19. Bhutanese Refugees in Nepal
20. Refugees from Rakhine State, Myanmar in Bangladesh
21. Southern Iraq
22. Afghanistan Region
As of end-1993, over half the estimated 5.2 million refugees in Asia were Afghans in Pakistan (1.4 million) and in Iran (1.9 million). There are reported to be 650,000 Iraqis in Iran. Other large groups are refugees from Myanmar in Bangladesh (200,000), Vietnamese in China (290,000), Sri Lankans in India (115,000), as well as considerable numbers from the conflicts in Cambodia, Laos and Vietnam, in other countries (data from UNHCR, Statistical Overview, 1994).
No comprehensive data are available on the numbers of internally displaced populations in Asia. The numbers are certainly in the millions. Figures of 600,000 Afghans internally displaced are quoted, and up to one million each in Iran and Myanmar.
In this section of the report, we 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 also include information on Southern Iraqi refugees in Iran. The current situation for the Afghan refugees/displaced populations, the largest single group in Asia with approximately three million affected people, is also described below.
The estimated number of Bhutanese refugees in Nepal remains at just under 85,000 [SCF 29/11/94, UNHCR 20/10/94]. The overall situation seems well controlled, with normal indicators. For instance, crude mortality rates amongst this population were recently estimated to be 0.09/10,000/day, while the under five mortality rate was 0.06/10,000/day, levels of wasting measured by screening under fives was found to be 2.9% (see Annex 1 (19a)) [SCF 29/11/94].
However, at the end of September the incidences of micronutrient deficiency diseases were 2.2/10,000/day for mild beri-beri, 0.09/10,000/day for severe beri-beri, 1.37/10,000/day with angular stomatitis, 0.005/10,000/day with pellagra, and 0.6/10,000/day with scurvy. This is a significant reduction compared to earlier in the year but a continuing cause for concern.
UNILITO (a micro-nutrient fortified blended food) is continuing to be distributed as pan of the general ration. Dried skimmed milk, which had been unavailable for supplementary feeding programmes due to lack of stock, has now arrived in the camps [UNHCR 20/10/94].
During this period an epidemic of plague occurred in the camps although the disease is now reportedly under control.
Overall, this refugee population can be considered to be at high risk of micronutrient deficiencies (category I in Table 1). With the changes made to the food basket, the tendency in the population should be one of improvement.
There are no new reports on the approximately 190,000 refugees from Myanmar in Bangladesh. It is assumed that repatriation is continuing and that this populations not currently at heightened nutritional risk (category IIc in Table 1).
The most recent reports on the Marshland Arabs in Southern Iraq (approximate population 220,000) describe a deteriorating situation.
Interviews with Marshland Arab refugees newly arrived in Iran indicate a dramatic decline of water in the southern marshes, especially in the summer months. This is mainly due to the drainage programme carried out by government of Iraq forces. The reduction in the water level has deprived the population of food, construction materials and means of transportation. Furthermore, there is almost no drinkable water left in any part of the marshes [UN: Situation of Human Rights in Iraq, 8 Nov 1994].
Difficulties for the Marshland Arabs are further compounded by the fact that they have limited access to the monthly government food ration cards that are normally available to every Iraqi citizen. In most cases this is simply due to political discrimination. With no direct access to food, many have become dependent upon intermediaries and smugglers who sell them flour, sugar and oil at black-market prices. However, increased control of the marshes by government forces further restricts movements making populations more isolated and dependent on depleted natural resources. The final insult is the aerial bombardment and artillery shelling of the marshes indiscriminately pursued by government Eventually, many refugees have little choice but to flee their natural territory [UN: Situation of Human Rights in Iraq, 8 Nov 1994].
There is no doubt that the violations referred to above have continued up until this report and indeed the flow of Marsh Arabs seeking refugee status into South West Iran has continued unabated. Most of the new arrivals are in very poor physical and psychological condition which partly reflects the fact that access to health care is extremely limited for the inhabitants of the marshes as there are no clinics inside the marsh area [UN: Situation of Human Rights in Iraq, 8 Nov 1994].
Overall, the refugees in camps in Iran are not considered to be at heightened nutritional risk (category IIc in Table 1), while the Marshland Arabs still in Iraq are considered to be at high risk (category IIa in Table 1).
The situation for the approximately 3.1 million people in the region affected by the continuing civil war in Afghanistan remains largely unchanged since the last RNIS report The "Consolidated Inter-Agency Appeal for Emergency Humanitarian Assistance for Afghanistan" covering the period October 1994 - October 1995 envisages the provision of assistance to some 1 million internally displaced persons and covers relief activities, mine clearance and voluntary repatriation programmes.
Displaced in Kabul The level and intensity of fighting between forces loyal to the President, and those of the Supreme Coordination Council, increased dramatically in August Over 6,000 casualties were reported during the month with many families fleeing towards the relative safety of Jalalabad. Given the continuing blockade of the city and absence of government stocks or subsidized food, it can safely be presumed that the 32% level of wasting recorded amongst the displaced in May 1994 (approximately 440,000) has not changed significantly.
Displaced in Jalalabad The overall security situation in the Eastern region of Afghanistan has remained stable. During August over 20,000 people arrived in Jalalabad fleeing the fighting in and around Kabul. There are two large camps for the displaced in Jalalabad (population over 180,000) and a number of smaller ones. One camp (Sarashahi) is now said to be over-full so that efforts are being made to locate a new camp site. There are no new nutritional survey data since August when levels of wasting in Sarashahi camp were recorded at 14.6% and 18.6% in two different camp sections [UNHCR 16/09/94].
Refugees in Pakistan There has been a marked reduction in the rate of voluntary repatriation of the approximately 1.4 million Afghan refugees currently residing in Pakistan. With widespread fighting in Afghanistan it is expected that this trend will continue into 1995. Despite the border closure policy of the Government of Pakistan, it is expected that just over 100,000 new Afghan refugee arrivals will be registered by the end of 1994.
A nutritional survey carried out in May 1994, showed that the proportion of acutely malnourished children in the refugee camps in Baluchistan has almost doubled since 1991 and 1992 and was significantly higher (3.7%) than in North West Frontier Province and Punjab (1.7%) (see Annex 1 (22a)). The higher prevalence of diarrhoea in Baluchistan (25.1%) than in NWFP/Punjab (12.7%) may be an important contributory factor in explaining this difference [UNHCR May 94].
The general ration for refugees will be halved from the beginning of 1995 and will contain 5 kgs of wheat and 300 gms of oil per person per month. Prior to this, efforts are being made to provide vulnerable group feeding and targeted food for-work programmes to act as safety nets once the ration is reduced [UNHCR 31/08/94, SCF 29/11/94].
Refugees in Iran The rate of repatriation of the approximately 13 million Afghan refugees in Iran has also markedly slowed and is not expected to speed up significantly without an improvement in security in Afghanistan. In August only 11,013 people returned which is a 47% decrease compared to July.
Overall, the displaced population in Kabul can be considered to be at high risk (category I in Table 1) with high levels of wasting, and the population in Jalalabad could also be considered to be at high risk (category IIa in Table 1) due to over-crowding. The refugees in Pakistan and Iran are probably not currently at heightened nutritional risk (category IIc in Table 1).
How can external agencies help? There is a continued need for a general ration programme for the displaced in Kabul and those in camps in Jalalabad. Given the rate of influx into the Jalalabad camps there is a need for more regular nutritional and mortality surveillance. The significantly higher levels of diarrhoea in the Baluchistan camps compared to the NWFP camps in Pakistan suggest the need for improving sanitation conditions in the former. Furthermore, given the planned general ration reduction for 1995 in the Afghan refugee camps in Pakistan, it will be important to implement more regular nutritional surveys in order to detect as early as possible any adverse effects of the ration reduction upon nutritional status.
