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 (1.3 million). There are reported to be 650,000 Iraqis in Iran. Other large groups are refugees from Myanmar in Bangladesh (100,000), 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 over one million each in Iran and Pakistan.
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 previous 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 situation for the Bhutanese refugees in Nepal is stable and well-controlled. The number of refugees rose slightly in December and is now just over 85,000. There are currently no plans for repatriation [IFRC 1994, UNHCR 19/01/94].
Due to a miscommunication, the last RNIS report indicated an outbreak of plague in the camps which in fact never occurred. Rather than an outbreak, plague prevention training took place [SCF, UNHCR pers.comm.].
Overall, with the improved food basket available, it can be assumed that the incidence of micronutrient deficiencies, reported on in previous RNIS bulletins, is continuing to decline and that this population is not currently at heightened nutritional risk (category IIc in Table 1).
Repatriation to Myanmar is continuing for the refugees in Cox’s Bazaar, Bangladesh. During January over 19,000 refugees repatriated leaving just below 100,000 refugees in remaining camps. As a result of repatriation many camps are being closed [UNHCR 07/01/95].
Information on the remaining refugees in Bangladesh indicate a stable and satisfactory situation (category IIc in Table 1). The crude mortality rate in December was 0.02/10,000/day and the under five mortality rate was 0.04/10,000/day which are both very low. Approximately 13% of children are registered in supplementary and therapeutic feeding facilities [UNHCR 7/01/95].
Reports indicate that the situation for the Marshland Arabs in Southern Iraq (approximately 220,000 people) continues to deteriorate. The drainage programme carried out by government of Iraq forces, limited access to government food rations, increased control of the marshes restricting population movements and aerial bombardment and artillery shelling all conspire to push this population out of the marshes and seek refugee status in neighbouring Iran. However, there are no current nutrition or health survey data to indicate the extent of the suffering of the population remaining in the marshes. More information is however available on those who have managed to cross the border into Iran.
It is estimated that over 12,000 people have crossed the border to Iran at Himmet since June 1993. In Iran, these refugees are housed in three different camps. It is currently estimated that there are a further 4,100 refugees at Himmet, a small and narrow dirt road linking the marshes of Southern Iraq with Iran. In mid-January, assistance in the form of blankets and plastic sheeting was delivered to the refugees in Himmet [AMAR Appeal 23/01/95, UNHCR 13/01/95].
The situation for the majority of the approximately 3.1 million people in the region affected by the continuing civil war in Afghanistan remains largely unchanged since the previous RNIS report, but if a UN sponsored transfer of power succeeds it is hoped the situation will improve. However, there appears to have been some deterioration in nutritional status of the large displaced population in northern Kabul in the latter part of 1994, while the nutritional situation of the displaced population in camps in Jalalabad appears to have improved significantly.
Displaced in Kabul There are approximately 600-700,000 people living in Kabul. An estimated 400,000 have been displaced by the continuing civil war. The majority of this displaced population live in private buildings for which they pay rent while an estimated 20,000 live in public buildings, In the Southern mainly rural districts of Kabul, nearly 60% of the population appear to be refugee returnees from Pakistan while 25% of the population are internally displaced. In the northern part approximately two thirds of the population are internally displaced [ICRC 01/01/95].
The city of Kabul is effectively divided into two parts with the six northern rural districts controlled by government while the southern rural districts are held and controlled by the Herb-i-Islami. Except for some locally grown fruits and vegetables, all foods sold on the northern markets have been purchased on the Herb-i-Islami controlled markets in the south and transported to the north by thousands of Kabulis crossing the front line daily. Food has therefore been reaching the northern part of the city in spite of the year old blockade. However, this has inevitably meant more expensive foods in the north [ICRC 01/01/95].
In general, prices of food and other essentials have doubled and in some cases tripled over the past twelve months. This inflation has succeeded abandonment of the “limits coupons”, which provided the entire population with non-food items at subsidized prices, closure of the government shops in 1992, which provided subsidised foods to specific target groups, and most importantly, removal of subsidies for government bakeries in 1992 making the flat bread “nan” the most expensive staple rather than the cheapest [ICRC 01/01/95].
Periodic surveys have strongly suggested that the nutritional status of the displaced population of northern Kabul has deteriorated with the trend continuing in the last half of 1994. The most recent survey shows that the proportion of cases of moderate wasting has risen since the previous survey in April 1994 with 40% wasting among the displaced and 35% among residents see Annex 1 (22a)). This deterioration is believed to reflect greater food scarcity with over 75% of the population without food stores and reliant on daily food purchases. The increasing cost of nan (consumed daily) is known to be very problematic [ICRC 01/01/95].
The last week of 1994 heralded signs of potential improvement in the food security situation for northern Kabul with the announcement that the northern population would be granted free access to three large food markets in the south [ICRC 01/01/95].
The food security and nutritional situation in the south is reportedly better than in the north with only 28% levels of wasting (see Annex 1 (22b)) and the majority of the population having food stores. Furthermore, there is less reliance on the markets as nan is often made at home. However, child mortality rates in southern Kabul appears far higher with major causes of death due to measles, dysentery and dehydration [ICRC 01/01/95].
Displaced in Jalalabad Fighting in Kabul has displaced large numbers of people many of whom have fled towards Jalalabad. Most of the displaced population have settled in Sharashahi and Hadda camps.
Information from Sharashahi camp in November showed 6.2% wasting with 1.4% severe wasting (see Annex 1 (22c)). The crude mortality rate was less than 0.5/10,000/day and the under-five mortality rate was less than 1/10,000/day. These indicators are satisfactory and are an improvement over the 18.6% wasting measured in August 1994. There was also a marked decrease reported in the incidence of diarrhoea which has in the past been exacerbated by over-crowding in the camp. Food basket monitoring showed that there had recently been no sugar or beans distributed in the general ration and that rice was heavily insect infested. Furthermore, there had been no fuel distribution even though winter was approaching [MSF-H 24/01/95].
A screening conducted in Hadda camp in November recorded 11.7% wasting with 2.9% severe wasting (see Annex 1 (22d)). A subsequent nutritional survey in December found overall wasting levels of 6.2% with 1.0% severe wasting (see Annex 1 (22e)). However, measles immunisation coverage was only 34.7% [MSF-H 24/01/95].
Kamaz Camp for the Displaced There are approximately 2,500 families displaced from Kabul who are currently living in Kamaz camp in northern Afghanistan near the border with Tajikistan and Uzbekistan. The camp was originally set up in 1993, but received a further influx of displaced people when renewed fighting broke out in Kabul at the beginning of 1994. A nutritional survey carried out in September 1994 found 8.3% wasting with 2.2.% severe wasting (see Annex 1 (22f)). Measles immunisation coverage was 77.4% [UNICEF/MSF-B 11/09/94].
Refugees in Pakistan There are no reports of any change the satisfactory nutritional situation of approximately 1.4 million Afghan refugees in Pakistan reported in the previous RNIS report.
Refugees in Iran There are no reports of change in the satisfactory nutritional situation of approximately 1.3 million Afghan refugees in Iran reported in the previous RNIS report.
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 limited food security, while the population in Sharashahi and Hadda camps in Jalalabad can be considered to be at moderate risk (category IIa in Table 1) due to erratic general ration distributions in the former and low levels of measles immunisation coverage in the latter. The remainder of the population affected by the Afghan civil war cannot be said to be at heightened nutritional risk (category IIc in Table 1).
How could external agencies help? Increasingly high levels of wasting in Kabul, especially in the northern part of the city, indicate the need to bolster up food security of the internally displaced. The most convenient method of doing this may be to support bakeries thereby effectively subsidising the prices of “nan” for the whole population. Other measures to improve food security might also be considered such as establishing food for work schemes. In Southern Kabul, there appears to be a need for increased support for medical facilities to reduce high rates of child mortality. Measles vaccination programmes are a priority in Southern Kabul and also in Hadda displaced persons camp in Jalalabad. In Sharashahi displaced persons camp in Jalalabad, there is a need for improved deliveries of the general ration and for supplies of fuel.
