Even without El Niño, the global picture for food security is bleak. Malnutrition is a leading cause of childhood death in poor countries, with 161 million under-fives chronically malnourished. Now new evidence from the Horn of Africa shows malnutrition among disabled children is much worse than previously thought. This is a region likely to feel El Niño’s impact keenly, so the sooner action can be taken to protect children, the better.
A study my team and I published last month examines the link between malnutrition and childhood disability in Turkana in northwest Kenya.  Turkana is the poorest county in Kenya. It is battling drought and suffers high levels of chronic food insecurity, with widespread malnutrition: 1-in-3 children without disabilities are malnourished. By comparison, the new data shows that a staggering 54 per cent of children with disabilities are malnourished.
There are several reasons for this — meaning interventions to tackle it can take different approaches or ‘entry points’. Firstly, lunch: this is the main meal of the day for many children, provided through a school feeding programme, but out of reach for those disabled children who do not go to school.
The obvious way to address this is to get more kids into school. But relief organisations will also need to go the extra mile to reach children with disabilities often missed by school lunch programmes. For example the Sangath NGO in Goa, western India, supports pre-school children with special educators, home care and community health workers.
Secondly, the nature of disabilities themselves can make eating a challenge. Children with cerebral palsy or cleft palate, for example, may have difficulties chewing or swallowing. Parents can easily end up sidelining their disabled offspring at mealtimes, particularly in the large families common in Kenya and many other developing countries. Training can help here. The Getting to Know Cerebral Palsy programme is one global example. The first step is to establish groups of parents of children with cerebral palsy in the community. They meet regularly and trainers come and run sessions on different topics, including ways of feeding affected children and the best type of diet.
There are also massive opportunities for strengthening such programmes through smartphones. As smartphone availability increases, training can become more mobile-phone based — and this will both widen access, reduce the funding and resources needed for training, and provide a resource for users to refer back to when needed. Smartphone apps have been improving patient care and rehabilitation for those affected by strokes, with pilots in India showing they are popular with patients and carers. Training apps could also transform disability care.
As the impacts of El Niño take hold in vulnerable regions of the world, training programmes like these should be expanded to provide a desperately needed defence against chronic hunger.
Hannah Kuper is codirector of the International Centre for Evidence in Disability at the London School of Hygiene & Tropical Medicine, United Kingdom. The centre is on Twitter as @ICED_LSHTM, and Kuper can be contacted on [email protected]