Nutrition Information in Crisis Situations - Mozambique
NICS 12, February 2007
Mozambique has been hit by several natural disasters in the last few months.
Between October 2006 and January 2007 heavy rains flooded the provinces of
Maputo, Gaza, Inhambane, Sofala, Manica Tete, Zambeze Nampula and Niassa,
affecting 46,5000 people (UNRC, 05/07). In January and February, the Zambezi
valley was flooded leading to the displacement of 107,000 people. They are
sheltered in accommodation and resettlement centres. About 56,000 people were
also affected but not displaced. In late February, the Buzi river basin was also
inundated and 13,000 people affected. Furthermore, in late February, a tropical
cyclone hit Inhambanhe, Sofala and Manica provinces, affecting approximately
150,000 people. The major impacts of these disasters are the destruction of
shelter, infrastructure, farmlands, water sources and assets, as well as the
lost of economic activities.
The National Disaster Management Institute (INGC) has implemented a
contingency plan, and response to the disaster is on-going (UNRC, 05/07). The
IASC cluster approach that aims at coordinating humanitarian response has also
been implemented (OCHA, 16/03/07). Funds from the Central Emergency Response
Fund and several donors were rapidly made available. Food and non-food items
have been distributed to the affected population. Seed and tool distributions
were also planned. The government of Mozambique has launched an appeal of US$ 71
m for recovery and reconstruction (OCHA, 13/03/07). The United Nations and
humanitarian partners have also launched an appeal of US$ 17.7 m to provide
relief and assistance to 435,000 affected people for six months.
As of beginning of March, the floods subsided but some camps reported
continuous arrivals (OCHA, 16/02/07). This was attributed to food shortages in
rural areas while food was available at the centres. On the other hand, some
people were returning to their villages. The government of Mozambique was
planning the distribution of take-home kits to promote resettlement.
Some 6,913 children have been screened in four flood-affected provinces.
Among them about 600 children were found moderately malnourished and provided
with high energy biscuits, and 35 severely malnourished children were referred
to hospital for treatment (OCHA, 16/03/07).
RNIS 20, June 1997
The returnees dependant on emergency assistance were thought to attain
self-sufficiency with the harvest in April. While there remains a number of
people requiring emergency assistance in Mozambique due to flood damage of
crops, these are not returnees and are therefore will no longer be included in
this report.
RNIS 19, March 1997
Emergency food assistance is currently being provided to
162,600 returnees and internally displaced people in Mozambique, mostly
concentrated in Tete, Gaza and Maputo provinces. This assistance will be
continued until the harvest in April 1997 when it is assumed that these
returnees will have achieved self-sufficiency. However, as this is the "hungry
period" just before the harvest when foods stocks for many have run out, food
aid to this group is currently a priority. A food security assessment conducted
in mid-1996 indicated that over 10% of families in Mozambique do not have
sufficient production or income to guarantee access to food and that at least
half of these families will experience prolonged shortage of food each year.
[WFP 10/02/97, MSF-CIS Dec 96]. Mozambique
Trend in numbers of returnees and
demobilised soldiers.
The nutritional and health situation in some districts in Tete
province has been described as worrying. Some cases of pellagra, which are
probably seasonal in nature, were noted in September. However, by October, the
number of cases had begun to decrease. Nutrition education programmes to prevent
these apparently seasonal outbreaks from occurring, are ongoing. In addition
some cases of measles were reported [MSF-CIS Dec 96].
Severe flooding has been reported in some provinces in central
and north western Mozambique. Among those provinces affected are Tete, an area
with many returnees still dependent on food aid. An estimated 400,000 people
have been affected and emergency operations are underway. Road communications
are very difficult and preliminary reports indicate that food stocks seem to be
running out. Weather forecasts suggest that heavy rains are set to continue
until April [DHA 21/02/97]. Overall, this population is not currently considered to
be at heightened nutritional risk (category IIc in Table 1). How could external agencies help? Sporadic cases
of measles which are reported in Mozambique indicate a need for improved
immunisation coverage. However, as access for immunisation programmes is
difficult in many of the districts where outbreaks are reported, an initial step
requires that road infrastructure be improved.
RNIS 18, December 1996
Emergency food assistance is currently being provided to
approximately 60-70,000 returnees and internally displaced people who returned
too late in 1995 to clear and cultivate sufficient land to obtain a reasonable
crop. It is hoped that these people will be self-sufficient after the harvest in
April 1997. A ‘Crop and Food Supply Assessment Mission’ is planned for
April 1997 to determine what, if any, the emergency food needs of this
population will be for the coming year [WFP-a 06/12/96].
Trend in numbers of returnees and
demobilised soldiers.
RNIS 17, September 1996
The food supply situation in country is expected to improve
considerably over the next year as the recent harvest in August produced 20%
higher yields than last year. Many provinces in the north and centre are
expected to be entirely self-sufficient in basic foodstuffs, and some areas are
reporting surpluses. There remain 154,000 people in Mozambique requiring
humanitarian assistance. Most of the emergency food needs can be met with local
purchases in surplus areas [FAO Jul Aug 96].
RNIS 16, June 1996
Mozambique - Trend in numbers
of returnees and demobilised soldiers.
 In view of the considerable increase in food production in
most areas, emergency food requirements are estimated to be substantially less
than last year. It is anticipated that the emergency relief operation in
Mozambique will begin to be scaled down, and an average of 154,000 returnees and
drought affected people will be targeted for food aid over the next year (May
96/Apr 97) in Mozambique [FAO 31/05/96]. With some notable exceptions, the nutrition situation in the
country is generally adequate. Initial estimates for the main grain harvest
indicate excellent production in the north and centre of the country while
bumper crops in neighbouring countries will also help to ensure lower prices for
any imported grain [FAO 31/05/96, MSF-CIS Feb 96]. However, principally due to flooding at the confluence of the
Limpopo river early in 1996, conditions have deteriorated in the province of
Gaza. As a result of the floods, emergency distributions were cut off to the
district of Chigubo where virtually 100% of the population is dependent on food
aid, so that many people had to resort to gathering wild foods. Similar, though
less grave, conditions were developing in Guro (Manica). Up to 38,000 persons
were displaced in February 1996 in three districts, where the flooding was most
severe, and sanitation conditions of the displaced were reportedly very poor
[MSF-CIS Feb 96]. In some areas of Mozambique health indicators have begun to
show worrying trends. In nearly all coastal districts as well as some interior
areas, malaria is reported even more prevalent than usual. Also, high rates of
diarrhoea are reported in Gaza province due to contaminated water supplies as a
result of the floods [MSF-CIS Feb 96]. A survey conducted in February in Memba district (Nampula
province) found 13.2% wasting with 3.0% severe wasting (see Annex I (11a)).
This high prevalence seems to be related to poor sanitary conditions and in
particular widespread measles, lack of health care and low income earning
opportunities. Poor nutritional status has also been reported in many districts
of Tete province. A nutritional survey in January showed 11 % wasting
with 2.3% severe wasting (see Annex I (11b)) in Chiuta district [MSF-CIS Feb
96]. The number of cases of pellagra reported in Mutarara district
has dropped considerably. This is thought to be due in part to the rainy season.
The long-awaited micro-nutrient enriched corn soy blend now being distributed
through hospitals, nutrition centres and to food aid beneficiaries is likely to
have contributed to this improvement [MSF-CIS 27/05/96]. Overall, those requiring emergency assistance in
Mozambique are not currently considered to be at heightened nutritional risk
(category IIc in Table 1), although some areas show slightly worrying levels of
wasting and should be closely monitored. How could external agencies help? There are
three main types of programmes that currently need instigating or strengthening
within Mozambique:
- supporting those
communities adversely affected by recent flooding by providing general rations
and seeds (where crops have been lost) and restoring safe water
supplies;
- strengthening health service provision, particularly for malaria control in
coastal zones, and immunisation campaigns where vulnerability to measles
outbreaks are likely to be greatest;
- strengthening logistic capacity in areas where poor roads and lack of transport
and storage capacity have undermined the general ration distribution programme,
e.g. several districts in Gaza province.
Distribution of enriched CSB has now been accomplished (after
the resolution of administrative problems), contributing to the successful
control of pellagra.
RNIS 15, April 1996
Trend in numbers of returnees and
demobilised soldiers.
 Current estimates are that there are approximately 1.2 million
returnees and drought affected people currently in need of food aid in
Mozambique. As household food stores dwindle between harvests, the
increased demand for many foods together with inadequate supplies has driven up
prices of commodities such as oil, sugar and rice significantly. The price of
white maize grain and flour has risen even more. Thus, the average numbers of
household meals is falling although other sources of income, particularly cashew
and some harvests of cassava and sweet potato seem to have stabilised the
nutritional situation in most areas of the country. Data up until January 1996
generally shows a stable nutritional situation in most areas of the country
although there were exceptions, e.g. certain districts in Niassa province
[MSF-CIS Jan 96]. The number of reported pellagra (niacin deficiency) cases in
Mutarara district continued to rise in December. Consignments of groundnut which
were purchased from Malawi in order to be added to the general ration in the
district have still not reached the affected population due to administrative
difficulties. Similar difficulties have been experienced with corn soy blend
provision [MSF-CIS Jan 96, MSF-CIS Mar 96]. More recently, the rains have begun,
and it is reported that the number of cases of pellagra is beginning to decline.
It is assumed that there is additional food now available locally that is
helping to improve the situation [UNHCR 04/04/96] Information collected until the end of 1995 showed fairly good
coverage of free food distributions for the most vulnerable populations although
there continued to be some areas where vulnerable groups were either
under-registered or inaccessible [MSF-CIS Jan 96]. Recent flooding may
significantly impact food production, especially in the south, and may render
new population groups vulnerable [UNHCR 04/04/96]. Overall, the population affected by niacin deficiency
with 1-2% prevalence reported, is at high risk (category IIa) in Table 1. The
remaining vulnerable population in Mozambique is not currently considered to be
at heightened nutritional risk (category IIc in Table 1) although increasing
prices are likely to cause some increase in child malnutrition. How can external agencies help? Deficiency of
the micronutrient niacin continues to be reported. Administrative difficulties
have been preventing the delivery of groundnuts to areas where pellagra has been
occurring for several months, e.g. Mutarara, and, despite a declining number of
cases reported, this intervention remains urgent for preventing
malnutrition.
RNIS 14, February 1996
Current estimates are that there are 1.2 million returnees and
drought affected people currently in need of food aid. The number of
beneficiaries is higher than originally planned as the 1995 May/June harvest did
not provide enough food for self-sufficiency throughout the year for as many
households as anticipated. Presently, the food pipeline is adequate until April
1996. With the exception of Tete and northern Manica, rainfall has been
favourable throughout the country, leading to extensive planting and good
prospects for agricultural production in 1996 where seeds and tools are
available. However, it has been reported that, in some districts, distributions
of seeds were late or insufficient [MSF-CIS Jan 96, WFP 12/01/96]. Mozambique
Trend in numbers of returnees and demobilised
soldiers.
Food security is generally stable, although two highly food
insecure areas exist in the south (Inhambwe) and centre (Tete, Manica and
Sofala) of the country. There have been several reports of insufficient food aid
allocations in certain priority districts. Several problems exist. According to
various NGO surveys, numbers of needy people may increase considerably as
harvests run out in many districts, e.g. Mabote and Funhalouro. Targeting by
implementing agencies is often poor; thus, there is a tendency to concentrate
distribution in those areas most accessible rather than in those areas with the
most vulnerable populations. Furthermore, some agencies have apparently chosen
to distribute half rations in order to increase coverage [MSF-CIS Jan
96].
In spite of these difficulties with the general ration
programme, there have been no reports of a deteriorating nutrition situation
from any district. As reported in the last RNIS, a nutritional survey in
Mutarara in November only found 5% levels of wasting. However, cases of pellagra
continued to be reported in Mutarara during October and November and during the
nutritional survey the prevalence of pellagra in the district was estimated at
1.4%. Accounting for confidence intervals and assuming a population of 250,000
it is possible that between 1600-5400 cases of pellagra occurred in the district
in November. In response to this outbreak, donors are looking into the
possibility of distributing fortified corn soy blend mix [MSF-CIS Jan
96]. Overall, the population with pellagra is placed in
category I in Table 1 and the remaining population of the district is likely to
be at high nutritional risk (category IIa in Table 1). The rest of the affected
population is probably not at heightened nutritional risk (category IIc in Table
1). How could external agencies help? There may be a
need to increase numbers registered for food aid relief in food insecure areas
where many non-beneficiaries are consuming extremely poor diets. More effective
targeting would counterbalance any tendency to saturate certain areas for
logistical or programmatic reasons. Some districts need immediate seed
distributions, e.g. Massingir, Chigubo, Changara, Cheringoma and
Muanza.
RNIS 13, December 1995
Mozambique - Trend in numbers of
returnees and demobilised soldiers.
 The number of returnees, demobilised soldiers and drought
affected people requiring food aid in Mozambique has risen to 790,000 [MSF-CIS
Nov 95]. This is a planned increase in beneficiary numbers following an initial
food security assessment earlier in the year which anticipated the limited food
stocks from the harvest being used by this time of the year. Food reserves at household level are variable. Districts in
northern provinces continued to report harvests into September. By contrast,
households in the provinces of Maputo, Gaza and Inhambane reported almost no
harvests during these months and reserves and markets reflected a rapidly
deteriorating food security situation. In numerous districts in these provinces
the only foods consumed were reported to be famine foods and in August the
province of Gaza proclaimed a state of emergency [MSF-CIS Oct 95]. The nutritional situation in the northern provinces of the
country remains more or less stable. Surveys undertaken in districts of Sofala
and Nampula province found very low prevalence of wasting (approximately 3%)
[MSF-CIS Oct 95]. The nutritional and health situation has however been
preoccupying in two provinces. An epidemic of meningitis in Nampula province
continued to spread and to claim lives during August, although by the end of
September the epidemic was reportedly under control. Measles immunisation
coverage in the province was only 11% [MSF-CIS Nov 95]. In Mutarara in Tete province, an outbreak of pellagra amongst
returnees has been reported continuously since August. The population of
Mutarara district increased form 50,000 to at least 200,000 due to the returning
refugees population from Malawi. The number of reported cases at clinics had
been steadily increasing with 169 cases reported in the first few weeks of
November. It is felt however, that cases may be under-reported as many people do
not have easy access to health centres. In response to the outbreak, WFP will
provide groundnuts to the returnees in Mutarara. There are no plans currently
for a population wide distribution although, should pellagra be confirmed
amongst the resident population, additional intervention measures may be
required [MSF-CIS 04/12/95]. A recent nutritional survey in Mutarara showed wasting and/or
oedema in 5.2% of children included in the survey. Severe wasting and/or oedema
were measured at 0.1% (see Annex 1 (11a)) [MSF-CIS 04/12/95]. Overall, the returnee population in Mutarara is at high
risk due to pellagra (category I in Table 1). The remaining vulnerable
population in Mozambique is probably not at heightened nutritional risk,
although pockets of malnutrition may exist. How could external agencies help? Nutritional
monitoring should be supported in areas where there are large numbers of
returnees, especially where harvests are known to be poor. Problems appear to be
related to distribution and targeting of beneficiaries. There is also a need for
careful follow up and assessment of the impact of ground-nut provision on the
rates of pellagra being reported in Mutarara district. Furthermore, there should
be some form of proactive monitoring of pellagra in similarly vulnerable areas,
e.g. where there are large numbers of recent returnees, perhaps through careful
checking of health centre records and interviews with health staff. Improvement
of measles immunisation coverage should be pursued.
RNIS 12, October 1995
The number of returnees, demobilised soldiers and drought
affected people requiring food aid in August in Mozambique was recently
estimated at 600,000. This is an increase of 240,000 people since July due to
household food stocks being used up. It is anticipated that this number will
continue to increase up until the end of the marketing year. Official
repatriation is complete, and the focus is now on reintegration programmes in
Mozambique [UNHCR 11/10/95]. D. Mozambique
Trend in numbers of returnees and demobilised
soldiers.
Harvests in the northern and central provinces of Mozambique
have been far better than in the southern provinces where maize prices have
already begun to increase. However, the overall food security situation in the
country continues to be stable in most areas. There are exceptions in certain
districts of Tete, Manica and Gaza provinces in the central and southern regions
of Mozambique. These districts have low food reserves as a result of poor
agricultural production (up to 70% of households have no reserves in some
districts). As this is the post-harvest period, such levels are cause for
concern. These findings are corroborated by information and indicators on growth
faltering, number of meals eaten, and dependence on famine foods which point to
a worsening problem. It is feared that due to the bad harvest in some of these
areas many people will not be able to save seed for the next planting season
[MSF-CIS Aug 95].
Nutritional surveys generally show very low levels of wasting.
A July survey in the province of Nampula found 4.0% wasting with 0.3% severe
wasting and another survey found 4.3% wasting and 1.6% severe wasting. In August
a subsequent survey in the province found only 1.9% wasting with 0.5% severe
wasting (see Annex I 11(a-c)) [MSF-CIS 08/95]. A large number of measles cases
were reported in Nampula indicating that immunisation coverage is not adequate.
A large number of kwashiorkor cases has been seen among admissions to feeding
centres in the province which may well be related to the incidence of measles
[MSF CIS Jun 95, WV Jun 95, MSF-CIS Aug 95]. A survey in July in the drought affected district of Magoe in
Tete province found 5% wasting with 2.1% severe wasting (see Annex 111 (d)). A
critical lack of drinking water in the province was noted in this survey. Two
nutritional surveys in July in Chibabave province and in Zambezia province found
3.3% levels of wasting (see Annex 11 l(e-f)) [MSF CIS 08/95. MSF-CIS Jun
95]. Food aid distributions have generally been adequate but there
continue to be problems in reaching certain remote areas or where insecurity
exists. Additional funds are being sought to strengthen food distributions to
affected population, including returnees. Overall, these surveys appear to confirm that while
food security varies within Mozambique, the nutritional status of populations
surveyed is normal for the region. How could external agencies help? Measles
immunisation needs to be stepped up in certain provinces such as Nampula. There
is a need to improve mechanisms for distribution of food aid to remote areas
receiving refugee returnees. This might involve further decentralisation of food
distribution systems. Drought affected areas such as Tete province also need
resources and agency support to improve water availability.
RNIS 11, July 1995
Trend In numbers of
refugees/returnees.
 As of mid-June, the organised repatriation of Mozambican
refugees in Malawi was completed, almost a year ahead of schedule [UNHCR
13/07/95]. Many of the returnees have now been in Mozambique long enough to have
had a harvest and therefore are no longer considered to require food aid.
Numbers of returnees and demobilised soldiers have accordingly decreased to
160,000. It is estimated that from May 1995, approximately 120,000 people who
had no harvest, mostly in the provinces of Gaza and Maputo, would require
emergency food aid and that this number was expected to increase to 400,000 in
October, mostly from Tete and Gaza provinces, as food stores from limited
harvests were used up. By the end of the marketing year the expected number of
beneficiaries would be 700,000. In March a further 23,000 refugees from Malawi
repatriated. This population, along with any other refugees who returned post
November 1994, are eligible for continued returnee assistance until the next
harvest in April 1996 [FAO 31/05/95, UNHCR 13/07/95, WFP 24-25/07/95]. An FAO/WFP crop assessment mission in April concluded that the
recent harvest was, as predicted, a good one, with a 10-13% increase in area of
land planted compared to the previous year and 140% greater yields than during
the 1993/4 season. However, wide variation in output was anticipated with the
four provinces in the north being roughly self-sufficient while other provinces
would have far lower levels of production [FAO 31/05/95]. In spite of the recent harvest, nutritional data still
indicate that there are vulnerable populations. A survey in Namacurra District
in Zambezia province found 12.3% wasting (see Annex 1 (11a)) [Ministerio da
Saude 07/04/95]. The recent harvest was variable throughout the district and the
general food distributions were said to only be reaching a small proportion of
the population so that further deterioration was feared [WV Apr 95]. Other surveys showed less worrying results. In Guija District
(estimated population 99,000) in Gaza Province levels of wasting were recorded
at 5.5% with 1.6% severe wasting (see Annex 1 (11b)) [MSF-CIS 10/04/95]. In
Magude District (estimated population 73,000) in Maputo province, wasting was
measured at 3.2% with 1.8% severe wasting (see Annex 1 (11c)) [MSF-CIS-a Apr
95]. In Guro District levels of 7.4% wasting were recorded (see Annex 1 (11d)).
In all these surveys it was noted that household food reserves were low or
non-existent and that wild foods were a significant part of the diet. The survey
teams therefore recommended that it was advisable to closely monitor these
populations as general food rations were being phased out from May
onwards. Overall, the assisted population is not
currently at heightened nutritional risk (category IIc in Table 1), although it
is likely that pockets of malnutrition exist in the more remote areas. How could external agencies help? The situation
appears to be improving as a result of the relatively good harvest, and as
greater numbers of returnees have resumed agricultural activities. However,
there are areas where crop production has been poor, or where new returnees have
arrived too late to produce a crop. There are also population groups who are not
easily accessible for delivery of food aid. The existence of these vulnerable
groups is periodically reflected in nutritional survey results or high levels of
growth faltering at Mother Child Health centres. Agencies should therefore give
priority to the continued monitoring of these groups.
RNIS 10, April 1995
E. Mozambique - Trend in numbers
of refugees/returnees.
 The pace of repatriation to Mozambique was fastest between
April and October 1994 partly as a result of the October elections and also so
as to returnees could prepare land in time for the 1994-5 crop season. Since
October 1994, the rate of return slowed to more or less 1,000 people per month.
The total number of refugees/returnees in the region is now estimated at 1.6
million. Approximately 1.5 million of these are returnees/internally displaced
within Mozambique who are targeted beneficiaries for food distributions. There
are approximately 100,000 new arrivals expected back in Mozambique in 1995 from
the following countries. Malawi (50,000), South Africa (5,000) Tanzania (35,000)
and Zimbabwe (20,000) [UNHCR 01/05/95]. However, it would appear that food distributions only reach a
proportion of this population. For example, data from Tete province in December
indicated that only approximately 55% of the planned beneficiaries received
their food entitlement with the main obstacles being lack of transport capacity,
difficult access due to the rains and lack of pre-positioning and commodity
shortages. WFP have confirmed their intention to stop free food distributions to
current beneficiaries by the end of April 1995 so that subsequent beneficiaries
will only include refugees who have returned after December 1994 (close to
100,000) and identified vulnerable populations. It should be noted that
returnees receive seeds and tools during the first year of their settlement to
enable them to contribute to their food self-sufficiency [UNHCR
01/05/95]. Prices of food grains have continued to rise in pre-harvest
1995 and in certain places the markets are reported to have no staple foods on
sale. There are also indications that an increasing number of families have no
food reserves and are eating famine foods as well as reducing the number of
meals each day. As occurred last year, there are reports of deaths due to toxic
food poisoning from consumption of famine food [MSF-CIS Dec 94, MSF-CIS Jan
95]. Good harvests are anticipated in the north of the country,
while the South will probably see poor ones. Expectations for the central region
are mixed. An assessment mission was planned for April 1995 [MSF-CIS Dec 94,
MSF-CIS Jan 95]. High levels of growth faltering were reported in various parts
of the country during December and January. Growth faltering rates at some
health centres in Tete province were over 25%, over 20% in some areas of Manica
province and a particularly alarming 46% in Chokwe. This apparent decline in
nutritional status led to a number of nutritional surveys. One of these surveys
was conducted in villages in Angonia district and found the prevalence of
wasting to be 7.7% with 3.7% severe wasting (see Annex 1 (11a)). This led to the
opening of a nutritional rehabilitation centre in the north of the district
[MSF-CIS Dec 94, MSF-CIS Jan 95]. Other surveys in Mutarara-North and Alua (Namapa) found 11.9%
and 18.9% levels of wasting with 2.7% and 4.5% severe wasting respectively (see
Annex 1(11b,c)) [MSF-CIS Dec 94, MSF-CIS Jan 95]. A measles outbreak has been noted in two districts of Zambezia
province where access is difficult for vaccination teams [MSF-CIS Dec
94]. Overall, the refugee/returnee population in the
region is not currently considered to be at heightened nutritional risk
(category IIc in Table 1). How can external agencies help? There is
a need for more financial support for agencies delivering relief in Mozambique
so that their capacity to transport relief items can be improved. The food
pipeline could also be improved and planning is necessary to pre-position food
in advance of the next rainy season. It is also important that the planned
re-targeting of the general ration should be based on rigorous food security and
self-reliance criteria and that where populations are omitted from the
programme, that nutritional surveillance is established in order to closely
monitor any potential negative impact. Care must also be taken that nutritional
survey methodologies are standardised across the country to avoid a situation
where results cannot be properly compared between areas and population
groups.
RNIS 9, February 1995
The number of people in the region in need of humanitarian
assistance is approximately 1.6 million, most of whom are returnees and drought
affected people. The elections and subsequent installation of the new president
in early December 1994 took place without incident and it now appears that
Mozambique is entering a period of relative peace and stability. The UN Special
Operation in Mozambique (UNOMOZ) completed its mandate and is in the process of
withdrawing its troops, equipment, etc [UNHCR 12/12/94, UNSC 23/12/94, WFP
16/02/95]. Trend in numbers of
refugees/returnees.
 In December, it was reported that 1.5 million refugees had
returned to Mozambique, and that repatriation was completed from Zambia,
Swaziland, Zimbabwe and Tanzania. There remain approximately 90,000 refugees in
Malawi, mainly in Nsanje district, the majority of whom are expected to return
by June 1995. Of the approximately 120,000 Mozambican refugees in South Africa,
only 40,500 are reportedly willing to repatriate due to the relative economic
advantages of living in South Africa [IFRC 18/01/95, MSF-CIS Aug/Sep 94, UNHCR
12/12/94, WFP 16/02/95]. There is growing concern over a drought in Southern Africa and
its effects on crops, particularly in Central and Southern Mozambique, due to be
harvested in April 1995. Although the predicted harvest failure will lead to the
need for emergency food assistance in 1995/6, the scale of the requirement will
only be known at the end of the growing season. A food co-ordination meeting in
Mozambique recently proposed the establishment of a 50,000 mt maize reserve in
preparation for drought induced food shortages. There are fears that crop
failure could jeopardise the continuation of repatriation and resettlement [FAO
06/12/94, WFP 30/12/94, WFP 20/01/95. WFP 03/02/95]. Recently, there have only been limited food security and
nutritional data from Mozambique, partly reflecting the fact that many NGOs
temporarily withdrew personnel during the election period as a precautionary
measure. The most recent information is that with the arrival of the pre-harvest
“hungry” season, household food reserves are declining, consumption of
wild foods is on the increase and markets show lower quantities of fewer
commodities at higher prices. While this situation is not believed to be
especially alarming, agencies suggest that particular attention needs to be
focussed on drought affected areas and on those regions that have received large
numbers of returnees [MSF-CIS Oct 94]. Although the situation in Mozambique is stable, there
increasing concern over the situation for returnees in parts of Zambezia,
Sofala, Tete and Gaza provinces due to the proposed cut-backs in funding for
returnee reintegration programmes. In these areas there have been reports of
repeated shortages of food distributions compounded by logistical problems and
poor targeting of eligible beneficiaries. A local assessment mission indicated
severe and increased levels of malnutrition in Angonia and Tsangano, Tete
province [MSF-CIS Oct 94, WFP 16/02/95]. Overall, and with the exception of recent
returnees, the affected population is not currently considered to be at
heightened nutritional risk (category IIc in Table 1). How could external agencies help? There is a
need for donors to support efforts to establish a maize reserve in Mozambique
that can be used to respond to any urgent needs resulting from the impact of the
current drought on food supply. There is also continued concern over the
capacity of agencies to provide necessary support to all recent returnees.
Consistent reports of inability to target all returnees effectively and
resulting hardship, suggest the need to review current targeting strategies in
order to identify where and why these are failing. Furthermore, plans to
cut-back funding for returnee re-integration programmes should only be
implemented if it is believed that nutritional and health monitoring is adequate
to rapidly identify any deterioration as a result of planned reductions in
aid.
RNIS 8, December 1994
The number of people in the region in need of assistance
remains at 1.8 million. Most of these beneficiaries are returnees and
demobilized soldiers. The elections that were scheduled for the end of October
took place, although Renamo issued conflicting signals as to whether it would
accept the results. Trend in numbers of
refugees/returnees.
 Repatriation is moving ahead, and is now completed for
Swaziland and Zambia. The total number of returnees in Mozambique is estimated
to be 1.5 million, 700,000 of whom returned in 1994. It is hoped that
repatriation from South Africa, Tanzania and Zimbabwe will be completed by early
1995, and from Malawi by September 1995 [WFP 21/10/94, WFP 16/12/94, UNHCR
27/10/94]. The increased number of returnees to Mozambique from July to
September has put pressure on food resources. It is, therefore, anticipated that
shortages of pledges for maize and vegetable oil will result in breaks in the
food pipeline by March 1995. Local and regional purchases for prepositioning of
two months requirements are being organized for the northern provinces [WFP
21/10/94, WFP 16/12/94]. Mozambique as a whole will remain in need of food assistance
until next years harvest due to the failure of much of this years crops. The
northern areas of Manica and Sofala provinces, the southern region of Tete, and
areas of Maputo and Gaza were most adversely affected by shortfalls of rain.
Crop production was further affected by the proliferation of rats, particularly
in the drought affected areas. CIS food habit surveys confirm this picture where
75% of households in the districts of Chicualacuala, Guija and Mbabane in Gaza
province reported that they lacked food reserves. The proportion of households
reporting complete dependence on wild foods the day before had also increased
considerably in many of these drought affected areas. Three nutrition surveys during August in the districts of Caia
and Marromin in Sofala province found low levels of wasting of between 2.4%-
4.9% (see Annex 1(6a-c)) [AICF Aug 94]. Food distribution is currently targeted to returnees,
demobilized soldiers and "affected" populations. However, many agencies have
faced difficulties in reorganizing distributions for returnees, many of whom
have returned to inaccessible areas. This situation is exacerbated in those
areas which have recorded poor harvests. At the end of the dry season, problems with water supply and
quality were reported throughout the province of Tete. Access to safe water was
also a problem in parts of Manica province [MSF-CIS Jul 94]. Early in October, an outbreak of bubonic plague was reported
in Tete province. Cases were also reported in some refugee camps in Malawi, in
spite of temporary closure of the border between Mozambique and Malawi. The
outbreak now appears to have been successfully contained [WHO 03/10/94, UNHCR
07/10/94]. The refugee/returnee population in the region is not currently
thought to be at particular nutritional risk (category IIc in Table
1). How can external agencies help? Donors need to
rapidly pledge more maize and vegetable oil for 1995. There is also a need to
plan more carefully for future returnees so that the food security of those
travelling to more inaccessible areas can be better safe-guarded. This might
necessitate providing cash or food coupons for those returning to known remote
areas.
RNIS 7, October 1994
As repatriation of refugees and demobilization of soldiers in
Mozambique moves ahead, the number of people in the region in need of
humanitarian aid remains stable at approximately 1.8 million. Registration for
the elections in Mozambique scheduled for the 27th-28th of October continued
into August despite some minor disturbances [MSF-CIS May 94]. Since the signing of the peace agreement between the
Mozambican government and RENAMO in October 1992, about 900,000 Mozambican
refugees have returned home. The greatest movement has been from Malawi from
where approximately 700,000 refugees have returned. Large-scale repatriation of
refugees form Tanzania and Zambia planned to start in July have been delayed.
Official repatriation from Swaziland was completed on June 3rd [MSF-CIS May
94]. C. Mozambique
Trend in numbers of refugees/returnees.
Mozambique will remain in need of food assistance until next
years harvests due to the failure of much of this years crops. The northern
areas of Manica and Sofala provinces, the southern region of Tete province and
areas of Maputo and Gaza provinces were the most adversely affected by rain
shortfalls in the country this year [MSF-CIS May 94].
Nutritional status data in the country generally shows a
stable situation. Levels of wasting measured in Manica Province were between
2-8% with 0.1% severe wasting in May. Other surveys carried out since January
1994 in Mozambique show consistently low levels of wasting. However, other data
indicate that there are pockets of food stress. In Inhambane province,
interviews conducted showed that 12% of households in Mussenge reported the
consumption of only wild foods the day before and that approximately one third
of households reported food stores of less than one month in May. Lack of access
to parts of Niassa province have disrupted food distributions and is causing
concern, while the Renamo zone of Mogincual district in Nampula province has
been without organized food distributions between January and May 1994 despite
demonstrable need and the occurrence of new cases of tropical neuropathy
[MSF-CIS May 94]. Reports in June from Zambezia, Sofala and Tete province
indicate that although the harvest in April and May has improved food security
and overall numbers of admissions to nutritional centres are at their lowest
since the beginning of the year, the harvest is unlikely to be sufficient for
the entire year. Furthermore, people are still suffering from food shortages, as
evident from numbers enrolled at feeding centre, but often not benefitting from
food support. This applies particularly to returnees who are the most vulnerable
as they are not yet established on land and are unable to rely on traditional
support structures. At the same time, their mobility can make it difficult to
identify them for registration into the food aid network [WVa June
94]. The refugee/displaced/returnee population in the Mozambique
region is not currently considered to be at heightened nutritional risk
(category IIc in Table 1). How could external agencies help? Food aid
deliveries need to be focused on returnees, and follow-up through to the next
harvest will be necessary to detect any nutritional problems. Nutritional
surveys in areas difficult to access could help to quantify potential
problems.
RNIS 6, August 1994
The estimated number of people in need of humanitarian
assistance in the region remains stable at 1,850.000. Repatriation of the
refugees in South Africa began in April at the rate of approximately 2000 per
week. Estimates of this total population vary from 30,000-250,000. Repatriation
has also been continuing from Malawi and at a faster rate then planned possibly
as a result of the drought there. There are presently 300.000-500,000 refugees
in Malawi out of an original population of 1.3 million. Repatriation to northern
provinces of Mozambique has faced considerable obstacles with much concern
expressed about WFP and UNHCRs logistic capacity to meet the immediate needs of
the returnees [MSF-CIS Apr 94, WFP 4/07/94, WFP 5/08/94]. C. Mozambique
Trend in numbers of refugees/displaced.
Mozambique is gradually preparing for the general election in
October but the government and RENAMO are demobilising soldiers more slowly than
expected. Over the last few months humanitarian work has been impeded by both
insecurity, caused by the proliferation of "armed gangs", and the abundance of
land mines with many accidents being reported [MSF-CIS Apr 9].
The harvest conditions in the country are generally considered
to be poor with drought conditions in the South. In certain areas this is
complicating the reintegration of returnees and demobilised soldiers. The
aggregate food balance for the country is expected to be slightly better than
last year but this is offset by the expected increase in demand due to the
resettlement of populations. Target levels for those requiring emergency food
aid in Mozambique were 1.1 million in April. During August approximately 957,000
people will receive food assistance in Mozambique [MSF-CIS Apr 94, WFP 4/07/94,
WFP 5/08/94]. The nutritional and health situation in the country was
relatively stable throughout April. However there have been areas where food
insecurity was poor and levels of wasting relatively high. One major area of
concern was the almost inaccessible Northern Niassa province where high rates of
malnutrition were found in April. High prevalence of wasting, 11.7%, were also
found in Changara district in Tete province (see Annex I (6a)). Mogincual
district in Nampula province was also identified as a food insecure area with
reports of growth faltering over four consecutive months [MSF-CIS Apr
94]. Overall, the refugee/returnee/displaced population is not
considered to be at heightened nutritional risk, although pockets of
malnutrition are known to exist. How could external agencies help? There needs to
be greater preparedness for those returnee groups who are known to be returning
to less accessible locations, i.e. heavily mined areas or where roads are likely
to made impassable due to rains. This might involve allocating bigger food
packages before departure to avoid the increased levels of malnutrition now
being seen amongst such groups. More funding and personnel are needed in order to speed up the
demining process in Mozambique. Accidents are reported every month, and are
likely to increase in numbers as more refugees return. Food shortages for the operation are predicted for
November/December. It is urgent that new donations are confirmed and shipped
with a planned arrival for November/December.
RNIS 5, June 1994
Estimates for the numbers of people in need of assistance in
the region (Mozambique and refugee hosting countries) remain stable at
1,850,000. It is estimated that assistance in Mozambique will be required at
least until March 1995, the main beneficiaries being returnees arriving after
the planting season (October), demobilized soldiers and drought/cyclone affected
populations [WFP 16/05/94/].
C. Mozambique - Trend in numbers of
refugees/displaced.
 Repatriation is continuing. As of April 1994 out of this 1.85
million total, 775,000 refugees had returned to Mozambique. The arrival of a
further 51,000 is expected over the next few months although there are an
estimated 800,000 Mozambican refugees still residing in neighbouring countries
[MSF-CIS Feb 94, WFP 16/05/94]. Those people in areas with access to land who had previously
received timely and adequate agricultural inputs were believed to have
sufficient food until the coming harvest, but inadequate rains have led recently
to poor harvest prospects. In addition, those who had failed to plant, e.g. new
returnees, will continue to be dependent on food distributions. Some problems
with food distributions had been noted due to poor roads, transportation
problems, lack of fuel and insufficient quantities of food available. As a
result certain areas have not received distributions for several months, e.g.
Mogincual in Nampula district [FAO/WFP May 94, MSF-CIS Mar 94, WFP
9/06/94]. Thus, the nutritional situation in Mozambique was reported to
be generally stable, but with pockets of malnutrition thought to exist,
especially among recent returnees [MSF-CIS Feb 94]. Increasing rates of
malnutrition have been reported in districts of Tete and Nampula provinces with
significant numbers of new returnees. The health situation in districts affected by cyclone Nadia in
Nampula and Cabo Delgado provinces, e.g. the district of Nacaia Porto, has been
precarious as health infrastructure and water supply systems were damaged [DHA
19/04/94]. Anti-personnel mines remain a severe problem throughout the
country with accidents continuing so that some NGOs have been forced to
reconsider their activities in isolated provinces. These mines also render many
fields useless that would ordinarily be used for farming [MSF-CIS Feb
94]. Overall the population is not currently considered to be at
particular nutritional risk (category IIc in Table 1). How could external agencies help? A key
priority is to establish a better system of monitoring recent returnees. This
may require greater decentralization of international agency staff, on a
temporary basis to areas where large groups have returned. Agencies supporting
recent returnees may need more resources for such activity. Logistics remained a
problem for remoter areas in part because of land mines, partly because of a
lack of infrastructure. A transition to more local food purchasing is planned,
showing a shift from food aid to non-food resources. More use of local trading
channels for food distribution is desirable.
RNIS 4, April 1994
C. Mozambique
Trend in numbers of refugees/displaced.
WFP are providing emergency food aid for 1,850,000
beneficiaries of whom approximately one third are returnees. It is estimated
that 600,000 Mozambicans who were previously refugees in South Africa, Malawi,
Swaziland, Zimbabwe, and Tanzania, returned in 1993.
Food distribution has been posing a problem in some areas as
there is inadequate transport capacity to move food while road conditions have
deteriorated due to the rains. This is the situation in Mecula District, Niassa
Province where, according to reports in January, returnees from Tanzania had
been without assistance for months. An assessment in the region in December
showed levels of wasting at 13.6% (see Annex I 6a) [MSF-CIS Dec.93]. Land mines also remain a problem as the rains have exposed
some deeply buried mines which have caused accidents. Mines have also inhibited
farming in some area. However, in January, the number of mining incidents
declined considerably. In several districts "growth faltering rates" increased to
around 15% while the number of malnourished children admitted to feeding centres
increased in several areas. As January is the peak of the hungry season this may
be a seasonal trend of increasing malnutrition as food reserves are dwindling.
It may also reflect the greater vulnerability of returnees many of whom arrived
too late to participate in last years agricultural season while others did not
possess enough seeds and tools to do so. Others may have received food
assistance upon arrival but as they moved further towards their zones of origin,
ended up beyond the reach of food aid distributions [MSF-CIS Jan.94]. In January there were no more cases of cholera reported in
Namapa district and the outbreak in Memba was diminishing. The number of deaths
reportedly due to diarrhoea also seemed to be decreasing [MSF-CIS
Jan.94]. Meteorological data indicated favourable rains throughout
January and the prospects of a good national harvest in February [MSF-CIS
Jan.94). Overall, the situation appears to be under control although
there are pockets of heightened vulnerability. This population is therefore not
considered to be currently at particular risk (category IIc in Table
2). How could external agencies help? Most of
the areas into which the population has returned are now accessible in terms of
security, although there are pockets, particularly in the north, that are
logistically difficult to reach. Rehabilitation of the means of livelihood of
the returning population is needed. The repair and development of
infrastructure, roads, bridges, etc. is required. In the short run, access to
remote areas in the north may require airlifting with a transient high cost
De-mining operations will be of high priority, not only to prevent injury, but
to rehabilitate livelihood.
RNIS 3, February 1994
In November reports indicated a serious shortage of food in
the provinces of Sofala, Manica, and Zambezia as a result of spoilt food aid
imports and absence of mechanisms to transfer grain from food surplus to deficit
provinces. October/November rains were insufficient in certain key provinces,
e.g. Nampula. As a result, relief food aid needs for 1994-5 are estimated at
119,340 MTS. [MSF-CIS 1/11/93] In principle only refugees and internally displaced people
qualify for free food aid. During January 1994 some 666,000 returnees and
1,200,000 internally displaced were receiving emergency assistance. Repatriation
from South Africa started in January with refugees returning to homes in Maputo
and Gaza. The latest reports on the nutrition situation are from
November when the situation appeared stable throughout the country. The only
worrying nutritional data concerned refugees crossing the Tanzania/Mozambique
border and returnees to Mecula District of Niassa (population approximately
21,000). There is no food assistance available for these returnees, and five
deaths due to starvation have been reported. [MSFCIS 1/11/93] Although cholera continued to affect Nampula and Cabo Delgado
province in November, cases were dwindling and an outbreak in Chuire was said to
be under control. [MSFCIS 1/11/93] Latest reports in January indicate that some areas are
becoming inaccessible because of rains or land mines and that it may become
necessary to airlift food, although funding for such an operation is not yet
available. [WFP 28/1/94] This situation in general appears to be under control,
although there are areas of concern. The population is not currently considered
to be at any particular heightened nutritional risk (category IIc in Table
2).
RNIS 2, December 1993
The status of Mozambican refugees in Malawi, Zimbabwe,
Swaziland, Tanzania and South Africa is stable and spontaneous and organized
repatriation is continuing. The total refugee/returnee population was estimated
at 1,515,000 in August 1993, of which an estimated 546,100 are returnees within
Mozambique. An additional estimated 850,000 are internally displaced. In August the rates of returnees to Mozambique decreased but
repatriation of the 25,000 refugees from Swaziland began in September. Since the
signing of the peace accord a year ago, there have been 401,132 arrivals in
Northern/Central provinces (10% from Zimbabwe and 90% from Malawi). The current
UN planning figure for emergency feeding in Mozambique is 1,396,100 (i.e.
546,100 returnees + 850,000 internally displaced). A cereal shortfall is predicted for the 1993/1994 marketing
year, despite the improved harvest. Not all of the shortfall will be covered by
commercial imports, it is presently estimated. On the provincial level, the food and nutrition situation is
stable but with large differences between certain population groups. Nutrition
surveys conducted amongst at-risk groups such as the recently resettled indicate
high levels of wasting based on MUAC measurements (>30%, <12.5 cm).
However, surveys using weight-for-height data generally indicate levels of
wasting <10% among the general populations. It is still difficult to assess
populations in RENAMO zones in a number of provinces, both to evaluate their
nutritional status and to provide nutrition and health services. The situation
may well deteriorate during the coming hungry season especially in areas like
Gaza Province where the first and second harvest have been very poor. Nampula Province is particularly worrying as the nutrition
situation appears to have been deteriorating. An epidemic of tropical neuropathy
caused by cassava intoxication suggests food insecurity as the cassava is being
harvested early and prepared too quickly. New cases were being reported in
September, but no information has been available since then. The sanitary situation is also worrying. A major outbreak of
cholera has been reported in Nampula Province and Southern Cabo Delgado. It has
apparently affected several thousand people although numbers of new cases
appeared to go down in October. Water supply is becoming increasingly
problematic as wells are drying up in several provinces (Gaza, Inhambane, Manica
and Zambezia). Diarrhoea and dysentery are still important problems in many
provinces. The entire 2,365,000 Mozambican refugee/returnee population is
placed in the "not at risk" category in Table 2 (column IIb). However, an
unknown number of returnees are clearly experiencing emergency conditions with
reports of cassava intoxication, cholera and high levels of wasting (indicated
by an (a2) in column I). The overall situation of
relative stability seems likely to persist in the coming months although there
will continue to be pockets of crisis as basic needs provision for new returnees
fails to meet demand in the early stages of resettlement. The start of the rainy
season in the northern and central provinces could exacerbate the cholera
outbreak.
RNIS 1, October 1993
The status of Mozambican refugees in Malawi, Zimbabwe, Zambia,
Swaziland, Tanzania and South Africa appears stable. Both spontaneous and
organized repatriation is occurring following the signing of the peace accord
last year. The almost total disappearance of pellagra in Malawi since
fortification of maize flour began -- only 400 cases have been reported since
its inception -- is in marked contrast to the 18,000 cases reported during the
height of the outbreak in 1990. The total refugee population in the area is
currently estimated at 1,515,000. The food security situation for most of the returnees to
Mozambique continues to improve with indicators of food stocks, levels of
malnutrition, and access to water all either improving or stabilizing. There are
however various populations at serious risk due to a variety of factors and
given the approach of the hungry season (December-April) efforts to reduce
vulnerability will need to be increased. Furthermore, these populations must be
carefully monitored. Examples are as follows. In Caia and Mutarara Districts (see on Map 6) the situation
remains critical due to the isolation of the area, the lack of general services,
and the high rate of influx of returnees from Malawi as well as the general
failure of the harvests. In Derre in Morrumbala District (see Map 6) there are
acute nutritional problems with isolated populations at risk from epidemics.
Prevalence of wasting in June was 14% with 5% severe wasting. In Gaza region
(see Map 6) there are large numbers of displaced people settled around towns in
areas with wholly inadequate resources. This has resulted in widespread
nutritional difficulties throughout large sections of the populations in these
regions. Thus, in Chicualacuala District (see Map 6) prevalence of wasting is
10% with 5% severe wasting. In pans of Chokwe District (see Map 6) wasting rates
of 17%, with 11% severe, have been recorded in June while in parts of Guija
District (see Map 6) wasting rates have varied between 9-20% with severe wasting
as high as 14% in some parts (June 1993). A July survey in areas of Nampula Province found 38% wasting
as defined by less than 12.5 cms MUAC. It appears that many wasted children seen
at feeding centres are from either recently resettled populations or living in
RENAMO zones. July saw a significant increase in diarrhoea disease with many
cases of dysentery. Cholera has also been reported in the provinces of Zambezia,
Sofala and Maputo. | 
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