The following section describes the nutritional situation of IDPs in Ambon Island, East Timor and West Pontianak. These locations have been chosen as they have IDP populations which require food assistance, in addition the RNIS has received survey reports concerning the populations in these areas. This coverage is not comprehensive; other IDP populations in need of food assistance do exist in Indonesia.
Ambon Island, Molucas Province
Ambon island is situated to the east of the Indonesian archipelago and is the administrative capital of a chain of islands, known as the Molucas, stretching between the islands of Sulawesi and Irian Jaya. The population is both Christian and Muslim. In January 1999, there was an outbreak of violence between the Christian and Muslim communities that resulted in the widespread destruction of property and the subsequent forced migration of large sections of the two communities (approximately 20,000 people were displaced). The IDPs are now living in about 48 camps across the islands. Most of the camps are segregated by religion, although others are mixed. The camps themselves are diverse in nature. Some have communal accommodation in public buildings (e.g., churches and mosques) and others are groups of vacated houses. Further IDPs are housed with host families (ACF-F - 07/99).
ACF-F undertook a nutritional survey in May/June 1999 to obtain baseline data on the prevalence of malnutrition amongst the population in these camps. The survey estimated the prevalence of acute wasting in the under-five population at 11.2%, which included 0.8% severe wasting. No oedema was recorded. Chronic malnutrition or stunting (height-for-age) was estimated at 31.5, which included 9.0% severe stunting. No statistically significant differences in the prevalence of malnutrition were found between the different religious groups. It is probable that traditional weaning habits - children are given breastmilk and then rice porridge - has exacerbated the problems for the weaning age group which had a higher prevalence of malnutrition than the older groups.
This population is currently receiving 2,100 kcal/person/day from WFP (including rice, dry fish, oil, sugar and salt). The children under-five have recently started to receive a blanket supplementary distribution of WSB. The report suggests that the major cause of the malnutrition in this population is the IDP's lack of purchasing power. Food availability in the markets of Ambon, which is a fertile island, is good. The population displacement, however, was accompanied by wide-scale destruction of property and goods, leaving many of the IDPs with little in the way of assets, and divorcing people from their land and modes of livelihood. Thus, many of the IDPs do not have access to a constant/sufficient income. This "vulnerability" has been exacerbated by the difficult economic climate in Indonesia following the Asian financial crisis in July 1997. In addition, there has been a breakdown in access to normal health facilities, and many of the IDPs are living in poor conditions. This has resulted in a poor health environment which has impacted negatively on the nutritional situation.
The first half of September saw a dramatic increase in human rights violations and violence in East Timor. Since the results of the ballot, in which over 78% of the voters opted for an independent East Timor, armed pro-integration militia members have erected roadblocks throughout the capital, Dili, and controlled the streets. According to reports received from, UNAMET (the UN mission for East Timor), militia members were terrorising and murdering unarmed civilians, burning houses, displacing large numbers of people, as well as intimidating, threatening, and attacking personnel of international organisations. The militias forcibly moved civilians out of East Timor into West Timor, while thousands fled into the surrounding hills and jungles of East Timor (UNHCHR - 17/09/99).
More recently, since the UN force (approximately 3,800 soldiers) has arrived in East Timor Dili is returning to normal and some people have already returned. However, UNHCR has received persistent reports about some of the camps in West Timor housing people displaced from East Timor being run by anti-independence militias who intimidate East Timorese, keeping them in West Timor against their will (GoA - 27/09/99; UNHCR -28/09/99).
Numbers Affected
The most recent estimates of the numbers of people displaced by the violence range from 300-400,000. As of September 23rd, the Government of Indonesia has registered 214,00 IDPs in 31 camps and shelters throughout West Timor and nearby islands, although UN estimates are slightly lower. According to the government, the majority of IDPs are located in Kupang, Belu and Timor Tengah Utara. There are an estimated 200,000 IDPs in East Timor (AAID - 21/09/99; USAID - 21/09/99, 27/09/99).
Food assistance
WFP has approved an EMOP to provide emergency rations to 150,000 IDPs within East Timor for two months (WFP - 20/09/99). The agency has also approved a Special Operations programme to finance a joint logistics cell for the crisis. The cell will receive, store and transport humanitarian aid. WFP and the Australian Defence Force have begun to air-drop humanitarian daily rations and high protein biscuits in Ermera and Bobonaro, and areas of East Timor known to have high concentrations of IDPs. (AAID - 21/09/99; USAID - 21/09/99, 27/09/99).
The most recent WFP estimates suggest that up to 740,000 people (out of a total population of 890,000) will require food assistance for six months. This includes 490,000 IDPs and 100,000 returnees who will require full rations and a further 150,000 IDPs requiring half rations. These figures are obviously preliminary and need to be confirmed through food assessments as soon as possible (WFP - 24/09/99).
Food security
USAID reports that their assessment team in Jakata has not received any anecdotal reports of starvation or critical malnutrition in Timor. Food stocks in West Timor are sufficient to meet current needs, but access to food may worsen without external assistance and/or if militia activity persists. In contrast, food availability is reported to be a growing problem in East Timor, particularly for IDPs in isolated locations. There are also concerns about micro-nutrient and protein deficiencies resulting from an extended bulk grain (rice) diet. A relatively high incidence of micronutrient diseases reported in Tomor in a UNICEF/MOH Mother and Child Health Survey for Indonesia in 1995 (MOH - 1995; USAID - 20/09/99)
The planting season in Timor should normally begin in six weeks. The displacement may disrupt this schedule and reduce planting which will lead to longer term food shortages.
Public Health Environment
The provision of water will be UNHCR's priority for the camps in West Timor as September is the peak of the dry season. UNHCR also reports that the camps are overcrowded and lack sanitation facilities (UNHCR -21/09/99).
West Pontianak, Kalimantan
Fighting between ethnic Madurese and Melayu in Sambas, West Kalimantan, resulted in the initial displacement of about 30,000 Madurese. Some 6,000 settled in camps in Singkawang and a further 11,000 went to Pontianak and the surrounding area. The majority of the IDPs in Pontianak are in 10 camps. These camps are either public/Government owned buildings such as football stadiums and badminton courts or are in army bases (ACF-F - 09/99).
ACF-F undertook a survey in these camps in late July in response to alarming reports of a poor health situation and high mortality rates, particularly amongst the under-fives. The prevalence of acute wasting was estimated at 14.1%, which included 2.3% severe wasting. No oedema was reported. This prevalence was not as high as expected, given the reports received prior to the assessment. Reasons given for this include the 2,300 kcal/person/day ration given the population by ICRC.
Overall, the nutritional situation of the IDPs in Ambon and Kalimantan are not considered critical at this time. Nor are there any reports of a nutritional emergency in Timor as yet. However, the IDPs in Timor are at moderate risk (category IIb) given that they have a poor food security outlook unless they are resettled before the planting season starts. Their public health environment is also inadequate.
Priorities and Recommendations:
Priorities for Timor:
· Allow UNHCR access to the IDPs in West Timor who may be being held against their will.Recommendations from the ACF-survey in Ambon include:
· Continue the general food distribution and the recent addition of the supplementary rations to the under-fives, but change the additional supplementary ration from WSB to Vitadele, which is specially formulated for the Indonesian context.Recommendations from then ACF-F survey in West Pontanak include:-· Encourage the resumption of full medical facilities in Ambon, particularly Maternal and Child Health activities to ensure vaccination and weight monitoring.
· Promote health education to mothers, focusing on weaning practices and the prevention of diarrhoea and acute respiratory infections.
· Continue to monitor the nutritional status of the population by anthropometrical surveys.
· Continue to monitor the food security situation through the use of post-distribution surveys, and the close monitoring of food prices in Ambon.
· Continue the general food distribution and treat the malnourished children.
· Monitor the nutrition and health situation in the camps.
· Train the health staff to cope with severe malnutrition.
· Promote health education within the camps.
