United Nations System
Standing Committee on Nutrition

Great Lakes Region

Burundi

A cease-fire agreement was signed on the third of December between the Burundi government and the FDD (Forces for Defence of Democracy), one of the two main rebel groups (Reuters, 03/12/02). However, the other main remaining force, the FNL (Forces of National Liberation) did not participate in the peace talks. Despite the truce, clashes continue to be reported.

Refugees, returnees, displaced persons

As of 31 December 2002, UNHCR estimated that a total of 52,853 Burundians have returned to Burundi from Tanzania, which includes 31,421 facilitated returns and 21,432 spontaneous returns (OCHA, 12/01/03). Because of an upsurge in violence, returns have dropped dramatically over the past weeks. In addition, the number of Burundians who fled to Tanzania has greatly increased. Some 17,000 Burundians entered Tanzania in October 2002 (AFP, 14/11/02), compared to 3,000 in September (RNIS 39).

Following renewed fighting in Uvira area in the Democratic Republic of Congo since mid-October, thousands of Congolese have sought refuge in Burundi. About 12,000 were registered at the end of October and a new wave of about 9,000 arrived at the end of 2002 and the beginning of 2003. Refugees first settled near the volatile border area, in Gatumba and Bujumbura rural provinces. UNHCR began to move them to newly-developed camps; as of mid-January, 3,000 were settled in Cishemeye camp, in Cibitoke province and 2,400 were settled in Gasorwe camp in Muyinga province (UNHCR, 07/01/03). It seems that far more Congolese were prevented from crossing Burundi's border.

Disease outbreak

No new cases of cholera were diagnosed during the second week of October (OCHA, 31/10/02). About 1,100 cases of meningitis and 257 deaths were reported in October 2002. Northern and central provinces were particularly affected. A vaccination campaign has been launched in northeastern Burundi (MSF, 25/10/02).

A malaria epidemic has been declared in Gitega and Ngozi provinces (MSF, 05/12/02).

Food security and nutrition situation

A two-month delay in rains for the 2003 A crop season (September/October-January) and the poor 2002 C harvest (September) is putting pressure on the food security of the population, at least until February 2003. Fighting and inflation are further compounding the situation (SAP-SSA, 11/02). It is estimated that the number of people in need of food aid could rise from 580,000 to 1.2 m (WFP, 02/12/02). History of admissions to feeding centres shows that admissions were significantly lower in 2002 than in previous years, especially than in 2000 and 2001 (see graph). However, the number of admissions has been reported to have increased since October 2002.

Admissions to Therapeutic Feeding Centres, Burundi (UNICEF Burundi)

Admissions to Supplementary Feeding Centres, Burundi (UNICEF Burundi)

Overall - The current food security situation in Burundi seems to be very precarious. Close monitoring and food aid should be provided in order to prevent any significant deterioration of the nutrition status.

Democratic Republic of Congo

Peace talks between the government and the two main rebel groups, the Congolese Liberation Movement (MLC) and the Congolese Rally for Democracy (RCD) resumed in South Africa at the end of October 2002. On the 17 December, all parties reached an agreement to end the four-year war. They agreed to set up a government of national unity. President Kabila will keep his function until elections are held in two years' time. Four vice-presidents, who will represent the government, the two rebel groups and the unarmed opposition, will be designated. Ministries will be distributed among the different parties (AFP, 17/12/02). However, renewed violence has spread in eastern DRC.

The Security Council has expanded to 8,700 the number of military personnel of the United Nation Organisation Mission in the DRC (MONUC) (UNSC, 04/12/02).

Following the withdrawal of Rwandan and Ugandan troups (which were backing rebel groups) as part of the peace agreement signed with those countries, Zimbabwe, Angola and Namibia, which were supporting the Kinshasa government, announced a final pull-out of forces at the end of October 2002 (OCHA, 25/10/02).

Upsurge in displacement

The withdrawal of Rwandan and Ugandan forces has led to an upsurge of fighting in north-eastern Congo.

In Inturi region, at least 500,000 people were displaced due to renewed fighting between Lendu and Hema communities (OCHA, 06/11/02). Over 5,000 people have crossed the border with Uganda (Xinhua, 23/10/02). The issue of ethnic cleansing has also raised concern (HRW, 31/10/02).

About 35,000 people were reported to have fled from Makeke town into Beni town on 31 December 2002 (MSF, 04/01/03). They are only a small part of hundreds of thousands who might be displaced in the region (MSF, 04/01/03, OCHA, 08/01/03). Extreme violence against the population has been reported (MSF, 04/01/03). However, a cease-fire agreement was reached on 31 December 2002 between the three factions which fight in the area. They also agreed to guarantee freedom of movement to the civil population and humanitarian organisations. MONUC will deploy military observers to the area (UNNS, 31/12/02).

The crisis affecting the northern town of Bunia continues. A cholera outbreak has been on -going since August and a humanitarian flight has been denied access (OCHA, 18/10/02).

In South-Kivu, the Mayi-Mayi forces took the town of Uvira, formerly controlled by the RCD, in mid-October. The town was recaptured by the RCD one week later. This led to the displacement of an estimated 60,000 people, of whom about 17,000 crossed the border with Burundi and 500 sought refuge in Tanzania (OCHA, 23/10/02). It seems that some 20,000 returned to Uvira after they were not permitted to enter Burundi (OCHA, 22/10/02). Despite the truce, a new upsurge in violence in the area at the end of December led to a new displacement of the population, of which 9,000 entered Burundi (UNHCR, 07/01/03).

Thousands of people have fled from Orientale Province to Eringeti area, northern Kivu (Tear Fund, 11/12/02).

In Katanga Province, 75,000 people were displaced by fighting between government troops and the Mayi-Mayi (22/11/02).

Maniema province

Before the war, Maniema Province was considered as the breadbasket of Congo. The region has been cut off from the rest of the country since the Kindu-Lubumbashi railroad was closed four years ago. Furthermore, in the months of August-September only, Kosongo area, southern Maniema, suffered from 15 attacks. Several villages have been burned or looted. Some 131,000 people, including 77,000 IDPs, are considered to be in need of humanitarian aid. A survey done by Concern in four sub-health zones of Kazongo health zone, showed a prevalence of acute malnutrition of 11.7%, including a high 3.8% rate of severe malnutrition. The rate of acute malnutrition was reported to have doubled since the last survey conducted in February 2002 (OCHA, 22/11/02).

Refugees

Forcible repatriation of Tutsi Congolese refugees from Rwanda (RNIS 39) appears to have ceased (OCHA, 25/10/02). The previously repatriated, who are settled in Kitchanga transit camp, are in great need of food and non-food aid (WFP, 07/11/02).

Overall - Although few nutrition data are available, the affected population in north-eastern DRC, and especially the IDPs, are considered to be at high risk of malnutrition (category I). If the cease-fire agreement proves to be effective, access to the population may improve and desperate humanitarian situations may be discovered.

Tanzania

Tanzania hosts more than 500,000 refugees, mainly from Burundi and to a lesser extent , from DRC and Rwanda. The political and military conflicts in the Great Lakes region continue to cause refugees to enter the country. Some 17,000 Burundians entered Tanzania in October 2002 (AFP, 14/11/02), compared to 3,000 in September (RNIS 39). There has also been an increase in refugees entering Tanzania from eastern DRC.

UNHCR announced that repatriation of Rwandan refugees from Tanzania was concluded at the end of 2002. About 23,500 Rwandan refugees have been repatriated in 2002, of whom 19,000 have been repatriated in November and December 2002 (AFP, 02/01/03). However, Refugee International expressed its concern about this repatriation movement (RI, 13/01/03). It appears that the repatriation was less than fully voluntary. According to RI, the plan was set up too quickly. A review of the refugees unwilling to repatriate was not implemented before the repatriation deadline. Furthermore, at the beginning of the repatriation plan, the reception of the repatriated refugees in Rwanda was inadequate. Some Rwandan refugees, unwilling to repatriate, spread out in Tanzania or went to another country. It seems that 3,000 Rwandan refugees have fled from Tanzania to Uganda (Xinhua, 18/12/02).

Burundian returns have dropped dramatically over the past weeks because of an upsurge in violence in Burundi. The Tanzanian government has reiterated its opposition to refugee integration (Xinhua, 21/10/02).

Nutrition status of the refugees

A nutritional survey was undertaken by UNHCR, in collaboration with their partners, in July 2002 (UNHCR, 07/02). Eleven refugee camps in western Tanzania, which host almost all the refugees settled in the country, were surveyed. People are almost entirely reliant on relief aid because they cannot engage in agricultural activities and are not allowed to move beyond the 4 km perimeter of their camps. It seems that some refugees are able to cultivate home-gardens.

The nutrition situation of the refugees was under control (see table). It has remained stable over the past three years. Vitamin A supplementation coverage varied from 82% to 98%. Crude and under-five mortality rates, recorded through routine surveillance, have remained stable since the beginning of the year: CMR were around 0.3/1000/month and under-five mortality rates varied slightly between 0.8 and 1.2/1000/month. There were no reports of particular health or water and sanitation problems in the camps. WFP food distributions were adequate in the first semester of 2002. However, WFP distributed only 72% of the cereal ration in December 2002 because of a cereal shortage. WFP has also warned that the cereal pipeline may be empty from February 2003, unless new contributions are made (WFP, 13/12/02). Disruption of food distributions in previous years had a disastrous effect on refugee health and mortality; a 50% ration cut obliged refugees to sell their mosquito nets in order to buy food, which led to an increase in mortality.

Acute malnutrition, refugee camps in western Tanzania, July 2002 (UNHCR, 07/02)

Overall - The nutrition situation of the refugees in western Tanzania is under control (category IV). Adequate relief aid supply has to be continued.

Recommendations and priorities

From the UNHCR survey:

• Maintain stable public health environment
• Ensure that the international community provides adequate food basket
• Strengthen infant feeding programme

Uganda

Karthoum has agreed to indefinitely extend the right of Uganda to implement anti-LRA (Lord's Resistance Army) operations within Sudan (AFP, 21/11/02).

The LRA has pursued attacks against civilian populations and humanitarian convoys in the districts of Gulu, Kitgum and Pader, where there are an estimated 750,000 IDPs in 41 camps (WFP, 10/02). The Ugandan government policy of re-grouping people into protected camps also raised concern. It seems that security is not guaranteed in the camps and that basic services are not adequately provided for (HRW, 29/10/02). This policy also prevents people from cultivating and makes them totally dependent on food aid (RI, 22/10/02). FEWS reported that only 25% crop cultivation has been completed in northern Uganda (FEWS, 14/10/02). January's harvest, which usually covers food for the first semester of the year will probably be almost non-existent (WFP, 10/12/02). In Gulu district, agricultural activities were restricted to two kilometers outside of the camps; limited production of cassava, potatoes, beans and rice has been reported. IDPs relied on brewing of local drinks, casual labour and assistance from relatives as sources of income (WFP, 10/02).

The prevailing insecurity renders access to IDPs almost impossible outside the main towns; WFP delivers food aid under heavy military escorts. Food delivery was hampered by insecurity and pipeline breaks. WFP was obliged to reduce the food ration by 30% in October 2002 and anticipated a 40% cut in January 2003 (WFP, 20/12/02).

The conflict has also recently extended into neighbouring Lira and Adjumani districts. Some 42,000 people have been reported to have fled their homes into Lira town in September. The influx of IDPs has more than doubled the town's population. A few of them were able to access their fields to harvest (FEWS, 14/10/02).

Eastern Uganda

Poor rainfalls have affected crop performance and have resulted in a poor harvest, estimated at 60 to 65 % of normal. However, most of the households had cultivated cassava, helping them to meet their food needs, and food stocks have been reported to be adequate in most households until next harvest. There are pockets of food insecurity, which include Usuk and Kaplebyong counties, in Katakwi district, where about 85,000 people are displaced in protected camps for fear of Karamonjong raiding (FEWS, 14/10/02). Market crop prices have increased since August but remain affordable for the majority of the population (FEWS,14/10/02).

Refugees

Some 7,000 refugees from Ituri area, RDC, sought refuge in western Uganda. They moved with some goods and herds. They are currently settled among the host community (OCHA, 18/12/02).

In addition, some 3,000 Rwandan refugees, formerly settled in Tanzania arrived in Uganda in fear of being repatriated from Tanzania (Xinhua, 18/12/02).

Overall - The situation of IDPs in northern Uganda is still very precarious (category II).