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Nutrition in Emergencies

UNHCR Initiative to Combat Micronutrient Deficiencies in Refugee Populations

UNHCR recently received funds from the United Nations Foundation for a project to combat micronutrient deficiencies among refugees. The project aims to enhance the nutritional status of refugee children, women and adolescents in four countries: Tanzania, Kenya, Uganda and Ethiopia. The project, to be completed in two years, is expected to do the following:

· explore the use of iron cooking pots as a vehicle to address iron deficiency anaemia which is an endemic problem among refugee populations (jointly with WFP);

· develop field-friendly techniques to facilitate the assessment of micronutrient deficiencies among refugee groups;

· alleviate anaemia and improve pregnancy outcomes through the use of multiple micronutrient supplements.

During the second half of the year 2000, UNHCR launched, in collaboration with WFP, a pilot project to investigate the use of iron cooking pots in refugee settings as a vehicle to address iron deficiency among high risk groups. This part of the project is implemented through the Centers for Disease Control and Prevention (CDC) in Atlanta and the Institute of Child Health (ICH) in London. It was launched in Tanzania by means of a pilot test in a small camp. Distribution of the pots in a larger camp is expected to take place early in 2001 pending positive results from the initial pilot test.

In the other three countries (Uganda, Kenya and Ethiopia) micronutrient supplementation for pregnant women will be investigated. The development of field-friendly techniques is an ongoing process and agencies in the field have expressed great interest and willingness to collaborate.

The ultimate goal of the project is to improve the nutritional status of refugee women, adolescents and children by way of:

· Investigating the possible provision and use of iron pots over the standard aluminium pots (see p 33) used to improve the iron content in the refugees’ diet, which may eventually lead to a change in policy.

· Drafting operational guidelines on the provision of micronutrient supplements to targeted groups.

· Introducing field-friendly techniques to assess micronutrient deficiencies in refugee camps, which will facilitate timely and accurate assessment and appropriate interventions to reduce excess morbidity and mortality among refugee women, children and adolescents. The final results of the project are expected in 2002.

Contact: Zahra Mirghani, Senior Technical Officer (Food and Nutrition), Division of Operational Support, UNHCR, case postale 2500, CH 1211 Geneva 2 Depot, Switzerland. EMail: mirghani@unhcr.ch

Nutrition And The Environment: The Importance Of Wood And Water World Food Programme

People suffer from malnutrition due to a combination of factors that are directly related to environmental conditions. The links between nutrition and the environment may appear obvious, but they often go unnoticed when planning assistance programmes. This is especially true during the frantic early days of responding to a crisis. For example, food variety, food preparation practices and sanitary conditions are often assessed separately from food needs.

· For many of the world’s poorest people, natural resources are the basis for their livelihood strategies in normal times and ensure their very survival in times of crisis. In Southern Sudan, the reliance on wild foods can be a coping mechanism necessary for survival. However, negative coping mechanisms can endanger life, health or longer-term food security. In Somalia, people resorted to eating seeds that had been coated with pesticides. In Tanzania, instead of eating the maize food provided by the international community, people planted the seeds, even though it was a hybrid variety and could not produce a future crop.
The Availability of Fuel-wood

The availability of fuel-wood is a crucial link between environment and nutrition. In times of fuel-wood shortage, households may be forced to change their cooking habits - reducing the number of meals, the quantity of food consumed and the types of food cooked. Fuel-wood shortages may also affect the quality and nutritional value of food consumed.

· Refugees in Bangladesh were prohibited from collecting standing wood and were given no fuel; they burned corncobs to prepare their meals. They resorted to selling part of their food aid and risked imprisonment for collecting fuel-wood illegally.
Insufficient boiling of water due to fuel shortages may increase the incidence of illness from consuming contaminated water or poorly prepared food. Children are particularly affected by diarrhea caused by poor hygiene or improperly cooked foods.
· In Angola, newly displaced women were forced to use leaves and twigs for cooking. Water did not boil due to an inadequate fire, contributing to waterborne diseases and diffic ulties in cooking beans. It took up to ten hours of cooking for the beans to reach an edible state.
In times of fuel-wood scarcity women spend extra time searching for wood. This is time they could spend producing and preparing food, caring for children and earning income. Women’s security also becomes an issue as they seek fuel-wood further from home.
· Refugees living in camps in Tanzania spend, on average, two entire days each week and travel great distances to obtain sufficient fuel-wood. Violence against women is also a problem: as many as one in four female refugees has been assaulted in search of fuel-wood.
WFP’s Response

WFP addresses nutrition-environment linkages by providing food to be consumed immediately - with specific activities designed to prevent malnutrition - and by meeting longer-term food needs. WFP considers a number of strategies to reduce demand and prevent deforestation and adverse nutritional impacts when fuel-wood is scarce. These include: providing pre-cooked blended foods in place of beans, supplying finer-milled grains or furnishing local milling facilities, and using energy-saving approaches, such as partial pre-cooking of cereals and pulses. However, WFP is often limited to commodities received from donors, leaving little flexibility in the foods provided. WFP encourages donors to provide food commodities that reduce cooking time, such as pre-cooked yellow split peas. WFP also works with its partners to assure the supply of cooking fuel and the inputs for wood production.

WFP times its assistance to coincide with the lean or hungry season, the critical time when people depend on forest plants and other natural resources for food and income. In India WFP assisted forest-dependent villagers to increase production of traditional forest commodities and conserve indigenous species.

WFP is committed to ensuring that women have adequate food and their nutrition is not put at risk. In many cultures, women and girls eat last and suffer most when there is insufficient food in the household. This is why WFP has established targets to put 80% of WFP’s relief food directly in the hands of women, and between 50- 60% of its resources under the control of women in other situations. Also, WFP asks women about their need for food as well as the availability of clean water, sanitary facilities and complementary inputs such as fuel.

WFP is working with its partners to generate awareness about the causes of malnutrition. We know it is as much a health and environmental issue as a food problem. We are working to ensure that all of our programmes reflect these important linkages.

Contact: Anne Callanan, Technical Support Unit ODT, Operations Department, WFP, Via Cesare Giulio Viola 68, Parco dei Medici, 00148 Roma, Italy; EMail: anne.callanan@wfp.org Web: www.wfp.org

ACC/SCN Refugee Nutrition Information System

The SCN Secretariat is very pleased to announce that Brian Jones began working as RNIS Coordinator in December 2000 - the next RNIS Report (# 32) should be produced within the next few weeks


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