Highlights

The total number of refugees and internally displaced people requiring emergency food assistance has decreased over the reporting period, due mostly to the attainment of self-sufficiency by some in Rwanda and Sierra Leone. However, the total number of people considered to be at heightened nutritional risk has increased mainly due to a deteriorating situation in Ethiopia and Liberia.

Angola The security situation in Angola has remained stable over the last two months and the nutritional situation in the country is generally adequate. The increasing capacity of humanitarian agencies to rapidly implement general ration and selective feeding programmes in previously isolated areas has ensured that when high levels of wasting are identified, these conditions are rapidly brought under control.

Rwanda/Burundi (Great Lakes) Region The recent coup in Burundi has not stemmed the rising tide of violence which continues to cause population displacement and hinder humanitarian relief efforts. All Rwandan refugees have left Burundi, and Burundi nationals continue to flee to neighbouring Uvira, Zaire and Tanzania due to the insecurity. The nutritional status of the Rwandan refugees in Zaire is generally adequate and stable, although the on-going reduction in the general ration and the ban on refugee economic activity are likely eventually to lead to rising levels of malnutrition. Apart from periodic incidents in the western prefectures, the security situation in Rwanda has remained stable. The situation is also much calmer in the Masisi area of Zaire with many of those displaced by recent ethnic conflict now returning home. However, refugees from this crisis now resident in Rwanda are in a poor nutritional state having endured a long, arduous journey which involved, in many cases, a period of time in an overcrowded and poorly served transit centre. This problem is being addressed by the provision of general and supplementary food assistance.

Ethiopia Recent surveys in the Somali refugee camps have shown very high levels of wasting (15-21%) with a deterioration in all camps. This is largely ascribed to incomplete and erratic general rations, poor water availability leading to outbreaks of diarrhoeal disease and lack of ration cards for new arrivals. The presence of large quantities of relief food on the market has raised questions regarding the suitability of general ration commodities provided, over-registration of refugees and the overall cost-effectiveness of the food aid programme for Somali refugees in the eastern camps. In contrast, the Sudanese refugees in the western camps have an adequate nutritional status and are generally far more self-sufficient.

Kenya A recent set of survey in the Somali refugees camps in Kenya showed levels of wasting between 15.1-18.6%, which represents a marked deterioration in the situation since the last set of surveys. Cases of scurvy, which appear to occur on a seasonal basis, were also noted during the survey.

Liberia Region Famine situations are being uncovered in many newly accessible areas of Liberia. Extremely high levels of wasting (e.g. 47% in Buchanan and 21% amongst the displaced in Monrovia), and low levels of measles immunisation coverage are being found. The cease-fire in Sierra Leone is holding and the overall situation is said to be improving as humanitarian agencies strengthen relief and rehabilitation programmes. Current plans are to phase out general ration programmes to refugee populations in Guinea and Cote d’Ivoire by the end of 1996, although it is anticipated that targeted feeding to vulnerable groups will continue.

Somalia A combination of food price inflation and logistical difficulties as well as ongoing security problems has reportedly led to a significant increase in the number of children attending feeding centres in Mogadishu. As the limited harvest runs out toward the end of 1996, increasing food supply problem could arise. The flood-induced displacement of large numbers of families from Juba valley to Kismayo is causing concern among agency staff, with anecdotal reports of rising levels of malnutrition in all camps for the displaced.

Sudan The condition of the displaced population around Khartoum remains critical: as opportunities for self-sufficiency have been eroded by settlement relocation, basic needs provision remains inadequate. However, the formation of a Government committee to review agency requests for better access to this population is a first step towards improving their plight. The long-term problems in southern Sudan are relatively unchanged as periodic insecurity and natural events such as flooding and drought affect food security for many people in the region. However, the number of Operation Lifeline Sudan flights delivering relief goods given clearance has improved dramatically over the past few weeks. Unfortunately, a shortfall in food aid pledges and cash funds for monitoring could jeopardize continuation of the programme at a time when opportunities for greater humanitarian relief deliveries exist.

Afghanistan Taliban forces took over Kabul on 27 September 1996; it is, however, too early to determine the impact this may have on the health and nutrition situation of the population. Prior to these developments, a combination of interventions, including targeted feeding programmes, food-for-work schemes, increasing numbers of feeding centres and subsidies extended to bakeries were continuing. Although there was a temporary disruption of food deliveries to the displaced camps in Jalalabad when the Taliban took control of the city, distributions have now resumed and the situation in the camps is reportedly stable.

ADEQUACY OF FACTORS AFFECTING NUTRITION

Factor

Burundi/Rwanda Region

Liberia

Mozambique

Sierra Leone

Somalia

Sudan

Uganda

Zaire - Masisi

Angola

Burundi

Rwanda

Tanzania

Zaire

1. Degree of accessibility to large population

Ö

X

Ö

Ö

Ö

O

Ö

O

O

O

Ö

X

2. General resources

- food (gen. stocks)

Ö

X

Ö

Ö

X

Ö

Ö

Ö

Ö

X

Ö

?

- non-food

Ö

X

Ö

Ö

X

Ö

Ö

Ö

Ö

?

Ö

?

3. Food pipeline

Ö

?X

Ö

Ö

X

?

?Ö

X

Ö

X

Ö

?

4. Non-food pipeline

Ö

?X

Ö

Ö

X

?

?Ö

?

Ö

?

Ö

?

5. Logistics

O

X

Ö

Ö

X

O

O

O

O

O

O

X

6. Personnel*

Ö

X

Ö

Ö

Ö

Ö

Ö

Ö

O

O

?

?X

7. Camp factors**

Ö

?X

Ö

Ö

Ö

Ö

na

Ö

O

O

X

?X

8. Rations - kcals

Ö

X

Ö

Ö

X

O

Ö

Ö

?X

O

Ö

?X

- variety/micronutrients***

Ö

X

Ö

Ö

X

O

Ö

Ö

?X

O

Ö

?X

9. Immunization

X

?X

Ö

Ö

Ö

O

X

X

O

?

Ö

X

10. Information

Ö

X

Ö

Ö

Ö

O

Ö

Ö

O

X

Ö

X

Ö Adequate	O Problem in some areas	X Problem	? Don’t know
?Ö Don’t know, but probably adequate	?X Don’t know, but probably inadequate		na not applicable

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

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

*** Rations may be inadequate due to inaccessibility.

Note: Situations for which detailed information is available are included in this table. Other potentially critical situations (e.g. Ethiopia or Shaba, Zaire) are not currently included due to a lack of detailed information. They will be included as more information becomes available.

PLEASE NOTE The Reports on the Nutrition Situation of Refugees and Displaced People will now be published every three months. Updates on rapidly changing situations, and where new information is available, will be published every six weeks after each three monthly report. The information in the Updates will be mainly equivalent to that in Table 1 - population numbers in different nutritional risk categories - plus any new nutritional survey data, similar to the presentation in Annex 1 of the present reports. Further outputs will be developed in response to needs. The Updates will, where feasible, be transmitted by e-mail in Word Perfect 5.1. If you want to receive the Updates, please either contact the ACC/SCN by e-mail (accscn@who.ch); or fill in the enclosed form to receive by mail; or write or fax to ACC/SCN at the addresses on the front cover. The full report in its present form will be sent every three months.