Pagak Reception Center, July 2020. Photo courtesy of UNHCR.

Ethiopia: 1 in 4 Refugee Children in Pagak Are Dangerously Malnourished

Action Against Hunger warns of growing nutrition emergency as COVID-19 leaves thousands of South Sudanese refugees stuck at the border

Action Against Hunger, the world’s nonprofit hunger specialist, today warned of a growing hunger crisis in Ethiopia. Newly released data reveals that nearly one in four South Sudanese refugee children who recently arrived in Gambella suffer from life-threatening malnutrition. COVID-19 cases in the country have more than tripled in the past month, complicating hunger relief efforts. 

Action Against Hunger conducted a mass screening of 1,955 refugee children younger than five years old in Pagak Reception Center from July 13 to 17, 2020, and data released today shows that 23.6 percent were acutely malnourished, including five percent diagnosed with severe acute malnutrition, the deadliest form of hunger. This prevalence is more than double what the UN Refugee Agency considers a serious public health emergency

After conflict broke out in parts of South Sudan in May, more than 8,200 people sought refuge in neighboring Ethiopia, arriving in the Pagak Reception Center, a temporary station set up in May before the border closed due to COVID-19. Normally, the refugee resettlement process would move new arrivals from the temporary reception center to better-established camps within two to three weeks. Currently, the relocation process has been delayed for months due to COVID-19 restrictions and a lack of testing kits

Action Against Hunger provides lifesaving nutrition treatment to children in Pagak, but the  reception center has no hospital facility, substandard water and sanitation services, and little capacity to provide other essential support. Many refugees need additional medical treatment for malnutrition, COVID-19, or other health issues, yet the nearest health center is 35 miles away, with no reliable transportation system. Malnutrition can complicate illness, with malnourished children 12 times more likely to die than their well-nourished peers. 

“We are deeply concerned about the health of these children,” said Beza Abebe, Ethiopia Program Director, Action Against Hunger. “This vulnerable population does not have access to enough food, clean water, and health services needed to prevent malnutrition. On top of this crisis, COVID-19 presents a real threat to refugees, host communities, and humanitarian workers alike. People are desperate and afraid. We are facing a true emergency.” 

High malnutrition rates in Pagak are linked to the low availability of nutritious foods, limited access to water, sanitation, and hygiene, and poor infant and child feeding practices. 

Crowded settlements and poor access to water, sanitation, and hygiene services make COVID-19 prevention extremely difficult in Gambella, which is seeing an increased community transmission. With 595 cases currently confirmed in Gambella, Action Against Hunger experts believe the true infection rate may be much higher.

“While all new refugees are now required to be tested for the virus, testing supplies and PPE are limited. We suspect that many people are avoiding testing because of the severe stigma and fear that comes with COVID-19,” Abebe said. “We are providing health education to stop the spread of COVID-19 and malnutrition, as well as mental health support to refugees and frontline workers. In recent weeks, we have seen a sharp increase in admissions to our health centers in other parts of the Gambella region.”

“Sadly, Pagak is not alone. Across the region, millions of people are hungry,” said Hajir Maalim, Horn and East Africa Regional Director, Action Against Hunger. “While it will take months for official data on malnutrition to be released, the early indicators are clear. The global community must come together to fight this war on two fronts, both hunger and the pandemic.”

Action Against Hunger in Ethiopia

Operational since 1985, Action Against Hunger’s teams in Ethiopia provide lifesaving nutrition, food security, mental health, and water, sanitation, and hygiene support to communities most in need. In 2019, its staff of 615 reached more than 950,000 people with gender-sensitive programs to promote food security and livelihoods; malnutrition treatment; and water, sanitation, and hygiene services that promote long-term resilience.

Correction, August 10, 2020
An earlier version of this statement said that funding issues had forced the UN World Food Program to cut food rations to refugees in Ethiopia by 30 percent in April. This is not accurate, and we apologize for the error. 


Action Against Hunger is leading a global movement to end hunger in our lifetimes. It innovates solutions, advocates for change, and reaches 25 million people every year with proven hunger prevention and treatment programs. As a nonprofit that works across 50 countries, its 8,300 dedicated staff members partner with communities to address the root causes of hunger, including climate change, conflict, inequity, and emergencies. It strives to create a world free from hunger, for everyone, for good.