NAIROBI — A decision by extremist Islamic militants to ban delivery of food aid and a ‘‘normalization of crisis’’ that numbed international donors to unfolding disaster made south-central Somalia the most dangerous place in the world to be a child in 2011.
The first in-depth study of famine deaths in Somalia in 2011 was released Thursday, and it estimates that 133,000 children younger than age 5 died, with child death rates approaching 20 percent in some communities.
That’s 133,000 under-5 child deaths out of an estimated 6.5 million people in south-central Somalia. That compares with 65,000 under-5 deaths that occurred in all other industrial countries in the world combined during the same period, a population of 990 million, said Chris Hillbruner, a senior food security adviser at FEWS NET, a US-sponsored famine warning agency.
‘‘The scale of the child mortality is really off the charts,’’ Hillbruner said in a phone interview from Washington.
FEWS NET was one of two food security agencies that sponsored the study. The other was the Food Security and Nutrition Analysis Unit — Somalia. The two agencies had warned the world as early as fall 2010 that failed rains in Somalia meant a hunger crisis was approaching.
‘‘The world was too slow to respond to stark warnings of drought, exacerbated by conflict in Somalia, and people paid with their lives. These deaths could and should have been prevented,’’ said Senait Gebregziabher, the Somalia director for the aid group Oxfam.
The new study put the total number of famine deaths at nearly 260,000.
In March 2011 some 13,000 people died in the famine, the study found. In May and June 30,000 people died each month — at least half of them children. The UN’s formal declaration of famine did not occur until July.
‘‘I think that one of the key issues is that there was this normalization of crisis in south-central Somalia, and that I think the international community has become used to levels of malnutrition and food insecurity in southern Somalia that in other parts of the world would be considered unacceptable,’’ Hillbruner said.
In Washington, State Department spokesman Patrick Ventrell said the hardest-hit famine regions were controlled by the extremist Islamist group al-Shabab.
‘‘Al-Shabab’s inhumane blockage of humanitarian assistance prior to and during the famine, including banning dozens of humanitarian organizations from providing lifesaving assistance, thwarted a more rapid international rapid humanitarian response that could have saved even more lives,’’ Ventrell said. ‘‘And equally, al-Shabab’s refusal to allow affected populations to leave al-Shabab-controlled areas prevented them from seeking assistance elsewhere.’’
The study was conducted by Francesco Checchi, an epidemiologist at the London School of Hygiene and Tropical Medicine, and Courtland Robinson, a demographer at Johns Hopkins University. It drew on 200 mortality surveys by the Food Security and Nutrition Analysis Unit, including 61 from the famine period, and data on food prices, wages, and humanitarian access.
Philippe Lazzarini, the chief UN humanitarian coordinator for Somalia, said in a news conference from Mogadishu Thursday that the death toll was shocking and sobering. He said the report confirms that aid groups should have done more before famine was declared.
Lazzarini also noted that more than a dozen aid groups were banned from operating in south-central Somalia by al-Shabab, a hardline anti-West political decision that made saving lives ‘‘extraordinarily difficult.’’ He said that before famine was declared the crisis did not get the attention it should have, in part because of a lack of access because of al-Shabab.
‘‘The famine was almost a silent drama of tragedy,’’ he said. ‘‘It was not on the news. Media did not have access. Agencies did not have access. The extraordinary challenge of access explains why the early response, despite the early warning, did not really take place.’’