An Excellent Summary of the Current Nutritional Situation in the Jewish Community of Gondar, Ethiopia

Malnourished Jewish Children Awaiting Aliyah in Ethiopia

SSEJ needs financial support to sustain and hopefully expand programs of supplemental nutrition for the children of the Beta Israel community remaining in Ethiopia. We currently are providing two daily meals to chronically malnourished children 0 – 5, chronically malnourished pregnant women and nursing mothers in Gondar, Ethiopia. Nursing mothers are eligible during the first 6 months after they give birth while their children are exclusively breast feeding.  We would also like to add another 40 pregnant women to the existing program in Gondar even though they are not technically malnourished to improve the birthweight of newborn children. 

Additionally, due to lack of funding, we cannot provide any nutritional assistance to the malnourished Beta Israel children, pregnant women and nursing mothers in Addis.  We are also hoping to provide modest lunches to children attending our after-school programs (ages 6 – 14) in Gondar but have not yet secured the funding. 

Background

There are currently approximately 14,000 Beta Israel awaiting permission from the Israeli government to emigrate from Ethiopia to Israel.  Approximately 11,000 reside as internally displaced refugees in Gondar, a provincial city in northwest Ethiopia; the remainder live in Addis Ababa. Over 70% members of the two communities have first degree Ethiopian Jewish relatives in Israel. Community members have been waiting for permission to make aliyah for period ranging up to 20 years.  In one of the poorest countries of the world, they are the poorest of the poor.

In November of 2015, the government of Israel decided that Beta Israel previously rejected for aliyah under the restrictive conditions of prior government resolutions should be inspected and those meeting expanded criteria should be brought to Israel.   It was expected that most of the 9000 on that list would be found eligible.   (There are an additional 5,000 who arrived in Gondar after the Jewish Agency took over the NACOEJ compounds in 2011.  They are not eligible for aliyah under this decision even though they have maternal Jewish ancestry).

There were delays in implementation of the resolutions which did not commence until May 2017 when aliyah commenced but was limited to 1300 (many of whom were from the villages rather than the internal refugees trapped in Addis and Gondar).  Pursuant to a government decision, 1,000 were supposed to make aliyah in 2019 but it currently looks like the government will authorize only 600.  

Nevertheless, based on the history of the past 30 years, during which the government has frequently slowed down or even stopped aliyah completely, we believe it is likely that the vast majority of the people awaiting aliyah will become future citizens of Israel. But the current slow rate of aliyah means that assistance for this community is likely to be necessary for a number of years until they become future citizens of Israel. 

SSEJ

SSEJ was founded in 2001 to provide humanitarian aid to Ethiopian Jewry.  It has an illustrious list of supporters including founding honorary president, the late Eli Wiesel, winner of the Nobel Peace Prize.   Professor Wiesel’s successor is the former Democratic candidate for Vice President, Senator Joseph Lieberman. 

SSEJ’s counsel, include world-renowned attorneys, Professor Alan Dershowitz of Harvard, former Canadian Justice Minister and Attorney General Irwin Cotler, one of the world’s leading authorities on international human rights (recently nominated for the Nobel Peace Prize); Joseph Feit, the third member of the legal team,  has received awards from both the Knesset and the Jewish Agency for his efforts on behalf of Ethiopian Jewry for the past 30 years.  Copies of SSEJ’s Federal income tax exemption certificate and registration as a charity with New York State are available on request.

SSEJ Activities in Ethiopia

SSEJ currently is the principal organization providing assistance – though far from adequate due to lack of funds – for the Ethiopian Jews awaiting aliyah. For example, two compounds are maintained for the community, one in Addis and one in Gondar.  Medical care is provided for 850 children between the ages of 0 – 5 in Gondar at a medical clinic (there are no funds for older children or for any ongoing medical care in Addis Ababa). The doctors in charge of the clinic describe them as life-saving as the medical and nutritional condition of the children – discussed below – was extremely poor. The children suffer from diseases such as typhoid, typhus, malaria, intestinal parasites, anemia etc.  The program is life-saving; in a country with a 5% infant mortality rate, in calendar 2018 there were no fatalities among the 850 children in SSEJ’s medical program. 

SSEJ also provides 15 hours per week of after school education to hundreds of children in grades 1 – 8 (math, science, Hebrew, Jewish culture) so that when they arrive in Israel their absorption will be that much easier.  The children would learn better and attendance would increase if we were able to provide them with a modest lunch. 

 SSEJ also helps fund eyesight restoring surgery and drugs to prevent blindness in children with eye infections through an extraordinary program run by Dr. Morris Hartstein of Israel.

 An educational summer camp has been run in Addis and Gondar for the past several years (current total registration of 2100).  The children are provided with lunch funded by the North American Conference on Ethiopian Jewry (“NACOEJ”).

SSEJ also provides support for rent, maintenance and the utilities of the compounds in Addis and Gondar, funds the expenses of numerous volunteers from Israel (32 this summer alone), funds a Beit Midrash and teacher training program and provides funds to sustain Jewish religious life in both cities.

SSEJ does not make public appeals for funding thus reducing administrative costs to a bare minimum.  

Supplemental Nutrition for Malnourished Children Awaiting Aliyah

Two years ago, SSEJ commissioned a study by ten doctors – including the former head of Shaarei Tzedek’s Pediatric Department, Professor Arthur Eidelman, doctors from Gondar Medical School and Dr. Hartstein – to determine the medical and nutritional situation of the community.  The survey, subsequently published as a peer reviewed article, came to the same conclusion as a prior peer reviewed article; supplemental nutritional assistance is urgently needed for the children 0 – 5 who are significantly chronically malnourished.As United Nations reports and the medical literature indicate, mental and physical damage caused by chronic malnutrition of young children especially stunting) can be significant and is often irreversible. Thus, the 0 – 5  age group became SSEJ’s priority. 

Consequently, SSEJ established a program of supplemental nutrition. However, due to funding limitation initially only one meal per day was provided to the malnourished children in Gondar.   Due to lack of funds, no food is provided to the children in Addis Ababa even though prior studies established that the Jewish children in this community were also badly malnourished.Within the last few months, based on urgent medical advice, SSEJ began providing a second daily meal.  

Approximately 462 children out of 850 children under 5 are eligible for the current nutrition based on the severity of their malnutrition.  Forty malnourished pregnant women also receive one meal per day.  The program is run under the supervision of Dr. Mehretie, the leading pediatrician in Gondar. Educational information and lectures are given to the women on what foods the children need to constitute a balanced diet for the meals not provided by the program.   The content of the nutritious meals provided by the program was determined by Dr. Mehretie in consultation with leading nutritionists. 

 There has been a dramatic improvement in the condition of the children since the program was established however it is clear that more is needed.   Clearly there is a need to extend to extend eligibility for the feeding programs to all children from 0 – 5 (even if not currently significantly malnourished) and pregnant women who are technically not severely malnourished (as it seems cruel to wait until their condition deteriorates, rather than prevent damage before it occurs).  Additionally, nutritional assistance should be extended to the children in Addis.  

When we were providing only one meal per day, attendance rates of eligible malnourished children were unsatisfactory.  The compound is very far from the homes of many of the women. Many women had one child eligible for the program and another child ineligible who they could not leave unattended at home.   Mothers who brought the ineligible child were placed in the heartbreaking situation of feeding one child and denying any food to another. 

To deal with this problem, three months ago SSEJ started to provide modest meals for 80 children carried in to the compound on their mothers’ backs.  These children are not technically sufficiently malnourished – yet – to meet the doctors’ criteria.  But they clearly are at risk for falling into this category and providing them with food has also had the result of significantly increasing attendance rates.

SSEJ also distributes iodized salt to the families in the program to prevent iodine deficiency and provides soap for hygienic purposes.  We hope to institute a program, in consultation with Dr. Mehretie, to address micronutrient deficiencies amongst the children. 

Operation of Nutrition Program

Currently, an average of 350 malnourished children up to the age of 5 regularly attend the feeding program out of 462 seriously chronically malnourished children recommended by the doctor for inclusion in the nutrition program. Others attend on a less frequent basis. Far more would attend but people have to walk great distances to get to the feeding center, a factor of particular consequence during the rainy season. 

Every child who attends gets a meal including eggs, bananas (orange substituted seasonally), bread, milk, potato and fortified porridge.  The program is supervised by a full-time nurse Sr. Woinshet.  Each child is now provided with a similar second take home meal.

The content and cost of the meals is as follows: 3 small eggs – 11 birr; bread – 1.5; banana 3.0; potato – 1.5; fortified porridge – 5.0; orange 4 (when seasonally available) instead of banana every other day – 23; 0.2-liter milk – 3.5 birr.   When you include other expenses (salaries, fuel, utilities etc.) – 6 birr per meal – = 32 birr per meal (not including the cost of Neguise Alemu’s salary discussed below).  Divided by 27.8 = 1.19 dollars per meal. There are approximately 27.8 birr per dollars.  Prices have risen recently above costs cited due to inflation. We must canvass suppliers constantly to obtain the best prices. Our program director has advised us that he expects significant increases in food prices in the coming months. 

The current 12-month direct cost of the supplemental nutrition program is $195,000 per year.  This does not include any allocable overhead for the salary and living expenses of our fulltime program director, Nigusie Alemu, currently on leave from Israel’s Ministry of Education; he spends a great deal of his time on the nutrition program. His salary and living expenses are paid solely by funds SSEJ raises or has raised from generous individuals and are not covered by foundation or other grants. 

It should be noted that medical assessments were done on the pregnant women which found that over 60% malnourished. The reports were that they had not eaten fruit and vegetables for a long time and did not eat eggs or drink milk. 

Evidence that SSEJ’s Nutrition Program Works

The nutrition program provided substantial benefits to the stunted and underweight chronically malnourished children effective even when they received only one daily meal. They gained a substantial amount of weight and height (though not enough). The children had higher energy levels and attentiveness (e.g. children who simply sat on the ground listlessly now, play, running around and demonstrate curiosity about the world around them.)  As opposed to the situation before the nutrition program started, the children now have normal appetites.  

A substantial bonus, is the fact that the rate of illness among the children on the one daily meal program declined substantially to the point where they had 28% fewerannual visits to the medical clinic than children who are not on the program (2.9 per year as opposed to 3.7).  

Further significant gains were achieved by the recent addition of second daily meal. Avery recent study by Dr. Mehretie confirms that the addition the second daily meal has substantially increased the weight gain and growth rate while further significantly reducing the morbidity rate. The study compared malnourished children up to the age of 3 years for the 3-month period from March 12, 2018 (once daily feeding) to the same period in 2019 (twice daily).  The children in 2019 had over twice the weight gain, 17% more growth in height and 30% fewer visits to the doctor (reduced from 1 to 0.7; children who were not on the program at all had 1.3 visits). 

Comparative Data

We do not believe that philanthropic funding decisions should be based upon a comparison between the nutritional status of the young Beta Israel children and those of the general Gondar population  Even if the Beta Israel children as a group did not have greater rates of malnutrition than their neighbors, those Beta Israel children who are significantly malnourished should be provided with the food they need. Nevertheless, some potential donors ask whether chronic malnutrition is more common amongst the Beta Israel children compared to other children in the City of Gondar. 

According to Dr. Mehretie’s study compared the stunting and underweight rates of Beta Israel children (who are under his medical care) to the rates of randomly selected non-Beta Israel children in Gondar.  , while the chronic malnutrition rates in both groups is poor, the malnutrition rate amongst Beta Israel children is higher.  The results showed that 32.5% of under 5 Beta Israel children were underweight as compared to 19.7% of children from the general population; 39.6% of Beta Israel children were stunted as compared to 31.1% of children from the general population of children in Gondar.  

There are many reasons for this including the fact that the parents have been displaced from their countryside home, are not well educated and can only secure temporary jobs. Additionally, some of the Beta Israel lack the residency permits required to obtain many permanent jobs. 

Funding of SSEJ Programs

SSEJ does not receive any money from the Federation system (NACOEJ blessedly receives a grant from the compassionate people at MetroWest). JDC has repeatedly declined to take over the medical programs in Ethiopia for the Beta Israel children even though it ran clinics in Ethiopia for the community in the past and currently provides assistance to non-Jewish Ethiopians. JAFI, under its new Chairman Isaac Herzog has been helping SSEJ raise some funds from third parties. NACOEJ has been providing significant funding to the nutrition programs. However, continuation of this funding is dependent upon its ability to raise money dedicated to the nutrition program every year as the expenditures are not part of its core budget. SSEJ has received 3 donations of $50,000 (2 from the DEAR Foundation) over the past several years. But these are annual grants and we have no way to predict if those funds will be forthcoming in the future.

In short, SSEJ, which has no fundraising staff (or staff of any kind) is dependent for its annual budget in Ethiopia of approximately $600,000 dollars on funds it receives (or has received in the past) from a small group of generous contributors. There is a pressing need to put its funding on a stable basis to continue its programming, including the supplemental nutrition program and to extend the scope of the food programs as described above. 

Role of Humanitarian and Religious Communities

Israel will decide when and whether the members of this religiously observant community are permitted to make aliyah.  But it is philanthropic organizations who will decide, by action or inaction, the physical and mental condition of the children when they are finally permitted to rejoin their families.  In addition to the urgent humanitarian concerns, it is obviously far cheaper to prevent malnutrition while the children await aliyah rather than to trying to cope – if possible – with the adverse consequential physical and mental once they arrive in Israel. 

Donations

If you blessedly wish to help fund the supplemental nutrition programs outlined above,  funds can be sent as follows:    SSEJ’s address is:  SSEJ 459 Columbus Avenue Suite 316 NYC, NY, 10024.    Funds can also be wired to SSEJ:  JPMorgan Chase  270 Park Avenue NY, NY, 10017  – Account Number: 701071263   – Routing Number:   021000021

Of course feel free to contact SSEJ through Joseph Feit at jfeit@stblaw.com(US cell phone 516 316 2345) if you have further questions or require additional information.  

July 29, 2019 

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