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Suffering in Silence IV

Photo: Josh Estey/CARE

Photo: Josh Estey/CARE

Photo: Josh Estey/CARE

The 10 most under-reported humanitarian crises of 2019


In 2019, countries across the world were rocked by activists, demonstrating the potential for anyone to become or support a changemaker. Global movements have increasingly gone viral, spreading messages more quickly and widely than ever before.

Whether it was people participating in the #trashtag challenge [1], a Swedish teenager driving a revolution of the climate emergency or a massive wave of people protesting from Khartoum to Santiago to demand change from those in power – the outcomes were felt online and offline.

With so many people taking to the streets, what about those who remained silent? And with global trends in the spotlight, has the world also paid more attention to under-reported crises? In 2019, over 51 million people suffered in 10 crises away from the public eye. Meanwhile, a stock photo of an egg became the most-liked post on Instagram with almost 54 million likes [2]. Although for the average person on earth, life is better today than ever before, around 2% of the global population (160 million people) will require US$28.8 billion in humanitarian assistance to survive. This is a fivefold increase of needs since 2007 [3].

With CARE’s fourth global “Suffering In Silence” report, we are starting to see a trend of certain countries annually remaining on the list of the most under-reported crises. While we expanded the analysis in 2019 by including Spanish and Arabic online media coverage (in addition to English, French and German), the results are surprisingly similar to previous years: 6 of the 10 crises had already appeared in the ranking at least twice in the past three years; 9 of the 10 crises take place on the African continent. They range from drought to displacement, conflict, epidemics and food insecurity.

160 million people will require $28.8 billion in humanitarian assistance to survive

In order to address these recurrences, we need to ask: what are the factors that contribute to the silent suffering? The duration of a crisis may play a role, along with its effect on, or how it is affected by, international geopolitics.

The European Commission defines a forgotten humanitarian crisis as a severe and protracted humanitarian situation in which people receive little to no international aid. In addition, there is a lack of political will to end the crisis as well as a lack of media attention, meaning the crisis develops beyond public perception [4].

CARE more than 2.4 million online online articles from 2019 to find which major crises were the most underreported.
CARE more than 2.4 million online online articles from 2019 to find which major crises were the most underreported.

As a humanitarian organization, CARE works tirelessly to deliver aid in places that are off the public radar. Getting support to the people who need it most is harder still when the world pays them little attention. Those with a voice in public, from individuals to politicians and media representatives, have a political and moral responsibility to pay attention to crises that are neglected. Each one is one too many.

“Suffering In Silence” serves as a call for the global community to speak up for people in crises who are otherwise forgotten. The aim of this report is to analyze those crises that, though affecting many, have received little of the world’s attention while acknowledging that each emergency is unique in its causes, needs and complexity. Finally, the report also addresses the question of how to ensure better global attention to humanitarian situations, outlining seven ways to shine a light on forgotten crises.

Photo: Josh Estey/CARE
Photo: Josh Estey/CARE

10. Lake Chad Basin

Ten years of armed conflict, displacement and hunger

The crisis in the Lake Chad Basin has many faces: 10 years of conflict and violence, poverty, hunger, displacement and the sinking water levels of the lake have led to nearly 10 million people in need of humanitarian assistance. [68]

In Chad, about 657,000 displaced are in need of help. In addition, thousands of refugees from the Central African Republic and from Sudan have sought refuge in Chad. Their prospects of returning remain restricted since the safety situation in their home countries continues to be fragile. The burden of displacement does not only pose exceptional challenges to the refugees but also puts strain on host communities.[69]

In neighboring northeast Nigeria, chronic under-development and poverty persist.[70] Insecurity has led to waves of mass displacement and continues to impact humanitarian operations. At least 20 aid workers have been killed in northeast Nigeria since the beginning of the humanitarian response in 2016. Recent surges of armed violence caused 40,000 people to flee to Cameroon. Many of them were forced to return, which violates the principle of voluntary return.[71] Displacement rates reached a new peak with 2.5 million people displaced.[72]

10 million people are in need of humanitarian assistance

Another threat for the suffering population is the worsening food crisis. In Cameroon, Chad and Nigeria, there are almost 3.4 million people with irregular access to food at crisis and emergency levels.[73] In Chad, the number of malnourished people increased by 29% in 2019 compared to the year before, and by an alarming 59% for children during the lean season.[74] In Nigeria, 3 million people are food insecure, an 11% increase since October 2018.

One reason for the critical situation in the region is the shrinking of Lake Chad as a consequence of climate change and exploitation. The lake once served the people as a source of life for fishing or as watering fields. Today, the lake has only one- tenth of its surface area left.[75]

Due to limited access to clean water, lack of hygiene and low immunisation coverage, diseases and epidemics such as measles, cholera, hepatitis E and malaria spread rapidly. Combined with a dysfunctional health system, the consequence is a mortality rate of 133 per 1000 people; one of the highest worldwide.[76]

Pregnancy and childbirth are life-threatening in the Lake Chad Basin, with maternal deaths accounting for 45% of all deaths of women aged 15 to 49 years.[77] Marriage of under-aged girls is widespread and sexual violence as well as exposure to trafficking and other forms of gender-based violence is rampant because of the armed conflict.

Nana’s words to her daughter, Fatima, who has been missing since armed men attacked their village in Nigeria five years ago:

My dear daughter, I don’t know if you’re ever going to read this or how you are. But I hope you are well. No matter what, we will find a way for you to go back to school. If we would have had money to send you to school, I would have helped you. I see that most of the children who have gone to school lead better lives today.

We are not doing so well. We don’t have enough food or clothes. We also don’t live in a good place. We only live in a tent in a camp but it’s better than living in the bush. Many organisations are here to help us. If I could even just see you for one moment, it would make me so happy. I’m praying that one day we will see each other again. All I need is for you to be with us. I want you to forget about the life in the bush. You are always in my memories.

Your mother.

Photo: Makmende Media
Photo: Makmende Media

9. Ethiopia

Ten years of armed conflict, displacement and hunger

Ethiopia faced multiple challenges in 2019: there was a drought in the eastern and south-eastern parts of the country, localized flooding, as well as the significant humanitarian and recovery needs of internally displaced people, refugees, returnees and host communities.[60]

Across the country, 84% of all families live in rural areas and depend on subsistence farming. The country faces recurrent droughts and severe land degradation in many areas, which exacerbates the extreme poverty. Humanitarian needs like health, water and food assistance mostly arise from natural hazards, particularly drought and flooding. Several consecutive years of drought in southern and south-eastern Ethiopia have worsened the food security situation and disrupted the livelihoods of hundreds of thousands of farmers.[61] About 7.9 million people suffer from a serious level of malnutrition, particularly pregnant and lactating women, infants and the elderly. Localized flooding worsens the hunger situation. People’s livelihoods are at risk due to crop losses, livestock diseases and displacement. In 2019, about 200,000 people are estimated to have lost their homes.[62]

7.9 million people suffer from malnutrition

Ethiopia is one of the world’s most drought- prone countries; unpredictable rains and in some years the complete failure of seasonal rains are linked to climate change. While the country contributes only 0.27% to global emissions, it suffers extremely from the impact of the human-made climate crisis.[63]

Overcrowded shelters in displacement and return areas in combination with lack of access to basic services have increased the risk of gender-based violence for women and girls. Many resort to desperate measures such as survival sex to be able to cover their most essential needs.[64] Women and girls affected by the drought also face an increased risk of sexual violence when fetching water or collecting firewood.

CARE has been working in Ethiopia since 1984. In 2019, we reached 684,000 crisis-affected people with life-saving humanitarian assistance and projects to increase food security and resilience, nutrition and access to water. CARE is also working to increase awareness of climate impacts and to improve people’s capacity to respond and adapt their livelihoods so they can better deal with the immediate and long-term implications of climate change.[67]

Due to infrequent rainfall, Amina Ame Usman has not harvested anything this season. “The soil is fertile, but the problem is the water shortage,” she says. Although she planted seeds, they did not grow. “Now, we have nothing.” Amina, a widowed mother of six, relied on sorghum (a cereal grain) to feed her children. Since the drought, which has largely affected the eastern part of Ethiopia for the last six years, Amina’s family has been struggling. Without the supplementary income from her harvest, Amina hasn’t even been able to buy basic necessities such as soap or medicine for her family. She receives food rations from CARE such as wheat and lentils but still struggles to make ends meet. “It’s not only my family,” she says. “The whole community around me is suffering.” [66]

Photo: Rakietou Hassane Mossi/CARE
Photo: Rakietou Hassane Mossi/CARE

8. Burkina Faso

of women are married before the age of 18 in Burkina Faso

of women are married before the age of 18 in Burkina Faso

Overall, around 1.5 million people in Burkina Faso needed humanitarian aid – protection, food and livelihoods assistance – in 2019, and this number is expected to rise to 2.2 million in 2020.[57]

The risk of experiencing gender-based violence, sexual assault and rape is elevated, especially for displaced women and girls due to a lack of security in settlements. These incidents often go unreported. Furthermore, child marriage is widespread in Burkina Faso, with one in two women (51%) married off before the age of 18.[58]

CARE supports communities in Burkina Faso with water, hygiene, sanitation, food and tools to adapt to climate change. In the long term, CARE also focuses on conflict prevention, peacebuilding and women’s inclusive participation. We reached more than 400,000 people in 2019.

Djenaba Diallo, 60, is from Sagou. She has been living in a camp since the beginning of the year, when she had to flee her village after an attack that left two of her sons dead. Now, she shares a tent with her six daughters, one son and 40 of her grandchildren. Fortunately, Djenaba owned more than 50 goats and sheep. Thanks to this livestock, she was able to sell milk to make a living. “But I lost everything else during the attack and I still have family members who are in the bush with their cattle,” she says. “They had gone to feed them when we were attacked and we do not know where they are. We worry about them.” Djenaba’s greatest wish is to be reunited with all her family members and to return to peace. And she just wants the basics covered: food and better shelter. “There are almost 50 people staying in my tent, this does not allow us to live well and we can easily infect each other with illnesses. We need help.”

Photo: Sven Torfinn/CARE
Photo: Sven Torfinn/CARE

7. Kenya

Trapped in the middle of floods and droughts

Kenya is a popular tourist destination and is well known for breathtaking landscapes and wildlife. But climate change is heavily and continuously showing its impact on the East African country. Kenya has been facing droughts in recent years, with the most severe hitting the country in 2016/17. Scientists found that the probability of such a drought has doubled because of human-made climate change raising sea-surface temperatures.[45] In 2019, rainfall was at least 20% below average, leading to a prolonged drought and adding to consecutive failed harvesting seasons that destroyed livelihoods and diminished the ability of communities to cope.[46] In western Kenya, the long rainy season has been the driest on record.[47]

This directly affects the nutrition situation in the country, which remains alarming. More than 1.1 million people live without regular access to food and more than 500,000 children under five are in need of treatment for malnutrition.[48] Continuing dry conditions across Kenya have led to the deterioration of livestock and crop productivity, higher food prices and a decrease of water. Agricultural production has halved according to estimates. When there is not too little rainfall, there is far too much: heavy rains displaced tens of thousands of people during the fall months and destroyed farmland and livestock. This worsened an already dire food situation in the country.

500,000 children under five are in need of treatment for malnutrition

Adding to this, conflicts over waning resources in the shadows of the climate crisis are already a reality. Tensions between communities are rising as the competition for scarce resources such as land and water intensifies.

The climate extremes exacerbate existing inequalities, vulnerabilities and negative gender norms.[49] Girls face particular risks, including child marriage.[50] While women and girls are suffering disproportionately, they also bring unique experiences and skills as active agents of change and first responders. CARE is trying to harvest their power in community resilience when it comes to disaster risk reduction, climate change and resilience-building strategies.

Significant needs for food, livelihood support, water, sanitation, health and protection exist in drought-affected areas in Kenya. In 2019, CARE reached more than 660,000 disaster-affected people with life- saving supplies and more than 1.1 million people to support their food and nutrition security as well as resilience and adaptation to climate change.

Climate crisis, floods and droughts: 1.1 million people go to bed hungry. Half a million children require medical treatment for malnutrition.

Photo: Getty Images
Photo: Getty Images

6. Democratic People’s Republic of Korea

Hunger behind locked doors

Due to the political isolation of North Korea and the ban on journalists in the country, the dire humanitarian situation of large parts of the population remains hidden from the eyes of the world.

The UN estimates that around 10.9 million people are in need of humanitarian assistance to meet their food, health, water, sanitation and hygiene needs.[38] An estimated 43% of the population is undernourished as agricultural food production fails to meet their requirements due to the lack of modern equipment, compounded by heatwaves, droughts and floods. Several such natural disasters in 2018 led to increasing food shortages in 2019.

The Global Hunger Index classifies North Korea’s situation as ‘serious’ since the percentage of the people suffering from malnutrition has grown continuously in recent years and is now up to almost half of the population.[39] A very poor dietary diversity contributes to this alarming figure. Almost 40% of the people in North Korea, especially in rural areas, do not have access to clean drinking water and many lack safe sanitation facilities. As a result, the risk of illness is high and diarrhoea is still one of the top causes of child deaths.[40]

10.9 million people are in need of aid in North Korea

Lactating and pregnant women are particularly affected by the food crisis and water shortages. They lack necessary nutrients and cannot meet the needs of their children, who then often end up chronically malnourished as well. This cycle of malnourishment has disastrous effects as consequently children are often stunted – a severe health impediment that is even more likely to hit girls than boys.[41] Additionally, existing health facilities lack life-saving medicines and equipment.[42] With many mothers giving birth at home with no medical support, the maternal mortality ratio remains high.[43]

The geopolitical position of North Korea has major impacts on humanitarian work in the country. Organizations struggle to deliver aid supplies since there is little funding and no banking channel for humanitarian transfers. Access for international media is hardly ever granted – resulting in a lack of up-to-date data, coverage and public awareness.[44]

Life in hunger and isolation: More than 40% of the population do not have access to clean drinking water or enough food.

Photo: Silvia Di Giovanni/Pixabay
Photo: Silvia Di Giovanni/Pixabay

5. Eritrea

Fleeing drought and repression

Even though Eritrea’s population suffers from a drought-induced food and water crisis and recurring armed violence and displacement, it is hardly ever covered by international media. As the country remains widely cut off from the outside world, aid organizations and media face major challenges. The last reliable data on the humanitarian situation states that half of all children under five are stunted as a consequence of malnourishment.[32]

A severe drought in 2019 following an above- average dry year in 2018 now worsens the situation as further crop failures lead to food insecurity and malnourishment in wide parts of the population. Nomadic communities are especially vulnerable to natural disasters such as drought and flooding during rainy seasons. The national food production is largely unable to meet the people’s needs: estimates suggest that a good agricultural season can only produce 60-70% of the country’s requirements, a bad year just 20-30%.[33]

Even though the existing conflicts with Ethiopia and Somalia were officially put to an end last year, landmines and other explosive war remnants still endanger people. The prolonged military service obligation and forced labour coupled with ongoing conflict and poor economic conditions continue to leave young Eritreans no other choice than to migrate.[34]

1/2 of all children under five are stunted as a consequence of malnourishment

Hundreds of thousands leave the country every year, making Eritrea one of the countries with the strongest exodus of people. On their route towards what they hope to be a better life, many experience torture, rape and kidnapping.

In Eritrea, women and girls are exposed to severe gender-based risks: child marriage is still common in many conservative communities, leading to girls becoming mothers at a very young age. This deprives them of the chance to go to school and live a self-determined, independent life.[35] Additionally, female genital mutilation remains a widespread practice even though it is formally illegal. The mutilation results in a very high maternal mortality rate and lifelong suffering for women.[36]

Since private humanitarian organizations are banned from operating inside the country and access for journalists is almost impossible, many Eritreans suffer in silence.[37]

Half of all children under the age of five suffer from chronic malnutrition and show growth deficits.

Photo: Irenee Nduwayezu/CARE
Photo: Irenee Nduwayezu/CARE

4. Burundi

Instability fueling a humanitarian crisis

With prolonged political insecurity, high levels of poverty and significant human rights concerns, the humanitarian situation in Burundi remains fragile. Natural disasters, population movements, malaria epidemics and the risk of Ebola crossing into the country compound an already precarious situation. Despite increasing returns of Burundian refugees from Tanzania, close to 326,000 people still remain refugees in neighboring countries including Rwanda, Uganda and the Democratic Republic of Congo. With a quarter (24%) of returnees without land following repatriation, more than 106,000 people are displaced inside Burundi; many returnees have been displaced again due to severe weather conditions, including floods and droughts, and the socio-political situation.[27]

While levels of food insecurity and malnutrition have improved in 2019 due to relatively good agricultural seasons, the majority still live under the poverty line and lack basic services, such as healthcare, water and sanitation.[28] Reports indicate that some 1.7 million people – over 15% of the country’s population – chronically struggle to feed their families and are experiencing a steady decline in off-farm income. The country is suffering from a slowdown of economic activity and a disruption of markets and trade. In addition, a recent joint national nutrition and food security survey found that 5% of all children are malnourished, with 1% experiencing severely acute conditions.[29]

1.7 million people chronically struggle to feed their families

According to the Human Development Index,[30] Burundi is among the poorest countries in the world, ranking 185th out of 189, and the country most affected by chronic malnutrition. Limited access to water and sanitation also aggravates the risk of communicable diseases. While over 90% of the population depend on agriculture for their livelihoods, Burundi has some of the lowest land productivity rates in East Africa due to land conflicts, extreme population density and environmental degradation. Burundi’s low preparedness for emergencies and crises is troubling. Communities lack capacity to cope with severe shocks such as droughts, epidemics and floods, which often claim lives and undermine livelihoods.[31]

Women and girls suffer the most. Not only do they bear additional financial and domestic responsibilities to look after their families, but many also endure daily violence and insecurity. Some resort to paid sex to support themselves and their children.

In 2019, CARE provided emergency packages that are specially tailored to the needs of women and girls. CARE helps vulnerable women with small savings groups to start up small businesses. At the same time, CARE works with communities to provide information about balanced nutrition and how to prepare food safely in order to prevent malnutrition.

“My daughter Irene was sick, lost weight and did not grow like her brothers and sisters since she was three years old. Her body started to swell, her skin oozing with serious infections. I was so worried seeing Irene’s malnourishment that I thought I would get high blood pressure and die, too,” says Consolate, mother of six children. Irene became too sick to even walk and her condition was getting worse each day until she received support from CARE, teaching Consolate about better agriculture, nutrition and hygiene practices. “CARE helped me save the life of my youngest daughter and keep my whole family safer and healthier,” says Consolate.

Photo: Darcy Knoll/CARE
Photo: Darcy Knoll/CARE

3. Zambia

On the frontline of climate change

In Zambia, the effects of climate change are undeniable. An estimated 2.3 million people in the country are in urgent need of food assistance as a result of recurring and prolonged droughts.[18] Food insecurity due to extreme weather events, pests or epidemics is nothing new for the landlocked nations in Southern Africa, however, temperatures in the region are rising at about twice the global rate, according to the Intergovernmental Panel on Climate Change. Zambia, along with its neighbouring nations, is increasingly being impacted by more extreme weather shocks.[19] As such, malnutrition rates remain persistently high in Zambia – approximately 40% of children under five are stunted.[20]

In 2019, seasonal rainfalls in southern and western Zambia were recorded at their lowest levels since 1981.[21] The lack of rainfall has devastated people’s livelihoods after prolonged dry spells in 2015/16 and again in 2017/18, from which many families had not yet recovered.[22] For the second consecutive year, cereal crop harvests decreased sharply, with some districts recording an almost complete failure of the maize crop.[23] This has put families who rely on these crops to sustain their livelihoods in a dire situation. As a result of crop failures, household stocks are rapidly depleting and families have been forced to sell their livestock and other assets to secure food to survive. This demand for food has in turn driven up the price for maize, the main staple crop in Zambia, which was 70% higher in August 2019 compared to the previous year and is continuing to rise.[24] Furthermore, as families search for safe drinking water, boreholes are increasingly becoming overused, making access to water a major concern.[25]

2.3 million people in Zambia are in urgent need of food assistance

In Zambian society, women play a crucial role in food collection and preparation as well as the care and feeding of children. The drought has placed additional hardships and risks on women as they cope with the changing climate.[26] For example, some women now report waking up as early as 3 a.m. in order to be the first to collect the scarce water available and then spend all day searching for food. Many have resorted to collecting whatever wild fruits they can find to feed their families.

CARE started its operations in Zambia in 1992 to respond to the severe drought of the early 1990s. Currently, CARE supports the rehabilitation and drilling of boreholes in the most drought-affected areas to provide safe drinking water. CARE so far has reached about 36,000 crisis-affected people with humanitarian assistance and 54,000 people with aid to improve their food and nutrition security and resilience to climate change.

The current drought has forced Moono and her husband to make difficult decisions. They had to take their children out of school and sell all of their livestock. Otherwise, they would not be able to buy food. “Before the drought, we grew enough food for us to eat and had leftovers to sell, including maize, sorghum and vegetables,” Moono explains. But nothing grew this last season. “Now we are even eating wild roots and fruits.” The whole family is desperately searching for water and food. The longer the season lasts, the longer the distances they have to travel to find both. “We have one meal a day now and no food left over,” she says. “We don’t know what we will do until the next harvest. That’s not until in April.”

Photo: Sebastian Wells/CARE
Photo: Sebastian Wells/CARE

2. Central African Republic

A brutal conflict in the heart of Africa

Since gaining independence in 1960, the Central African Republic (CAR) has enjoyed only short periods of political calm. The latest internal conflict broke out in 2013 and intensified in 2017. Fights have led to widespread displacement and an escalation of humanitarian needs. Despite the signing of a peace accord in early 2019, the security situation remains tense. About 2.6 million people, more than half of the population, are in desperate need of humanitarian assistance.[12]

Violent clashes and attacks on civilians have forced one in four citizens of the Central African Republic to flee their homes. More than 600,000 people are displaced inside their own country and almost 594,000 people have sought refuge in neighbouring countries such as Cameroon, the Democratic Republic of Congo and Chad, all of which struggle with high poverty rates themselves.[13]

Years of conflict have also taken their toll on health, water supply and sanitation, as well as crippling agricultural production patterns. Consequently, 1.8 million people – 41% of the population – are severely food insecure.[14] Particularly in areas with high numbers of displaced people, access to agricultural fields is limited due to movement restrictions. This prevents households from planting and maintaining their crops, hunting and gathering. In addition, security concerns along trade routes have disrupted market activities and contributed to shortages of food and rising prices.[15]

1.8 million people are severely food insecure in the Central African Republic

As in most armed conflicts, women and children are particularly vulnerable to sexual and gender-based violence and often resort to desperate measures including “transactional sex” to be able to afford basics like food. Some are even pushed into this practice by distressed parents.[16]

With 244 attacks in 2019, the Central African Republic is one of the most dangerous places in the world for aid workers.[17] Regular attacks on staff, looting of facilities and road blockages are a daily struggle for humanitarian agencies. Poor road conditions make it extremely hard to reach those in need. Heavy seasonal rainfall and flooding have further complicated the delivery of humanitarian aid.

CARE continues to support Central African refugees and host communities in the neighboring countries of Cameroon and Chad, ensuring access to water and sanitation, distributing plastic sheeting and sanitary items and working to prevent sexual and gender-based violence.

Khadija is putting her eight-month- old sister onto the scales. It is 10 a.m. and she has been patiently waiting in line in front of the CARE health centre in Chad, far away from her home in the Central African Republic. Although she is only nine years old, Khadija carries the responsibility at home. She came to this health centre to get additional food for her sister, who is severely malnourished. CARE not only supports refugees with oatmeal, but also teaches Khadija how to prepare food for her little sister. At home, Khadija receives help from her 70-year-old grandmother, Fatime, who is worried about the well-being of her grandchildren. “We can eat only once a day – usually we eat rice or millet. During the rainy season, we always try to grow some vegetables, but it is never enough for all of us. I know it will have effects on the children’s development. But what should we do?”

Photo: Clément Radar/CARE
Photo: Clément Radar/CARE

1. Madagascar

Hungry and forgotten

Madagascar is a country mostly known for its unique wildlife and rich biodiversity. But it also ranks among the poorest countries in the world, with three-quarters of its population living on less than US$1.90 per day.[5] It is one of the countries most affected by the human-made climate crisis due to its dependence on agriculture and natural resources on the one hand, and its high exposure to natural disasters, such as recurring cyclones, chronic droughts and pests, on the other.[6]

At the end of 2019, more than 2.6 million people were affected by the impacts
of drought,[7] and more than 916,000 people were in immediate need of food assistance.[8]

Madagascar has the world’s fourth highest rate of chronic malnutrition, with one in every two children under five suffering from stunting.[10] This severely impairs their cognitive and physical development, increasing the risk of contracting or developing other diseases. At the beginning of 2019, an unusually large measles outbreak with more than 127,000 confirmed cases coincided with the seasonal occurrence of the plague. These diseases affected children the most.[11]

Approximately 80% of the Malagasy population is engaged in agricultural activities, and thus highly susceptible to climate shocks affecting the crop cycle. Over recent years, the Grand Sud region in particular has suffered from consecutive years of severe rain shortfalls during the agricultural season, which were further aggravated by the El Niño weather phenomenon in 2016/17. The fall armyworm infestation since 2017 and below-average precipitation in 2018 reduced harvest yields of the main staple foods: rice, maize and cassava. Increased food prices forced families to sell their assets, reduce the number of meals per day and travel increasingly longer distances to search for alternative incomes.

2.6 million people in Madagascar were affected by the impacts of drought

This particularly affects women, as rising levels of food insecurity place additional burdens on them. Struggling to feed their families, they are vulnerable to abuse and exploitation. Crop damages and income losses often increase family tensions and the likelihood of child marriage and domestic violence.

CARE provided life-saving humanitarian assistance to more than 40,000 people in Madagascar and helped improve food and nutrition security for 105,000 people. CARE supported the drought-affected population by increasing productivity and profitability of crops and worked with farmers on using modern farming techniques. CARE also repaired broken water systems and established new ones, while supporting village savings groups to help people set up alternative sources of income. The main goal was to support communities to become more resilient to climate change and recurring natural disasters.

Celestine, a widow and mother of seven, used to walk nine kilometers to the closest well to fetch water. Some days, she just couldn’t make it. “That’s when the children drank water from the river,” Celestine remembers. “But it made them sick.” The consequences can be disastrous, particularly for children: poor water and sanitation have a detrimental effect on child growth and development, often leading to malnutrition and stunting. Even in years without drought, access to drinking water remains one of the major challenges for people living in the south of Madagascar. This is why Celestine’s village formed a water management committee. CARE trained them on the treatment and purification of water and provided the equipment necessary to transport it to the village. Now Celestine receives 20 litres of drinking water every day. It’s not much, but it’s a start.

What can we do?

Seven ways to help shine a light on forgotten crises

With so many different types of disasters and conflicts repeatedly ignored by the media year after year, the question remains: what can or should be done? While the reasons for a crisis to be forgotten may share commonalities, the solutions can be many and varied. Anything from simple actions to creative attempts can make a difference. But doing nothing is not an option. Here are seven important actions that are crucial to shine a light on millions of people and their suffering.

For governments and policy-makers

1. Consider reporting as a form of aid:

Reporting on crises surely cannot compete with life-saving assistance in the form of food, clean water or medical aid. However, crises that are neglected are also often the most underfunded and protracted. A quick analysis shows a strong correlation between the amount of media coverage and funding received: 3 of the 10 most under-reported crises in this report also appear in the UN’s list of most underfunded emergencies in 2019.78 With close links between public awareness and funding, it needs to be acknowledged that generating attention is a form of aid in itself. As such, humanitarian funding should include budget lines to raise public awareness, particularly in low-profile countries. This can be used to encourage affected countries to increase their local news coverage, to offer press visits to emergency- affected areas, or to provide logistical support and training for journalists. At the same time, it is crucial that press freedom constitutes a condition for receiving aid. Affected countries have a responsibility to support unrestricted coverage and unhindered media access in order to improve humanitarian conditions. Press freedom is essential to shine a light on issues that would otherwise be forgotten.

2. Money is not enough:

In order to reach an increasingly younger, active and diverse population, it is crucial
to use voices that can reach wide audiences. In today’s world, policy-makers more than ever are required to engage and inform the public. Young people are increasingly concerned about the interconnected climate and humanitarian crises occurring in their backyard. They would like to be educated through in-depth, trustworthy information with on-the-ground stories in real time, from real people. In a digital landscape built on attention and speed, there are many opportunities for governments and policy- makers to demonstrate their commitment and help drive media attention to crises, starting from a simple tweet to participating in a campaign on forgotten crises.

For the media

3. Reporting on the under-reported:

Representation matters and reporting on the misery and adversity of marginalised people79 is extremely important to ensure that their voices are heard and concerns addressed. When covering sensitive or complex issues, media outlets must ensure that linkages are explained – for instance, recognising the diverse forms of gender-based violence including early marriage and intimate partner violence, or the ties between human-made climate change and its consequences on stressors such as forced displacement, conflict, health or gender inequality. While the number of people in need is likely to rise in the coming years, their suffering cannot be ranked, regardless of the extent of a disaster. Focusing only on the number of deaths can shift attention away from underlying challenges and overlook people who will urgently need help. Media attention on under-reported issues helps to move the mainstream narrative from numbers to impact and from outcomes to root causes. Examples of change include committing to devote a certain percentage of world coverage to humanitarian crises that do not receive sufficient attention; sending one reporter to one forgotten crisis per year; or doing one round-table event about a forgotten crisis advertised through your platform.

4. Stories of hope:

More and more research points to the fact that fear and pessimism trigger conservative and suspicious views, while hope and optimism tend to generate more liberal views. The project “Hope not Hate” states: “Where people are more likely to feel in control of their own lives, they are more likely to show resistance to hostile narratives, and are more likely to share a positive vision of diversity and multiculturalism.”80 “Hidden Tribes”, a 2018 report from “More in Common,” 81 insists that the media landscape accentuates the conflicts but downplays the solidarity in our society. It advises us to find common ground to counteract the divisions magnified on our screens with stories of human contact and respectful engagement that “spotlight the extraordinary ways in which [people] in local communities build bridges and not walls, every day”. In the midst of crises and suffering, it can be difficult to find positive angles. But when they are found, they can be a powerful force to combat populist fear framing and dehumanization and instead trigger empowerment and solidarity.

For aid agencies

5. Focus on the people and solutions:

Dwindling news budgets, plummeting advertising revenue and downsizing of foreign correspondent networks have left a void in crisis coverage. This is increasingly filled by aid agencies who provide news content or organise press visits. While aid agencies can and should play their part in reporting on neglected crises and highlighting the voices of people affected, it is important to recognise the need for localised angles when pitching stories not necessarily in line with their agendas. Humanitarian organisations have a duty to promote the role of local and national actors and acknowledge the work that they carry out. Including them as spokespeople when security considerations permit is crucial. Issues of trust, professionalism, norms and ethics play a major role on both sides. While aid agencies are often restricted in political messaging for reasons of impartiality or relying on local administrations to provide aid, the media has an obligation to report based on transparency, neutrality and accuracy. It is crucial to understand each other’s limits, risks and goals so that partnerships can truly address the local needs of those suffering.

For the public

6. Lend your voice to the voiceless:

Know that your voice can and does make a difference, even if your newspapers, TV and phone screens are devoid of ‘good news’. Volunteering your energy, money and time can feel like a drop in the ocean, especially when you take action on some of the world’s most forgotten crises. But every supporter action can and does make a difference. We have witnessed how one Swedish teenager’s climate change protest grew into a global movement of millions. Across Africa and other parts of the globe, more than 6.7 million women are turning empowerment into financial independence and better lives through CARE’s village savings groups.82 With the rise of citizen journalism and people taking issues to the streets around the world, there is no doubt that every voice matters and can start or strengthen a movement towards change.

For businesses

7. Help responsibly

Recognize corporate social responsibility not primarily as a PR or image boost, but as a duty towards the communities affected by conflict and natural disaster – many of which are caused by extractive and other industries. Consider carefully the investments you are making in humanitarian settings and work towards a triple bottom line of people, planet and profit. Ensure that any investments made in humanitarian settings are done for the long-term benefit of local communities. While leveraging strengths and assets, keep in mind that the most urgent needs of people in need are typically food, clean drinking water, emergency shelter or medical care. In most cases, cash contributions are much more effective than in-kind donations, allowing needs to be covered and ensuring donations will feed into the existing humanitarian response. Also, providing flexible emergency funding to NGOs can help them respond better to forgotten crises. Moreover, address and reduce your contributions to underlying stressors such as human-made climate change.

About CARE International

Founded in 1945, CARE International works around the globe to save lives, defeat poverty and achieve social justice. We put women and girls in the centre because we know that we cannot overcome poverty until all people have equal rights and opportunities.

CARE International works in 100 countries to assist more than 68 million people to improve basic health and education, fight hunger, increase access to clean water and sanitation, expand economic opportunity, confront climate change and recover from disasters. More than 70% of those helped are women.


Using the media monitoring services of Meltwater Group, CARE International analyzed those humanitarian crises that received the least media attention in 2019. More than 2.4 million online media hits were captured in the time period from January 1 to November 15, 2019. To filter according to scale, we identified countries in which at least one million people were affected by conflicts or natural disasters. The result was a list of 40 crises that were analysed and ranked by the number of online news articles mentioning each country and respective crisis. This report summarises the 10 most under-reported crises, starting with the emergency that received the least amount of media attention at number one.

In order to mitigate potential biases, we triangulated the data on affected populations using several sources whenever possible, prioritising those we have historically deemed to have been most objective and accurate. The overall number of people affected by each emergency is derived from ACAPS, Reliefweb and CARE’s own data. In cases in which one crisis affects more than one country, such as the Lake Chad Basin displacement crisis, the countries were grouped together. Multiple large crises affecting the same country were separately ranked and analysed. The analysis that underpins the report is drawn from online media coverage in Arabic, English, French, German and Spanish. Though not universal in scope, this report represents a tendency of global media attention. It seeks to contribute to a wider discussion between the humanitarian aid sector, media outlets and policy- makers on how to jointly raise awareness and deliver aid to those in need.

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