1. Angola (see Map 1 and Figure 3)
2. Benin/Ghana/Togo Region
3. Burkina Faso and Mauritania - Malian Refugees (see Map 3)
4. Burundi/Rwanda Situation (See Map 4 and Figure 3)
5. Central African Republic
6. Djibouti (see Map 6)
7. Ethiopia (see Map 7)
8. Kenya (see Map 8)
9. Liberia/Sierra Leone Region (see Map 9 a, b and Figure 3)
10. Mauritanian Refugees in Senegal (see Map 3)
11. Mozambique Region (see Map 11 and Figure 3)
12. Somalia (see Map 12 and Figure 3)
13. Sudan (see Map 13 and Figure 3)
14. Uganda (see Map 14)
15. Zaire (see Map 15)
16. Zambia
Trend in numbers of displaced/war affected. Shaded areas indicate those at heightened nutritional risk.
Apart from a few minor incidents, the security situation throughout Angola has remained calm in recent weeks. Food availability in many areas is gradually improving as a result of the recent good harvest and increased access, particularly by overland transport, to populations requiring food aid. On average over 60% of relief item transport is now by road. However, political constraints have delayed the de-mining process in certain areas, thereby preventing the use of some key transport routes.
Reasonable harvests have led to the cessation of food assistance in areas such as Kwanza Norte and Gonguembo. The phasing out of general rations is also planned in numerous other areas where the nutritional situation appears to have improved. Programmes to re-integrate formerly displaced populations, involving support for agricultural rehabilitation activities, have been continuing successfully in many locations. Emergency assistance is now being provided to approximately 1 million internally displaced or war affected people and demobilised soldiers and their families [UNHCR 1995-7, WFP 17/11/96, 22/03/96].
It appears that levels of wasting decline rapidly in those areas where humanitarian agencies now have improved access. For example, overland humanitarian relief deliveries to Moxico Province began in mid-November 1995 at a time when prevalence of wasting was very high. Now, the most recent survey indicates a 6% prevalence of wasting and/or oedema with 1.4% severe wasting and/or oedema (see Annex I (1a)) [UNHAA-a 04/03/96, USAID 01/03/96].
In Kwanza None Province, where many relief agencies have recently been working, a nutritional survey in Gonguembo showed 7% wasting and/or oedema with 1% severe wasting and/or oedema (see Annex I (1b)). Another survey in N'Dalatando showed 5% wasting and/or oedema with 2.2% severe wasting and/or oedema (see Annex I (1c)). [UNHAA 04/03/96, WFP 08/03/96]. In contrast to these encouraging results, a recent survey in Lucala, Kwanza Norte province revealed 17.1% wasting with 6.1% severe wasting (see Anne I (1d)). The survey team recommended an urgent intervention in health and nutrition amongst the population [UNHAA-a 25/03/96].
A survey in Calandula, Malange Province, showed 9% wasting and/or oedema with 3.1% severe wasting and/or oedema (see Annex I (1e)). This elevated level of wasting is attributed to a combination of health problems, poor dietary practices, and poor food security due to theft of the current harvest [UNHAA-a 04/03/96, WFP 08/03/96].
In Menongue, Kuando Kubango Province, a recent survey showed 9.3% wasting and/or oedema with 3.1% wasting and/or oedema (see Annex I (1f)). In light of these somewhat elevated levels of wasting, it was recommended to continue food aid distribution, along with seeds and tools [UNHAA-a 25/03/96].
A recurrent problem identified by agencies working in Angola is that vaccination coverage and health service provision is poor. For example, shortage of drugs for the treatment of trypanosomiasis is threatening the continuation of all programme to combat the disease which is particularly prevalent in the north of Angola while a recent UNICEF mission in Kwanza Sul indicated a severe lack of drugs in the province [UNHAA-a 11/03/96].
Overall, the affected population in Angola appears to be more food secure as a result of the recent harvest and levels of wasting declining in many accessible areas (category IIc in Table 1). It is likely, however, that some pockets of malnutrition exist in areas which are not yet accessible to outside assistance.
How could external agencies help? Now that the country is moving from an emergency phase to a more protracted rehabilitation phase, humanitarian agencies are involved in a variety of sectors and may need support for numerous activities. An imminent consolidated appeal to be issued by UN/DHA in April will specify which activities need resourcing. Priorities may include:
· continuing the restoration of health services to deal with major health problems i.e. malaria, diarrhoea, ARI, trypanosomiasis;More specific needs include:· targeted feeding programmes;
· mass immunisation campaigns, mainly for measles.
· drugs for the treatment of trypanosomiasis, which is prevalent in northern Angola;The long term need for immunisation programmes and improved health care delivery are now beginning to be addressed in Angola (see RNIS #14). The food pipeline for edible vegetable oil has been ensured (see RNIS #13).
· drugs to treat common illnesses in Kwanza Sul;
· improved delivery of health services in Calandula, Malange Province where high morbidity levels are thought to be contributing to elevated levels of wasting.
There are approximately 111,000 refugees in the Benin/Ghana/Togo region, the majority of whom are Togolese. They fled Togo in January 1993 but as the political conflict which gave rise to the exodus has largely been resolved, spontaneous repatriation has been occurring for some time. Plans for an organised repatriation are currently being prepared with funding being sought for different programme elements. It is now hoped that the majority of the refugees in the region will be repatriated by the end of 1996.
Benin There remain approximately 20,000 Togolese refugees in Benin. A few individuals are spontaneously repatriating, and a more comprehensive repatriation programme will begin once funding is secured. It is expected that the repatriation process will continue throughout 1996. Provision of food aid is planned until the end of the year. There is no reported change to the adequate nutritional status of these refugees [UNHCR 27/03/96].
Ghana Approximately 71,000 Togolese refugees remain in Ghana. There are 9,000 refugees who have already expressed their desire to return to Togo and who are expected to repatriate soon. Food aid provision is scheduled to continue until June 1996, when it is estimated that almost all the refugees will have repatriated. There is no reported change in the adequate nutritional status of this population [UNHCR 27/03/96].
The 14,000 Liberian refugees in Ghana have not yet begun to repatriate due to continued insecurity in Liberia, However, repatriation plans have been established for this population (see section #9 for further details). There are no reports of change to the adequate nutritional status of this refugee population.
Togo There are approximately 6,000 refugees from Ghana in Togo. There are no reports of any change to their adequate nutritional status.
Overall, the approximately 111,000 refugees in the region are not currently considered to be at heightened nutritional risk (category IIc in Table 1).
There are approximately 60,000 assisted Malian refugees in Burkina Faso and Mauritania. This decrease in the total refugee population is due to repatriation.
Burkina Faso Some spontaneous repatriation is taking place among the Malian refugees in Burkina Faso and it is currently estimated that there are 27,000 refugees remaining. There is no reported change to the adequate nutritional status of this population [UNHCR 12/02/96].
Mauritania There remain approximately 33,000 Malian refugees in two camps in Mauritania. The decrease in number from the last RNIS report is due to a combination of spontaneous and organised repatriation [UNHCR 13/01/96, 27/03/96].
A recent survey conducted in the two camps between February and March 1996 showed an unstable nutritional situation. Wasting was measured at 14.6% and severe wasting was 1.4%. Oedema was measured separately at 1.6% (see Annex I (3a)). These results show no statistical difference to those obtained during the previous survey in May 1995. The crude mortality rate was 0.93/10,000/day (3 × normal) and the under-five mortality rate was 2.3/10,000/day (2 × normal). It is, however, possible that these rates are an under-estimate due to the observed reluctance to disclose information on mortality amongst this population. The most common cause of death was diarrhoea [MSF-F/MDM 12/03/96].
These nutritional problems are felt to be largely attributable to two main causes. First, the ration had been irregular and lacking in some commodities, such as pulses. More recently, however, food distributions were at 1950 kcals/person/day. Furthermore, many families with livestock which provided both milk and meat have returned to Mali, leaving remaining refugees largely without these food sources. Secondly, high levels of diarrhoea are probably also having an impact on wasting levels. Only a small percentage of families had access to parcels of land for crop production [MSF-F 04/04/96].
Overall, the refugees in Burkina Faso are not currently considered to be at heightened nutritional risk (category IIc in Table 1). In the two camps for Malian refugees in Mauritania high levels of wasting continue to be reported. These refugees can therefore be considered to be at high nutritional risk with elevated levels of wasting (category I in Table 1).
How can external agencies help? Continued high levels of wasting need to be investigated with a view to identifying and rectifying primary causes. In order to begin addressing the problem, the regular provision of a full general ration needs to be ensured and an assessment made of whether coverage of selective feeding programmes are adequate. Furthermore, the causes of high levels of diarrhoea should be ascertained, and appropriate action taken in the water and sanitation sectors.
Trend in numbers of refugees/displaced and proportion severely malnourished or at high nutritional risk (shaded area).
The focus of discussions at a recently held summit meeting between the presidents of Rwanda, Burundi, Tanzania, Uganda and Zaire was on encouraging the repatriation of two million Rwandan and Burundi refugees, and to bring to a halt the emerging crisis in Burundi [WFP 22/03/96]. Fighting is continuing in parts of Burundi and placing those populations in insecure areas at nutritional risk. The government strategy of surrounding refugee camps in Goma and Bukavu with a view to restricting refugee activity and encouraging repatriation is continuing. However, in comparison to the overall number of refugees, there has been relatively little repatriation in recent weeks.
Current estimates of affected populations by country of present residence are given in the box below:
|
|
Feb 95 |
Apr 95 |
Jul 95 |
Oct 95 |
Dec 95 |
Feb 96 |
Apr 96 |
|
Burundi |
740,000 |
492,500 |
515,000 |
315,000 |
504,000 |
275,400 |
290,000 |
|
Rwanda |
335,000 |
1,750,000 |
800,000 |
725,000 |
800,000 |
737,000 |
737,000 |
|
Tanzania |
630,000 |
686,000 |
644,000 |
629,000 |
621,000 |
653,000 |
624,000 |
|
Zaire |
1,290,000 |
1,130,900 |
1,202,200 |
1,158,000 |
1,146,000 |
1,211,000 |
1,166,000 |
|
Uganda |
5,000 |
5,000 |
6,700 |
6,400 |
6,400 |
6,800 |
6,900 |
|
TOTAL |
3,000,000 |
4,064,400 |
3,167,900 |
2,831,400 |
3,077,400 |
2,883,200 |
2,823,900 |
Security problems have also reportedly impacted refugees and internally displaced in recent weeks. For example, tensions between the refugees and militia have been reported in Rukuramigabo refugee camp following the announcement that the camp was to be closed in two weeks With the exception of sporadic shootings in the surrounding hills, the capital has remained calm with banditry being the main security risk factor. There have also been reports of militia attacks on IDP camps in Bubanza province [DHA 13/03/96, WFP 22/03/96].
Repatriation of Rwandan refugees is continuing and it is currently estimated that there are just over 90,000 refugees remaining in the northern part of the country. The rations currently distributed to this refugee population provide 1,950 kcals/person/day. The most recent nutritional data available on this population comes from a survey in November 1995 in Rukuramigabo camp in Kirundo which showed levels of wasting and/or oedema at 1.7% and severe wasting and/or oedema at 0.2% (see Annex I (4a)) [UNHCR 1/03/96]. There have been recent reports of increases in the numbers of children attending selective feeding programmes in Magara and Rukuramigabo camps and that many of the new admissions have exhibited signs of kwashiorkor [UNHCR 07/03/96].
Nutritional survey data for internally displaced and resident populations in areas of insecurity indicate a more worrying situation. The last RNIS report noted levels of wasting in four camps for internally displaced people ranging from 15-18.2%. A more recent survey in Ngozi province (population 510,000) in December 1995 found 9.3% wasting with 1.2% severe wasting amongst a sample of resident and displaced households; oedema was measured at 1.8% (see Annex I (4b)). These elevated levels of wasting may partially be explained by the timing of the surveys which was in the “hungry season” just prior to harvest. However, limited access to food due to the effect of insecurity on agricultural activity has undoubtedly played a significant role. The survey also determined that coverage of selective feeding programmes in the province is very low (less than 2% of malnourished children were enrolled at feeding centres). Furthermore, default rates at the feeding centres were very high. This was mainly thought to reflect the financial difficulty imposed by participating in these programmes and difficulties of regular attendance due to insecurity [ACF Dec 95].
Since this survey, some roads in the province have been washed away by rains leading to a reduction in amounts of food delivered. Furthermore, the ration was recently reduced to 1,600 kcals/capita/day due to lack of stocks [UNHCR 06/03/96, WFP 16/03/96]. It is therefore likely that the nutritional condition of this population has continued to decline.
Rwanda The pace of repatriation of refugees sped up slightly during February, with a reported 23,000 refugees returning from neighbouring countries. The majority of returnees came from Burundi and Zaire [UN 15/03/96, WFP 08/03/96]. However, during the first half of March less than 3,000 refugees returned with most returnees coming from Zaire [WFP 28/03/96]. Refugees from the Masisi area of Zaire, where ethnic conflict has recently intensified, are continuing to arrive.
The security situation in most of the country is reported as calm with the exception of the western border areas with Zaire where regular incursions and security incidents, such as a recent attack on an NGO vehicle in Cyangugu province, take place. The UN peacekeeping force (UNAMIL) will reportedly not have its mandate renewed and troops will be withdrawn by April 19. Trials of those with suspected involvement in the genocide will also begin at this time. A small political office representing the UN will remain open in Kigali [DHA 08/03/96, IRIN 22/03/96, WFP 01/03/96, 12/04/96].
It is expected that food aid will be needed for approximately 737,000 vulnerable people, including displaced and returnee populations, in the first half of 1996. It is anticipated that the food supply situation will remain tight in parts of the prefectures of Kibungo, Gikongoro, and Butare and in areas of Cyangugu, Kibuye and Gitarama. Elsewhere in the country, although the harvests have been satisfactory and markets are well supplied, the low purchasing power in the post-war economy still results in inadequate food access for large sections of the population. During February WFP distributed food to approximately 296,000 persons in all prefectures of Rwanda. The largest share of food was distributed through food for work and income-generating activities. Some 45,900 people believed to be vulnerable to food shortages were provided with general food rations through targeted assistance and seed protection programmes. [FAO 28/12/95, FAO Jan/Feb 96, UN 15/03/96]. The health sector is reportedly recovering with most of Rwanda's 250 health centres and 36 hospitals now operating. Morbidity and malnutrition rates among children are now believed to be lower than pre-war rates [USAID 18/03/96]. Although there are no new nutritional survey data, the recent harvest and relatively unimpeded food aid programme suggests that the nutritional status of the majority of people is likely to be satisfactory. However, it should be noted that short-falls of oil and sugar for food aid programmes are expected in April [WFP 08/03/96].
Goma, Zaire It is currently estimated that there are 695,000-714,000 Rwandan refugees in the Goma camps. At the end of February, the government of Zaire reaffirmed its position that it would continue to restrict economic activities of refugees and that all NGOs were to begin phasing down their programmes. The Zairian military had surrounded certain camps in Goma and Bukavu with a view to enforcing these restrictions and encouraging repatriation, and agencies working in the camps have been instructed to gradually replace Rwandan staff with Zairians. There is now anecdotal information that the military blockade of camps has eased [UNHCR-a 22/03/96, WFP 16/02/96, 08/03/96, 15/03/96, 12/04/96].
NGOs have also been informed of the closure of all selective feeding programmes for malnourished children in every camp except Kibumba, as a result of budgetary constraints. However, with the exception of Kibumba, where according to a survey in November 1995, levels of wasting and/or oedema are highest at 8.3%, the low levels of wasting are felt to warrant the closure of these programmes. Nutritional surveys are planned for May 1996 in order to verify that the closure of the centres has not had an adverse impact upon refugees [UNHCR 28/02/96, UNHCR-a 22/03/96, WFP 16/02/96, 08/03/96, 15/03/96].
As the refugee community fear and anticipate a general pulling out of relief agencies, the level of thefts and security incidents is reportedly increasing. Supplies of firewood have been severely reduced, in part due to the escalating conflict in the Masisi region of Zaire which has until now been a major source of wood. This has forced many refugees to illegally enter nearby nature preserves, in search of wood [WFP 15/03/96].
The ration has recently been increased from 1,520 kcals/person/day to 1,700 kcals/person/day to compensate for loss of agricultural wages. However, a break in the pipeline for com soy blend was predicted for mid-April leading to a decision to reduce quantities in the general ration in order to extend supplies for longer. Furthermore, the price of vegetable oil in all camps had increased by as much as 50% mid-March as it had been absent from the general ration for the preceding two weeks. It is anticipated that the oil ration will improve again in April [UNHCR-a 22/03/96, WFP 15/03/96, 22/03/96].
Bukavu, Zaire There are approximately 295,000-310,000 Rwandan refugees in Bukavu. Some camps have been surrounded by the Zairian military as in some camps in Goma, in order to restrict refugee economic activity and encourage repatriation. However, until now there has only been limited repatriation of refugees to Rwanda [UNHCR 28/02/96, WFP 01/03/96].
Rations have recently had to be reduced below 1,700 kcals/person/day and it is reported that stocks of vegetable oil, which were very low, have been replenished [WFP 01/03/96, 12/04/96].
Uvira, Zaire There are approximately 176,000 refugees in Uvira. Most of these refugees come from Burundi (roughly 110,000) while the remainder are from Rwanda. The number of new arrivals from Burundi has slowed in recent weeks, possibly due to the mining of the border area [WFP 23/02/96].
The health and nutritional status of this population appears adequate with low mortality rates recorded in the last RNIS report. More recent information is that there has been a steady decrease in the number of children at selective feeding programmes in the camps. Water supplies in the camps are mostly at or above the target minimum of 10 litres/person/day, although levels are still below the general accepted goal of 20 litres/person/day [UNHCR-a 22/03/96, 06/03/96].
Salt had been absent from the ration, but was re-introduced at the end of March [UNHCR 28/02/96].
Tanzania There are currently about 624,000 refugees from Rwanda and Burundi in Tanzania. Repatriation has been proceeding at a very slow pace over the past few weeks. General rations delivered in March provided 1900 kcals/person/day, although rations for a brief earlier period had been considerably lower. The current food stocks and expected deliveries are only adequate until the end of April [WFP 08/03/96, 22/03/96].
Recent reports from the camps for Rwandan refugees in Karagwe district show an adequate health and nutrition situation. In Kagenyi camp (estimated population 16,000) the crude mortality rate was recently measured at 0.81/10,000/day (about 2 × normal) and the under-five rate was 1.45/10,000/day (again about 2 × normal). In Rubwera camp (estimated population 26,000) the crude mortality rate was 0.28/10,000/day (normal) and the under-five rate was 0.69/10,000/day (just below normal) (see Annex I (4c,d)). The main current health problem in both camps is the high level of malaria and resulting anaemia [MSF-CH Feb 96].
There has been no new information on the nutrition situation in the refugee camps in Ngara district. It is therefore assumed that, as indicated in the previous RNIS report, the nutritional situation in these camps is adequate and stable. Refugees are not allowed to work outside of a four kilometer radius of the camps. However, some refugees flout this restriction and are cultivating land [LSHTM 05/04/96].
Uganda There are approximately 6,900 Rwandan refugees in Uganda whose nutritional status is reportedly adequate [UNHCR 25/03/96].
Overall, the internally displaced population in Burundi can be considered to be at heightened nutritional risk (category IIa in Table 1) due to insecurity. The refugees in Goma, Bukavu and Uvira, Zaire can be considered to be at moderate nutritional risk (category IIb) due to some security problems, and a lack of fuel for preparing food. The refugees in Tanzania and Uganda, along with the vulnerable population in Rwanda are not currently though to be at heightened nutritional risk (category IIc in Table 1).
How could external agencies help? In Burundi needs include:
· regular nutritional surveys of internally displaced camp populations, especially in areas of insecurity in order to determine if food aid needs are being adequately met;In Rwanda needs include nutritional monitoring in those areas where food supply is known to be poor.· increased coverage of selective feeding programmes in areas of insecurity, such as Ngozi, and a review of the appropriateness of feeding programme design, e.g. on site feeding may be more appropriate in areas with high levels of insecurity;
· funds for an aircraft operation which is essential to the distribution of relief commodities within Burundi;
· urgent need to supply sugar and oil for distribution during April.
In Zaire needs include more donor pledges of com soy blend and oil for the general ration.
In Tanzania needs include development of a strategy for use of land for cultivation, particularly in Ngara.
A lack of cooking fuel for the people in the camps around Goma and Bukavu, Zaire was noted in RNIS #14 report, and although efforts have been made to bring in more fuel, supplies are currently still inadequate. The need for improved logistical capacity in Burundi (RNIS #14) has been partially addressed with the re-opening of Bujumbura port.
There is a continuing influx of Sudanese refugees into the Central African Republic and it was recently estimated that there are just over 27,000 assisted Sudanese refugees in the country. There are also approximately 5,000 assisted Chadian refugees whose nutritional status is believed to be adequate [UNHCR 16/01/96].
There are no reports of change for the approximately 25,000 Somali refugees in Djibouti whose nutritional status has been reported as adequate in recent RNIS reports.
The estimated number of refugees receiving food aid in Ethiopia is 376,000 people comprising 275,000 Somali, 63,000 Sudanese, 18,000 Djibouti and 9,000 Kenyan refugees and 11,000 internally displaced people around Addis Ababa. There are a further 35,000 unassisted refugees in Ethiopia (not included in Table 1).
Despite the dry season fighting in southern Sudan no significant increase in the rate of influx of refugees to western Ethiopia has been noted. Recent events in north-west Somalia and neighbouring eastern Ethiopia have sparked off tensions in some of the camps in Eastern Ethiopia and a spate of hijackings by the opposing clans has also made travel between Hartisheik and the Aware camps more hazardous [DHA Jan 96, Mar 96].
The food stocks and expected deliveries for the refugee programme is good for blended foods and resourcing for pulses and salt is now improving. However, there is concern that if arrivals of oil scheduled for March are delayed oil shortages will be faced, and there is a need to resource cereals for this programme [DHA Jan 96, Mar 96, WFP 12/04/96].
There are no new nutritional data available for any of these populations. The most recent information available (mid-1995) showed a variable nutritional situation with low to moderately high levels of wasting for the Somali refugees in the eastern camps and a generally adequate situation for the other refugee groups. It can be assumed that this situation has little changed.
Overall, since no information to indicate that the situation has changed is available, it is assumed that the populations in Fugnido, Kebre Beyah, and Darwonaji remain at high risk (category I in Table 1) and the populations of Hartisheik, Teferiber, Daror and Aisha can be considered to remain at moderate risk (category IIb in Table 1). The remaining refugee populations are probably not at heightened nutritional risk (category IIc in Table 1).
There are approximately 173,000 refugees remaining in Kenya. 126,000 of these are Somali, 41,000 are Sudanese and 6,000 are Ethiopian.
The nutritional situation in the Dadaab camps (Hagdera, estimated population 37,000, Ifo, estimated population 34,000 and Dagahaley, estimated population 32,000) appears to be adequate. The most recent nutritional surveys were carried out in August 1995 (details in RNIS #12) and showed levels of wasting and/or oedema ranging from 6.2-8.9%. Mortality rates recorded in October 1995 were at normal levels [MSF-B 18/03/96].
Since the August survey, the average general ration distribution has provided 2,000 kcals/person/day, although inequity in the distribution system is regularly observed through food basket monitoring. Furthermore, there has been no provision of com soy blend in the general ration since October 1995. This is particularly worrying given the scarcity of fresh fruit and vegetables in the region and the known vulnerability of this refugee population to outbreaks of micro-nutrient deficiency disease, in particular scurvy [MSF-B 18/03/96].
Overall, the refugees in Kenya are not currently thought to be at heightened nutritional risk, although it will be crucial to monitor the nutritional situation to detect signs of scurvy if CSB is not reintroduced in the general ration. This will be especially important towards the end of the summer and the autumn, when outbreaks of scurvy have occurred in the past.
How can external agencies help? Given the lack of availability of fresh fruit and vegetables to camp populations and the historical susceptibility to scurvy in these camps, there is a clear need to provide sources of vitamin C, and re-introduction of micronutrient fortified (including vitamin C) corn soy blend into the general ration, possibly on a seasonal basis.
Trend in numbers of refugees/displaced and proportion severely malnourished and at high risk (shaded area).
Recent fighting in Monrovia is leading to large-scale displacement. It is too early to assess the nutritional impact of this most recent fighting. Elsewhere in Liberia, the security situation is making it difficult to establish a clear time frame for repatriation plans. Furthermore, several areas of the country remain periodically inaccessible to relief activity so that affected populations may be at nutritional risk. The recent election of a new president in Sierra Leone and subsequent talks with rebel leaders are giving rise to guarded hopes that the desperate situation in the country may begin to improve. However, given the shattered infrastructure, massive displacement to over-crowded urban centres and length of time that some populations have been cut-off from assistance, there will be a need for large-scale humanitarian support for many months to come even if political progress is rapid. Recent nutritional surveys in Sierra Leone (e.g. in Bo) continue to show extremely high levels of wasting amongst some urban populations.
Current estimates of the numbers of people affected in the region are summarised below:
|
Location |
Feb 95 |
Apr 95 |
Jul 95 |
Oct 95 |
Dec 95 |
Feb 96 |
Apr 96 |
|
Liberia |
1,800,000 |
1,900,000 |
1,900,000 |
1,900,000 |
1,900,000 |
1,800,000 |
1,800,000 |
|
Sierra Leone |
506,000 |
500,000 |
730,000 |
730,000 |
730,000 |
730,000 |
756,000 |
|
Cote d’Ivoire |
330,000 |
330,000 |
227,000 |
305,000 |
305,000 |
305,000 |
305,000 |
|
Guinea |
568,000 |
603,000 |
578,000 |
536,000 |
605,000 |
605,000 |
536,000 |
|
TOTAL |
3,204,000 |
3,333,000 |
3,435,000 |
3,471,000 |
3,540,000 |
3,440,000 |
3,397,000 |
There are an estimated 1.8 million refugees, displaced and war-affected people in Liberia. The recent crop assessment mission to Liberia found that massive population displacement had reduced production of rice to about one quarter of pre-war levels. Cassava production has also been adversely affected. The volatile security situation determines that those populations who are sporadically cut off from humanitarian aid are at some nutritional risk. For example, there have been anecdotal reports of increasing humanitarian needs in Bong Mines, and Grand Cape Mount. Acute shortages of food have also been reported in three camps for internally displaced people in Tieni, Bo Waterside and Sinje [FAO Jan/Feb 96, WFP 01/03/96].
In contrast, populations that have been easily accessible in recent months show a far more stable nutritional situation. For example, a recent survey carried out in Buchanan (estimated population 50,000 displaced living in camps and displaced sites and 50,000 resident people) showed 4.1 % wasting with 0.6% severe wasting. Oedema was measured at 0.5% (see Annex I (9a)). However, the crude mortality rate was 3.0/10,000/day (10 × normal) and the under-five mortality rate was 5.0/10,000/day (4 × normal). Main causes of mortality were diarrhoea and fever. Measles immunisation coverage was low at 52.7%. Over 80% of the population have been in receipt of a general ration [ACF Feb 96].
Another survey has recently been completed in Bong County (estimated population 141,000). Levels of wasting were measured at 6.1% with 1.4% severe wasting (see Annex I (9b)). There was no significant difference in levels of wasting between resident and displaced populations. In contrast to these low levels of wasting, mortality rates were extremely high. Crude mortality rates were 5.5/10,000/day (22 × normal) and under-five rates were 8.5/10,000/day (8.5 × normal). Measles immunisation coverage was very low at 6.2%. The food situation of this population was considered to be precarious as food stocks were low and the next harvest is not expected until July. Morbidity rates were also considered to be very high with fever and diarrhoea the most common complaint [ACF 22/02/96].
Plans for the voluntary repatriation of the approximately 750,000 Liberian refugees residing in neighbouring countries have been drawn up, but due to the fluid security situation in Liberia the proposed timing of the programme may well have to remain flexible. It is estimated that 623,000 refugees will wish to return and that approximately 70,000 of this population will return spontaneously without agency assistance [UNHCR Feb 96].
Sierra Leone Despite a marked decrease in security in many parts of the country which resulted in continued population movements, elections took place as scheduled, and Ahmad Tejan Kabbah was elected president in mid-March. There are hopes that this election will mark the beginning of a new period of peace with talks between representatives of the new government and rebel leaders already underway. Following improvement in the overall security situation and the declaration of an unconditional cease-fire by the RUF in mid-March many internally displaced have returned to their villages of origin in Bo and Magburaka provinces. [DHA 07/03/96, UNHCR 22/03/96, WFP 28/03/96].
It is currently estimated that there are at least 1.6 million internally displaced people in Sierra Leone requiring some sort of humanitarian assistance. Only approximately 210,000 of this population are in camps with the remainder living amongst local communities whose coping mechanisms are reportedly stretched beyond reasonable limits in their efforts to support the displaced. Populations of urban centres have increased dramatically, for example the population of Freetown has almost doubled. Similar situations are reported for the towns of Kenema, Makeni, Matru, Bonthe mainland, Kailahun, Segbwema, Zimmi and Dam. In each case the influx is causing over-crowding, outbreaks of disease and overburdening of social services. Food distributions have begun in many areas, for example Dam, Segbwema, and Zimmi [DHA-a Mar 96, ICRC 09/04/96].
The violence in the country has displaced farmers and cut-off greater and greater areas of cultivatable lands. Food has therefore become increasingly scarce, and when available, often appears in markets at prohibitively high prices. It is hoped that approximately 756,000 people will receive a general distribution in 1996, although it is recognised that emergency food aid activities must be a part of a larger strategy to increase food security for the entire population not just the displaced. It is also critical that donors support the process in a timely manner as the capacity of relief organisations to deliver assistance is greatest during the first half of the year i.e. the dry season [DHA-a Mar 96].
Difficulties that currently exist in implementing general ration distributions include problems with identification and verification and registration of beneficiaries, inability to establish a strategic grain reserve, lack of consensus over composition of a food basket and weaknesses in the capacities of local NGOs to undertake traditional implementation roles [DHA-a Mar 96].
Public health, water and sanitation facilities are also in a critical situation in Sierra Leone. Only 16 percent of the country's health centres are said to be operational and during 1995, outbreaks of cholera and measles were reported in several urban centres [DHA-a Mar 96].
Reaching civilians in need outside the Western area has been enormously problematic as road transport has been severely disrupted due to insecurity. Airlifts have been under taken as the only viable option. One very positive development has been the governments permission to begin cross-border delivery of relief supplies from Guinea into Kailahun area.
An assessment in June 1995 showed a very bad situation in Kailahun. At that time, most of the population was living in the bush and wasting, as measured by QUAC stick, was 33% and severe wasting was 29%. Furthermore, kwashiorkor and wasting were seen among older children and adults. Government clearance for food distributions was granted in February 1996. The food situation by then had improved somewhat. Many people had moved back to the villages and therefore had greater access to food. Currently, the farmers are beginning to prepare the land for planting, and agricultural inputs are urgently needed [ICRC 31/03/96].
The nutritional situation in large urban centres appears to be extremely variable and dependant on recent humanitarian agency access, employable coping strategies and the scale of recent displacements. For example, a survey in Bo town (estimated population 250,000) in November 1995 found wasting levels of 13.1% with 1.2% severe wasting. In the camps for the displaced (estimated population 16,000) wasting and/or oedema was 25.3% with 4.3% severe wasting (see Anne I (9c-d)). The survey found that nearly 30% of families claiming to be displaced were not registered and that almost 60% claimed to have never received a general ration distribution. Up to 30% of malnourished children were not enrolled in selective feeding programmes [ACF 11/11/95].
A more recent survey in March 1996 found little change with wasting and/or oedema rates of 12% with 1.2% severe wasting and/or oedema in the town and 23.8% wasting with 3.5% severe wasting and/or oedema in the camps (see Annex I (9e-f)). Since this survey it has been reported that coverage of the general ration distribution has improved significantly [MSF-B 18/03/96, 05/04/96].
In October 1995, levels of wasting in Bonthe Islands were reported to be almost 13% (see RNIS #14). More recent information indicates that wasting levels have declined substantially, although precise figures are not available [MSF-B 05/04/96].
The main highways to Bo, Kenema and Makeni have now been re-opened and food is being distributed to these urban centres. Recent survey data from Kenema show wasting at 6.3% in the town, with 1.0% severe wasting and/or oedema. In RTI camp, just outside of Kenema, wasting was measured at 8.6% with 0.2% severe wasting. No oedema was seen in either the town or in the camp (see annex I (9g-h)) [MSF-H 04/04/96].
Cote d’Ivoire There remain approximately 305,000 Liberian refugees in Cote d’Ivoire. Although some limited spontaneous repatriation may be occurring, it is believed that most refugees are crossing into Liberia during the day and then returning to Cote d’Ivoire at night with a view to retaining refugee status until there is greater confidence in the prospects of long-term peace and security in Liberia [UNHCR 22/03/96].
Guinea There are approximately 605,000 Liberian and Sierra Leonean refugees in Guinea of whom 536,000 receive food aid. [UNHCR 22/03/96]. In the past the nutritional security of much of this population has been described as adequate but precarious and highly vulnerable to any breaks in the food aid pipeline [RNIS #14].
Overall, the populations of Buchanan and Bong counties in Liberia are at high risk due to elevated mortality rates (category I in Table 1); the population in the camps around Bo are also at high risk due to elevated levels of wasting. The remaining displaced population in Sierra Leone is likely to be at heightened nutritional risk (category IIa in Table 1) due to insecurity. The population in Liberia that is inaccessible, or only periodically accessible can be considered to be at moderate nutritional risk (category IIb in Table 1) while the accessible population in Liberia and the refugees in Cote d'Ivoire and Guinea are probably not at heightened nutritional risk (category IIc in Table 1).
How could external agencies help? Effects of recent fighting in Monrovia could not be assessed as of 12 April. In Liberia needs include:
· strengthening nutritional survey capability so that levels of malnutrition can be quickly determined in newly accessible areas, for a rapid targeting of food aid where needed and feasible;A consolidated appeal for Sierra Leone, coordinated by UN/DHA, to be launched in April, along with the reports included here, suggest some needs. These include:· survey reports (e.g. Buchanan County) continue to show very high mortality rates, due mainly to diarrhoea and fever in children, as well as malnutrition (oedema, kwashiorkor), which require urgent action, notably an extension of measles immunization coverage (e.g. 6% only covered according to survey results from Bong County).
· sporadic general ration distribution, due to insecurity, are a continuing problem; on some occasions in the past demonstrations of high levels of malnutrition have helped in obtaining agreement for food distribution, indicating that further surveys could be useful;Recent reports indicate that the food pipeline for the region which was reported as inadequate in RNIS #14 has improved substantially in recent weeks. However, cash needs for monitoring and logistics support remain an urgent priority. It appears that the needs for increased measles immunisation throughout both Sierra Leone and Liberia have still largely to be met.· the coverage and equity of food distribution in large urban areas in being hampered by inadequate registration which needs improving;
· because of the sporadic general food distribution, selective feeding centres, mainly for children, are in operation, and expansion of this coverage may need to be considered;
· urgent distribution of farm inputs as in many areas the planting season will begin soon (April and May);
· investment in rebuilding and extending health, sanitation and water infrastructure throughout the country.
There was a final food distribution to the approximately 52,000 Mauritanian refugees in Senegal in December 1995. This population is now considered to be self-sufficient and will no longer receive assistance [UNHCR 06/02/96].
Trend in numbers of returnees and demobilised soldiers.
Current estimates are that there are approximately 1.2 million returnees and drought affected people currently in need of food aid in Mozambique.
As household food stores dwindle between harvests, the increased demand for many foods together with inadequate supplies has driven up prices of commodities such as oil, sugar and rice significantly. The price of white maize grain and flour has risen even more. Thus, the average numbers of household meals is falling although other sources of income, particularly cashew and some harvests of cassava and sweet potato seem to have stabilised the nutritional situation in most areas of the country. Data up until January 1996 generally shows a stable nutritional situation in most areas of the country although there were exceptions, e.g. certain districts in Niassa province [MSF-CIS Jan 96].
The number of reported pellagra (niacin deficiency) cases in Mutarara district continued to rise in December. Consignments of groundnut which were purchased from Malawi in order to be added to the general ration in the district have still not reached the affected population due to administrative difficulties. Similar difficulties have been experienced with corn soy blend provision [MSF-CIS Jan 96, MSF-CIS Mar 96]. More recently, the rains have begun, and it is reported that the number of cases of pellagra is beginning to decline. It is assumed that there is additional food now available locally that is helping to improve the situation [UNHCR 04/04/96]
Information collected until the end of 1995 showed fairly good coverage of free food distributions for the most vulnerable populations although there continued to be some areas where vulnerable groups were either under-registered or inaccessible [MSF-CIS Jan 96]. Recent flooding may significantly impact food production, especially in the south, and may render new population groups vulnerable [UNHCR 04/04/96].
Overall, the population affected by niacin deficiency with 1-2% prevalence reported, is at high risk (category IIa) in Table 1. The remaining vulnerable population in Mozambique is not currently considered to be at heightened nutritional risk (category IIc in Table 1) although increasing prices are likely to cause some increase in child malnutrition.
How can external agencies help? Deficiency of the micronutrient niacin continues to be reported. Administrative difficulties have been preventing the delivery of groundnuts to areas where pellagra has been occurring for several months, e.g. Mutarara, and, despite a declining number of cases reported, this intervention remains urgent for preventing malnutrition.
Trend in numbers of returnees and internally displaced with proportion severely malnourished or at high nutritional risk in shaded area
An estimated 840,000 people comprising 600,000 returnees and 240,000 internally displaced people, currently require humanitarian assistance in Somalia. Food for work and other relief projects are being implemented throughout the country. The security situation remains fluid with factional clashes reported in different areas. For example, some UN personnel were recently evacuated from Bardera for a month due to insecurity. However, February has generally been described as a relatively calm month [FAO Jan/Feb 96, WFP 22/03/96].
Final reports on the recent “Deyr” harvest indicate that the estimated total national sorghum and maize production was slightly higher than the pre-war average. However, production varied significantly between regions with least favourable yields found in Gedo region. Humanitarian agencies have been focusing their attention on the Juba valley where some villages have been assessed as having a high level of food insecurity [DHA 06/03/96, FAO Jan/Feb 96, WFP 22/03/96].
Sharp rises in food prices in recent months, the accelerated devaluation of the national currency and periodic insecurity in parts of the country are creating hardship for large sections of the urban Somali population - and in particular the jobless. Aid agencies are operating large numbers of feeding centre in Mogadishu specifically targeted to women, children and orphans. However, in spite of these adverse factors a recent assessment of the internally displaced in over seventeen camps in North Mogadishu found wasting and/or oedema rates of only 2.1% (see Annex I (12a)) [DHA 06/03/96, FAO Jan/Feb 1996, WFP 22/03/96].
There have been no updates on the nutritional situation in Bardera since the previous RNIS report where levels of wasting were recorded at 19% in November 1995.
Cholera has been reported in some regions in Somalia but is apparently under control in all areas except Mogadishu where over 1,800 cases had been identified by the end of February [DHA 06/03/96].
Overall, there are no specific reports to a change in the nutritional status of the vulnerable population; however relatively good harvest in some areas has probably helped the food security situation. The population in Bardera is likely to continue with high prevalence of malnutrition (category I in Table 1). The remaining population is likely to be at moderate risk (category IIb in Table 1).
How could external agencies help? Feeding centres in urban areas appear to be contributing to maintaining a relatively good nutritional situation, and need continued support. Camp populations and the affected resident populations around the camps e.g. Bardera, probably have high malnutrition prevalences requiring additional interventions. There is also a need for improved logistical support for cholera treatment and prevention, particularly in Mogadishu.
The total number of people needing emergency assistance in Sudan is currently estimated to be 2.2 million. This number comprises 1.7 million displaced and/or war affected people in southern Sudan, 154,000 people in the transitional zone, 119,000 displaced people around Khartoum and 200,000 Ethiopian and Eritrean refugees mainly residing in the Eastern camps.
Fighting continues in southern Sudan and often inhibits relief programme activity. For example, only recently food and technical equipment were looted from a barge on the Sobat river. The barge convoy had to return without making its planned delivery. Aircraft operations have been severely curtailed since late November 1995 when the government temporarily banned all OLS and other relief flights due to insecurity. Although the flight ban was officially lifted in early December the government are still not granting flight clearance for the main delivery craft and donors will not commit funds without assurance that the aircraft can be operated without clearance limitations [USAID 20/02/96, WFP 22/03/96].
In light of these restrictions on relief deliveries and the slightly poorer 1995 harvest which led to immediate and marked food price inflation, it can be expected that large numbers of people will be experiencing considerable nutritional stress in southern Sudan. However, there are no recent nutritional survey data to support this supposition. Nevertheless, on the basis of local reports, rapid food security assessments are frequently carried out and where need is identified, as was recently the case near Malakal, food, seeds and tools are distributed. Access to health services is extremely varied in southern Sudan with only 4% access in Bahr el Ghazal and 100% access in Western Equatoria [UNICEF 95].
A re-registration in the three camps for displaced people outside Khartoum has led to a revised estimate of 119,000 for this population. Unlike most of the 1.8 million displaced people living and working in the Khartoum area who are not in camps, this population receive some humanitarian assistance. Most recent information from the camps indicate “unacceptably high levels of malnutrition” among children in Al Salam and Wad Al Bashir camps. There have also been reports of high levels of vitamin A deficiency amongst this population (previous RNIS report) [USAID 20/02/96, FAO Jan/Feb 96, WFP 22/02/96].
A census is being conducted for the Ethiopian and Eritrean refugees, and results are expected at the end of April. There are no new nutritional data on these refugees; most recent information showed a somewhat variable situation with, for example, 15% wasting recorded in Shagreb camps (estimated population 33,000), and 7% wasting in Um Rakuba (estimated population 12,000).
Overall, the displaced population around Khartoum is in category I in Table 1 due to vitamin A deficiency. The affected population in Southern Sudan and in the transitional zone can be considered to be at moderate nutritional risk (category IIb in Table 1), although there are likely to be areas where the nutritional risk is very high. The remaining refugee population is probably not at heightened nutritional risk (category IIc in Table 1).
How could external agencies help? In southern Sudan needs include:
· nutritional surveys in areas where there is known displacement and/or recent incidents of conflict in order to identify most vulnerable groups needing assistance and to determine whether the poor harvest and limited relief deliveries are leading to a deterioration in nutritional status;In camps around Khartoum high levels of wasting and vitamin A deficiency persist and feasible interventions need to be identified, e.g. improved general rations, expansion of selective feeding programmes, vitamin A prophylaxis, improved health service delivery.· re-doubled efforts to negotiate flight clearances with the government in order to increase relief activities in the south;
· new food aid pledges for 19% to make up current shortfalls;
· improving health service provision and access in all provinces except Western Equatoria where there is reportedly 100% access.
There are currently almost 227,000 assisted Sudanese and Zairian refugees in Uganda, broken down as follows:
|
Origin |
Feb 95 |
Apr 95 |
Jul 95 |
Oct 95 |
Dec 95 |
Feb 96 |
Apr 96 |
|
Sudanese Refugees |
300,000 |
310,000 |
322,000 |
324,000 |
217,000 |
210,000 |
214,000 |
|
Zairian Refugees |
313,000 |
13,000 |
13,400 |
13,700 |
11,800 |
12,300 |
12,300 |
|
TOTAL* |
313,000 |
323,000 |
335,400 |
337,400 |
228,800 |
222,300 |
226,300 |
* Rwandan refugees in Uganda are included in section #4.There has only been a slight influx of Sudanese refugees from southern Sudan in recent weeks. Efforts to decongest the refugee areas of Koboko and Adjumani are continuing [UNHCR 25/03/96].
A recent survey of the transit centres in Adjumani, Moyo district (total estimated population of transit centres and settlements is 77,000) found 11.8% wasting and/or oedema with 2.0% severe wasting. The situation was slightly worse in settlements in this area where wasting and/or oedema was measured at 16.4% with 5% severe wasting and/or oedema (see Annex I (14a,b)). These figures indicate a relatively high prevalence of malnutrition, moreover, higher than previous surveys. The nutrition situation may be becoming critical. The food ration is currently set at 1900 kcals/person/day and at the time of the survey (mid-February) supplies had been sufficient for approximately six months. The survey concluded that some of the settlements are not viable and that people who have settled there will never achieve independence from external food aid and so will continue to be highly vulnerable to any disruption to the general ration or their ability to purchase food locally [MSF-CH 13/02/96].
It was also noted that the re-enumeration which took place in October 1995 led to a reduction by some 40% in the planning figure for refugee assistance. Although this has led to more equitable distribution of food aid, it has also reduced the capacity of refugees to exchange part of their ration for other essential non-food items. Measles immunisation coverage in the area of Adjumani is thought to be almost 100%, although only between 50-64% of those surveyed had an immunisation card [MSF-CH 13/02/96].
Since this survey, rebel activity in northern Uganda has increased and led to some disruption of food deliveries to the camps and settlements [UNHCR 25/03/96]. It is therefore probable that the nutritional situation for these refugees has worsened further.
There has been no reported change to the adequate nutritional situation for the 12,300 Zairian refugees in Uganda.
Overall, the refugees in Adjumani can be considered to be at high nutritional risk (category I in Table 1) due to elevated levels of wasting and decreased general ration supplies. The remaining Sudanese refugees are considered to be at moderate nutritional risk (category IIb in Table 1) due to decreased food supplies, while the Zairian refugees are probably not at heightened nutritional risk (category IIc in Table 1).
How could external agencies help? There are indications of increasingly urgent nutritional needs in Northern Uganda, with very recently some disruption of food aid deliveries. The situation may require watching closely, with increased food deliveries as security allows.
Refugees in Zaire (excluding Rwandans and Burundis included in section #4) There are an estimated 169,000 Angolan refugees in Zaire of whom 50,000 are assisted in some way. It is hoped that most of the unassisted population will spontaneously return to Angola now that the situation has improved there. Organised repatriation for the 50,000 assisted refugees is scheduled to begin by mid 1996 [UNHCR 17/01/96, Jun 95-Dec 97].
There are approximately 94,000 Sudanese refugees receiving some assistance in Zaire. The slight increase is due to a small number of new arrivals fleeing the continued insecurity in southern Sudan [UNHCR 17/01/96].
There are over 12,000 Ugandan refugees and a further 6,000 new arrivals whose refugee status unclear [UNHCR 17/01/96].
Displaced from Shaba, Zaire There are approximately 600,000 people who have been displaced by ethnic violence which erupted in the Shaba region at the end of 1992. This population fled north into the Kasai region where many had ancestral links. During the migration large numbers stopped temporarily in villages along the route north, while others settled permanently at these sites.
Currently, there is little further displacement from the Shaba region and the most recent set of nutritional survey information shows that the level of self-sufficiency obtained by this migrant population varies enormously. Most recent survey data were included in RNIS #14. These surveys showed low levels of wasting among most of these people.
The exception to this was in Mwene Ditu where in October 1995 wasting was measured at critically high levels of about 43% in the displaced population, estimated at 40,000 people, and 17% in the local affected population (estimated at 220,000). It has recently been reported that the nutrition situation in and around Mwene Ditu has not improved. Over 6,000 children are included in supplementary and therapeutical feeding centres and financial support for these centres is apparently running out [MSF-B 09/04/96].
Masisi Region, Zaire Since November 1995, there has been a marked escalation in a conflict in Masisi zone of North Kivu (estimated population 500,000-600,000). The conflict is between the Banyarwanda people (Rwandese origin), most of whom are Hutu, and Zairians of mostly Hunde ethnic origin. Although lack of access precludes an accurate assessment of numbers, many people are undoubtedly being killed and tens of thousands displaced from their homes. Estimates of the total number of displaced people vary widely and range from 100,000 to 250,000. The reason for this dramatic explosion of conflict at the end of last year appears to have been related to the threatened expulsion of Rwandan refugees in December 1995 [DHA 26/02/96, WFP 16/02/96].
The area has been inaccessible to humanitarian organisations since January due to the high level of insecurity. Poor roads and the risk of being associated with one faction also make it very difficult for humanitarian agencies to work in the area. Many of the displaced people are surviving by living among extended families or friends and using marginal land to cultivate their own crops. A nutritional survey carried out in Kinchanga, where some 12,000 displaced people are gathered, showed an extreme crisis with wasting and/or oedema rates measured at 31 % with 13% severe wasting and/or oedema (see Annex I (15a)) [MSF-H 13/02/96].
Most recent reports are that fighting is continuing in the Masisi region and that some of the conflict incidents are occurring closer to Mugunga refugee camp in Goma [WFP 15/03/96].
Overall, the displaced and resident affected populations in Mwene Ditu is in category I in Table 1 due to elevated levels of wasting, as is the population in the Masisi region. The remaining displaced population from Shaba and the refugees are not currently considered to be at heightened nutritional risk (category IIc in Table 1).
How could external agencies help? In Mwene Ditu, financial support to continue the functioning of feeding centres is one priority.
More information is needed from the Masisi area where ethnic violence is leading to large scale displacement. Very probably interventions including emergency food and health assistance are urgently needed for several thousand people.
Organised repatriation of the approximately 26,000 assisted Angolan refugees in Zambia is scheduled to begin in 19% and will be completed over a fourteen month period. Before departure refugees will undergo health and nutrition screening and be given updated health cards while children under five will be vaccinated. There are a further 70,000 unassisted refugees who have been considered self-sufficient for a long time, and are expected to repatriate without assistance [UNHCR Jun 95-Dec 97].
