(introduction...)

Neither food output, nor prices, nor any other variable like that can be taken to be an invariable clue to famine anticipation, and once again there is no substitute for doing a serious economic analysis of the entitlements of all the vulnerable groups.

Amartya Sen

In unstable situations, morbidity and mortality often increase considerably.^2-6 Whether and to what extent food shortage, malnutrition and increased mortality are causally linked remains a matter of debate,^7-12 but the importance of food goes far beyond physical survival, even in emergencies. Although during the emergency phase water and shelter may be more important for short-time survival,¹³ food is indeed one of the priorities. Food shortage and access to food are invariably important issues in unstable situations.^9,14,15 Aid agencies often consider food aid as the most urgent need of refugees.

Food aid in times of food scarcity intends to reach those without the means to obtain it. Food aid does not, however, take place in a vacuum, but in a social context, even if society is in disarray.^16,17 Food is one of the main economic assets in countries in crisis. It is not because food aid is supplied free ('not to be sold or exchanged'), that it loses its economic value. The poorer and the more disrupted the society, the higher the relative value of food. Not surprisingly, some may try to misappropriate food aid, not only to feed themselves or their community, but also to gain economic benefit. Food aid also influences local offer-and-demand balances. Food scarcity raises food prices, to the benefit of those offering food on the markets, mainly merchants, but sometimes producers too. These are potential losers if food aid effectively reaches those in need.

During armed conflicts, poorly supplied fighting forces may claim a share of the food intended for civilians. Food aid distributed to refugees may be transported across borders to supply guerrillas, or the civilian populations that remained behind. Food may even be used as a weapon of war.¹⁸ Armies may try to starve certain areas for military purposes, destroy or loot food stocks and crops, and hinder food aid.

Within such contexts, all aspects of food aid are highly problematic.¹⁹ First, the quantity of food aid is always a balancing act between supplying enough to feed those in need, and limiting supplies so as not to disrupt the local markets. Second, if it is still relatively easy to decide when food aid should start, or when it is insufficient, it is considerably more difficult to know when food aid should decrease or stop altogether.²⁰ Third, the identification of beneficiaries is another major problem. Registration is often incomplete and fraught with difficulties. Distinguishing those in need of food aid from those not in need is always somehow arbitrary. Distinctions are often based on value judgements that may not be the same for those delivering and those receiving assistance.^21,22 Fourth, logistic constraints often hamper transport and distribution. Lastly, appropriate distribution channels are difficult to design and control.

Because of these difficulties, food aid is more often than not contentious,²³ it is the most visible benefit granted to refugees, and conflicts may erupt or crystallise around it. It is a source of conflicts between humanitarian agencies and refugees, among humanitarian agencies and among refugees, between refugees and hosts, between humanitarian agencies and merchants, between humanitarian agencies and donors, between donors and host governments.^17,24,25

Humanitarian agencies have gained considerable experience with food aid to refugees. Manuals describe how to organise refugee registration, anthropometric surveys, food distribution, food basket monitoring, as well as supplementary and therapeutic feeding programmes.^19,26,27 This know-how is, however, largely based on experience within relatively closed systems, such as refugee camps, where beneficiaries are entirely dependent on food aid. Strategies used are not necessarily appropriate for open refugee situations, where beneficiaries of food aid (the refugees) live integrated, both spatially and economically, with non-beneficiaries (the hosts). This makes selection and registration of beneficiaries considerably more difficult. Some refugees may be self-sufficient, while some hosts may not. In open situations, nutritional programmes invariably induce system effects in the wider society, and affect local balances.²⁸

Throughout PARLS, food aid was contentious and fraught with difficulties. At no point in time, satisfactory solutions were found. This chapter analyses decision making in food aid, and reviews the experience in Guinea with refugee registration, with assessment of the nutritional situation, and with food aid.