There are approximately 96,500 Bhutanese refugees registered in seven camps in Nepal's Jhapa and Morang districts. These refugees began entering Nepal in late 1990; the influx peaked in the first half of 1992. Since the beginning of 1998 no new arrivals have been accepted by His Majesty's Government of Nepal (HMGN). The refugees, who are mostly ethnic Nepali speaking groups from the southern plains of Bhutan, fled their country in fear of the enforcement of new citizenship laws and the "one nation, one people" policy of cultural assimilation in the late 1980's. Eight official ministerial-level talks have been held between the Bhutanese government and HMGN without any effective resolution being achieved thus far - this indicates that the problem is unlikely to be resolved in the near future.
Nutritional Survey
SCF-UK conducted its annual nutritional survey among children aged 6-59 months in June (see Annex). The prevalence of acute wasting was estimated at 4.1% (<80% median weight-for-height). No child surveyed was severely wasted or odematous. The graph opposite compares these findings to those of previous years. It can be seen that the level of malnutrition has been below 6% since 1993. The survey estimated the prevalence of acute stunting (height-for-age) at 31.7%, which included 7.0% severe stunting. This figure is lower than the national prevalence in Nepal.
Prevalence of wasting (<80% median weight-for-height) in the Nepalese Refugee Camps
Note that the prevalence of wasting defined in terms of z-scores was somewhat higher - 9.9% of the children surveyed were classified as acutely wasted (<2z scores) and 0.5% were severely wasted (<3z scores). This finding may require an increase in the requirement of supplementary food commodities for the camps.
SCF-UK also examined factors which may be associated with nutritional problems in these camps:
· Measles vaccination status - was high at 97.3%.The last RNIS described an increase in the prevalence of micro-nutrient deficiencies in the camps between January and June of this year. More information on this subject will be available in the next RNIS when the results of a survey due to be undertaken by CDC in October are available.· Vitamin A supplementation campaign - 98.7% of children were covered by the most recent campaign in April.
· Breastfeeding - 98% of children less than 12 months old and 92.2% of those less than 24 months old were breast-fed. This data is difficult to interpret, however, as no information about weaning practices were reported.
· Morbidity - according to parental reports, 35.9% of all children had been sick in the fifteen days prior to the survey. 62.5% of the wasted children were reported to have been ill compared to 34.7% of the non-wasted children. This implies a cross-sectional association between illness and malnutrition, but the relationship was not statistically significant.
· Income - 29.7% of the households interviewed had a regular income of some sort. Only 11% of the families with a malnourished child had an income source whereas 89% of these families had no income. Again, caution must be used when interpreting these results as no statistical association was shown.
· Gardens - 42% of all households had a kitchen garden. No association was seen between malnutrition in children and the possession of a garden.
Overall, the refugees in the Nepali camps are not considered to be at heightened nutritional risk.
