An agreement between the governments of the six countries involved in the conflict in the DRC was signed in Lusaka on July 10th. More recently, the agreement was signed by the Ugandan backed rebel group Mouvement de Libération Congolais (MLC) and the other major rebel group, the Rassemblement Congolais pour la Démocratie (RCD). The agreement calls for the cessation of military activities within 24 hours of all parties signing. A Joint Military Commission should then implement and monitor the cease-fire, the withdrawal of foreign forces from the DRC, the deployment of an international peacekeeping force, the disarming of militia groups and the initiation of an inter-Congolese dialogue on the political future of the DRC. At the time of going to print, the rebel factions were still unable to agree on the representation of the Joint Military Commission (IRIN - 02/09/99, 08/09/99).
Despite the ceasefire agreement, large numbers of civilians continue to be exposed to indiscriminate violence, looting and destruction of productive assets in almost all parts of the country, thus forcing their displacement. Thus, the reporting period was marked by high mobility of the affected population within the country and cross border movements. The table below shows the geographical location of the estimated 836,000 IDPs in DRC. These figures are considerably higher than those estimated previously. This increase reflects both the continuation of a high level of military activity in the eastern provinces and in western and northern Equateur. The increase in the number of IDPs reported is also due to the improved accessibility to displaced populations that has resulted in greater accuracy and depth of the information presented (OCHA - 19/08/99, 24/08/99, 15/09/99).
|
Katanga |
E. Kasai |
Equateur |
Maniema |
N. Kivu |
Orientale |
S. Kivu |
|
185,000 |
60,000 |
126,000 |
20,000 |
160,000 |
80,000 |
195,000 |
The accessibility of vulnerable populations both in RCD and government controlled areas has significantly improved since the signing of the Lusaka peace agreement, although long bureaucratic formalities are still required to gain access to many areas. Remaining pockets of inaccessibility are primarily defined by; military activity in the northern (Equateur) and southern (Katanga and eastern Kasai) fronts; protracted insurrection (the Kivus and Orientale) and re-emerged "tribal" clashes in Orientale (OCHA - 24/08/99).
The WFP EMOP for war-affected populations in DRC remains seriously under-funded. At the time of going to print, only $5.8 million had been pledged out of a total of $30 million required (WFP - 15/09/99). Thus despite the improvement in accessibility, many of the war-affected populations will still be unassisted.
Economy
Any positive impact of the Lusaka cease fire agreement on the economy of the DRC was short-lived and negligible. Economic indicators are still in decline: devaluation of the national currency and inflation continue. The country's major sources of income - copper and cobalt production, as well as diamond mining - are in recession. The state's revenue from diamond sales is further threatened by the rebel advance in Kasai. The country's economic performance has had a serious impact on purchasing power and food security, particularly in urban areas (OCHA - 15/07/99, 19/08/99, 24/08/99).
Kinshasa
Access to food continued to become more difficult for the population in Kinshasa in the reporting period. The main factors affecting household food security are hyperinflation and an inadequate flow of foodstuffs into the market. The US embassy in Kinshasa estimated a 41% increase in food prices in the food market between June and July (OCHA - 15/07/99).
Research by the Diocesan Bureau for Medical Research (BDOM) indicates that 80% more cases of malnutrition were being treated in church sponsored centres in June 1999 compared to June 1998 (this may be partially due to the increased number of feeding centres open this year). A survey undertaken by the AAH-USA in Kimbanseke Commune of Kinshasa in late July estimated the prevalence of wasting and/or oedema at 8.7%, which includes 2.9% severe wasting and/or oedema. Oedema was found in 2% of the children measured. Chronic malnutrition or stunting (height-for-age) was estimated at 33.3%, which includes 13.5% severe malnutrition. Children's mothers were also examined using the BMI (kg/m2). The results can be seen in the table below. 11.5% of the women were classified as malnourished, which included 4.3% severely malnourished. A further 15.5% of the women could be considered to be at risk of malnutrition.
|
16.0<BMI |
16.0<=BMI<17.0 |
17.0<=BMI<18.5 |
18.5<=BMI<25 |
25<=BMI<30 |
BMI>=30 |
|
4.3% |
7.2% |
15.5% |
64.7% |
6.5% |
1.8% |
Province Orientale
MSF-H have been running a nutrition programme in Kisangani since a survey conducted in January estimated the prevalence of acute wasting and/or oedema at 13.2% which included 9.5% severe undernutrition (compared to the results of a WHO survey which found 3.7% acute wasting and/or oedema and 3.0 severe wasting and/or oedema in November 1997). In a demographic review of the admissions to the Feeding Centre it was noted that an increasingly large number of children were coming to the Kisangani centres from areas far outside the town. Many children had travelled 40-50 km for treatment and some up to 160 km. Thus the NGO decided to undertake a survey in the Aire de Sante de Madula (about 30 km south east of Kisangani) on the routes to Ituri and Lubutu in early August (MSF-H 08/99; MSF-H - 09/09/99).
The MSF-H survey estimated the prevalence of acute wasting and/or oedema at 13.2% and severe wasting and/or oedema at 9.5% (see Annex). About one third of the malnourished children had bilateral oedema, including 80.3% of the severely malnourished children. These prevalences are very similar to those recorded in Kisangani in January. The report suggested that the malnutrition could be attributed to the area's economic decline and the generalised insecurity. The peak prevalence of malnutrition occurred approximately 35 km from Kisangani. The authors suggested that those in more rural areas were less malnourished because they were able to produce their food at home. Those closer to the town had easier access to the town's facilities, but those in between had neither advantage. The measles vaccination coverage rate in the survey was dangerously low at 12.8%, particularly given the nutritional status of the children.
MSF-H conducted a comparison of local market prices in Kiangani town between September 1999 and August 1998 (pre-conflict). The prices of all goods compared were significantly higher following the war, for example casava leaves had increased from US $0.02 to $1.00 over this period (MSF-H - 15/09/99).
Conflict between the Hema and Lendu ethnic groups in Ituri district, Province Orientale has led to a sharp increase in cholera cases and a measles epidemic according to reports recently received. The conflict, which began in mid-June, has made approximately 40,000 people homeless and resulted in a heavy death toll (up to 3,500 people). The displaced are reported to be living in conditions of poor hygiene. In addition, health centres in the region have been looted, torched or abandoned, leaving both the local population and the displaced without medical aid. In response to the measles epidemic MSF-H has launched a large-scale vaccination campaign targeting 30-35,000 children. It has also distributed anti-cholera drugs and water purification sets. (IRIN - 03/09/99; MSF-H - 18/08/99; OCHA - 15/09/99).
Katanga
The first UN mission to northern Katanga which has been able to obtain full and unconditional access to areas affected by population displacement since the beginning of the war identified more than 54,000 displaced persons in the area. Over 28,000 IDPs were registered in Lubumbashi, of whom only 3,300 were being assisted. An estimated 125,000 residents of the Manono area were also believed to be dispersed in "hardly accessible" areas of Kiluba. The assessment mission noted that the coping mechanisms of the host communities in Katanga were "seriously weakened" and that they had difficulty supporting the displaced. Anecdotal reports of high rates of morbidity and mortality among displaced children have been received, although these reports are unconfirmed at the time of going to print (IRIN - 18/08/99; OCHA - 15/09/99).
Further anecdotal reports of a poor food security situation and a growing number of malnourished children in Kalemie have been received. According to a recent report, most of the supply routes into the town have been cut because of the war, and only small amounts of food have been arriving from Moba, which has resulted in food being priced at about four times pre-war levels. The food security in Moba, traditionally the area's bread basket, was also reported to be poor as the war had disrupted agricultural activities in the area. About half of Moba's 400,000 residents had left the town, many were still hiding in nearby forests (IRIN - 02/09/99).
South Kivu
As a result of intensive population movement, insecurity, and military activity compounded with drought, the food security situation is reported to have deteriorated in South Kivu over the past two months. FAO has estimated that some 125,000 households will not be able to cultivate during the coming agricultural season unless interventions are carried out immediately. The UN humanitarian office in South Kivu estimates that food shortages will directly affect 800,000 people in this area, including 195,000 who are displaced. No further information concerning this situation is currently available to the RNIS (OCHA - 15/09/99).
Polio vaccination campaign
The campaign to vaccinate children against polio is reported to have successfully reached 6.7 million of the country's 10 million children under five. Fighting stopped in 90% of the country to allow the campaign to proceed. Despite fighting in Kisangani on the final day of the campaign, 70% of children in the city were still vaccinated (OCHA - 15/09/99; WHO - 20/08/99).
Although the overall operation has been described as a success, considerable numbers of children in the rural areas were not covered. This was partially due to less awareness of the campaign in rural areas. A combination of security and logistical problems resulted in disappointing coverage of only 23% in Equateur province (IRIN - 26/08/99).
Refugees in DRC
Angolan refugees
There are an estimated 157,000 Angolan refugees in DRC. The difficult situation in Angola continued to generate refugee influxes into Bas Congo province. Poor road conditions and the number of military roadblocks are forcing WFP to use rail transport in order to provide food for feeding programmes in Katanga province for over 43,000 Angolan refugees in the area. A scarcity of wagons is causing frequent delays in food dispatches and disrupting planned distributions. As a result of the inadequate food deliveries, UNHCR continues to supply complementary food items to this group of refugees (OCHA - 19/08/99, 15/09/99; UNHCR - 27/09/99).
The current nutritional situation of these refugees is unknown. Reports earlier in the year suggested that the nutritional status was very poor, but improvements in the situation due to a general food distribution for children under five has been reported more recently (WFP - 30/04/99).
Refugees from Congo-Brazzaville
In mid-September there were an estimated 20,000 refugees from the RoC in DRC. The rate of arrival of Congolese refugees to Bas Congo has diminished over the reporting period and many are returning to Congo-Brazzaville. However, anecdotal reports suggest the health and nutritional condition of the newly arrived refugees (mainly from the Pool region) is very poor, much worse than those who had arrived earlier. There are no survey data available to the RNIS, however, to confirm these reports. UNHCR and WFP continue to try to provide assistance, but there are difficulties in getting supplies to the area (IRIN - 30/07/99; OCHA - 15/07/99).
Burundian, Rwandan and Sudanese refugees in DRC
There are an estimated 20,000 Burundian and 10,000 Rwandan refugees in the Kivus. There are also a further 61,000 Sudanese in Province Orientale. The nutritional situation of these refugees is unknown.
Overall, improvements in the nutritional situation are expected provided the cease-fire agreement holds and humanitarian agencies are allowed free access throughout the country. Thus it is probable that the inhabitants of Kinshasa, Kisangani and other areas that are accessible are at moderate risk of malnutrition (category IIb). Anecdotal reports suggest that the IDPs in South Kivu and Katanga are at greater risk, although this information requires confirmation (category IIa). There is little or no information about the nutritional situation of the large number of other IDPs in other areas of the country. Thus the nutritional situation of all these people must therefore be classified as unknown (category III). Given the situation in Congo-Brazzaville, it is probable that the refugees from this country are at high risk of malnutrition (category IIa). The nutritional situation of the other refugees is unknown (category III).
Priorities and Recommendations:
· Provide international support for the implementation of the Lusaka agreement in order to promote regional stability.From the MSF-H survey outside Kisangani:· Provide funds to support WFP's programme.
· Conduct surveys and needs assessments in newly accessible areas in order to determine needs on a provincial basis.
· Gain access to the previously inaccessible rebel-held areas.
· Transport all severely malnourished identified in the survey to Kisangani TFCs for treatment.· Investigate potential sites for nutritional centres outside Kisangani using demographic data from the Kisangani nutritional centres.
· Alert UNICEF and other EPI health officials to the low measles coverage in the area.
· Strengthen nutrition education in the communities.
· Identify an agricultural or fishing partner to strengthen food security.
