1. Liberia Region
2. Western Ethiopia/Eastern Ethiopia/Ogaden
3. Sudan
4. Kenya
5. Somalia
6. Mozambique Region
7. Burkina Faso
8. Angola
9. Southern Sudan
10. Uganda
11. Shaba/Kasai Regions, Zaire
12. Ghana, Togo, Benin Region
13. Central African Republic
14. Zaire (Refugees)
15. Burundi/Rwanda Situation
16. Mauritania/Senegal
17. Djibouti
18. Zambia
(see Map 1 and Figure 3A)
A Liberian peace agreement which contained a provision for an immediate cease-fire as well as a timetable for creation of buffer zones, safe-havens, demobilization of soldiers and eventual democratic elections was signed in Accra, Ghana, on the 21st of December 1994. There is optimism that this new agreement will hold as the principal signatories represent all Liberian warring factions. Apart from a few small-scale skirmishes, the cease-fire appears to be holding. Unfortunately, the situation in neighbouring Sierra Leone has continued to deteriorate during the new year period with greatly intensified rebel activities leading to massive internal displacement and a further refugee outflow into Guinea. The total number affected by the crisis regionally has, therefore, increased to just over three million people. The food pipeline for vegetable oil and beans for the region is said to be very weak with need for early provision of cash funds for staffing and logistic support costs to ensure necessary food aid logistics, co-ordination and monitoring [WFP 20/01/95].
Trend in numbers of refugees/displaced and proportion severely malnourished and at high risk (black area).
Current estimates of the populations affected by the conflict are summarized in the box below.
|
Location |
Feb 94 |
April 94 |
June 94 |
Aug 94 |
Oct 94 |
Dec 94 |
Feb 95 |
|
Liberia |
1,750,000 |
1,750,000 |
1,750,000 |
1,750,000 |
1,692,000 |
1,615,000 |
1,800,000 |
|
Sierra Leone |
300,000 |
297,000 |
300,000 |
300,000 |
300,000 |
506,000 |
506,000 |
|
Cote d’Ivoire |
250,000 |
250,000 |
234,000 |
250,000 |
325,000 |
330,000 |
330,000 |
|
Guinea |
600,000 |
415,000 |
628,000 |
539,000 |
534,000 |
534,000 |
568,000 |
|
TOTAL |
2,900,000 |
2,712,000 |
2,912,000 |
2,839,000 |
2,851,000 |
2,988,000 |
3,198,000 |
As a result of the cease-fire and improved security, agencies have been able to re-start cross-border food convoys from Cote d’Ivoire to Upper Nimba county and WFP have been planning cross-line food convoys to Bomi and Cape Mount For example, in December, rice, vegetable oil and CSB were distributed in Nimba county, and in February there was a food delivery to Cape Mount [WFP 08/01/95, WFP 16/02/95]. There are also plans for cross-border food deliveries from Guinea to Upper Lofa county for a population, including many Sierra Leonean refugees who, due to insecurity, have been cut off from assistance for over one year. [UNHCR 30/01/95].
The most recent nutrition surveys available from Liberia (October 94) show low levels of wasting amongst the displaced in Montserrado county (an ECOMOG controlled area), In Somokai town and Paynseville displaced centres, levels of wasting were found to be 7.7% and 5.8% respectively (see Annex 1 (1a,b)). One would expect to find considerably higher levels of wasting amongst those populations who have effectively been cut-off from all relief in recent months [MSF-H 03/10/94].
Sierra Leone Simultaneous rebel attacks on a number of large towns throughout the country during the Christmas week caused large scale displacement within Sierra Leone. Continued fighting has meant that all UN and NGO international staff working outside of Freetown have been moved into the city and the Southern, Northern, and Eastern provinces are said to be cut off from the Western area. Due to the deteriorating security situation, private transporters are reluctant to transport relief food into these areas without an army escort. WFP has only minimal stocks prepositioned in Bo, Kenema and Segbwema, available for distribution to the displaced and managed by a skeleton national staff [WFP 30/12/94, WFP 08/01/95, WFP 20/01/95, WFP 16/02/95].
Although the numbers and locations of the internally displaced and refugee population will have recently changed due to the increased insecurity, a food supply assessment mission completed in November 1994 estimated that there were 490,000 IDPs in the districts of Kenema, Daru, Makena, Bo town, Gondama and Gerihum areas and a further 7,000 Liberian refugees in Waterloo camp near Freetown [WFP/UNHCR 05/11/94].
Cote d’Ivoire Conflict in Liberia up until the end of December 1994 led to a continued influx of refugees into Cote d’Ivoire. Although the number of Liberian refugees is estimated to be 330,000, this is recognised to be a provisional figure in anticipation of an imminent census of new arrivals, who it is estimated number between 85,000 to 120,000 people. There are also approximately 97,000 Liberian refugees who were estimated to be self-sufficient in March 1994, and will stop receiving food aid in 1995 [WFP 16/02/95].
Liberian refugees in Cote d’Ivoire have continually been encouraged and supported by government and relief agencies in their efforts to attain self-sufficiency. In line with this policy, their food rations have been reduced over the years and currently stand at 200 gms of cereal and 25 gms of vegetable oil per person per day (equivalent to about 1,000 kcals/person/day). However, there has been some recent concern expressed about the adequacy of partial rations for new arrivals. Furthermore, a recent devaluation has effectively doubled the price of consumer items for partly self-sufficient refugees. Preliminary results of a nutritional survey conducted in January 1995 amongst refugees in the Tabou area of Cote d’Ivoire also give cause for concern as levels of 14.8% malnutrition were recorded with 4.5% severe malnutrition (see Annex 1 (1c)) [UNHCR Jan 95].
Guinea The upsurge in fighting in Sierra Leone has led to an influx of refugees into the Forecariah prefecture of Guinea. At the end of January 1995, the number of new arrivals was estimated to be 35,000 [UNHCR 30/01/95, WFP 03/02/95]. This recent influx increases the total number of registered Liberian and Sierra Leonean refugees in Guinea to approximately 568,000. There are reportedly 120,000 refugees in Guinea who have achieved self-sufficiency and food aid for this group will be phased out [WFP 16/02/95]. There are reported to be many thousands more refugees in Guinea who are not registered [CAMA Oct 94].
It is estimated that about a quarter of the refugees are found in urban centres with the rest either integrated into villages or in rural refugee camps. The government of Guinea maintains a liberal “open-door” policy in providing asylum to Liberian and Sierra Leonean refugees and permits spontaneous settlement in local communities with few restrictions on refugee farming and employment [CAMA Oct 94].
However, some difficulties are reported to exist in the refugee programme in Guinea. One problem is that there have been frequent delays in processing the registrations and responding with food assistance for new arrivals. Furthermore, the partial rations provided have been criticised as inadequate for new arrivals. Another problem is that there are large numbers of unregistered refugees (perhaps as many as 25% of the refugee population) who are not provided with any food assistance. Some nutritional surveys are reportedly finding high levels of malnutrition among unregistered new arrivals. A further problem that has been identified is that it has proven difficult to target additional support to vulnerable groups, such as female headed households and the elderly. Overall, these problems with the food assistance programme have been compounded by food stock ruptures which have led to reduced rations being distributed [CAMA Oct 94].
Preliminary results of a nutritional survey in mid January 1995 found rates of malnutrition amongst refugees between 4-12% (see Annex 1 (1d)), with up to 30% malnutrition reported amongst new arrivals [UNHCR Jan 95].
Overall, the approximately 1.3 million people in Monrovia, Buchanan and surrounding areas of Liberia are not currently considered to be at heightened nutritional risk (category IIc in Table 1). The approximately 500,000 people who have until now only been sporadically accessible in the counties outside of the Monrovia area can be considered to be at high nutritional risk (category IIa in Table 1). The refugee/displaced population in Sierra Leone can be considered to be at high nutritional risk since food supplies are being disrupted by current levels of insecurity (category IIa in Table 1). In Cote d’Ivoire and Guinea refugees can be considered to be at moderate risk with new arrivals, vulnerable groups and unregistered refugees at high risk, but estimates of the numbers of people affected are not available.
How could external agencies help? With continuation of the cease fire large areas of Liberia will become increasingly accessible. There will be a need for nutritional and health surveys in formerly inaccessible areas in order to establish need for general and selective feeding programmes as well as health programmes; measles immunisation programmes would probably be a priority. Organisations may therefore need to gear up for expanded relief programmes in Liberia. Unfortunately, the deteriorating security situation in Sierra Leone is currently preventing implementation of needed relief measures in most areas, although agencies will need to prepare for increasing numbers of displaced people in large towns, e.g. Freetown.
Given the allocation of partial general rations for refugees in Guinea and Cote d’Ivoire, there is a need to determine whether these rations are adequate for new arrivals who may have limited means with which to secure even partial self-sufficiency. There is also a need to improve immunisation coverage in the Tabou are of Cote d’Ivoire. Nutritional surveys could be disaggregated to determine levels of wasting among new arrivals in both countries. There also appears to be a need to speed up the registration process for new arrivals in Guinea.
There is an urgent need for donors to pledge greater quantities of beans and oil for the whole regional programme as well as more cash to support staffing, logistical, co-ordination and monitoring components of the programme.
(see Map 2)
The number of refugees/returnees in Ethiopia has increased to 379,500 due largely to an influx of Somali refugees into Eastern Ethiopia and the continued influx of Sudanese refugees into Western Ethiopia.
Most recent estimates are that there are approximately 259,000 Somali refugees in Eastern Ethiopia. This increase is due to an influx of 74,000 refugees fleeing fighting in Hargeisa. It is presently believed that the main influx is over. These refugees have arrived in many of the camps along the Eastern border, easing their integration into the existing camps. Food distributions for new arrivals were carried out in January 1995 [SCF 25/01/95, UNHCR 31/01/95]. A massive re-validation exercise carried out in September and October 1994 which established that the number of ration cards in the Somali camps were at least three times in excess of the actual population, is seen as the first step in preparations for repatriation. Crude mortality rates in the camps are extremely low at 0.2/10,000/day [UNHCR Nov 94].
There continues to be a slow but steady influx of Sudanese refugees into the West of Ethiopia and current estimates are that there are 51,000 refugees in three different settlements. Much of the nutritional data come from the Administration for Refugee-Returnee Affairs (ARRA); the most recent of this is from October 1994. Levels of wasting in the three sites varied from 5.4% with 0.4% severe wasting in Dimma (estimated population 11,800), to 15.7% with 1.5% severe wasting. The higher rates were measured in Fugindo settlement (estimated population 26,000) and are not substantially different from rates measured in May 1994 (14.2% wasting and 0.8% severe wasting) (see Annex 1 (2a,b,c)) [UNHCR 27/10/94, UNHCR 31/01/95].
There are no reports of any significant change in the nutritional status of the approximately 28,000 returnees in Gode camp in the Ogaden region who have consistently been in nutritional and health crisis over the preceding two years due to erratic provision of general rations and inadequate health services. The most recent nutritional information is from a survey in August 1994 when wasting was measured at 19.8% with 1.4% severe wasting and water and sanitation provision were described as inadequate and unsafe (see Annex 1 (2d)) [UNHCR Aug 94].
There are also about 6,500 Kenyan refugees and 25,000 Somalis in Southern Ethiopia. The most recent nutritional information available is from July 1994 when levels of wasting were measured at 15.7% with 3.2% severe wasting (see Annex 1 (2e)). The level of severe wasting had increased significantly since the previous survey in January 1994 (1.0% severe wasting) [UNHCR Jul 94, UNHCR Nov 94].
There are approximately 10,000 refugees form Djibouti in the North-east region of Ethiopia. No details on their nutritional status are currently available.
Overall, the refuge population in Eastern Ethiopia is not reported to be at heightened nutritional risk, despite the influx of new refugees (category IIc in Table 1). Most of the Sudanese refugee population is not considered to be at heightened risk (category IIc in Table 1) except the population of Fugindo camp that is at moderate risk due to high levels of wasting. The returnee population in the Ogaden can still be considered to be in a critical state (category I in Table 1). The refugee population in Southern Ethiopia can be considered to be at moderate risk with elevated levels of wasting (category IIb in Table 1) and no information is currently available on the Djibouti refugee population (category III in Table 1).
How could external agencies help? Although the nutritional situation for refugees in Ethiopia is generally adequate, there is a need to investigate further why somewhat elevated levels of wasting persist in camps such as Fugindo and among refugees in Southern Ethiopia. The continuing crisis in Gode urgently requires that measures are taken to provide regular general rations to the displaced population and that sanitation and water supply is improved.
(see Maps 3A and 3B and Figure 3B)
An FAO/WFP crop and food supply assessment mission to Sudan in December forecast that the 1994 production of sorghum and millet would be a record 85% above the previous years production and 9% more than the 1992/3 bumper harvest. The mission also reported that the large harvest may exert a downward pressure on prices and, given sharp rises in production costs, there are concerns about prices falling, perhaps even below a break-even point [FAO 22/12/94].
Trend in numbers of refugees/displaced and proportion severely malnourished and at high risk (black area).
Based largely on these figures and the findings of an earlier Operation Lifeline Sudan (OLS) assessment mission in southern Sudan, the transitional zone and the Khartoum displaced camps, the mission estimated that only 1.2 million beneficiaries would require emergency food aid in Sudan during 1995. This figure comprised 720,000 displaced and war affected persons in the South and 335,000 displaced persons in the transitional zone and Khartoum with an additional 125,000 war affected in other locations. However, the mission also warned of the need to anticipate possible escalation of hostilities in the South and the consequent need for contingency planning in assessing food aid requirements in the event of further displacement [DHA Dec 94. FAO 22/12/94].
Given the amount of carry over food stocks from external aid in 1994, it is anticipated that no further commodity contributions are needed for the 1995 programme, although international assistance will be required to support logistic and monitoring activities, identify pockets of malnutrition and vulnerable groups, and help in the transition from relief to rehabilitation activities [FAO 22/12/94, WFP 16/02/95]. However, given levels of iodine deficiency goitre in the West and South of Sudan, a ration of 5 gms of iodised salt is to be added to the emergency food basket. The logistical capacity already exists amongst WFP and other agencies to provide salt along with the other relief commodities [DHA Dec 94].
There have only been a limited number of nutrition surveys in Southern Sudan since the previous RNIS report. One survey was carried out in November in Mogale camp, Southern Sudan, (estimated population 46,000), and found 18% levels of wasting with 6.5% severe wasting (see Annex 1 (3a)) [AICF Nov 94]. These levels are high and as this is a camp population it is possible that the excellent harvest may only have a modest impact on this population’s access to food.
Another survey was conducted in Tonj, Bahr-el-Ghazal in December 1994 and found only 5% wasting (see Annex 1 (3b)). However, a significant number of children were reported to be between 80-90% weight for height indicating vulnerability to any reduction in food availability [WV 05/01/95].
We can assume that the greatly improved access and subsequent food deliveries in Southern Sudan due to both greater donor support for air transport and reduced military activity, and which were reported in the previous RNIS report, have continued as there have been no reports to the contrary.
There is no new nutritional information on the approximately 200,000 Ethiopian refugees in camps in eastern Sudan, However, it is hoped that up to 50,000 refugees will be repatriated from these camps by the end of 1995 although land availability remains a stumbling block as many previous returnees have not yet been allocated plots by the regional administrations in Ethiopia [UNHCR Nov 94].
Overall, although pockets of food insecurity will inevitably exist in Sudan, the greatly improved harvest situation in the whole country and better access in the South, suggests that the majority of the population are not currently at heightened nutritional risk (category IIc in Table 1). However, the information that we have from Mogale camp indicates that this population are at high nutritional risk (category I in Table 1) due to high levels of wasting found.
How could external agencies help? While the food pipeline for Sudan is adequate and there is a greatly reduced population in need of food relief following the excellent harvest, further cash pledges are still needed to allow flexible logistics and monitoring of the food aid programme. Also, there is a need for more nutritional survey information on displaced populations, particularly in the South, who may not be in a position to benefit greatly from the harvest The data showing high levels of wasting in Mucoso camp for the displaced in Southern Sudan may be indicative of the vulnerability of displaced populations in the South.
(see Map 4 and Figure 3C)
At the end of January 1995, it was estimated that there were approximately 232,000 refugees in Kenya. This population comprises 196,000 Somali refugees 26,000 Sudanese refugees and 10.000 Ethiopian refugees. The decrease in numbers from the previous RNIS (255,000) is due almost entirely to a re-registration exercise conducted in Kakuma camp although during this period there have also been new arrivals (mainly from Sudan) and repatriations (mainly to Somalia) [UNHCR 31/12/94, UNHCR-b 31/01/95, WFP 16/02/95]. An air lift of some 4,500 Ethiopian refugees back to their home region in Addis Ababa. Gode and Dire Dawa, has been scheduled for early 1995 [UNHCR Nov 94].
Trend In numbers of refugees.
The most recent reports on the nutritional status of the refugee population in Hagadera indicated 5.3% wasting with 0.8% severe wasting (see Annex 1(4a)). These are very low levels of wasting. Apart from temporary closure of the road to the Dadaab camps (Ho, Dagahaly and Hagadera) in November due to the rains, there is no reason to assume that this situation will have changed greatly. As there are no new reports of scurvy in the camps, this population is not currently considered to be at heightened nutritional risk (category IIc in Table 1) [UNHCR 31/01/95, WFP 17/12/94].
(see Map 5)
An estimated 600,000 people in Somalia will remain dependent on emergency food aid during 1995. This overall number is comprised of 300,000 internally displaced people and an equivalent number of recent returnees. The present harvest is estimated to be 75% of pre-war yields and a 127% increase over the 1993/4 harvest, but is still lower than average production between 1986-90. Reports suggest that the excellent harvest in August (Gu season) has had a positive impact upon nutritional status [FAO 09/12/94, WV Oct 94].
Sporadic fighting between local administration forces and the Idagale clan in Hargeisa has led to over 74,000 people fleeing to neighbouring Ethiopia and internal displacement in the North West, while in Southern Somalia incidents of inter-clan fighting and banditry continue to be reported, most notably around Mogadishu where thousands of residents have been forced to seek refuge in safer parts of the city.
The phased withdrawal of UNOSOM which began in October 1994 and is scheduled to be completed by March 1995, has led a number of NGOs to withdraw temporarily from UNOSOM evacuated areas such as Kismayo and Baidoa in order to observe the impact upon security. In most cases, NGOs have returned within a matter of weeks although a few NGOs have ceased humanitarian operations in Somalia completely as a result of the level of insecurity. Due to the current uncertain security climate, repatriation efforts could slow down and there is a palpable fear that pockets of unrest could erupt into larger scale civil-war once UNOSOM forces have completely left in March [USAID 30/12/94, WFP 17/12/94].
There are no recent nutritional or health surveys available from Somalia although one NGO working in Bay region has reported on the urgent need to improve EPI coverage throughout the country, which has suffered due to the war and subsequent insecurity. In Bay region immunisation coverage of under fives is estimated to be only 10% [WV Nov 94].
Overall, the 600,000 people requiring humanitarian assistance in Somalia are currently considered to be at moderate nutritional risk (category IIb in Table 1) due to the is mounting concern about the security situation in the country.
How could external agencies help? With the increasingly fragile security situation in Somalia and the possibility of a rapid deterioration following the final withdrawal of UNOSOM in March, the need to support indigenous NGOs with training and resources is becoming more pressing. Many local agencies may be called upon to implement relief activities should conditions deteriorate. It is therefore a priority that remaining international NGOs review, and where appropriate, support the capacity of such agencies to undertake necessary relief activities.
(see Map 6 and Figure 3D)
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.
(see Map 7)
There are currently approximately 20,000 Malian refugees in Burkina Faso. This population is comprised of two distinct groups. There are 6,000 refugees who arrived between 1991-3 whose condition has been described as satisfactory (category IIc in Table 1); a further 14,000 refugees are mainly Touareg pastoralists who began arriving in June/July 1994. Many of this latter group were described as destitute on arrival and in urgent need of basic assistance, especially food. However, at the time of the influx there was no food in warehouses or the pipeline so that this population received very little food assistance between June and October 1994 [UNHCR 14/10/94].
The Touareg refugees are mainly settled in three locations which the government have argued were not intended to host such large numbers. Fears have therefore been expressed about possible epidemics and there have been qualitative reports of poor health and cases of malnutrition amongst this recently displaced population. These new arrivals could be considered to be at moderate nutritional risk (category IIb in Table 1) [UNHCR 14/10/94].
How could external agencies help? There is a need for baseline nutrition and health surveys to determine the need for and type of assistance required by this population. The situation for this population is complex as many refugees have urban and familial links which provide some level of economic independence.
(see Map 8 and Figure 3E)
Estimates of the numbers of people needing humanitarian assistance remain at 3.2 million. The current drought in most of the Southern Africa region is not reported to be affecting Angola and the forecast is for one of the better agricultural seasons in recent years [DHA Dec 94, WFP 13/01/95].
Trend in numbers of displaced/war affected.
Assessment missions continue at an increased pace throughout the country as security improves and more and more of the country opens up following the peace agreement signed in November 1994 and the decision by the UN to send in peace-keeping forces. Initial findings are that the situation had deteriorated in areas that were cut off from food aid for long periods. For example, in Jamba an assessment team found an urgent need to distribute food to children under five years old, women and other vulnerable groups, while in Lucala the team found “deplorable health conditions despite plentiful locally produced food” [UNSC 08/02/95, WFP 27/01/94].
Food distributions by air and road to previously inaccessible locations have been continuing. For example, general dry food distributions were re-initiated in Huambo in December, In Dondo, approximately 60,000 people are receiving a general radon, and it is believed that many of the displaced are beginning to return to their homes. In N’dalantando, 47,000 people are receiving a general ration [WV 07/01/95].
In Malange (estimated population 180,000), where food has consistently been available over the past few months, a recent nutritional survey indicated a much improved situation. Wasting was measured at 2.8% with 0.9% severe wasting (see Annex 1 (8a)). This indicates a dramatic improvement since September 1994 when the city had been cut off from relief supplies for several months and rates of wasting were measured at 15.3% with 4.8% severe wasting. The crude mortality rate for December was still elevated at 1.7/10,000/day (6 x normal) and the under five mortality rate was 2.7/10.000/day [Concern/MSF-H Dec 94].
It is reported that the rapid decrease in rates of wasting in Malange is directly related to the resumption of the general food distribution in September 1994 and that this indicates a considerable reliance on external aid by the population. Since external aid remains a major source of food for the population, there are fears that any reduction in food aid would result in an almost immediate deterioration in the nutritional status of the population. If, as has been suggested, the ration in Malange is to be reduced, it may be advisable to monitor the situation very closely in order to detect any early signs of deteriorating nutritional status. The results of the survey are not felt to accurately reflect the nutritional status of the adult population for whom there is believed to be a continuing need for selective feeding especially amongst the elderly. [Concern/MSF-H Dec 94].
A cholera outbreak was reported in January in Cubal with 100 cases identified by January 10th. By the end of the month more than 700 people had reportedly been affected [WFP 13/01/95, WFP 27/01/95].
Overall, the population can be considered to be at moderate risk due to a high degree of dependance on external food aid (category IIb in Table 1)
How could external agencies help? As the food security and nutritional situation in Angola gradually improves and levels of emergency food aid are reduced, there is a need to closely monitor any impact of food aid reduction on nutritional status. Given that large sections of the population may remain highly dependent on food aid for some considerable time, nutritional monitoring systems should be established before food aid reductions are implemented. Also, further pledges of maize, vegetable oil and CSB are needed to cover the planned food delivery targets up until June 1995.
(This is now included under section #3 Sudan)
(see Map 10)
The total number of refugees in Uganda continues to increase, largely due to influxes of refugees from Southern Sudan. Current estimates of major refugee populations in Uganda over time are summarised below. These estimates are currently under review and a census is planned for the near future [WFP 16/02/95].
|
Origin |
Feb 94 |
April 94 |
June 94 |
Aug 94 |
Oct 94 |
Dec 94 |
Feb 95 |
|
Sudanese Refugees |
188,000 |
190,000 |
206,000 |
230,000 |
268,000 |
274,000 |
300,000 |
|
Zairian Refugees |
5,000 |
5,000 |
15,000 |
16,000 |
16,000 |
16,000 |
13,000 |
|
TOTAL* |
193,000 |
195,000 |
221,000 |
246,000 |
284,000 |
290,000 |
313,000 |
*Rwandan refugees are discussed under # 15.Sudanese refugees continue to arrive at the rate of 300-500 people per day bringing the total number of refugees in Uganda to over 300,000. Most of these new arrivals are single males reportedly avoiding conscription [UNHCR-a 31/01/95].
The crude mortality rate for December for the Koboko camps (estimated population 111,000) was 0.28/10,000/day and the under five mortality rate was 0.64/10,000/day. These rates are both within normal limits for the region. A screening of all new arrivals under five years old at the camps found wasting levels of 9.7% with 6.8% severe wasting (see Annex 1(10a)). A few cases of measles were also reported in the camps. Currently, the main medical problem is malaria accounting for over 30% of all medical cases seen at health centres [MSF-H Dec 94].
After a recent census, me number of Zairean refugees in now estimated to be almost 13,000. Their nutritional status is believed to be adequate [UNHCR 09/12/94].
Overall, despite the continuing influx of Sudanese refugees, the situation in the camps appears to be under control so that these refugees are not currently considered to be at heightened nutritional risk (category IIc in Table 1).
How could external agencies help? The situation for the majority of refugees is adequate. However, extremely high levels of malaria and occasional reports of measles indicate a possible need to review both additional malaria control measures that could be taken in the vicinity of camps and measles immunisation rates, especially given the continuous influx of new arrivals from Southern Sudan.
(see Map 11)
We have no new information on the almost 600,000 people who have been displaced by ethnic violence which erupted in Shaba region in 1992. The previous RNIS report indicated a generally improved, but nonetheless precarious, nutritional situation for the large majority of this displaced population.
(see Map 12)
The Togolese refugee crisis began almost two years ago in January 1993. At the peak of the exodus, approximately 300,000 refugees were registered, some 150,000 in each of the two main asylum countries, Ghana and Benin. As a result of spontaneous repatriation since then, there are currently only 115,000 refugees in Ghana comprised of 14,000 Liberians and 99,000 Togolese and there are 50,000 Togolese refugees in Benin [UNHCR 20/11/94, WFP 16/02/95].
Signs that the political situation in Togo is returning to normal are giving rise to hopes that organised repatriation can begin in earnest soon. For example, the Togo/Ghana border is open again after being closed for almost one year. This hope is given added urgency by the fact that the presence of the refugee population has created serious hardship for the local host populations and is exerting enormous pressures on already over-burdened social and administrative infrastructures in both host countries [UNHCR 20/11/94].
There is little information on the nutritional situation of these refugee populations although there have been reports of severely delayed general radon distributions, In the Atlantic region of Benin (23,280 refugees), the November general ration distribution only took place in mid December while in the departments of Mono and Zou, refugees had reportedly still not received their October 1994 ration in January 1995 [UNHCR 18/01/95].
There are approximately 180,000 people in Northern Ghana displaced by ethnic violence which broke out in February 1994. Although WFP and UNHCR are providing aid to this population, there is currently some concern over the lack of agency presence to assist with rehabilitation programmes for this internally displaced population [UNHCR 20/11/94. WFP 16/02/95].
Overall, most recent information is that the nutritional status of these populations is adequate (category IIc in Table 1) with the exception of the 23,000 refugees in Benin who are not receiving regular rations. This group could be considered to be at moderate nutritional risk (category IIb in Table 1).
How could external agencies help? The recent erratic delivery of general rations to Togolese refugees in Benin suggests a need to evaluate the constraints which are currently affecting this programme. Furthermore, there is a need to establish nutritional monitoring of this population in order to determine whether erratic general ration deliveries are having an adverse nutritional impact.
In Northern Ghana there is a need for greater agency presence to assist in the rehabilitation programmes for this internally displaced population.
(see Map 13)
The Chadian refugee population in the CAR had increased slightly to 13,300 by the end of November 1994. There are some indications that these refugees migrate to CAR for the harvest of cotton and other crops. Problems with the distribution of the general ration reported in the previous RNIS report have continued. The November distribution took place three weeks late and supplied a ration with no beans and only half the cereal entitlement [UNHCR-a Nov 94, WFP 16/02/95].
The number of assisted Sudanese refugees remains at 25,500 people. A measles outbreak was reported among this refugee population in late November and resulted in 29 deaths. Necessary medication was flown in and as of mid-December 1994, the epidemic was reportedly under control. There are also reported water supply problems for this population which are apparently having an adverse impact on hygiene and health. The problems are caused by a lack of material for well construction [UNHCR-a Nov 94, UNHCR 07/12/94].
Overall, the Chadian and Sudanese refugee populations may be said to be at moderate nutritional risk (category IIb in Table 1) due to erratic and incomplete general ration distributions in the former case and the measles outbreak in the latter case.
How could external agencies help? While problems with general ration distributions persist there is a need to establish nutritional monitoring to determine any resulting adverse impact. Also, following the recent measles outbreak, vaccination coverage must be re-assessed and further immunisations instigated, if appropriate.
(see Map 11)
The number of assisted refugees in Zaire is now approximately 104,700 people, excluding the Burundi and Rwandan refugees who are discussed in section #15 below. This total is comprised of 41,000 Angolan refugees, 62,000 Sudanese refugees, and 1,700 Ugandan refugees [UNHCR-a 09/12/94].
It is thought that the signing of the Angolan peace accord could lead to large-scale repatriation of the Angolan refugee population. However, there continues to be a steady stream of arrivals from Sudan to Zaire, although repatriation to Uganda is continuing [UNHCR-a 09/12/94].
There is no current information available on the nutritional status of these refugee populations, although it is thought to be adequate (category IIc in Table 1).
(See Map 15 and Figure 3F)
The number of people estimated to require emergency assistance as a result of the regional crisis has decreased since last December to approximately three million people. This is due to a number of factors including relatively good harvests in Burundi and Rwanda and the return of many internally displaced to their homes, as well as re-registration exercises undertaken in the refugee camps in Tanzania and Zaire. Population estimates over time are summarised below.
Trend in numbers of refugees/displaced and proportion severely malnourished or at high nutritional risk (black area).
|
|
Feb 94 |
April 94 |
June 94 |
Aug 94 |
Oct 94 |
Oct 94 |
Feb 95 |
|
Burundi |
282,000 |
536,000 |
1,000,000 |
1,230,000 |
770,000 |
1,200,000 |
740,000 |
|
Rwanda |
272,300 |
250,000 |
2,060,000 |
2,040,000 |
2,500,000 |
1,860,000 |
335,000 |
|
Tanzania |
300,000 |
60,000 |
410,000 |
353,000 |
556,000 |
607,000 |
630,000 |
|
Zaire |
60,000 |
60,000 |
113,000 |
1,500,000 |
1,240,000 |
1,506,000 |
1,290,000 |
|
Uganda |
- |
- |
10,000 |
10,000 |
10,000 |
4,000 |
5,000 |
|
TOTAL |
914,300 |
906,000 |
3,593,000 |
5,133,000 |
5,076,000 |
5,177,000 |
3,000,000 |
Available nutritional survey data from the refugee camps in Tanzania and Zaire and the camps for the internally displaced in Rwanda show very low levels of wasting. However, since early January 1995, WFP has been warning of a serious food availability crisis which will hit the entire sub-region in March 1995 unless action is urgently taken by the donor community. In recent weeks, WFP have been forced to take emergency measures in order to continue to supply food, using loans, cash resources and scarce International Emergency Food Reserves. However, these actions will only meet the most immediate needs for the next eight weeks and will have a major effect on WFP’s capacity to respond to emergency needs elsewhere in the world this year. In view of this critical situation, donors are being urged to make provision of cash resources, for procurement of commodities on regional and international markets, an immediate priority. Cash contributions for non-food requirements, such as agency operating costs, are also urgently needed.
Burundi Current estimates are that there are 740,000 people in Burundi needing food assistance. This number includes 521,000 internally displaced Burundis and 219,000 Rwandan refugees. The January 1995 harvest (there are three main harvest seasons in Burundi) was predicted to be far better than the equivalent harvest last year but still some 10% lower than the 1993 harvest Nevertheless the overall food supply situation remains extremely restricted with wide provincial variations. The most precarious food security is to be found in the Northern provinces of Kayanza, Ngozi, Muyinga and Kirundo, and Karusi province in the centre of the country. These provinces, where most of the internally displaced population and all of the Rwandan refugees are located, are still affected by frequent ethnic clashes. The food situation in these provinces is extremely precarious because of limited food supplies, looting and theft of crops and the virtual non-existence of farm stocks [FAO 16/12/94, WFP 08/01/95].
Violent incidents including threatened hostage taking and looting of warehouses have repeatedly been reported throughout December and January in the Northern provinces of Kirundo, Ngozi, Muyinga and in Karusi province in Central Burundi. There have also been violent outbreaks in rural Bujumbura in early January. In several cases this has led to temporary suspension of food aid assistance and evacuation of international agency staff. Furthermore, private companies have reportedly been reluctant to move food for the humanitarian operations in the North due to frequent incidents of banditry and looting. By the end of January, security had deteriorated to the point where WFP had requested army escorts to deliver food in the northern province of Muyinga [WFP 08/01/95, WFP 27/01/95, WFP 03/02/95].
There is currently very little movement of Rwandan refugees in and out of the country, although 6,000 refugees were transferred from Cibitoke to Muyinga in January. In Bubanza and Cibitoke, return packages are being given to internally displaced people with plans to extend this programme into the province of Rutana. Currently, the general ration for the internally displaced does not include oil due to limited supply in country. Furthermore, low stocks of beans due to low quantities in the pipeline and border problems may hinder the return package operation planned in February for up to 122,000 beneficiaries.
Although no quantitative survey data are currently available, reports indicate an acceptable nutritional situation among the displaced in Cibitoke and Ruyigi, although the health status among the displaced in Ngozi is said to be poor with little NGO presence in me area [WFP 20/1/95, WFP 27/01/95, WFP 03/01/95].
Surveys among the Rwandan refugees also indicate low levels of malnutrition. As a result some NGOs have terminated refugee therapeutic feeding programmes [WFP 10/02/95]. Earlier reports on the internally displaced in Ngozi and Kayanza province in October and November 1994 indicate very low general ration receipts, high levels of default at selective feeding centres due to insecurity, and high levels of re-admission (almost 20%) due to the inadequate general ration [MSF-B Oct 94, MSF-B Nov 94].
Rwanda The overall security situation in the northern part of the country appears to be calm, but the situation in the south has been far less stable with a number of incidents involving ex-government forces crossing over the border. There have also been security incidents involving returnees at waystations dissatisfied with their allocated ration. There are reports that some internally displaced in Gikongoro are unwilling to return home due to the perceived threat of insecurity in their home area. Nevertheless, relocation of the internally displaced from camps in Rwanda (Operation Retour) is continuing and it is hoped that all the internally displaced people in camps will be relocated and camps closed by the end of February 1995. Over 37,000 displaced people had been returned to their communes of origin by mid-February 1995. The numbers of Rwandan refugees repatriating from Goma, Zaire is reportedly increasing, with as many as 1,000 returnees a day entering Rwanda since 10 February. However, repatriation of refugees from Tanzania continues at a slow pace [DHA 20/02/95, WFP 13/01/95, WFP 20/01/95, WFP 27/01/95, WFP 03/02/95].
Many of Rwanda’s internally displaced are in the prefecture of Gikongoro. In December 1994 a nutritional survey in the displaced camp of Ndago (estimated population 45,000) found 11.3 % wasting with 1.9% severe wasting (see Annex 1 (15a)). These levels of wasting are high for Rwanda and may partly reflect the fact that almost 10% of the camp population claimed not to be receiving a general ration in spite of efforts to improve the food distribution system. Measles immunisation coverage was 94% [AICF 06/12/94]. These figures compare less favourably with a nutritional survey of children under five years of age conducted in Kaduha commune, Gikongoro, in November 1994, which found only 4.7% levels of wasting with 0.5% severe wasting. Measles immunisation coverage was estimated to be between 85%-95% (see Annex 1 (15b)) [MSF-F 03/11/94].
Due to limited areas planted and a lack of agricultural inputs, a recent FAO crop assessment mission predicted that the aggregate production of food crops for the first 1995 agricultural season would only be about one half of the equivalent season in 1990 (the most recent normal year). The mission concluded that large quantities of relief food would therefore be required in 1995 for Rwandas estimated 5.6 million population.
Tanzania The total refugee population in Tanzania at the end of January was 632,500. Refugees continue to arrive at a rate of 2,000-3,500 per week. These new arrivals are mainly from Burundi although some are still coming from Rwanda [WFP 27/01/95].
A cholera outbreak was reported in Ngara in December and by mid-January the number of cases was still increasing. Although this is a controlled outbreak, deaths are occurring. These are said to be occurring mainly at night when expatriate staff cannot be present due to poor security [MSF-H 12/01/95]. Water availability in the camps has continually been poor and is still only six litres/person/day after eight months of this refugee programme. Benako lake is currently dry [WFP 20/01/95]. Crude mortality rates in the Ngara camps at the end of December were between 0.33-0.89/10,000/day (normal to 3x normal) and the under-five mortality rate was between 0.43-1.03/10,000/day. The mortality rates do not appear to be increasing due to the cholera outbreak [MSF-H 17/01/95].
Food basket monitoring was carried out in December in Musuhura camp (estimated population at the time 55,000). The average ration distributed was 1,755 kcals/person/day. The minimum ration was 1,430 kcals/person/day and the maximum was 2,100 kcals/person/day [MSF-H 19/01/95]. By the end of January, it was reported that food distribution was going well and there was a distribution of a full food basket [WFP 27/01/95].
At the end of January 1995, security incidents were reported involving threats made against international agency staff as warnings against any attempt to arrest and prosecute alleged war criminals. All camps in Ngara and Karagwe districts were placed on alert following these incidents.
There is continued concern about the environmental impact of the fuel wood consumption needs of the camps. An estimated 1,200 mt of fuel wood are being consumed daily and relations between refugees and local residents in Kagenyi I and II camps are reported to be worsening with threats to interrupt food supplies and chase refugees collecting firewood [WFP 27/01/95, WFP 03/02/95].
Goma, Zaire The first phase of a registration exercise has now ended having identified 726,000 refugees. Voluntary repatriation is continuing slowly with a total of 239,000 refugees being repatriated since August 1994. There were serious disruptions to refugee food supplies in the Goma camps in late December and early January due mainly to closure of the border with Rwanda as well as over-lengthy customs clearance procedures. Closure of the border, which prevented all cross-border food deliveries, was due to the holidays as well as introduction of a new currency in Rwanda. Camps stocks were therefore totally depleted and rations had to be cut. By the end of January, the border was again open although custom formalities were still causing delays in food deliveries [WFP 08/01/95, WFP 13/01/95, WFP 20/01/95. WFP 27/01/95].
Nutritional surveys in December generally show a vastly improved situation in the camps. In Kahindo camp wasting was measured at 3.8% with 0.9% severe wasting (see Annex 1 (15c)). The camp supplementary feeding programme was terminated as a result of these low levels of wasting [MSF-B 19/01/95]. A survey in Kibumba camp (estimated population 180,000) at the end of December showed 2.2% wasting with 0.9% severe wasting (see Annex 1 (15d)). These results demonstrate a downward trend in rates of wasting - in August 1994 wasting rates were measured at 20.2% and in October only 6.4%. In the most recent survey, measles immunisation coverage was 90%. These latter results are particularly re-assuring given the fact that general ration receipts in Kibumba were on average little more than 1,500 kcals/caput/day during the month of December [MSF-B 31/12/94]. However, security problems are reportedly frequent, and Zairean troops are now deployed in the camp [WFP 17/01/95].
A survey conducted in Katale camp (estimated population 150-200,000) in December recorded 7.8% wasting with 5.3% severe wasting (see Annex 1 (15e)) and only 65% measles immunisation coverage. Crude mortality rates were measured at between 0,32-0.43/10,000/day, depending on assumed population size. Although these figures represent a somewhat worse situation than those found in Kahindo and Kibumba camps, they do reflect improvement since the previous survey in October 1994 when rates of wasting were measured at 10.4% with 5.8% severe wasting [MSF-H 07/02/95].
In contrast to these camps, a survey in Kituku camp (estimated population 20,000) in December recorded 27.6% wasting with 20.6% severe wasting. Many malnourished adults were also reportedly being seen at feeding centres. The stark difference with the situation in the other camps prompted questions about the validity of the findings so that a repeat survey was under-taken in mid- January 1995. This subsequent survey only found 12.4% levels of wasting with 7.8% severe wasting (see Annex 1 (15f)). The improved results were believed to reflect better diagnosis of oedema by the survey team and a real improvement in the camp’s health and nutritional status due to the opening of a feeding centre and the onset of the dry season [MSF-H 07/02/95].
Bukavu, Zaire Current estimates are that there are 348,000 refugees in Bukavu. A census is being planned and it is expected that the new figure will be about 20% less than current estimates. A recent pre-census registration at the sites of Kashusha and Birava reduced the number of beneficiaries by 15% and 18% respectively [WFP 08/01/95, WFP 10/02/95]
By the end of December, the security situation in Bukavu had deteriorated to the point where relief activities were suspended each evening at 1800 hours. Incidents of looting and robbery were being reported virtually every week with a number of NGOs forced to evacuate staff for their own safety. A contingent of 1,500 Zairean soldiers is expected to be placed in the camps to restore security [WFP 13/01/95, WFP 20/01/95, WFP 27/01/95, WFP 03/02/95].
As in Goma, the border was closed following introduction of the new currency in Rwanda, stopping relief supplies in early January. When the border re-opened, transportation delays were experienced leading to the partial depletion of stocks in Bukavu. As a result, rations had to be cut to 950 kcals/person/day, which is less than half the theoretical ration. Loans for commodities in short supply were obtained in early February [Oxfam 07/02/95, WFP 27/01/95, WFP 03/02/95].
Surveys conducted at the end of December and the beginning of January showed levels of wasting ranging from 0.4% to 4.3% and severe wasting from 0 to 0.7% (see Annex 1 (15g)) [UNHCR 05/01/95]. These very low levels of wasting are believed to reflect the fact that many of the refugees have been receiving double rations as lack of a proper census has led to an over-supply of food to the camps. Also, many refugees reached this pan of Zaire with some resources of their own. However, nutritional status can be expected to deteriorate if the food supply situation doesn’t improve soon.
Uvira and Kamanyola, Zaire A recent assessment in early January resulted in a reduction in the estimated number of beneficiaries in the Uvira area from 370,000 to 216,000. Due the influx of 7,000 Rwandans from South West Rwanda at the end of the month, the total figure is now 224,000 refugees. Contention over the census has led to road blocks with some NGO personnel being temporarily taken hostage. A restructuring of the zones in the Uvira region is taking place to reduce the number of camps from 27 to 11 [WFP 08/01/95, WFP 27/01/95, WFP 03/02/95].
Uganda There are approximately 5,000 Rwandan refugees in Uganda, although there are recent reports of two way movement between Tanzania and Uganda making precise estimates of numbers uncertain [UNHCR 31/01/95, WFP 13/01/95].
Overall, the population affected in the region can be considered to be at moderate risk (category IIb in Table 1) with the exception of the population in Uganda who are not currently reported to be at heightened nutritional risk (category IIc in Table 1). It should be noted that this situation is currently faced with serious problems (i.e. increasing insecurity, gaps in the food pipeline) that could lead to a rapid change in the nutritional status of this population.
How could external agencies help? The most urgent priority is for donors to provide cash for local and regional purchases of foods for the region. Without this it can be expected that the substantial gains recently made in the nutritional condition of refugees and the internally displaced will be rapidly reversed. In Tanzania, water supplies to the camps have been very poor since the inception of the programme in June 1994. This needs to be urgently remedied especially as poor water supplies may have had some role in the recent cholera outbreak in Benaco. Requirements for fuel must also be addressed by relief agencies working with refugees in Tanzania as the impact of refugee fuel use is creating extreme demands on the host population. In Rwanda, where “Operation Retour” is proceeding rapidly, the need to ensure an adequate general ration for all those eligible in camps for the internally displaced must not be over-looked. Current reports indicate that up to 10% of camp populations may not receive a general ration.
(see Map 16)
It was hoped that conditions for repatriation for most of the 52,000 Mauritanian refugees in Senegal would be established in 1994. However, this has not yet been achieved and this population will receive a final phase of food assistance [UNHCR 30/01/95, WFP 16/02/95].
(see Map 17)
There are no reports of any change in the nutritional or health situation of the Somali and Ethiopian refugees in Djibouti. However, there has been continued repatriation of Ethiopian refugees since September 1994 so that the overall refugee population in Djibouti may now be well under 30,000 [UNHCR Nov 1994].
(see Map 18)
There are no reports of change in the situation of approximately 12,700 Angolan and Zairean refugees in Zambia, although the current drought affecting much of Southern Africa may create tensions between allocation of scarce government resources to the existing refugee population and drought affected populations [WFP 16/02/95].
