement with over 137,000 Malian children removed from their families between January and May 2020. [115]

CARE and its partners such as the Malian aid organization YAGTU have been helping communities affected by drought, disaster and conflict with food security and nutrition. Between 2013 and 2019, CARE’s water, sanitation, hygiene and nutrition projects reached over 3 million people in Koulikoro, Segou and Mopti regions. As a result, children show a healthier body weight and stunting has decreased by 40 percent. Families are now 43 percent more likely to have clean drinking water. They are also twice as likely to treat their drinking water. Last but not least, women have more say: they are three times more likely to be involved in decisions on child health and on spending at home.

A mother and daughter stand outside in the sunlight.
Photo: John Hewat/CARE

9. Papua New Guinea

Resourcefulness in the face of challenges

Less than 10 kilometers from Australia’s most northern islands lies Papua New Guinea (PNG), one of the world’s most culturally diverse and naturally rich nations. It hosts over 800 languages and more than 1,000 distinct ethnic groups. However, in stark contrast to its neighbor, PNG is one of the least urbanized countries globally with the lowest life expectancy in the Pacific region. The island nation is prone to natural disasters. In 2020, it faced flooding, landslides and tremors in addition to the consequences of the global pandemic.

PNG is endowed with a wide array of mineral resources, including crude oil, natural gas, gold, copper, silver, nickel and cobalt, and produces a range of primary commodities such as: timber, cocoa, coffee, tea and palm oil. Challenges in development remain to date because of the rugged territory which makes transport difficult. The country’s population of more than 8 million is largely rural (87 percent) and highly dispersed; spread out across the highlands and over 600 islands and atolls. [116]

In 2020, the UN estimated that about 4.6 million people in PNG (more than half of its population) are in need
of humanitarian assistance. [117] Only 46 percent of the population has access to improved drinking water and some parts of the country face challenges in nutrition, lacking a balanced diet. [118]

Pre-COVID-19, PNG’s health system was already operating beyond capacity. [119] In July 2020, Port Moresby General Hospital – the country’s largest – launched a public appeal for face masks, gloves, hand sanitizer, and even blankets and laundry detergent. [120] Authorities are concerned that if COVID-19 were to take hold of the country, it would further weaken the healthcare system and derail efforts to combat endemic diseases such as tuberculosis, HIV/AIDS, malaria and polio, which reemerged in 2018. [121]

Almost every second child is stunted

Also endemic to PNG is malnutrition. Pre-COVID, almost one in two children (49.5 percent) were stunted. [122] This means that an estimated half a million children
in PNG will never reach their full growth potential. In a country where the majority of the population relies on subsistence farming to meet daily nutritional needs, [123] malnutrition among both children and adults was further impacted by the closure of fresh food and fish markets between March and June 2020 due to COVID-19 containment measures. [124]

PNG’s economy is driven by the extractives industries and agricultural commodities, fishery and forestry. But the economy is prone to shocks and has been negatively affected by COVID-19 restrictions and lower demand for commodities. As a result, Papua New Guineans are witnessing higher inflation and higher prices for basic goods. [125]

Among the population, women have been impacted hardest. Most market vendors are women and many have lost their incomes. Without the money they were bringing in before, their influence is sliding and they’re at greater risk of violence. [126] PNG has also one of the highest rates of sexual and physical violence globally, with nearly two out of three Papua New Guinean women having suffered some form of violence. [127] Overall, women here are less educated and have limited access to formal employment and essential services; placing the nation second to last on the UN’s Gender Inequality Index in 2019. [128] The government however, is committed to addressing these challenges and launched a national strategy to prevent and respond to gender based violence in 2017. [129]

To contribute to positive change, CARE engages in various programs across PNG with a focus on gender equality. We train health workers, strengthen service delivery and provide small-scale infrastructure improvements to remote and rural health facilities. CARE also works with the government, communities and teachers to increase the number of girls who attend school. All of CARE’s programs aim to strengthen the resourcefulness of the people of Papua New Guinea and to increase women’s opportunities to participate and thrive.

A woman sits outside with a bowl in her hands.
Photo: Karin Schermbrucker / CARE

10. Zambia

Extreme weather causing food shortages

Located in Southern Africa, Zambia, a large, peaceful country known for its copper mines and scenic beauty, is bearing the brunt of the global climate crisis. A total of 10.1 million, or about 56 percent of Zambians are in need of humanitarian assistance as a result of severe drought and flooding. [130]

Temperatures in the region have increased by 1.3 °C since 1960, while annual rainfall has decreased by an average of 2.3 percent per decade. [131] Recurrent droughts are putting the famous Victoria Falls under threat of drying up, [132] and Lake Kariba – the world’s largest artificial lake and Zambia’s primary hydroelectric power source – has dropped six meters in just three years. [133]

Whilst frequent power outages have negatively impacted the business sector, [134] the impact of drought has been particularly devastating for Zambia’s agricultural sector. The country has long been a large maize producer for the rest of Southern Africa. This year however, the Zambian government was forced to ban all ex- ports of grain, [135] while its neighbor, Namibia, declared a state of emergency. [136]

Zambians themselves are staring at acute hunger and malnutrition. As of July 2020, an estimated 2.6 million people were in urgent need of food aid. [137] Consecutive droughts, locust plagues and floods have left no crops to harvest. These, combined with livestock disease outbreaks, [138] and the adverse effects of COVID-19 movement restrictions, [139] have negatively impacted livelihoods. Presently, the country is battling a locust invasion that is putting 88,700 households in urgent need of humanitarian assistance. [140] A single swarm of locusts – and already multiple swarms have entered the country’s southern region – can eat as much food as 2,500 people in a day. [141]

Over 10 million people in need of humanitarian assistance

COVID-19’s disruption of world commodity markets has also pushed down the price of copper, of which Zambia is major producer. [142] The World Bank expects that the Zambian economy will contract by about 4.5 percent in 2020. [143] This will likely further hamper the delivery of social services in the country. As it is, about 70 percent of urban dwellers live in highly dense informal settlements with poor water supply and sanitation. [144] According to the 2018 Zambia Demographic and Health Survey, only 33 percent of Zambians had access to basic sanitation services. [145] In the event of a drastic increase in COVID-19 cases in Zambia, pregnant and breast-feeding mothers would be particularly at risk as the country has the highest fertility rate in Africa with an average of 2,062 births per day. [146] The country also has some of the highest child marriage and teenage pregnancy rates globally. [147]

CARE is providing a gender-sensitive approach in its drought response and resilience programming to ensure the most vulnerable groups such as women and girls are prioritized and empowered, and that their specific needs are met. This includes working with women to set up savings cooperatives. CARE Zambia is also training 210 people in protection monitoring for food distribution in six districts, as well as assisting in rehabilitation and drilling of boreholes, hygiene promotion and provision of hygiene items for women and girls; as well as supporting the nutrition of 130,000 people. CARE has also provided food, water, sanitation and hygiene support, other emergency relief and livelihoods support.

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Using the media monitoring services of Meltwater Group, CARE International analyzed those humanitari- an crises that received the least media attention in 2020. More than 1.2 million online media hits were captured in the time period from January 1 to September 30, 2020.

We identified countries in which at least one million people were affected by conflicts or natural disasters. The result was a list of 45 crises that were analyzed and ranked by the number of online news articles mentioning the crisis, starting with the emergency that received the least amount of media attention at number one. The overall number of people affected by each emergency is derived from ACAPS, Reliefweb and CARE’s own data. The media analysis is drawn from online media coverage in Arabic, English, French, German and Spanish. Though not universal in scope, this report represents a trend of global online media attention. It seeks to contribute to a wider discussion between the humanitarian aid sector, media, policymakers and affected communities on how to jointly raise awareness and deliver aid to those in need.

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