19. Bhutanese Refugees in Nepal
20. Refugees from Rakhine State, Myanmar in Bangladesh
21. Southern Iraq
22. Afghanistan Region
The number of refugees in Asia grew from approximately 5.1 million in 1982 to 7.2 million in 1992. The single largest group of refugees comes from Afghanistan; in 1992 there were 4.2 million Afghans in Iran and 1.6 million in Pakistan accounting for about 80% of the total refugee population in the region [UNHCR 1993]. In this section of the report, we will start by including available information on the relatively small populations of Bhutanese refugees in Nepal and refugees from Myanmar in Bangladesh because of persistent reports of micronutrient deficiencies. As in the past, we will also include information on Southern Iraqi refugees in Iran. The current situation for the Afghan refugees/displaced populations, the largest single group in Asia at approximately 3 million affected people, is also described below.
There are approximately 85,000 Bhutanese refugees in Nepal. General food distributions continue to be regular and have contributed to very low levels of wasting found amongst this refugee population. However, as reported in the last RNIS, complete dependence upon the general ration was causing widespread outbreaks of micro-nutrient deficiency disease.
A recent joint WFP/UNHCR/SCF mission definitively confirmed the presence of micronutrient deficiencies amongst this refugee population. Cases of scurvy, beri-beri, pellagra, angular stomatitis and goitre were noted. Over 12,000 suspected cases of beri-beri were reported. However, analysis of the food basket showed that with the current ration (which had been adjusted since February to include parboiled rice, green or yellow vegetables and a fortified blended food called UNILITO) average micro-nutrient requirements would probably be met with the possible exception of iron and vitamin B12 [WHO 9/07/94].
The number of refugees from Rakhine State in Bangladesh decreased to just over 190,000 at the end of July. Large scale repatriation is now underway because of the “positive environment for repatriation on both sides of the border” [UNHCR 16/08/94].
The crude mortality rate for the month of July was 0.26/10,000/day and the under-five mortality rate was reported as 0.45/10,000/day. Both rates are within normal limits [UNHCR 16/08/94].
How could external agencies help? Ensure supply of fortified blended food in the general ration and monitor its consumption at household level.
There is no new information on the approximately 222,000 Marsh Arabs living both in Iraq and in camps in Iran.
There has now been war in Afghanistan for over 15 years. With the ending of the cold war and Soviet withdrawal in 1989, it was hoped that Afghans would have the opportunity to re-build their devastated country and that refugees in Pakistan and Iran would return to help the process. Unfortunately, the situation rapidly degenerated into further conflict between opposing ethnic and religious sectors of society. At the height of the conflict during the 1980s, there were almost 6 million Afghan refugees in Pakistan and Iran. The estimated number of refugees is now approximately 2.5 million with somewhere around 600,000 internally displaced in Afghanistan.
Displaced in Kabul Since the fall of President Najibullah's regime in April 1992 Kabul has been the scene of heavy clashes between the various parties struggling for power. Hostilities flared up again on the 1st of January 1994. It is now estimated that there are approximately 440,000 displaced people within Kabul, 380,000 of whom are living with relatives or friends and 60,000 others who have taken refuge in abandoned public buildings (i.e. schools, mosques, etc). The blockade of Kabul has led to limited choice of foods in the local markets and soaring prices. Contrary to previous years, there are now no government stocks or subsidized foods available. As a result, nutritional status appears to be deteriorating. A survey carried out in May 1994 showed 32% wasting with only 1% severe wasting (see Annex 1 (22a)). These results are significantly worse than those obtained between 1988-90 [ICRC 6/07/94].
Displaced in Jalalabad Fighting in Kabul has displaced large numbers of people, many of whom have fled towards Jalalabad. There are two large camps (approximately 163,000 people) and a number of smaller ones housing the displaced population from Kabul. Large numbers of people have also chosen not to settle in camps.
Data from February 1994 from Sarashahi camp indicated a level of wasting of 17.9% with 3.9% severe wasting (see Annex 1 (22b)). At the time, the food basket provided 1,500 kcals/person/day [MSF-H 18/02/94]. In August, the level of wasting was recorded at 14.6% and 18.6% in the two sectors of the camp, with severe wasting in 1.5% and 2.3% of children under five years of age (see Annex 1 (22c)). The food basket in June provided between 1,600 and 1,800 kcals/person/day. It is clear that families are often able to supplement their ration on the market. In June water availability in the camp was only 13.5 litres per person per day, which is well below the recommended amount of 20 litres/person/day. The continued high prevalence of wasting in the camp is thought to be due to both the inadequate food basket and the high incidence of diarrhoea [MSF-H Jun 94, MSF-H 23/08/94, UNHCR 26/06/94].
Refugees in Pakistan There are about 1,360,000 Afghan refugees still living in Pakistan including 20,000 who fled in early 1994. There is very little repatriation at this time, and the numbers are not expected to change considerably before the end of 1994 [IFRC 2/03/94, WFP/UNHCR 12/05/94].
A nutrition survey carried out in April showed levels of wasting between 1.7-3.7% (see Annex 1 (22d)) and a clear relationship between wasting and diarrhoea was observed [UNHCR May 94].
Refugees in Iran In May 1994 it was estimated that there were 23,000 Afghan refugees living in the camps in Iran. A further 1.3 million people are estimated to be living amongst the local population. Repatriation is proceeding slowly due to the continuing insecurity in Afghanistan [UNHCR 20/09/94, WFP 23/05/94].
How external agencies can help? In Kabul, a full ration for those living in mosques and other public buildings and a partial ration for other displaced persons is needed. Food for work programmes would also be useful as would support for the bakeries. In Jalalabad, an improved water supply is needed and a review of the general ration is also needed due to the levels of wasting reported in the camps.
