HIGHLIGHTS

Angola The continuing peace in Angola is allowing more internally displaced people to return home. Also, large numbers of Angolan refugees in neighbouring countries are expected to repatriate during 1997. The improving access to rural areas and freedom of movement of people and goods is allowing humanitarian agencies to shift the focus of their activities during 1997 towards rehabilitation and resettlement. The nutritional status of this population is expected to continue improving in the coming months.

The Great Lakes Region The final weeks of 1996 and early weeks of 1997 were characterised by increasing insecurity in the entire region and massive population movements. Conflict between government and rebel forces in eastern Zaire has forced thousands of refugees and residents to flee. Approximately 1.3 million Rwandan refugees returned home and are facing the problems of reintegration in an increasingly insecure environment. However, several hundred thousands of refugees and residents have been repeatedly displaced with many residing in makeshift camps in eastern Zaire until rebel advances have led to the dissolution of these camps. Violence continues to be widespread in Burundi and at least 200,000 people in the most insecure areas have been grouped into camps for security reasons. Although, over 400,000 Rwandan refugees returned home from Tanzania at the end of 1996, continuous insecurity in Burundi and Zaire has led to a constant influx of up to 2,000 refugees a day into Tanzania from these countries.

The Government of Rwanda and aid agencies have so far coped well with the massive influx of returnees. However, there has been a marked increase in security incidents recently leading to some disruptions to food, seed and tool provision. The stable nutritional status of these returning refugees could be adversely affected should current distribution disruptions continue. The situation is far more critical for those refugees and Zairians displaced in Eastern Zaire. Aid deliveries have been severely constrained by the war and mortality rates have been up to ten times the normal rate in some of the makeshift camps. Recent surveys in Burundi show a dire situation with levels of wasting of almost 20% and 14% oedema in some of the camps for the internally displaced and returning refugees. This is due to problems with delivering aid due to insecurity and in some cases overcrowding and unhygienic conditions.

Kenya The health and nutrition situation of the Somali refugees in the Dadaab area camps has deteriorated markedly over the past six months with current levels of wasting measured between 28-33%. The main contributing factors have been problems with the food supply and inequitable food distribution systems in the camps. In order to bring the situation under control humanitarian agencies are attempting to procure food locally and have also established a blanket supplementary feeding programme for all children under five years old.

Liberia/Sierra Leone As peace continues in Liberia, more areas of the country become accessible to humanitarian agencies. Populations facing extreme food insecurity are still being discovered in previously inaccessible areas although rapidly mounted emergency interventions appear to remedy situations in a short space of time. The peace process has also been moving forward in Sierra Leone with many IDPs returning home and plans being made for the repatriation of refugees during 1997. Improved access to needy populations has stabilised the nutritional status of populations that were previously vulnerable and recent nutritional surveys have only found low levels of wasting amongst populations affected by the civil war.

Sudan In spite of bumper harvests in many parts of Sudan, the food security situation in Darfur, Kordofan, the Red Sea Hills and Southern Sudan is precarious as these areas all have agricultural production deficits. Populations in Sinkat and Tokar provinces in the red Sea Hills are at particular nutritional risk as general ration programmes recommended several months ago in response to levels of wasting of almost 50% in some areas, have still not been implemented. There have been some improvements in provision of services to the displaced in camps around Khartoum, but this population still remains at nutritional risk due to isolation of the camps and inadequate provision of essential services. Recent information continues to demonstrate the variable nutritional situation of populations in southern Sudan. Conflict induced displacements occur regularly and rapid interventions are mounted as security allows. However, the long term erosion of livelihoods and assets brought about by this lengthy conflict predispose most of this population oh high levels of food insecurity.

Afghanistan Conflict between government and Taliban forces north of Kabul has led to movements of large numbers of people into the capital. This expanding population is placing a strain on existing resources and an estimated 20% of the population in Kabul are now considered to be poverty stricken. Although humanitarian agencies are providing support to a large cross-section of the population in Kabul, there are legitimate concerns that large numbers of Afghans are facing severe hardship and that the nutritional and health status of many may be threatened.

ADEQUACY OF FACTORS AFFECTING NUTRITION

Factor		Great Lakes Region
		Angola	Burundi	Rwanda	Tanzania	Zaire	Liberia	Sierra Leone	Somalia	S. Sudan	N. Uganda
1. Degree of accessibility to large			X	X		X				O	X
2. General resources
	- food (gen. stocks)		X							?
	- non-food		X	X		X				?
3. Food pipeline							?			?	X
4. Non-food pipeline						X	?			?
5. Logistics			X		X	X	O			O	X
6. Personnel*			?	?						O
7. Camp factors**			X		X	X	?		?x	O	?x
8. Rations - kcals			X	?	X	X	?		?	O	X
	- variety /micronutrients***		X	?	X	X	?		?	O	X
9. Immunization			?X				O	O	O	X
10. Information			X	X		X	O		O	O	O

Adequate	O Problem in some areas	X Problem	? Don 't know
? 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.

NOTE The Reports on the Nutrition Situation of Refugees and Displaced People are published every three months. Updates on rapidly changing situations, and where new information is available, are published on an 'as needed' basis, depending on the current situation. The information in the Updates is 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 full reports. Further outputs will be developed in response to needs. The Updates are, where feasible, be transmitted by e-mail in Word Perfect 5.1. If you would like to receive the Updates, please either contact the ACC/SCN by e-mail (accscn@who.ch); or write or fax to ACC/SCN at the addresses on the front cover. The full report in its present form is published every three months.