Climate Change Worsens Food Insecurity for Vulnerable Populations

As one of the countries most threatened by climate change, Madagascar is particularly exposed to recurring natural disasters, as demonstrated by the passage of Batsirai and Emnati—two devastating cyclones in 2022 that destroyed vital infrastructure, flooded crops, and worsened the living conditions of the population. The country's southeastern region, already vulnerable, saw its nutritional situation worsen significantly. In 2022, 19,195 children under five years old diagnosed at health centers in the southeast suffered from malnutrition, prompting an emergency intervention by MSF in the region.

"The cyclones Batsirai and Emnati completely changed our lives. At the time, the two cyclones destroyed our crops. If the winds didn't ravage them, the floods finished them off. Since that episode, we haven't had enough food for the entire year. Our harvests are no longer sufficient. We face periods of famine," says Soa Arilette, the mother of a malnourished child treated by MSF in Ambolomadinika, a village located in Ikongo district.

Soa Arilette is not the only one facing these changes. Agriculture is the primary source of income for the population, and the two cyclones drastically disrupted the nutritional situation. The floods destroyed rice, cassava, and vegetable plots, while the strong winds damaged rainfed and perennial crops. According to a report from Madagascar's Ministry of Agriculture and Livestock in 2022, it was estimated that more than 60% of agricultural land in the country was affected by these disasters, leaving more than 98,000 households in need.

A New Nutritional Dynamic

In the Ikongo district, a southeastern region of Madagascar where MSF has been working since 2022, malnutrition was rare before the cyclones hit. Rates were generally stable at around 1%. However, after these two cyclones, food conditions drastically changed. Rates stood at 6% in 2024, after peaking at 17% in 2022 after the Batsirai and Emnati. This figure highlights the communities' inability to recover quickly and the increased vulnerability of households, as explained in a report by the Ministry of Agriculture and Livestock

"We had never had such difficulty feeding ourselves before Batsirai. Since then, it's as if everything has collapsed. We struggle to find enough to eat all year round, and it's even harder when our harvests run out," says Soa Arilette.

"During harvest periods, the population has more or less enough to eat. But outside of these times, communities face real difficulties in finding food. As children are the most vulnerable, they are the most affected by the situation," explains Ambinison, head of the Ambolomadinika Health Center, one of the six health centers supported by MSF for malnutrition in the Ikongo district. Despite these challenges, the community is actively working to face malnutrition.

The population's reliance on climatic conditions, exacerbated by climate change, significantly impacts food security. Recurring episodes of cyclones and floods make crops increasingly uncertain, further aggravating malnutrition. The malnutrition rate in farming regions like Ikongo largely depends on the rainy and cyclone seasons. During peak periods, the overall malnutrition rate can reach 17%, as in 2022 after the passage of cyclones Emnati and Batsirai, while during harvest periods, it remains relatively stable at around 4%.

Health Interventions in the Ikongo District

The Ikongo district in southeastern Madagascar illustrates the challenges of geographic isolation and vulnerability to climatic threats. Poor road conditions and the increasing frequency of natural disasters make access to healthcare and the delivery of humanitarian aid difficult.

Since the project's launch, our teams have diagnosed and treated 4,140 children suffering from malnutrition. Initially, MSF focused on treating the most severe cases. However, in February 2024, to combat malnutrition more effectively, MSF expanded its efforts to include both moderate and severe acute malnutrition. Today, MSF supports six basic health centers offering primary CRENAS (outpatient therapeutic feeding center) services, as well as one CRENI (intensive nutritional recovery center) for diagnosing and treating malnourished children in the Ikongo district year-round.

In the coming months, Médecins Sans Frontières plans to intensify its interventions by collaborating with other partners, the Ministry of Health, and local communities to better address the impacts of climate change. This multidisciplinary project will provide medical support while tackling environmental challenges and focusing on livelihoods, access to water and sanitation, and education.