Contents
1. Djibouti; Uncertain Past - Promising Future
2. Military focuses on development in Africa, In Djibouti, US forces combat terrorism with civil affairs work.
Africa News, July 16, 2007/BYLINE: Addis Fortune
Djibouti; Uncertain Past - Promising Future
A girl gets fish from the fishermen at the Djibouti port, March 3, 2007. [© AP Images]
When a tenth of Djibouti's population crowded the small stadium named after the country's first president since independence, Hassan Gouled Aptidon, on the night of June 26, 2007, Aboubaker Omar Hadi, 49, was following the event live on TV from home. In the presence of its serving President, Ismael Omar Guelleh, and his wife, Kadra Mahamoud Haid, the 30th year anniversary of Djibouti's independence was celebrated with much fanfare, from fireworks to a military parade and the mass-wedding of 30 couples between the ages of 25 to 30.
If Mr. Hadi stayed at home the night of a live-band performance and fireworks on the eve of his country's independence day, it was hardly because he was not in a mood of merriment; in fact, he was among several Djiboutians seen that week unable to conceal their excitement of remembering the day their country became independent of French colonial rule. For many of them, the history of colonialism is still up-close and personal.
Mr. Hadi remembers a particular night 10 years prior to his country declaring its independence on June 27, 1977, for it has left in him a bitter memory of embarrassment. That French soldiers had forced themselves into his parents' house after midnight, located in Dikhil, a small town not far from the Ethiopian border, is still fresh in his memory.
They had ordered everyone in the house to get up and leave, before they conducted their search for weapons. That was a time when the French colonial power began to meet a popular uprising and resistance in its East African colony, then known as French-Somaliland. It was in that same year that today's Djibouti was renamed by France as "French Territory of the Afars and Issas" from what was a declaration in 1945, as an overseas territory of France.
Although it was an incident that had long gone, it was not without putting unwashed marks on the nine-year-old Mr. Hadi, who was at the time in fifth grade. Forty years later, his mind rereads how terrified his mother had been when forced to stand aside, with only pyjamas on."I will always live with my mind replaying that scene," said Mr. Hadi.
This is not to mention the years he now recalls when he and his friends were sneaking into the city of Djibouti through underground tunnels. Those were the days when the natives from outside of the city were required to have special passes to cross the barbed wire checkpoints, into the coastal city of Djibouti.
Mr. Hadi is not alone in remembering those years.
Hassan A. Waberi remembers the years when he was crossing the barbed wire that had encircled the city only after showing his pass almost every morning. He was in Bucharest, Romania, when Djibouti declared its independence attending his studies, after being granted a scholarship.
Independence day thus represents an occasion that grants Mr. Hadi comfort, knowing that his five children will never be subjected to such treatment that he and people of his generation had to go through once in their lifetime.
But it is a freedom won through hardship and the loss of human life, and a struggle spearheaded by politicians mainly from Mr. Hadi's clan, according to some historical accounts.
Indeed, how the French surfaced in Djibouti in the first place is a subject of a big historical gap of understanding between Djiboutians and many in Ethiopia. The all-too conventional understanding in Ethiopia of Djibouti's history is a piece of land that was part of Ethiopia before it was given away by Emperor Menelik to France under a 100-year lease arrangement, in exchange for the construction of the railway.
Almost all Djiboutians are baffled by this. As certain as Ethiopians are in their historical assertions, so are Djiboutians impulsive and dumbfounded in their reaction. For an Ethiopian, being challenged to cite any such agreement allegedly signed between France and Emperor Menelik is quite a common encounter.
If there is any historical certainty, however, there was a treaty signed between France and clan leaders of Afar in 1862, in the coastal town of Obock, the first capital of Djibouti. It was Emperor Tewodros who ruled Ethiopia at the time of French arrival at the Red Sea coast while Emperor Menelik had escaped from Tewodros' prison in Mekdela. He was 18 years old at the time and crowned as King of Shewa.
It took another seven years since the French had established their hold in Obock for Menelik to become Emperor of Ethiopia, following the death of Emperor Yohannes, in 1889. If there was any agreement Menelik had first signed while claiming the throne from Emperor Yohannes' heir, Ras Mengesha, at the time, it was with the Italians over Eritrea, a treaty, aka the "Wuchalie Treaty", that in fact led to the Battle of Adwa.
These are indeed historical chronologies that make a confrontation with a puzzled Djiboutian hard to ignore.
After their presence of over a century in the Horn of Africa, the French did not deliver Djibouti on a silver plate to its natives. It took two referendums and the lives of its freedom fighters such as Mahmoud Harbi and Djaema Mahamoud Boreh, who were assassinated when the aircraft they were in blew up over the Mediterranean Sea en-route to Djibouti. They were leaders of the clandestine movement to free this tiny part of the Horn of Africa from French colonial rule. Many of them were exiled into Somalia and Ethiopia, while there was also parallel political activity inside Djibouti, to pressure France to grant them independence.
This civic activity was in fact accompanied with protest marches and the outbreak of urban violence, which was frequently crashed by the French military, in the late 1960s and early 1970s.
Abdurahiman Ismeal Elmi, 48, remembers those days for they still have their mark on him today. Sustaining a childhood trauma of physical assaults from French military crackdown against the revolts, today, Mr. Elmi is very much reluctant to go near a crowd, whether it is demonstration or public celebration.
It took the accidental visit of General De Gaulle, post Second World War president of France, that led to a final referendum where Djiboutians voted for independence, overwhelmingly. On June 27, 1977, Djibouti became the 148th member of the United Nations (UN) and 49th member of the Organisation of African Union (OAU).
France continued to have a sizeable military presence following a deal it had signed with the new rulers, lead by Mr. Gouled, who had served as minister of education during the colonial period.
Nevertheless, the years since independence were hardly free from crises. The growing sense of disfranchisement by the Afars, who had one of their own, Ali Arif, as a president during the colonial time, had brought organised opposition. This became an open civil war in 1991, with the Afars launching a major assault under a newly established party, Le Front pour la Restauration de l'Ubite et la Democratie (FRUD). It was led by the late Ahmed Dini.
Although a splinter group of FRUD had created an alliance, in 1993, with the ruling party to form Rassemblement Populaire pour le Progres (RPP), it was not until the election of the current President in 1999 that Djibouti made a real peace with itself. A nephew of Mr. Gouled and security chief of his government. Mr. Guelleh had comfortably won his first election in April 1999. He subsequently managed to bring national reconciliation, where an Afar, Dileita Mohammed Dileita, became prime minister, since 2001.
If there was any sign of protest against his rule since then, it was seen in December 2000 when a disgruntled Police General, an Issa, had attempted a coup. This had little bearing when Mr. Guelleh, who was born and raised in Dire Dawa and speaks fluent Amharic, was re-elected in April 2005 in a one-man presidential election. But he challenged his countrymen and women claiming he would step down should he fail to get less than 70pc of their votes.
Since the late 1990s, Djibouti has enjoyed domestic calm in a very volatile and troubled region. And it is prospering economically, with its citizens' restored confidence in their future when compared to the 1990s when economic depression had engulfed it. Government was ailing to pay public servants for months, businesses were down and many of its citizens were in an exodus to Europe and the United States (US).
"That was a period when France had decided to reduce drastically the number of its soldiers, thus its economic assistance, and the new government in Ethiopia shut the borders against the once thriving contraband that fed eastern parts of Ethiopia and Dire Dawa in particular," said an Ethiopian who has lived in Djibouti for 30 years, arriving there four days after it declared independence.
Two things had merged at about the same time that was a blessing in disguise to Djibouti.
In 1998, Ethiopia was forced to move all its transit cargo to Djibouti, following the outbreak of the Ethio-Eritrean border conflict. It remains the case since then, that its over four million tonnes of cargo generates hundreds of million dollars to this nation of not even one million people.
Three years down the line, an international political development following the incident on September 11, 2001, in the US, brought western military powers to Djibouti, adding to the military presence of France. Germany, Spain and the US are the new players. The latter has its 2,000 soldiers stationed in Camp Lemonier, located adjacent to the Djibouti International Airport; under the command of the Combined Joint Task Force-Horn of Africa, it is the only military base the most powerful country on earth has in Africa.
This Western military presence is not without a cost to the countries that have housed their military personnel there. Djibouti's former colonial master, France, pays 38 million dollars and the Germans put an estimated 10 million dollars, according to a recent report by a Consortium of Investigative Journalists.
The largest fund, however, comes from the US; it paid over 53 million dollars in the three years since 9/11 in order to use the 88-acre Camp Lemonier. The lease agreement has been negotiated recently for Djibouti to get paid 30 million dollars a year, according to the same report. The foreign military financing the US government used to give to Djibouti grew from 100,000 dollars to 21 million dollars in the first three years after 9/11 and an additional five million dollars a year as coalition support funds are provided by the Pentagon.
This does not include the economic assistance Djibouti is getting from the US after its choice to be part of the global fight against terrorism, although its President condemned the invasion of Iraq and the continued presence of the US there, on a speech he delivered on independence day. Washington has now granted Djibouti 25 million dollars in aid as an economic support fund, an amount which was zero prior to September 11.
Djibouti's economy looks good, and thriving, as a result. But, this is an understatement about a country that has a history lacking official statistics.
"The economy is typically more robust than official data suggests," said a recent report by the Economic Intelligence Unit.
On paper though, it has a Gross Domestic Product (GDP) per capita of 983 dollars, a figure larger than any of its neighbors, including Ethiopia, which is struggling to increase it to 130 dollars. The economy is largely centered on port activities and services, a phenomenon that has barely changed since independence. It is a small economy with a national budget of 236 million dollars, and an import value that is barely half a billion dollars.
However, it grew by 4.5pc last year, while inflation was contained at 3.6pc, according to the International Monetary Fund (IMF).
And the leadership seems keen to have a vision that unites Djiboutians on the national desire of turning their 14,400sqm arid and torrid land into an African version of what Dubai is to the Middle East, a hub of trade and services. The promises are already there.
Since the arrival of Dubai Port International - now DP World - in 2000, to manage the Port of Djibouti on a 20-year concession, the economic revival is evident, not only with the changing face of the Port itself, but also the series of investments coming from companies based in the United Arab Emirates (UAE). Instrumental in this is Abdurahiman Boreh, a Dire Dawa born businessman, whose uncle was assassinated during the years of struggle for independence. He brokered a deal and served his country as a bridge in persuading managers of DPI to help his government make another Dubai in East Africa.
The result was a total of 800 million dollars investment in the past five years.
It was spent on the construction of a bulk petroleum, LPG, chemicals and edible oil terminal in Doraleh, a brand new Port 13Km east of the city centre. It was built and managed by Horizon Djibouti, a subsidiary company of Emirates National Oil Company (ENOC). When completed, with a planned container terminal, Doraleh is projected to consume up to half a billion dollars.
"Look at the new Port," said Ali, a taxi driver pointing his fingers at the number of oil terminals appearing from a distance, thus explaining why he is hopeful his country has a better future.
Doraleh is a monument for many Djibutians that gives them hope that what their President tells them about the future of their country is achievable. But it is not the only reminder. There are others visible on ground and yet to come.
A five-star luxury hotel was built alongside the Red Sea by Nakheel Hotels & Resorts, a Dubai interest that has put 75 million dollars building the resort hotel that was completed in only eight months in order to make it ready for the opening of a COMESA Summit Djibouti had hosted in November 2006. It was here, at the Djibouti Palace Kempinski, that the all-Djibouti exclusive party, organised by the First Lady, was held on the night of the Independence Day.
Djibouti Free Zone is a project that promises to give the country the opportunity to become another Dubai of this region. It was first opened in 2004, on a 32hct plot, after the government granted Jabel Ali Free Zone Authority (JAFZA), a subsidiary of Dubai World, a 30-year management concession in 2003.
The idea is to create a trade zone where businesses trading in food and beverages, construction materials, automobiles and spare parts, cigarettes, textile and garments do their business without being subjected to tax and duty. To date, the Free Zone houses 79 companies that have put over 20 million dollars capital in aggregate.
There is a second phase to it: comprising a 280,700sqm plot dedicated for light industrial units and warehousing facilities, it has a capacity to incorporate an additional 100 companies that can import industrial goods from the rest of the world and re-export them to countries in the Greater East Africa. It was inaugurated a day before Djibouti's 30th year Independence, by Prime Minister Dileita.
A promise was made to build a "cargo village" inside Djibouti International Airport in order to help landlocked countries such as Ethiopia send their goods by plane in order to ship it through the sea. This is a project praised by Djibouti authorities as pioneering on the African continent.
Amidst this optimism, a growing sense of purpose and national unity, as well as an overwhelming popular support, President Guelleh is hardly spared from questions. Although the opposition in Djibouti is described by an Ethiopian working there as "spineless and not serious", citizens are wondering, perhaps quietly, where all the money that is poured into Djibouti is going. The renovations of tarmac roads and the growing construction in the capital, where 70pc of the population lives, barely satisfy their quest for an answer.
Mariam, a young Afar woman, wants to see the government do a lot more in providing jobs to the younger generation. She wants the seeming economic rebound she sees in her country to be translated into giving her a "real and respectable job" rather than the work she has at one of the restaurant-bars in downtown Djibouti. She is lucky to have a job that pays.
The IMF is worried about the type of people it described as "ghost workers"; people who earn a monthly salary from the civil service without performing any duty to the organisation they supposedly work for.
Others want the government to spend more in building clinics, hospitals and schools all across the seven districts of the country. They see little.
"I wonder what they do with all that money," said a Djiboutian, anonymously.
There is little option for him to speak in public in a country that gives visitors the impression that there is hardly any public discourse on issues such as state expenditure. The electronic media is controlled by the state, and there are no privately owned newspapers. Seeing non-state actors, rights activists or academics organise public debates on issues in any of the hotels is rare, if there are any at all.
"Come and see our debates at our megilis," a retired Member of Parliament (MP) advising one of the ministries, who was born in Dire Dawa, said in his bid to challenge such assertions.
He was referring to the culture of khat, where the scorching sun forces people in Djibouti to stay at home the whole afternoon and chew the leaf, thereby engaging in group conversations. Some of these conversations could become intense, especially when the issue is about Ethiopia's involvement in Somalia.
Although this is an issue dear to many Djiboutians, interestingly, President Guelleh chose to ignore it during his independence day address, while he spoke about Iraq and Palestine.
Yet, regional stability is crucial for Djibouti to grow economically and if it wants to realise its dream of becoming the region's business hub. Although it is exceptional in the Horn for not suffering domestic political turmoil, what happens around it affects it as much as direct involvement.
If it is putting too many resources and too much energy to build a brand new port incorporating oil and container terminals, it is because it eyes a lot larger market than what Ethiopia gives it. In a way, this is a strategic move to avoid total dependence on Ethiopia, thus establishing its new harbour as a point of transhipment, a location where big vessels drop containers to be picked up by other ships for onward destinations.
This requires the international shipping cartels to use the new port regularly and in huge numbers as they have tried in 2003, subsequent to the terrorist attack on the Port of Aden. The cost of insurance of these big vessels depends very much on the risk level evaluated by Lloyds Market Association, an international risk assessing firm based in London.
Because Djibouti is located in a troubled region of conflicts, it is classified by this organisation as a "high risk" port, thus making the cost of calling its port very expensive to these shipping lines.
"One of the greatest difficulties to overcome in the short term and prior to operation commencement in December 2008 is to help these shipping lines reduce the high costs of insurance they are forced to pay when calling to Djibouti," says a journal produced by the Djibouti Free Zone Authority.
A review of the region by an organisation that advises Lloyd's, Aegis, scheduled at the end of this month, is highly anticipated to help remove Djibouti from this list. So much is thus depending on what goes right in the Horn of Africa, a region that continues to be in turmoil.
But the personal challenge to the generation of Mr. Hadi is not so much in restoring confidence or sharing a promising future. It is in connecting their past to members of the young generation who have no experience about life under colonial rule.
Mahanoud Houssien was only five years old when his country became independent, too young to remember any of the French rules. He hears the stories of colonisation and the fight for freedom from his elders as does Gouled Abdoulkadir Abdi, 34, a French teacher at an elementary school. Their emotion to their country's past is not as powerfully emotional as their elders, though.
Military focuses on development in Africa
In Djibouti, US forces combat terrorism with civil affairs work. Will this be a model for a future US military command in Africa?
By Ginny Hill | Contributor to The Christian Science Monitor
from the June 22, 2007 edition
Djibouti - When Petty Officer Samson James Hathaway and his US naval construction team arrived in the village of Hol-Hol three months ago, they stood in the 100-degree heat and looked at the camels padding through the boulders and dust.
"We've got our work cut out for us here," thought Petty Officer Hathaway.
The marines and sailors set up home on a makeshift soccer field beside the Djibouti-to-Ethiopia railroad line, close to a Somali refugee encampment. The 26-man team from Gulfport, Miss., is tasked with reroofing the local school, installing new latrines, and building a meeting room. They will remain in Hol-Hol, a two hour off-road drive from the US military base at Camp Lemonier, until the job is completed in September.
This small group is part of a larger US military mission that aims to tackle the root causes of terrorism by focusing on diplomacy and development. Chiefly based at Camp Lemonier, the Combined Joint Task Force for the Horn of Africa (CJTF-HOA) works to project power into a region that's loaded with tension – most prominently, the civil war in Somalia. They're creating a model that could influence the formation of the US Africa Command (AFRICOM), a new, combined US military umbrella group that will become operational in 16 months.
"CJTF-HOA has served as a test-bed for ideas and concepts, and it has found approaches that work well in several countries on the Horn," says Rear Admiral Robert Moeller, executive director of the AFRICOM Transition Team. "Part of AFRICOM's charter is to be more collaborative, and it's important that our African partners see a consistency in our approach. Whether that's a long-term presence, like CJTF-HOA, or rotational, our engagement needs to be sustained."
Camp Lemonier's cramped 100-acre site on the outskirts of Djibouti City houses 1,800 military personnel and employs 700 Djiboutians, who are managed by US civilian contractors. The base comes under naval leadership, with close cooperation from the Marines, the Army, and the Air Force.
CJTF-HOA teams have completed hundreds of projects in the past four years, ranging from well-drilling, vaccination programs, disaster response, and military-to-military training. The $49 million budget for 2007 will fund operations in Djibouti, Ethiopia, Kenya, the Seychelles, and Yemen.
Colonel Michael McMillie, 449th Air Expeditionary Group commander, uses one C-130 aircraft to supply 300 US troops working in the field. "It's a major logistical challenge," he says. "We're trying to reach remote locations with no paved roads, and we're transporting delicate and expensive equipment."
Stephen Morrison, director of the Africa program at the Center for Strategic and International Studies, says he believes this far-flung fieldwork provides valuable training opportunities. "They're developing essential deployment skills, such as construction, camp maintenance, and team-building," he says. "And it's an ideal chance to practice community interaction in a semi-hostile environment."
Hathaway, whose Djibouti deployment came after five months in Iraq, says a unique aspect of his Hol-Hol mission is exposure to the local population. In Iraq, he survived incoming mortar rounds to build a runway and military housing but he never left the base. "Here, we see the same people everyday, we're relating one-to-one."
In an effort to overcome the language barrier, the Gulfport team defies Djibouti's punishing summer temperatures to play regular soccer matches with the local children.
"In the beginning, we were suspicious but now we've seen that they are good people and they're doing good things for our village," says Abdul-Rahman Bossis, an unemployed Hol-Hol resident.
Director of Public Affairs Major David Malakoff says he believes these outreach efforts can foster a positive impression of the American military, but he is honest about the challenge. "How much of a difference are we going to make? That's hard to say. It's not something that we can judge short-term," he says. "Our target group is today's children, so we're not going to know for 10 or 15 years. But we hope that, in the long run, we could be saving lives."
Michael O'Hanlon, foreign policy analyst at the Brookings Institution, thinks that civil affairs programs "created in partnership with host governments and combined with efforts to foster economic progress can be very useful as part of a broader strategy."
But Alex de Waal, director of the London-based advocacy and research organization Justice Africa, argues that global media coverage of the US military in combat overshadows the potential good will generated by such small-scale projects.
"January's air strikes targeting al-Qaeda suspects in southern Somalia had a disastrous impact on America's image in the region," he says. "US gunships didn't take off from Camp Lemonier but many people in the region assume it is all part of the same plan."
It's not yet clear how Camp Lemonier's function will evolve when the current patchwork of responsibilities under Pacific, European, and Central Commands are consolidated into a single unit for the whole continent.
Rear Admiral Moeller says CJTF-HOA provides a good example of the kind of interagency coordination that AFRICOM hopes to achieve. "We've understood for a long time that the challenges in Africa cannot be solved by the military alone. Economic development, responsive governance, health, crime, and poverty are all pieces of the security environment."
The CSIS's Mr. Morrison says American stakes in Africa have risen dramatically in the last couple of years in relation to energy security, counter-terrorism, and intensifying competition with China. "The creation of AFRICOM reflects the need for a more unified approach and a higher priority in managing US military interests on the continent. But it's still at the planning stage. Decisions about AFRICOM's internal structure and base locations will come when the mission is more clearly defined."
Djibouti
Ranked 150th out of 177 on the UNDP Human Development Index, Djibouti is classified as both a least developed and a low-income, food-deficit country. The economy is largely service-based and agriculture accounts for only 3% of the GDP. It is dependant on imports for the majority of its food requirements. According to national statistics approximately 60% of the population live under the national poverty line. Extreme poverty increased from 9.6% in 1996 to 42.2% In 2002. The country continues to recover from the 1990- 1994 civil war that led to large displacements of people and the destruction of schools and clinics.
Djibouti's infant and under-five mortality rates are among the highest in Sub-Saharan Africa. The poor health status of children is primarily a result of widespread malnutrition. Suffering from the regional instability in the Horn of Africa, it is home to approximately 27 000 refugees. There are pockets of severe food, water and health insecurity in the interior of the country.
Djibouti Statistics:
Basic Indicators
Under-5 mortality rank 30
Under-5 mortality rate, 1990 175
Under-5 mortality rate, 2005 133
Infant mortality rate (under 1), 1990 116
Infant mortality rate (under 1), 2005 88
Neonatal mortality rate, 2000 38
Total population (thousands), 2005 793
Annual no. of births (thousands), 2005 27
Annual no. of under-5 deaths (thousands), 2005 4
GNI per capita (US$), 2005 1020
Life expectancy at birth (years), 2005 53
Total adult literacy rate, 2000-2004*
-Net primary school enrolment/attendance (%) , 2000-2005* 33
% share of household income 1994-2004*, lowest 40%
-% share of household income 1994-2004*, highest 20%
Total expenditure on health as % of GDP (2004): 6.3
Total expenditure on health per capita (Intl $, 2004): 87
Probability of dying between 15 and 60 years m/f (per 1 000 population): 384/336
Source: The State of the World's Children
Main Public Health Issues and Concerns
Health Status
- Infant and under-five mortality are 97 and 138 per 1000 live births respectively. Acute respiratory infections, diarrhoea and malnutrition are the main causes of morbidity and mortality amongchildren under five.
- Life expectancy at birth is estimated at 52.8 years.
- Tuberculosis, diarrhoeal diseases, malaria and measles are among the main causes of morbidity and mortality.
- More than 30% of children under five suffer from malnutrition, accounting for a third of all deaths in that age group.
- Maternal mortality is estimated at 730 per 100 000 live births.
- The current AIDS prevalence rate is about 3%.
- The incidence of TB is 734 per 100 000 and rising. The percentage of multidrug resistant cases is 1.6%.
*
Health System
* The health system is mostly curative-oriented; investment in preventive medicine is scarce.
* The system is characterized by weak infrastructure, lack of equipment and poor maintenance.
* There is a lack of trained and motivated personnel. Staff is insufficient in terms of quantity and quality, as well as in terms of geographical distribution. According to the MoH, the General
Hospital Peltier, located in the capital, absorbs 70% of the country’s public health workforce.
* Vaccination coverage is low; this is due to the poor utilization rate of services, the unavailability of immunization services in health facilities and poor geographical access to services in some regions.
* The MoH has set up a consultative committee on the prevention and management of outbreaks. A surveillance system for communicable diseases has been put in place, including immediate notification as well as weekly and monthly reporting.
* There are an estimated 1.6 physicians, 8 nurses and midwives, 9.6 health workers and 16 hospital beds per 10 000 people.
* Total expenditure on health is approximately 5.8% of the GDP. Public expenditure on health is
67.3% of the total health expenditure and private expenditure is 32.7%. Per capita total
expenditure on health is US$ 78.
* There are three categories of health providers: the public sector includes all the facilities related to the Ministry of Health (MoH), the Ministry of Interior and the Ministry of Defence (as well as the French military cooperation hospital); a semi-public sector depending on the Social Services and the private sector (the French military hospital provides also private health care).
Main Sector Priorities
The main health sector priorities include:
* Supporting national priority health programmes and basic services, including surveillance and
outbreak control, mother and child health, immunization, mental health, education, etc.
* Supporting the health sector reform and the implementation of a primary health care system;
* Reviewing the health financing system;
* Developing human resources as well as capacity building for health staff;
* Developing a national policy on the supply and use of essential medicines;
With the regards to the ongoing food crisis, the main humanitarian priorities include:
* Rapid assessments of the relief requirements;
* Emergency measles and meningitis immunization;
* Nutritional monitoring through the establishment of a surveillance system;
* Provision of essential drugs against diarrhoeal diseases, malaria and acute respiratory infections,
* Expansion of basic health service coverage in rural districts;
* Provision of clean drinking water and appropriate human resources for technical support.
Djibouti (May 2006)