Four famines on a scale unprecedented since World War II are on the brink of breaking out in Africa, and the scope of the problem is inspiring a new approach to humanitarian aid — to give cash directly to those in need.

According to the UN, more than 20 million people are currently at risk of starvation. Parts of South Sudan are already suffering from famine, but Nigeria, Somalia and Yemen may soon face a similar crisis due to drought and ongoing conflict.

"Already at the beginning of the year we are facing the largest humanitarian crisis since the creation of the United Nations," Stephen O'Brien, the UN's head of humanitarian efforts, told the UN Security Council earlier this month.

"Without collective and coordinated global efforts, people will simply starve to death."

While the days of the UN convoy carrying bags of grain are not over yet, a number of international aid groups are now giving money or vouchers to communities as a means to rapidly scale up their humanitarian efforts.

Feargal O'Connell is the regional director for the Horn of Africa with Concern Worldwide, a private aid organization based in Ireland. The group is currently using mobile payments to deliver direct cash transfers throughout East Africa.

As O'Connell tells Day 6 host Rachel Giese, they've been working on these techniques for more than a decade.

Internally displaced Somalis carry their belongings as they flee from drought stricken regions before entering makeshift camps in Baidoa, west of Somalia's capital Mogadishu. (REUTERS/Feisal Omar)

Choice gives 'dignity' to vulnerable people

O'Connell says that cash transfers are a relatively simple system to set up and then scale to meet the necessary demand in countries with a high prevalence of cellphones, where they can keep track of payments.

By contrast, commodities like grain or meat need to be transported to those communities, where they can harm local retailers who have to compete with free goods.

"You're really restrained by the logistics of it — the number of trucks available, the conditions of the road, the availability of fuel and things like that," says O'Connell.

As long as there's a functioning market in the community, which O'Connell says is common in countries like Somalia or South Sudan, cash is much easier to distribute and monitor.

O'Connell also argues the method offers affected families greater choice in how they use the aid, affording them "a certain amount of dignity."

A dust storm sweeps through a makeshift camps in Baidoa, west of Somalia's capital Mogadishu. (REUTERS/Feisal Omar)



Cash transfers are one tool of many

In Somalia, the World Food Programme, an UN agency, has registered 1.6 million people for a smart card system called Scope.

Scope works like a pre-paid debit card. Family members register their fingerprints to the card, and that gives them access to food vouchers they can redeem at more than 600 retailers across the country.

"It gives them a choice, and I think that's very important, especially for mothers because they're able to cook local food with local ingredients," says Amor Almagro, a communications officer with the WFP in Somalia.

The card has been used in partnership with UNICEF to deliver water vouchers. Beyond that, UNICEF is partnering with the Amal Bank in Somalia so that beneficiaries can receive local currency.

A boy watches sacks of food being airdropped by the UN World Food Programme near Rubkuai, South Sudan. (REUTERS/Siegfried Modola)

Important to have 'an honest discussion'

These UN agencies don't use these methods alone. Almagro says that in the Somali state of Puntland, one community might be able to use Scope, but another 30 kilometres away might not have a viable market to support it.

Though critics are concerned these methods will lead to irresponsible spending, Concern Worldwide has been researching how the money is used and has found that isn't the case.

"If your children are severely malnourished, or if you've been uprooted from your home because of conflict, it really means that [...] you're going to treat every penny that you have carefully," says O'Connell.

A child is checked for signs of malnutrition by a UNICEF health worker in South Sudan. (REUTERS/Siegfried Modola)

An important consideration for these groups is that they hear from the people they're serving what system works best for them and their market.

Too much cash can lead to inflation in local markets, making food more expensive. Meanwhile, some regions are too dangerous for markets to operate.

"The most important thing to do is to sit down with the community and have an honest discussion with them about [...] how they would prefer to receive the assistance," O'Connell says.

To hear Rachel Giese's conversation with Feargal O'Connell, download our podcast or click the 'Listen' button at the top of this page.