HIGHLIGHTS

The total number of refugees and displaced people in Africa has remained virtually constant over the last two months, and approximately six million people remain at considerable nutritional risk in Angola, Liberia, Sierra Leone, Ethiopia, Burundi, Rwanda, Zaire and Tanzania. However, the situation for the approximately 2 million people affected by conflict in Southern Sudan has improved as deliveries of relief supplies have increased. Micronutrient deficiencies are being seen in Kenya and Nepal.

Angola Access to all formerly besieged areas has now become possible with the signing of a truce between the GOA and UNITA in November and return of control to the government. Recent surveys conducted in several locations have shown the nutritional status of populations which were cut off from food aid for several months has deteriorated markedly. The recently improved access to these areas means aid supplies are now getting through regularly, and the nutrition situation should begin to improve.

Liberia Region Intensified fighting in the region has resulted in the continued influx of Liberian refugees into Cote d'Ivoire. In Sierra Leone, increased rebel activity has led to the displacement of up to 200,000 more people. The continued absence of NGOs in insecure areas has meant that most food aid deliveries can only take place when there is an ECOMOG presence. Although there are no data, it is probable that at least 600,000 people are at considerable nutritional risk in those areas of Liberia and Sierra Leone currently made inaccessible by insecurity.

Rwanda/Burundi Region The regional crisis affecting over five million people is still the largest in Africa. Although international relief efforts have managed to reduce the extreme levels of wasting and mortality seen in Zairian and Tanzanian refugee camps as recently as August, the relief programmes are still facing enormous difficulties. Insecurity in Burundi, overcrowding in the Tanzanian refugee camps and ethnic discrimination during food distribution in the Zairian refugee camps, are all hampering relief efforts. Although the wasting and mortality rates recently recorded in Rwanda, and the refugee camps in Zaire and Tanzanian are much lower than previously, levels are still three to ten times normal. The number of people at heightened nutritional risk in the region is estimated to be over three million.

Southern Sudan Improved deliveries of relief supplies in Southern Sudan are undoubtedly stabilizing the food security situation for large numbers of people. However, surveys continue to identify population groups where levels of wasting are still 20%-40%.

Kenya Although levels of wasting among the Somali refugees in Kenya are very low, recent, and possibly seasonal, outbreaks of scurvy are giving cause for concern.

Nepal Micronutrient deficiency diseases including, beri-beri, scurvy and pellagra, are still affecting the Bhutanese refugees in Nepal. However, reported cases are dwindling, which probably reflects the improved food basket.

Afghanistan Region The continuing war in Afghanistan is affecting over three million people. Approximately 600,000 have been displaced to Kabul and Jalalabad and are at considerable nutritional risk. The intensity of fighting in Kabul and resulting casualties and displacement has increased significantly in the previous months.

ADEQUACY OF FACTORS AFFECTING NUTRITION

Factor		Liberia	Ogaden	E, W, C, Sudan	Somalia	Mozambique	Angola	S. Sudan	Shaba	Burundi/ Rwanda
1. Degree of accessability to large population groups due to conflict		X						X		X
2. General resources
	- food (gen. stocks)		X						X	X
	- non-food		X	X					?	X
3. Food pipeline			X	?		X	X		X	X
4. Non-food pipeline			X				?		?	?X
5. Logistics			X			X			X	X
6. Personnel*			X	X	X				?	X
7. Camp factors**		?X		?				?X	X	X
8. Rations - kcals		X	X					?	X	X
	- variety/micronutrients	X	X					?	?X	?
9. Immunization		X	?	?		?	X	X	?	?X
10. Information		X	X	X	X		X	X	X

Adequate X Problem? Don't know Don't know, but probably adequate?X Don't know, but probably inadequate

* This refers to both adequate presence and training of NGOs and local staff where security allows.

** This refers to problems in camps such as registration, water/sanitation, crowding, etc.