HIGHLIGHTS

Angola International humanitarian agency programmes are now shifting their emphasis to reconstruction and rehabilitation of this war damaged country. Support for displaced and war-affected people will continue and large scale resettlement programmes have been drawn up. The nutritional condition of this population is stable and as peace consolidates this is expected to continue.

Great Lakes Region As rebel forces gained control of the country in mid-May, large numbers of Rwandan refugees and displaced from the Democratic Republic of Congo faced enormous hardship as camps were disbanded and newly displaced populations were inaccessible to humanitarian assistance. Mortality rates 20-40 times normal were recorded among these groups. However, many refugees have now returned to Rwanda and extremely high levels of malnutrition have been reported in transit camps. In Rwanda, food security is threatened by food price inflation and insecurity, which remains a problem particularly in prefectures receiving large numbers of recent returnees. In some cases, food distributions at commune level have been impeded. In Burundi, recent assessments show that populations in many of the "regroupment" camps as well as those for the displaced are living under conditions of very poor food security. The situation is made worse by economic sanctions and insecurity. Although there are few data, the nutritional situation in many of these camps is likely to be extremely poor. In Tanzania, logistical difficulties have adversely affected relief programmes for the refugee camps in the Kigoma regions. However, nutritional survey data generally shows a stable and adequate situation with levels of wasting less than 7% in all camps.

Ethiopia A recent survey in the long-standing returnee area of Gode showed a catastrophic situation with over 50% wasting, and 10% severe wasting. Recommendations were made to implement supplementary feeding programmes immediately, and to initiate programmes to encourage self-sufficiency for the longer term.

Kenya Lack of supplies of corn soy blend have prevented its distribution in the general ration for Somali refugees in the Dadaab camps. This is extremely worrying given the rates of wasting of 30% in these camps reported in the last RNIS. Nutritional assessments in the Kakuma camps showed levels of wasting of 40% among 6-11 year olds, and 20% among the 12-20 year old age group. The prevalence of anaemia was estimated to be between 75-85%. School feeding programmes are being implemented to remedy the situation.

Liberia/Sierra Leone The nutritional situation in Liberia has continued to improve in line with the increased stability in the country. Almost all areas are now accessible and most recent nutritional surveys show marked reductions in levels of malnutrition (to under 10% wasting) compared to previous surveys. There is still much reconstruction work to be undertaken in the country and as the hungry season approaches, it is likely that levels of wasting will increase. We have no information following the recent coup in Sierra Leone. Widespread violence in Sierra Leone, which preceded a coup d'etat forced many organisations to scale down or close operations in the country. It is unclear how this will impact the health and nutrition situation of the population.

Somalia Following the recent drought and reduced "Der" harvest food security has been deteriorating rapidly in Somalia. Food price inflation has been dramatic and levels of malnutrition appear to be on the rise with health centres reporting many more admissions of malnourished children. Water shortages are also affecting many areas and cholera cases are being reported in a number of major towns.

Sudan A bumper harvest in Sudan should ensure adequate food security for most of the country although some of the traditionally food deficit areas may still experience food shortages later in the year. There have recently been significant advances made by the SPLA in the south which along with rebel activity in northern Uganda has led to large numbers of returning refugees. Nutritional surveys show a widely varying situation amongst the displaced camps in southern Sudan. In some case levels of wasting are more or less normal while in other situation near famine conditions prevail with levels of wasting above 30%. These appalling conditions are mainly due to poor general ration deliveries and limited possibilities for supplementation of the ration.

Afghanistan Food shortages have recently been acute and food security appears to be deteriorating throughout the country. Food price inflation has been very pronounced putting the cost of bread beyond the means of large sections of the urban population. The coming harvest may also be poor in many areas and so may not alleviate this food stress. However, a recent nutritional survey in Kabul shows that nutritional status has not so far been adversely affected by the current food insecurity.

ADEQUACY OF FACTORS AFFECTING NUTRITION

Factor		Angola	Burundi	Rwanda	Tanzania	Dem Rep Congo	Liberia	Sierra Leone	Somalia	S. Sudan
1. Degree of accessibility to large population groups due to conflict			O	O		X				O	X
2. General resources
	- food (gen. stocks)									X	X
	- non-food				O					X	?X
3. Food pipeline		X								X	X
4. Non-food pipeline					O					X	?X
5. Logistics			X	O	X	X	O		O	O	X
6. Personnel*			?	?	O					O
7. Camp factors"			X		O	X	O		O	O	?X
8. Rations - kcals			X	O	O	O	?		O	O	X
	- variety/micronutrients***		X	O	O	O	?		O	O	X
9. Immunization			?X				X	O	O	X
10. Information			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, Democratic Republic of Congo) 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.