1. Angola
2. Great Lakes
3. Eritrea
4. Ethiopia
5. Kenya
6. Liberia/Sierra Leone Region
7. Somalia
8. Sudan
9. Uganda
10. Zambia
The prospects for peace in Angola seem remote. The country has been in a state of civil war since, and even before its independence. The humanitarian situation has not improved significantly during the reporting period: fighting between government and UNITA forces has intensified in some areas. Latest estimates suggest that 3.7 million people of Angola’s population of 12.7 million may be categorised as “war-affected”. Since January 1998, more than 1 million people have been confirmed as new IDPs (unconfirmed estimates are as high as 1.6 million). There has been an increase in the influx of Angolan refugees into Zambia and Namibia due to insecurity in the border regions since the start of the year (IOM - 28/03/00; WFP -30/03/00a).
Access and funding
Security conditions continue to be one of the major constraints for the delivery of humanitarian assistance activities: most relief aid is still delivered by airlifts which are extremely costly. WFP targeted some 1.13 million people for food assistance in March 2000, the majority of who are in the Provinces of Malange (240,3000), Huambo (206,000), Bie (200,300) and Huila (121,100) (WFP -30/03/00a). There continues to be a lack of access, for humanitarian agencies and others, to areas outside government control.
WFP has recently issued an alert that without substantial new donor pledges the Angola programme could face serious difficulties as of July. Serious pipeline breaks are foreseen (WFP - 30/03/00b).
Malange Province
The nutritional situation in Malange city has improved dramatically, according to a survey by MSF-H in January 2000 (see annex). Extremely high prevalences of malnutrition had been recorded in Malange in September 1999 (see RNIS 29). According to this survey report the population of Malange city is only 180,000, which is less than half previous estimates of 400,000 (MSF-H - 01/00).
MSF-H also undertook a nutritional survey in Lombe, a village 23 km east of the city (population 8,000) (see annex). Both Lombe and Malange have long been centres to which displaced people come, as they are perceived as relatively safe areas. The worsening situation in March 1999 forced more people to come to Lombe. The renewed conflict has halted or interrupted resettlement efforts, and relief programmes, in the form of dry ration distribution, have only recently started in Lombe. Examples of other nutrition programmes include the distribution of cooked free meals for children as well as sick adults by a Catholic mission, a ‘kitchen’ project focusing on lactating mothers, and a small food-for-work project. The results of the nutrition surveys can be seen in the table below (MSF-H-01/00).
Results of surveys in Malange and Lombe
|
|
Malange |
Lombe |
|
Children |
||
|
Proportion displaced |
15.3% |
52.7% |
|
Acute malnutrition |
||
|
(<-2z scores and/or oedema) |
7.8% |
17.1% |
|
Severe acute malnutrition |
||
|
(<-3z scores and/or oedema) |
1.1% |
6.4% |
|
Adults |
||
|
Proportion displaced |
17% |
50% |
|
Malnutrition |
||
|
(BMI<18.5 and/or oedema) |
34.6% |
53.6% |
|
Severe malnutrition |
||
|
(BMI<16.0 and/or oedema) |
10.9% |
22.3% |
|
CMR |
||
|
(deaths/10,000/day) |
1.6 |
1.3 |
|
Under-five mortality |
||
|
(deaths/10,000/day) |
2.5 |
2.8 |
|
Children |
||
|
Feeding programme coverage |
26.0% |
65% |
|
Adults |
||
|
Feeding programme coverage |
6.9% |
4.7% |
The prevalence of malnutrition was considerably higher in Lombe than in Malange, particularly for adults. This was attributed to the lack of a general ration distribution in Lombe. In addition, there are fewer supplementary feeding centres in Lombe and no therapeutic feeding programmes at all (MSF-H-01/00).
In Malange local residents had a significantly lower prevalence of malnutrition than IDPs (adults and children). This was not true for Lombe, possibly because the general circumstances of residents, particularly income opportunities for residents are as poor as those for the displaced (see graph). In Malange, a significant association (p<0.05) was found between children who drank water from unprotected wells and malnutrition. In Lombe, children who drank water from the river were more likely to be malnourished (MSF-H-01/00).
The prevalence of malnutrition (defined by z-scores or the BMI and/or oedema) in Malange and Lombe among residents and displaced
Kuito, Bie Province
The nutritional situation of IDPs in camps in Kuito and in neighbouring Kunje, Bie Province, is precarious. The population of Kuito town and its suburban barrios has been estimated at 130,000 and the population of Kunje town and its suburban barrios at 25,000. About 110,000 IDPs were registered at the time of an MSF-B/ICRC survey in December 1999. Two main waves of IDPs have been registered - December 1998 and September 1999 -corresponding to high levels of military activities in the province, and new arrivals were still being registered. The surveys of children aged 6-59 months in the towns and the I DP camps recorded a deterioration in nutritional status since March 1999 (see annex). Mortality rates remained elevated in both resident and displaced groups (MSF-B/ICRC-12/99).
Results of surveys in Kuito, Bie Province
|
|
March 1999 |
July 1999 |
Dec 1999 |
Dec 1999 |
|
Town |
Town & camps |
Town |
Camps |
|
|
% of IDP families |
14% |
53% |
29% |
100% |
|
Mortality |
||||
|
CMR |
1.9 |
2.2 |
1.9 |
2.4 |
|
Under-five mortality |
3.5 |
3.3 |
3.8 |
4.5 |
|
Acute malnutrition |
||||
|
(<-2z scores and/or oedema) |
4.2% |
12.7% |
8.0% |
16.1% |
|
Severe acute malnutrition |
||||
|
(<-3z scores and/or oedema) |
1.0% |
3.5% |
1.5% |
1.3% |
RNIS 29 reported on an outbreak of pellagra in Kuito between August and November 1999. WFP has since supplied niacin rich food supplements (blended food) for the cases identified and also their families. The general ration, however, currently contains only 8-10 mg/person/day of niacin compared to the recommended daily allowance of 15-20 mg/person/day (WFP/MSF-B/ICRC/UNICEF -01/2000). A 30 day supply of vitamin B complex tablets was distributed to all women of 15 years and over in December by MSF. The MSF-B/ICRC survey estimated that 86% of women in the town and 90% of women in the I DP camps had received the tablets. However, compliance rates were relatively low for a variety of reasons, including misinformation and suspicions about the purpose or side effects of the tablets. Cases of pellagra are being treated through the supplementary feeding centres (MSF-B/ICRC-12/99).
Matala, Huila Province
The nutritional situation of the IDPs in Matala, Huila Province has improved since October 1999 according to two ACH surveys conducted in January (see annex). In October a rapid nutritional assessment using MUAC had estimated extremely high prevalences of malnutrition. The recent surveys were conducted on children aged 6-59 months from both newly arrived displaced groups (defined as those who had arrived after August 1999, population approximately 15,000) and more established displaced groups (those who had arrived before July 1999, population approximately 35,000) (ACH - 01/00).
Results of surveys from Matala, Huila Province
|
|
Newly arrived IDPs |
More established IDPs |
|
Acute malnutrition |
||
|
(<-2z scores and/or oedema) |
9.9% |
6.7% |
|
Severe acute malnutrition |
||
|
(<-3z scores and/or oedema) |
1.7% |
1.3% |
|
Vaccination coverage |
||
|
Confirmed by card |
79.9% |
6.9% |
|
Confirmed by history |
10.1% |
17.5% |
|
Not vaccinated |
10.0% |
75.6% |
|
Under 5 mortality rate |
||
|
(deaths/10,000/day) |
5.2 |
1.0 |
|
Proportion of households interviewed who received WFP
food |
98.8% |
70.5% |
Ganda, Benguela Province
Two ACH nutritional surveys were conducted among children aged 6-59 months in Ganda, Benguela Province in February as a follow-up to a survey in October 1999 (see annex). At the time of the survey, the population of Ganda was estimated at about 36,000 residents - 3,000 IDPs in official camps and a further 6,300 IDPs living in the town either with host families or in rented accommodation. There have also been reports of a further 1-2,000 displaced people arriving in the area (ACH - 02/00; OCHA -20/02/00).
The prevalence of malnutrition (defined using z-scores and/or oedema) in Ganda, Benguela Province
The prevalence of acute malnutrition was extremely high among the IDPs in the official sites (see graph). Mortality rates for the IDP population (calculated by grave counting in the cemeteries around the displaced sites) were also elevated - CMR was estimated at 3.1/10,000/day and under-five mortality at 4.1/10,000/days. The IDPs in Ganda have very limited opportunities for self-reliance, their main source of income is from working on the residents’ farms but this work is infrequent and poorly paid. The displaced are able to plant on very limited plots around the campsites, but this activity does not produce enough food for the majority of households. Residents are also suffering as both agricultural production and economic activities in the area have been limited by insecurity. A limited number of animals are still owned by the residents (ACH - 02/00).
Huambo
SCF-UK/WFP/MINARS are verifying beneficiaries in Huambo. WFP plans to undertake a general food distribution in April, focusing on the IDP population. The situation will be reviewed in the next three months when the availability of food locally should improve after the harvest. Previous reports have suggested that both the resident and displaced populations have poor nutritional status. The nutritional situation is still reported to be of concern (WFP-30/03/00a).
According to WFP, a nutritional survey in Caala in November estimated the prevalence of acute malnutrition at 23.3% and severe acute malnutrition at 5.8% (WFP -13/01/00). This survey is currently unavailable to the RNIS. ICRC assisted some 16,000 IDPs in Caala in January-March. An estimated 2-3,000 new IDPs have arrived during the reporting period (WFP - 30/03/00a).
Angolan refugees in Namibia
Fighting has intensified in recent months along the Angolan border with Namibia and in other areas of the province of Kuando Kubango. UNHCR and WFP are currently assisting some 11,000 Angolan refugees in Osire camp, Namibia, about 230 km north of the capital Windhoek (IRINSA 28/02/00; WFP - 30/03/00a). There is no information on the nutritional situation of these refugees.
Overall, the nutritional situation appears to be quite variable from the surveys described above. Populations to which the international humanitarian community has recently gained access have generally experienced improvement in their nutritional situation (category II or III). Generally the nutritional situation for the IDPs living in official sites in Kuito, Bie Province, and Ganda, Benguela Province is worse than that of adjacent town residents (who include IDPs resident in towns) (category I), although in some smaller towns or villages like Lombe, Malange province the situation is similar for both IDPs and longer-term residents. In Matala the impact of non-nutritionally related causes of mortality are evident. The nutritional situation of the refugees in Namibia is unknown (category V).
Recommendations and priorities:
· Support WFP’s programme in Angola to avoid pipeline breaks from July onwards.From the MSF-H surveys in Malange and Lombe:· Maintain humanitarian assistance to the IDPs, particularly those in official camps or sites.
· Improve public health - a continued priority.
· Obtain information about the nutritional situation in UNITA controlled areas, and the need for humanitarian assistance.
· Improve the general food distribution to the IDPs in Malange to ensure in particular that the IDPs and malnourished adults are not excluded.From the MSF-B/ICRC surveys in Kuito:· Start a general food distribution in Lombe targeted equally at IDPs and residents.
· Start a therapeutic feeding centre in Lombe.
· Improve coverage of all selective feeding programmes in both Malange and Lombe, through active case finding.
· Investigate water sources in both Malange and Lombe to assess the links with malnutrition.
· Investigate the source of livelihood and food security of people in Malange and Lombe.
· Improve access to safe water and essential health care facilities in order to reduce the high mortality rates.For the pellagra outbreak:· Improve coverage of the selective feeding programmes through screening and active case-finding, and investigate delays in discharging recovered children.
· Initiate food basket monitoring and continuing to reinforce nutritional surveillance.
· Supply the IDPs with foods rich in niacin and other B vitamins (preferably groundnuts, otherwise corn soya blend)From the ACH survey in Matala, Huila Province:· Investigate whether or not residents are also suffering from other micronutrient deficiencies.
· Investigate the feasibility of setting-up local maize fortification schemes as a more long-term solution
· Continue to supply food assistance, and increase this if possible.From the ACH survey in Ganda:· Support food security through appropriate agricultural and income-generating activities.
· Establish a nutritional surveillance system in the camps for the longer-term displaced.
· Improve the measles immunisation rate for this group.
· Strengthen the provision of safe water for the newly displaced.
· Provide a general ration, shelter, essential kitchen and other non-food items to all IDP households in the official sites for three months.· Continue nutritional surveillance through the health centres.
· Strengthen active case finding.
Burundi
Rwanda
Republic of Congo (RoC)
Democratic Republic of the Congo (DRC)
United Republic of Tanzania
The humanitarian crisis in Burundi continues, particularly in Bujumbura Rurale where over 330,000 people remain in regroupment camps in appalling conditions. Large numbers of displaced people are beginning to return to their homes in the Republic of Congo after the peace agreements were signed in December 1999 and the humanitarian situation is improving. In the Democratic Republic of Congo, access to war-affected and other vulnerable populations was significantly reduced over the reporting period, and there are reports of a further 230,000 people being displaced. The humanitarian situation in some of the eastern provinces is reported to be particularly poor. A large number of refugees from Burundi and Democratic Republic have sought refuge in the United Republic of Tanzania since October 1999. The table below shows the estimated number of refugees, IDPs and returnees in need of assistance in the Great Lakes Region. A severe drought is currently affecting the horn of Africa including several countries in the Great Lakes Region.
Estimated numbers of refugees, IDPs and returnees in the Great Lakes Region
|
|
Mar-1998 |
June-1998 |
Mar-1999 |
Jun-1999 |
Sep-1999 |
Dec-1999 |
Mar-2000 |
|
Burundi |
600,000 |
670,000 |
222,000 |
451,000 |
617,000 |
821,000 |
830,000 |
|
Rwanda |
690,000 |
550,000 |
690,000 |
640,000 |
673,000 |
650,000 |
652,000 |
|
RoC |
400,000 |
50,000 |
213,000 |
213,000 |
343,000 |
823,000 |
438,000 |
|
DRC |
568,500 |
621,000 |
788,000 |
952,000 |
1,104,000 |
1,185,000 |
1,418,000 |
|
Tanzania |
345,000 |
329,000 |
328,000 |
373,000 |
373,000 |
400,000 |
465,000 |
|
Total |
2,603,500 |
2,220,000 |
2,241,000 |
2,629,000 |
3,110,000 |
3,880,000 |
3,803,000 |
The security situation in Burundi remains of concern. Reports of fighting in Bujumbura Rurale, Rutana, Ruyigi and Gitega have been received since the beginning of the year. The Arusha peace process talks have resumed under the leadership of Nelson Mandela and dialogue between the Government of Burundi and the major armed rebel factions has begun (OCHA - 03/00).
Humanitarian agencies have reported a deterioration in the humanitarian situation not only in the province of Bujumbura Rurale, but also in the provinces affected by the drought (North and East of the country) and in those affected by the escalation of the conflict (South and North, moving along the eastern border) (OCHA - 03/00). It is estimated that some 830,000 people, or approximately 13% of the total population, are presently displaced in Burundi. Many of these people have been displaced since 1993 (WFP-21/03/00).
Drought
A joint FAO/WFP/Ministry of Agriculture assessment in December 1999 estimated that 2,250,000 people need assistance because of a drought in the country. FAO inputs will include bean and vegetable seeds as well as hoes. WFP will provide seed protection rations for 10-15 days using the same beneficiary lists as FAO (OCHA -03/00; WFP-22/02/00).
Bujumbura Rurale Regroupment Sites
Since September 1999, almost 70% of the population of Bujumbura Rurale has been regrouped into camps around the capital. An estimated 350,000 people were forcefully relocated into 53 sites. Living conditions in the camps are reported to be appalling - they are overcrowded and there is insufficient access to food, water, sanitation and health-care. An outbreak of cholera occurred in December and the risk of further epidemics remains high (Oxfam -15/03/99; WFP-23/02/99).
The nutritional situation in the regroupment camps is variable. According to WFP, nutritional assessments undertaken in eight sites in December 1999 estimated the prevalence of acute malnutrition between 3.6% and 18.0%. The prevalence of severe acute malnutrition varied from 0.5-4.6%. Further rapid nutritional assessments in January 2000 in Kabezi, Kavumu and Ruyaga sites estimated the prevalences of malnutrition at 29%, 17% and 14% respectively. These reports are currently unavailable to the RNIS (WFP - 22/02/00, 23/02/00, 21/03/00).
There has been a large increase in the number of admissions of all age groups to the therapeutic feeding centre in Bujumbura Marie between July and December 1999 (see graph). This is despite difficulties in accessing the therapeutic centres. The increase is partially attributed to limited access to farmland and low harvests; diversion of food aid by soldiers; and limited general food distributions due to insecurity and the evacuation of NGOs and the UN in many sites (MSF-B - 01/00, WFP - 21/03/00).
Number of people in Supplementary (SFP) and Therapeutic (TFP) feeding programmes in Bujumbura Marie
Much of the population in the regroupment camps live off small businesses or obtain employment as casual labourers within Bujumbura town. Others have access to their fields and are able to harvest cassava. Factors associated with the malnutrition in the camps include the lack of access to fields, loss of crops due to looting, uneven distribution of relief foods, low vaccination coverage and outbreaks of disease. The uneven distribution of relief foods was due to problems of access and the compilation of beneficiary lists. In addition, the food pipeline has been insufficient (OCHA - 03/00; WFP - 22/02/00, 21/03/00).
Drought in some areas of the province is exacerbating the problems of regroupment. The FAO/WFP/Ministry of Agriculture assessment in December 1999 indicated that the 2000A harvest (January) will be down 50% compared to 1999 for approximately 25% of the regrouped population in the Imbo agricultural zone (WFP - 23/02/99).
In response to fierce international criticism, the Government of Burundi has undertaken to dismantle 11 camps by May 2000. Phase I of the dismantling is underway and approximately 11,000 of the 60,000 people living in these camps have returned to their homes. Phase II is currently being planned. The scale and nature of food and non-food needs in the months to come will be partially determined by the timing of the IDPs’ return to their homes. If the displaced have been able to plant in time for the 2000B season (planting should be in February and March) and the security situation remains stable, then it is possible food assistance will only be required on a large scale until the next harvest (May and June). However, food-aid needs will also be determined by the amount of planting and tending to their crops that people who are still in the camps are able to undertake. A further unpredictable but important factor is the amount of looting that may or may not occur as the crops mature (Oxfam -15/03/99; WFP - 23/02/00, 21/03/00).
WFP used resources from the regional PRRO to provide food for 255,000 people in Bujumbura Rurale between September and December 1999. A new EMOP for Bujumbura Rurale was signed on March 1 2000. This EMOP aims to provide food for an average of 257,000 people per month over the next six months (WFP - 21/03/00).
updated by ReliefWeb: 7.6.96Kayanza ProvinceThe boundaries and names shown on this map do not imply official endorsement or acceptance by United nations or ReliefWeb. These maps may be freely distributed. If more current information is available, please update the maps and return them to ReliefWeb for posting.
ACF-F conducted a food security assessment and nutritional survey in Kayanza Province in November 1999 (see annex). The majority of the survey population were returnees to Kayanza. The prevalence of acute malnutrition in children aged 6-59 months was estimated at 6.7%, which included 1.1% severe acute malnutrition (0.2% with oedema). These prevalences are significantly less than those estimated in January 1999 (see graph). The under-five mortality rate was estimated at 0.93/10,000/day and CMR at 0.56/10,000/day. The coverage of the therapeutic feeding centre programme was 26.3%. Measles vaccination was confirmed by card for 66.4% of children aged more than 9 months (ACF-F-11/99).
The prevalence of acute malnutrition (defined using z-scores and/or oedema) in Kayanza Province, Burundi In children aged 6-59 months
The survey also examined the nutritional status of adults (aged 18 years +) using the BMI and chronic energy deficiency (CED) cut-offs proposed by WHO (see table). Fourteen percent of adults were malnourished (BMI <17 kg/m2). A significantly larger proportion of older adults (defined as 50+ years) were malnourished than younger adults, as is usual in the developing world. The prevalence of CED in adults had decreased significantly since January 1999. CMR was estimated at 0.53/10,000/day. The coverage of the therapeutic feeding programme was 15.5% for adults aged 18-49 years old, but 0% for adults aged more than 50 years (i.e., none of the malnourished older group were enrolled in the feeding programme) (ACF-F -11/99).
Results of adult nutritional survey in Kayanza
|
CED grade |
18-49 years |
50+ years |
18+ years |
|
Severe CED |
3.2% |
7.6% |
4.5% |
|
Moderate CED |
7.4% |
14.2% |
9.4% |
|
Marginal CED |
16.9% |
25.5% |
19.4% |
|
Normal |
72.5% |
52.7% |
66.7% |
The food security assessment attempted to evaluate associations between various household characteristics and the risk of malnutrition in either children, adults or both. Characteristics examined included: the sex and age of the head of the household; the principle method of obtaining food; access to land; availability of cassava; possession of livestock; access to food aid; available income and household size. Twenty-five percent of households were female-headed. Farming is the main source of food and income for households. In some communes market-purchase of food is important because of insecurity and theft, which hinders cultivation. Ninety percent of households reported not having received food aid during 1999. Livestock ownership varied within and between collines, and most families had only one source of income. Most were involved in small-scale trade or services, or sold farm products (including coffee as a cash crop). The only statistically significant association found was that families with a malnourished child were more likely to have a malnourished adult than those without a malnourished child. The authors of the survey commented that a more vulnerable group within this population probably exists, but that further studies are required to ascertain their characteristics and hence design appropriate interventions (ACF-F -11/99).
Karusi Province
MSF-B has reported a large increase in the number of admissions of children aged 0-17 years old to the NGO’s therapeutic feeding centre in Buhiga between August and December 1999. The majority of cases came from outside Buhiga commune, from areas where there are no therapeutic feeding centres. A large proportion of the cases are from Ngozi province. Given that security conditions prevent a nutritional survey in the province it is not possible to assess whether the nutritional situation outside of Buhiga commune is worse than within Buhiga or whether the people are coming to the clinic because there are no clinics in the areas where they live (MSF-B - 01/00).
Rutana and Ruyigi Provinces
Population displacements have been reported in the Provinces of Rutana and Ruyigi due to a significant escalation of the conflict between the army and the rebels. There are unconfirmed reports that the Interhamwe and ex-FAR are participating in these attacks. The RNIS has not received any new information about the nutritional situation in these areas; the latest reports estimated the prevalence of acute malnutrition in Rutana to be 10-15% (see RNIS 28). The affected population in these areas receive little assistance as NGO and UN activities are limited due to the insecurity (OCHA-03/00).
Outflow of refugees
About 82,000 Burundians arrived in the United Republic of Tanzania between October 1999 and February 2000, bringing the total number of Burundians in the United Republic of Tanzania up to 340,000. Some 3,400 new arrivals were registered in only one day at the end of December (UNHCR - 31/03/00).
Overall, while the prevalence of malnutrition amongst the IDPs in Bujumbura is very variable, the RNIS considers a high proportion of these people to be at considerable risk (category I or II). Food insecurity is exacerbated by the appalling sanitary conditions. IDPs in other areas are considered to be at moderate risk (category II).
Recommendations and Priorities:
· Obtain access to IDPs in Bujumbura Rurale - this remains a priority.From the ACF-F survey in Kayanza:· Improve the living conditions of the IDPs in Bujumbura.
· Continue with therapeutic and supplementary feeding programmes.· Improve nutrition education and coordination with other programmes.
· Analyse and support local capacities that could prevent malnutrition.
· Establish a system for monitoring the nutritional and food security situation.
· Continue with agricultural support projects.
There remain an estimated 620,000 IDPs in Rwanda, the majority of whom are in Ruhengeri and Gisenyi Prefectures. The government is moving ahead with its controversial “villagisation” or “imidgudu” scheme throughout the country.
There has been no new information on the nutritional situation of the displaced. The most recent survey in June 1999 in Gisenyi described the displaced population at moderate risk of malnutrition (see RNIS 28).
Refugees
There are approximately 32,300 Congolese refugees (from DRC) in Rwanda (14,5000 in Kitiza and 17,800 in Gihembe). An estimated 10,000 Congolese refugees have spontaneously returned to North Kivu from Rwanda since mid-1999. The latest reports from UNHCR states that the nutritional situation of these refugees is satisfactory. There are also some 500 Burundian refugees in the country (UNHCR - 07/12/99, 31/03/00; WFP - 29/03/00).
Returnees
According to UNHCR, there have been over 5,000 returnees to Rwanda since January. This inflow can be attributed to the relatively stable situation in Rwanda and the concomitant deterioration in the humanitarian situation in eastern DRC (UNHCR - 31/03/00).
Overall, there has been no new information on the nutritional situation of the IDPs and refugees in Rwanda. It is assumed that the population remains at moderate risk (category IV).
Recommendations and priorities:
· It is important to obtain information on the nutritional situation of IDPs and refugees in Rwanda.
The second peace accord between the Government and opposition parties in the Republic of Congo (RoC) was signed on 29 December 1999 in Brazzaville. This has consolidated the first accord of 16 November and has resulted in a decline in military activities in the country. No reports of fighting have been received during the reporting period. Militia members are beginning to disarm voluntarily. Humanitarian access is expanding rapidly and approximately half the interior is currently reachable. The UN and NGOs are starting to provide rehabilitation assistance in communities of return, many of which had been completely gutted and left with few or no social services and economic activities (IRIN - 24/02/00, 10/03/00).
Displacement
The humanitarian situation is currently characterised by the continuous movement of displaced people from the forests to their homes and villages, particularly in areas where security is guaranteed. An estimated 400,000 people had returned by mid-February and a further 200,000 are expected to have returned home by April or May 2000. Thus approximately 600,000 (three-quarters of those who were still displaced in December 1999) may have returned home by the middle of this year (IRIN - 24/02/00, 10/03/00). At the same time, some displacement from the Pool to Brazzaville continues because of a lack of access to resources and health care in the Pool (ACF - 30/03/00).
Brazzaville
The nutritional situation in Brazzaville has improved dramatically since September 1999 (see RNIS 28). ACF-F conducted nutritional surveys among both adults and children aged 6-59 months in March in both the southern and northern zones of the city (see annex). The prevalence of acute malnutrition varied from 5.4-6.6% in children and 7.4-4.3% in adults (adult malnutrition was defined using a BMI<17.0kg/m2 for those aged 18-49 and BMI<16.0kg/m2 for those aged fifty or more, and/or oedema), indicating that, currently, there is not a nutritional crisis in the city (see graphs). The nutritional situation of the population is, however relatively precarious given that there are still many displaced families from outside Brazzaville (mainly the Pool) living with host families (ACF-F - 30/03/00). Previous assessments in Brazzaville found that IDPs were at higher risk of malnutrition than the residents (see RNIS 29).
The prevalence of acute malnutrition in children aged 6-59 months (defined using z-scores and/or oedema) in Brazzaville
The prevalence adult undernutrition (defined using the BMI an/or oedema) in Brazzaville
The Pool region
IDPs are returning to their homes in the Pool region as the security situation stabilises. Access to the Pool and the resumption of private and public transport has reduced the number of displaced at risk. The ICRC has closed their reception centre in Brazzaville for people displaced from the Pool. Humanitarian agencies have begun to undertake nutritional assessments in the region. Previous information about the nutritional situation in Pool was mainly obtained from reports from IDPs in safer areas. ACF opened therapeutic feeding centres in Boko and Mindouli (ACF-F -30/03/00).
In February, ACF-F undertook a MUAC assessment in Mayama (central Pool) on children between 75 and 130 cm tall (see annex). Eighteen percent of the sample was severely malnourished (MUAC<110mm) and 24.1% were had low MUAC (MUAC<125mm). The severely malnourished were taken to Brazzaville for treatment. In March in north Pool, ACF recorded MUAC measurements on 1903 children in various locations (the sampling methodology is currently unknown to the RNIS): 2% had very low MUAC and 9.9% had low MUAC (see annex). Thus the nutritional emergency in Pool appears to have passed, although ACF-F has stressed that there is an urgent need for medical assistance in the region (ACF-F - 30/03/00).
Niaria and Bouenza regions
ACF-F have reported that the nutritional situation in both Dolisie and (Niari region) and Nkayi (Bouenza region) is better than in Pool. This is partially attributed to easier access to food through farming and markets (ACF-F -30/03/00).
Refugees in RoC
Refugees from DRC have been crossing into RoC during the reporting period. They are fleeing fighting between rebel and government troops in Equateur Province, DRC. An estimated 25,000 refugees have settled in villages on the RoC side of the river Oubangui stretching some 500 km from Betou to the north and Njoundou to the south. Many of the refugees are fisherman and obtain their food from the river. UNHCR is facing fuel shortages and general insecurity in the area and hence the relief operation is extremely difficult. The agency has managed to provide plastic sheeting, fishing nets and soap to 13,500 refugees in 17 villages (IRIN -13/03/00; UNHCR -10/03/00).
There is no new information on the nutritional situation of the 8,000 Angolan or 5,000 Rwandan refugees in RoC.
Overall, the returnees to Brazzaville and war affected in the Pool and other areas, are considered at moderate risk of malnutrition, because although humanitarian agencies have access to them, many have lost their livelihoods (category III). Their nutritional risk has declined because of increased stability and humanitarian access. The nutritional situation of the other IDPs and returnees and refugees is unknown (category V).
Recommendations and priorities:
· As agencies gain access to previously closed areas, a range of humanitarian interventions is required to improve public health and strengthen food security.From the ACF-F surveys:
· Continue to treat severely malnourished in the centre in Mindouli.· Facilitate the prevention of malnutrition by nutritional surveillance in Brazzaville and the Pool.
· Continue to analyse the food security situation in Brazzaville and the Pool to develop appropriate food security interventions.
The reporting period has seen an unprecedented amount of diplomatic activity over the crisis in the DRC, culminating with the UN Security Council’s Special session that approved the expansion of the UN mission into the DRC. Fighting has continued in much of the country, however. Renewed fighting occurred in Equateur and Kasai provinces and a high level of inter-ethnic tension was sustained in Orientale. Access to war-affected and other vulnerable populations was significantly reduced on both sides of the frontline in January 2000, reducing the humanitarian community’s capacity to assist those in need. The reduced access was due to heightened insecurity in eastern parts of the country, and to the “bureaucratic” process for the granting of clearances in many Government-controlled areas (OCHA -15/02/99). Lack of access is the main constraint to humanitarian assistance in Eastern DRC. Out of a total estimated IDP population of 1.12 million, approximately 115,000 receive assistance in the Kivus and Orientale, 30,000 in Katanga, and 15,000 in Kinshasa.
Economy
The DRC wartime economy continued to decline in the reporting period. The Congolese Franc has continued to devalue and inflationary trends continue (333% in 1999). There have been official attempts to control market operations - including a ban on foreign currency holdings and fixing of the exchange rate at unrealistic prices. Shortages of basic goods are expected to worsen as importers and domestic traders who supply Kinshasa are being increasingly affected by these policies. Humanitarian agencies have also been affected and some are no longer capable of disbursing their limited project budgets to obtain goods and services at the fixed exchange rate (IRIN - 14/03/00; OCHA-03/00).
IDPs
There has been a 15% increase in the number of IDPs and Congolese refugees in third countries. IDPs alone increased by 230,000. There are currently an estimated 1.25 million IDPs within the country, whose distribution can be seen in the map/table below. New internal movements of the population have been recorded in all 11 provinces and the capital (OCHA-15/02/99).
Nutritional situation
The RNIS has received two new nutritional surveys for DRC in the reporting period in Kinshasa and Lemera in South Kivu. The latest report from OCHA suggests that some 10 million Congolese on both sides of the frontline face food shortages of varying degrees. The food security outlook is grim given that the majority of the food producing regions (the Kivus, Northern Katanga, parts of Maniema, western and eastern Orientale and Equateur) are seriously affected by the war. In addition, an estimated 800,000 farmers have been displaced and lost their production capacity; and road, fluvial and railway infrastructure is crippled by insecurity and dilapidation (OCHA -03/00).
Kinshasa
The most recent nutritional surveys in Kinshasa, undertaken by AAH-USA in October, indicated that the nutritional situation was not out of control and that the prevalence of acute malnutrition ranged from 3.5-7.7%. However, given the city’s huge population (6 million inhabitants), a very large number of children require supplementary feeding. The prevalence of malnutrition was highest in the outskirts of the city (see RNIS 29).
Following the nutritional survey, ACF carried out a food security assessment. The aim of the survey was to assess household food security and the impact of the economic crisis and conflict, with resulting increased unemployment; loss of purchasing power; and decline of access routes to the centre of Kinshasa. The survey assessed food security in 4 zones: Kimbanseke, Selembao, Kingabwa and Kinshasa (2 peripheral and 2 central zones) (ACF-USA -03/00a).
The results of the assessment indicated that food security is most precarious for the population living on the outskirts of the city. Conflict has led to increasing migration out of the city. The outskirts of the city are most severely affected because they are mainly dependent on agriculture, but opportunities to sell produce are limited because of degradation of access routes. There are few other income earning strategies. In addition, irrigation systems used for market gardening have been destroyed due to looting in the 1991 and 1993 wars. People also have difficulties accessing seeds and tools. Water, electricity and health services are either not functioning or non-existent. Furthermore, where such services do exist, many people have been unable to pay their bills and their services have been cut off. As a result, people either have to beg for water from their neighbours or are forced to get their water from contaminated sources. Fishing has been affected by a night curfew and theft. These factors have had a negative impact on food security and nutrition (ACF-USA - 03/00).
Acute food insecurity due to the current economic crisis was indicated by the following:
· Changes in consumption patterns: the majority of households are only eating one meal per day, whereas the better off would normally eat two or three. The poorest families have reduced the quantity of the one daily meal, or every family member has to fend for him or herself. Some only eat on alternate days. In the periphery, people collect wild foods such as insects, grubs and mushrooms.ACF identified the most socially vulnerable as being:· Changes in income earning strategies; a variety of alternative strategies have been developed. Some are based on speculation, i.e., the buying up of certain commodities, hoarding and selling them when the price has increased. Others include a system of loans without interest between groups of households, asking for gifts from relatives with regular salaries. Many have resorted to begging, and survey respondents mentioned an increase in prostitution (including by children, and sometimes only for food). Women in particular are looking for any way to make money, which reportedly has a negative impact on childcare.
· Reduction in expenditure on health and education.
· Changes in networks of sharing; in the periphery, there has been an increase in the proportion of nuclear families. Households refuse to host migrants, as they can no longer afford to feed them, and since there are few income earning possibilities in the periphery, there is little chance of the migrants contributing income to the household. In contrast, in the centre, the number of people living and eating together in one compound has increased. It is possible for households in the centre to host migrants because of the greater income earning possibilities there.
· The children of prostitutes, who are taken care of by their extended families, but not treated equally to other children in the family. Many of the children in the ACF feeding programmes are children of prostitutes.Recent anecdotal reports suggest that the food security in Kinshasa has improved since December 1999, because of the harvest. The food supplies to the city have changed from Equateur and Kisangani to BasCongo and Northern Kasai. However, the recent fighting in Kasai threatens the new food supply. It is expected that the hungry season will be earlier than usual because of the reduction in the harvest due to fighting (Fennell - 30/03/00).· Widows and orphans. These are not automatically taken care of by their extended family.
Orientale Province
The conflict between the Lendu and Hema tribes is a major source of instability in eastern DRC. The conflict has rapidly expanded from its epicentre (Djigu), and by mid-January 2000 affected several densely populated areas including Bunia. The alleged partiality of the Ugandan army (which has occupied the Ituri district of the DRC since November 1998) may be fuelling the confrontation that has resulted in a heavy death toll and the displacement of some 220,000 civilians (OCHA -15/02/00).
The IDPs are concentrated in isolated bush areas, major trading centres and in Bunia town (where a small amount of food is being distributed by MEDAIR). The displaced populations are reported to be in need of protection, shelter, food, medical assistance and safe water, but widespread insecurities are preventing an adequate humanitarian response. Some international NGOs have been forced to leave after being accused of impartiality (IRIN -03/03/00). The most recent nutritional survey in Bunia estimated the prevalence of acute malnutrition at 11.6%, including 9.1% severe acute malnutrition (see RNIS 29). Recent anecdotal reports suggest that adults are also becoming malnourished and that there have been increasing numbers of deaths from diarrhoeal diseases (IRIN -17/02/00).
In Djigu, the displaced have congregated around the trading centre. Many of the IDP’s houses and possessions have been destroyed - including seeds and tools. Seasonal planting has been affected which will have long-term implications for food security (IRIN - 03/03/00).
Recent reports have also described rising tensions in Kisangani, the site of a fierce battle between Ugandan and Rwandan troops in August 1999 (IRIN - 29/03/00).
North and South Kivu
IDP numbers are increasing in South and North Kivu. Hate speech and communal violence have increased alarmingly in the provinces, directed mainly at Congolese Tutsis (the Banyamulenge) by the Mayi Mayi militias. The longstanding ethnic tensions in the area have been exacerbated by the continuing Rwandan occupation and reported atrocities committed by their troops against the civilian population. War-affected communities are reported to be fleeing further from their homes in search of security and in anticipation of all-out war (IRIN - 31/03/00; OCHA -03/00). This displacement could have a severe impact on the food security of the affected population as the agricultural season is about to start.
SCF-UK undertook a food economy assessment of six areas of South and North Kivu Provinces between September and December 1999. There has been a decline in both the quantity and quality of foodstuffs consumed by farmers in traditionally wealthy agricultural regions of the Kivus. A summary of the findings is presented below (SCF-UK - 22/01/00). The main causes of food insecurity are the looting of livestock, disruption of trading activities and agriculture due to insecurity, loss of income (e.g. from sale of agricultural produce or wage labour), an increase in the cost of basic commodities, and displacement. Some people are reportedly held hostage in the forest.
South Kivu
· In all four zones (the Plaine de la Ruzizi, the Moyens Plateaux, the Savane and the Foret) all household types (poor, middle and rich) have suffered a reduction in their purchasing power since 1997. Households are able to obtain adequate calories and other basic items. However their reduced purchasing power has implications for the quality of diet, healthcare and education that they can afford.North Kivu· This loss of purchasing power is most serious for the poor in the Savane (which is the poorest zone). The poorest households are only able to obtain sufficient calories by forgoing expenditure on education and healthcare and reducing expenditure on soap, salt and other basic items. They are a priority for assistance.
· The ability of households to cope with a period of displacement (either when they are displaced themselves or when they must act as hosts) varies from zone to zone. Households in the Savane have the least capacity to cope with displacement, whereas those in the Foret have large fields of mature cassava that can be harvested. However, even those in the Foret may have longer-term problems if they are just harvesting (and not weeding or replanting because of security risks). Previous surveys in the region have shown that a purely cassava-based diet may lead to oedematous malnutrition.
· The Masisi Plateaux has suffered large-scale conflict since 1993, as well as extreme insecurity in the past two years. Large numbers of the population are displaced. Sources of food and income have decreased dramatically. Income sources for the poor include crop sales, agricultural labour and other labour types. Expenditure among the poor is minimal; none purchased kerosene and 60% of total expenditure was on food.The food economy assessment did not discuss mineral extraction in the Kivus, which could be an important source of income.· Most of the displaced who were previously rich have moved to urban centres where they are in business. The poor have generally moved to rural villages where they survive by being manual labourers or by producing their own crops
· The poor households in the Zone Volcanique, Rutshuru were affected by a reduction in crop production and an increase in the prices of items they need to purchase.
ACF-USA undertook a nutritional survey of children aged 6-59 months and mothers in Lemera health zone, South Kivu in January 2000 (see annex). Lemera is part of the Moyens Plateaux food economy zone, its altitude (which determines the vegetation and cultivation type) varies from 1,200-2,000m. Prior to the wars in 1996 and 1998, cassava, beans, rice, bananas, sweet potatoes, maize and coffee were all grown. Much of the produce was sold. The war caused displacement and a breakdown of irrigation and infrastructure systems. Much of the population have moved off their land and have lost their tools and other farming inputs. The insecurity continues together with regular displacements and systematic looting. As reported above, this has resulted in very decreased expenditure on any non-food items, such as healthcare and education. ACF-USA provided seeds and tools to 10,000 households in September 1999 and plans to do so again later this year (ACF-USA-01/00).
Insecurity resulted in the survey being delayed several times and eventually prevented the team from visiting all the villages in the zone, thus the results presented reflect the nutritional situation of the majority of the population (which was estimated at 115,000), but are not based on an entirely random selection of children. The prevalences of malnutrition in both mothers and children can be seen in the graph (maternal malnutrition is defined as BMI<18.5kg/m2 and/or oedema, and severe malnutrition as BMI<16.0kg/m2 and/or oedema). A high proportion of severe malnutrition was oedematous malnutrition. The high prevalence of severe malnutrition in children in relation to moderate malnutrition (4.8 and 6.1% respectively) was attributed to the lack of primary health care. The feeding programme coverage was estimated at 33.3% for children aged 6-59 months. Retrospective mortality, estimated over the three months prior to the survey, was estimated at 2.46/10,000/day for children under five. This indicates an emergency. The major cause of mortality was reported by mothers as being fever (68%), followed by diarrhoea (20%). The very limited access to health care is an important risk factor (ACF-USA - 01/00).
Equateur, West and East Kasai Provinces
Sporadic cease-fire violations transformed into intense fighting in Equateur province around Ikela and Opela during the reporting period. An estimated 250,000 people are displaced. Similarly, military activity in West and East Kasai has also intensified, and an estimated 140,000 people are thought to be displaced in these provinces (OCHA - 03/00). No nutritional information is available.
The prevalence of acute malnutrition (defined using z scores and BMI and/or oedema) in children aged 6-59 months and mothers in Lemera, South Kivu
Refugees in DRC
Despite the continuing unrest in the DRC, thousands of refugees still seek protection in the country. There have not been any significant refugee influxes recently.
Sudanese refugees
There are an estimated 72,000 Sudanese refugees in Orientale Province. There is no new information on their nutritional situation.
Angolan refugees
There are an estimated 156,000 Angolan refugees in Bas-Congo, Bandundu, and Katanga Provinces. Some 56,000 Angolans fled into DRC in late 1998 and early 1999. These people joined the 100,000 refugees who were already in the country. The most recent assessment of these refugees described their nutritional situation as non-critical (see RNIS 29).
Congolese refugees (from RoC)
There are an estimated 11,600 refugees from RoC in Bas-Congo. The most recent nutritional survey in this area recorded extremely high prevalences of malnutrition, particularly kwashiorkor (see RNIS 30). Repatriation of the Congolese refugees to RoC is ongoing and it is anticipated that this process will be speeded up by the increased stability in RoC (UNHCR-31/03/00).
Burundian refugees
There are an estimated 19,500 Burundian refugees in South Kivu (UNHCR - 31/03/00). UNHCR’s efforts to assist these people have been shattered by the fighting. There is no new information on their nutritional situation, but given the upheaval in South Kivu it is assumed that they are living in difficult conditions.
Rwandan refugees
There are approximately 35,000 Rwandan refugees in various locations throughout DRC. UNHCR and the Congolese government have started an operation to integrate some 5,000 of these refugees into Congolese society. There is no new information on their nutritional situation.
Ugandan refugees
There are an estimated 3,200 Ugandan refugees in Orientale Province (OCHA - 15/02/99). There is no new information on their nutritional situation.
Overall, it is extremely difficult to draw any definite conclusions about the nutritional situation of the displaced in DRC because humanitarian agencies are unable to gain access to much of the affected areas. However, it seems probable that the areas in which there has been recent fighting and displacement will be the most nutritionally vulnerable (Orientale, Kivus, Equateur, East and West Kasia). These people are therefore considered to be at high to very high risk of malnutrition (category I and II). The displaced in other areas are considered at high to moderate risk (category II and III). The nutritional situation of the people in Kinshasa is temporarily improved, but is likely to deteriorate when food prices rise at the start of the hunger season (category IV). Given the economic vulnerability of people in Kinshasa, they remain at nutritional risk. The nutritional situation of the refugees is assumed to be unchanged: the Angolan refugees are considered non critical and the Congolese in Bas Congo are at very high risk. The nutritional situation of the other refugees is unknown.
Recommendations and Priorities:
· People will only become food secure with an end to the conflict. In the meantime, negotiating access to war affected populations is the main priority.From the SCF-UK food economy assessment in the Kivus:
· Improve access to land, particularly for the poor. Provision of credit to the poor should be considered so that they can rent land.From the ACF-USA survey in Kinshasa:· Support farmers through the provision of tools and seeds. Implement projects to drain land and to counter erosion etc.
· Promote small-scale animal raising projects
· Rehabilitate roads in order to improve market access.
· Provide free healthcare to the displaced and returnees to help them recover from their journeys.
· Monitor food security information (crop production/yields, market prices etc).
· Improve public health; including access to health care and water.· Improve access to markets for the peripheral zones by repairing roads.
· Agricultural support: including promotion of the keeping of small stock, improving access to fishing tools, and rebuilding
· of irrigation systems.
· Improve nutritional support. Ensure that the severely malnourished are admitted to feeding programmes, train CHWs in nutrition monitoring and educate mothers in hygiene and sanitation.
Refugees from both Burundi and the DRC have continued to flood into the United Republic of Tanzania during the reporting period. In particular there has been a huge influx of Burundians, since October some 80,000 have sought refuge in the United Republic of Tanzania. The majority of the new arrivals are women, children and young men. The refugees are housed in camps in twelve locations in the Kagera, Kigoma and Tanga regions (UNHCR - 31/03/00; WFP -10/02/00).
At the end of March, UNHCR’s refugee caseload stood at 465,000 persons. The planning figures for WFP’s operation have increased to 525,000 (including 25,000 poor Tanzanians who live around the camps). Approximately 15,000 refugees receive therapeutic and supplementary feeding every month, including pregnant and lactating women. This operation is currently seriously under-funded (UNHCR - 28/02/00, 31/03/00; WFP-22/02/00).
The RNIS has not received any new information on the nutritional situation of the refugees. The most recent survey in Kigoma and Kagera estimated low prevalences of malnutrition in the camps (RNIS 27). Higher prevalences of malnutrition were recorded in the villages surrounding the camps (RNIS 28). Most of the refugees have no access to agricultural land are therefore totally dependent on the ration provided by WFP and its donors (UNHCR - 28/02/00).
Overall, the refugees in the United Republic of Tanzania are not considered to be at heightened risk of malnutrition (category IV), although if funding is not found for WFP’s programme there will be a break in the pipeline in July, which could lead to increases in the rates of malnutrition.
Almost 20% of Eritrea’s population is in need of humanitarian assistance according to the latest reports from UNCT. Some 372,000 war-affected people, who are living along the border with Ethiopia, and 212,000 drought-affected people, mainly in Northern Red Sea and Anseba Regions require food aid. This is an immense drain of resources on a country of a population of only 2-3 million people (UNCT-28/01/00).
War-affected areas
Twenty months have passed since the outbreak of the border conflict between Eritrea and Ethiopia in May 1998. After several months of calm, new fighting broke out in February this year and tension along the border remains high, preventing displaced people from returning to their places of origin. Despite efforts by the Organisation of African Unity and the international community the peace process seems to have stalled (UNCT - 28/01/00; UNDP-10/03/00).
One hundred and thirty thousand of the displaced have settled in a string of 31 makeshift camps in Debub and Gash Barka Zones and a further 135,000 are housed with host families. Others are living with host families in Guluj. Many have been displaced 2 or 3 times, as fears of a fresh attack have led to the movement of several of the camps within shelling range. The vast majority of those who are living in camps come from rural agricultural areas. Many have lost their livestock and their land, and consequently their livelihoods. All the displaced children have missed an entire year of education. Health services are severely overstretched as a result of the additional needs of the IDPs, combined with the loss of many health professionals who left their posts to join the army. Sanitation conditions are appalling and the risk of outbreaks of childhood diseases is high. The host population has also suffered. Displaced people are forced to compete with stable, resident populations for land, grazing areas for their animals, water and basic social services that were already in short supply (SCF-UK-17/03/00, 23/03/00).
Despite this bleak picture, the nutritional status of children under five has generally remained within acceptable limits. The Ministry of Health, SCF-UK and UNICEF jointly established a nutritional surveillance programme in approximately 32 sites (in camps and in the host community) in October 1999 (see annex). The surveillance programme is linked to a supplementary ration programme in the camps, so the majority of the children are measured every month. However, there is quite a lot of movement in and out of the camps (in order to prepare fields or harvest etc) and there fore the population numbers are not stable. The nutritional situation in different sites is variable; however, prevalences of wasting above 10% were reported in up to one-fifth of monitored sites in October. Since October, the overall prevalence of wasting has decreased (see graph). This is largely due to the government’s decision to distribute a locally produced supplementary food (DMK - a blended food made from wheat, chickpeas, groundnuts or milk powder and salt, and fortified with iron and vitamin A) to all children under five in addition to a general ration of wheat or sorghum, lentils or chickpeas and oil. Nevertheless, the current nutritional situation is fragile. Food stocks are running out and donors appear to be ambivalent about sending more; an interruption to the pipeline could result in very severe consequences for the nutritional situation of these people (SCF-UK -17/03/00,23/03/00).
The prevalence of wasting (defined using medians) among IDPs In Debub Zone (“D”) and Gash Barka Zone (GB), Eritrea
Overall, the nutritional situation of the war-affected population in Eritrea has to some extent stabilised although is still precarious given their dependence on humanitarian assistance. Pockets of malnutrition are likely to continue to appear unless preventative action is taken and therefore this population is considered at moderate risk of malnutrition (category III)
Recommendations and priorities:
· Prevent a break in the pipeline by supporting WFP’s programme for the Eritrean IDPs.· Continue nutritional surveillance of the war-affected population, and investigate the causes of high prevalence of malnutrition in the camps where it exists.
The food security situation in Ethiopia is extremely precarious for some 8 million people affected by displacement as a result of the border war with Eritrea or drought in crop-dependent and livestock-dependent areas.
War-displaced population in Tigray and Afar
An estimated 350,000 people have been displaced by the conflict with Eritrea (316,000 in Tigray and 34,000 in Afar). Political analysts do not predict further significant displacement in 2000. However, with no immediate end to the conflict in sight and after the loss of two farming seasons, it is anticipated that this population will require support for at least a further 12 months. There is an urgent need to ensure an adequate availability of food assistance and to address significant un-met needs for shelter as an increasing number of people are now living in temporary camps. Water supplies, sanitation services and access to health services also need improving (UNDP - 14/02/00).
The last nutritional survey (August, 1999) among the displaced in Tigray estimated the prevalence of acute malnutrition at 7.7% (see RNIS 29).
Drought in Ethiopia
An FAO/WFP crop assessment mission to Ethiopia in December 1999 estimated that some 7.6 million people affected by severe food shortages resulting from drought, water-logging and other weather-related hazards will require food aid support this year. The Mission has forecast the overall harvest in 1999 at 6% below that of 1998. This relatively low overall deficit masks very serious food shortages in specific areas including much of Tigray, northern parts of Amhara, east and south Oromiya, Somali, and south east SNNP and in Afar. In contrast to these traditionally vulnerable areas, in the surplus-producing areas of Ethiopia production was more than adequate, which means that food security will be very polarised in 2000 (FAO/WFP-26/01/00).
Coping mechanisms have been eroded for many rural households due to significant depletion of assets over recent years and limited income-generating activities, coupled with inadequate food aid response, poor targeting and resulting dilution of rations. A major cause of the current crisis was the poor harvest of the 1999 meher growing season (the main agricultural season harvested in November/December). The earlier 1999 belg (secondary season) was also extremely poor. This affected many of the traditionally food-insecure areas of the northeast of the country (South Tigray, North and South Welo), the eastern areas (East and West Harerghe), North and South Omo and the Special Weredas of southern Ethiopia (Amaro, Burji, Konso and Dirashe), as the bulk of their annual production is from cultivation of belg crops. In addition, the Somali region (Gode, Fiq, Liben, Korahe and Adfer zones) has received inadequate rainfall for the last three seasons resulting in the unusual migration of more than 57,000 pastoralists in search of water and food for human and livestock consumption (FAO/WFP - 26/01/00; UNDP -10/03/00; USAID - 07/03/00; WFP - 25/02/00, 31/03/00).
Not only have crops been lost, but large numbers of domestic animals have also died or lost their market value because of a combination of their poor condition and over-supply. For example, in Tigray livestock prices are half their level of the previous year. There is generally a chronic shortage of grazing and dry season forage, with the problem being more acute on very small farms in densely populated areas of Wollo, Tigray and elsewhere. Due to the late onset or the failure of the belg rains with consequent feed and water shortages, over 20,000 cattle were reported to have died in the Kobo and Alamata woredas in North Wollo and South Tigray. High livestock mortality was also reported from other areas (the Rift Valley area of Oromiya region, from Eastern and Southern Oromiya, and SNNP and Somali regions). Domestic animals are essential for land preparation for highland farmers (as well as for household food security) and any loss of livestock may adversely affect a farmer’s coping capacity. If the belg rains fail again this year all of the areas described above will require additional relief interventions in order to avoid severe stress and large-scale migration (FAO/WFP - 26/01/00; UNDP - 10/03/00; WFP -25/02/00).
MSF-H undertook a nutritional survey among children aged 6-59 months in Konso special woreda, one of areas severely affected by the drought, in January 2000 (see annex). Konso woreda is mainly dependent on belg harvest production, which accounts for 75-80% of overall agricultural production. Most of the community are rain-dependent farmers. The meher harvest, which was due in November and December, was minimal and localised. The belg harvest is not usually due until June, but is currently delayed at least one month. The price of livestock has decreased and livestock condition is generally poor due to the shortage of food. Other important indicators of stress include the sales of assets. The prevalence of acute malnutrition was estimated at 12.9%, including 2% severe acute malnutrition. Oedema was recorded in 0.9% of the children. There has been a decrease in the rate of malnutrition since August 1999. However, the population’s food security outlook is poor. In normal times, 82% of the population is dependent on agriculture in January for its main food source, but during the survey period this had dropped to 17%. An increasingly large proportion of the population was dependent on food aid or food purchase (the main source of cash income is petty trade) (MSF-H - 02/00; WFP - 31/03/00). No information was provided about the market supply of cereals.
Well-organised food-for-work schemes are in place in Konso, and these programmes covered more than 81% of the population. However, the free food distribution scheme (for households who do not have an adult fit for work) was reported to be irregular, and reached only 13% of the sampled population. Neither of the intervention programmes provides a ration that is nutritionally adequate if the ration is the sole source of food (less than 2000 Kcal/person/day and inadequate amounts of protein). The supplementary feeding programme coverage was 34%. Measles immunisation was also low at 24%. There were no reports of an increase in morbidity or mortality (MSF-H - 02/00).
In February WFP approved an EMOP to provide food to 2.3 million affected by natural disasters. (Although the overall assessed needs are that 7.6 million people require food assistance, it is standard WFP procedure in Ethiopia to request only one-third of the needs. The Ethiopian Government meets one-third and bi-lateral and NGO donations are expected to provide the difference.) The USDA recently approved a government-to-government contribution of 135,000 MT of food aid commodities for Ethiopia. According to recent USAID assessments, the most critical humanitarian issue in Ethiopia is the lack of infrastructure and resources to effectively monitor, deliver, and target relief assistance. In light of this, USAID/OFDA recently approved a $600,000 grant to WFP to increase the capacity of the port of Djibouti, which will assist in the delivery of food aid to Ethiopia in the coming weeks (USAID -07/03/00; WFP-25/02/00).
At the time of press, there was growing concern that the belg rains, which were due in February and March, have failed almost completely. This will result in a further increase in the number of people in need of food assistance (IRIN-30/03/00).
Refugees
There are an estimated 250,000 Sudanese, Somali and Kenyan refugees in Ethiopia. No new information has been received on the nutritional situation of these groups, which was reported to be non-critical in the most recent report (UNDP-14/02/00).
The southern Sudanese refugees are located in four different sites in western Ethiopia and are mainly farmers or agro-pastoralists. UNHCR is trying to persuade the Ethiopian authorities to make additional land available for agricultural activities in order to improve the refugees’ capacity for food production (UNDP -14/02/00).
The majority of the Somali refugee population is of rural origin with a pastoral economic base. Strategies for self-reliance are extremely limited, as refugees have no opportunities for employment, and no access to cultivable land. A limited number have become involved in petty trade and commerce. The refugees have well established, clan-based traditions and effective organisational structures for the management of their political, economic, social and cultural affairs. In 1999, 23,000 Somalis were assisted to repatriate (over 82,000 since 1997). UNHCR plans to repatriate some 60,000 Somalis to North West Africa in 2000. The refugees will each receive a cash allowance to enable them to feed themselves while in transit and WFP will provide a food package similar to those used for repatriation (UNDP -14/02/00).
Overall, the war-affected displaced population in Ethiopia remains at moderate risk of malnutrition (category III). The nutritional situation of the refugees appears to be non-critical, although more information is needed (category IV).
Priorities and Recommendations:
· Continue to provide support to the drought-affected populations, in terms of immediate food assistance and other initiatives, including food-for-work, to support food security.From the MSF-H survey in Konso special Woreda:· Given the lack of information on the nutritional situation of the refugees in Ethiopia there is a need to confirm that the situation remains non-critical.
· Distribute food to the poorest households (especially those without anyone who can participate in the food-for-work schemes) until the belg harvest.· Provide seed and other farming inputs for the belg planting in June.
· Review the reasons for poor coverage of the supplementary feeding programme and modify programme accordingly. Establish a new therapeutic feeding programme.
· Continue to monitor the nutritional, health and food security situation.
Refugees
There are currently some 215,000 Sudanese, Somalia and Ethiopian refugees in UNHCR camps in Dadaab and Kakuma. An estimated 20,000 new Somalia and Sudanese have sought refuge in the country since October 1999. WFP/UNHCR have reported a serious funding shortfall for the refugee operations in Kenya (IRIN - 01/03/00).
The RNIS has not received any new information on the nutritional situation of these refugees during the reporting period. The results of extensive food economy analyses and nutritional surveys were reported in RNIS 29. The food economy assessment found that the vast majority of the refugee population are almost entirely dependent on the ration provided by WFP and its donors. A break in the pipeline could have disastrous effects on the refugees’ nutritional situation.
Drought
An estimated 780,000 Kenyans are at risk of drought in the next few months according to information gathered through local and national early warning systems and drought response co-ordination mechanisms. Although this is usually a difficult time of year, the situation is particularly severe (according to satellite rainfall and vegetation coverage mapping, as well as locally collected indicators such as population movements, terms of trade etc). The outlook for rains for March - May is also poor in Turkana district, in the northwest of the country, which remains the most affected area with some 250,000 people at risk. Other affected districts include Marsabit, Moyale and Mandera. The main constraints impeding relief assistance include limited access to affected areas and inadequate targeting-mechanisms (Oxfam -15/03/00; USAID -07/03/00).
In Turkana, the drought-monitoring bulletin reports an overall worsening trend: 75% of the district is likely to be in a state of emergency by the end of March. There has been no rain for many months, leading to increasing water stress, diminishing pasture, increased incidence of livestock diseases and livestock concentration around permanent water sources, as a significant number of shallow wells have dried up. The majority of the population are nomadic pastoralists, but an increasing proportion are reported to be adopting more sedentary lifestyles, resorting to petty trading as a consequence of the loss of their livestock and subsequent impoverishment (Oxfam -15/03/00).
Overall, the nutritional situation of the refugees in Dadaab is not considered critical (category IV). Those in Kakuma are considered to be at higher risk because of a recent nutritional survey that estimated a relatively high prevalence of wasting in the camps (category III). However, the nutritional situation of these refugees could deteriorate rapidly if WFP’s funding shortfall for Kenya is not made up shortly.
Recommendations and priorities:
· Provide funding for WFP’s programme for Kenya urgently.
Liberia
Sierra Leone
Guinea-Conakry
Cote d’Ivoire
The nutritional situation for much of this region is stable or improving. Following the Peace Accord, much larger areas of Sierra Leone have become accessible to humanitarian agencies, although there is little information available about the nutritional situation. No significant changes in the humanitarian situation in Liberia, Cote d’Ivoire or Guinea-Conakry have been reported. The table below shows the numbers of affected people requiring assistance in these countries.
Estimated numbers of refugees, IDPs and returnees in the Liberia/Sierra Leone Region
|
|
Mar-1998 |
June-1998 |
Mar-1999 |
June-1999 |
Sep-1999 |
Dec-1999 |
Mar-2000 |
|
Liberia |
726,000 |
209,000 |
495,000 |
505,000 |
505,000 |
510,000 |
96,000 |
|
Sierra-L. |
200,000 |
300,000 |
400,000 |
708,000 |
758,000 |
758,000 |
757,000 |
|
Cote d’Iv. |
210,000 |
140,000 |
101,500 |
103,000 |
108,500 |
101,500 |
101,500 |
|
Guinea-C. |
405,000 |
614,000 |
470,000 |
400,000 |
488,000 |
488,000 |
489,000 |
|
Total |
1,541,000 |
1,263,000 |
1,466,500 |
1,716,000 |
1,859,500 |
1,857,500 |
1,443,500 |
Note that the numbers, given for Liberia are refugees only (returnees no longer included in this table). Numbers, for Sierra Leone are based on estimates of IDPs and refugees.
Liberia’s seven-year civil war ended in July 1997. Since this time the international relief community in Liberia has focused its efforts on the resettlement and reintegration of returning refugees and IDPs. Over 130,000 Liberian refugees have been assisted by UNHCR to return home and at least an estimated 200,000 people have spontaneously repatriated since the start of the repatriation programme in May 1997. Following the regional review of the progress made on the repatriation operation in February 2000, it has been decided to continue the assisted returns mainly from Cote d’Ivoire and Guinea until the end of 2000 (UNHCR - 12/12/99, UNHCR - 27/03/00; WFP -17/12/00).
An estimated 75% of IDPs have returned to their places of origin and it is probable that the remaining 25% may settle permanently where they are. The Government of Liberia and WFP no longer consider these people as IDPs and the RNIS will no longer include them in its reports. WFP, however, continues to provide assistance to some 420,000 people (many of them returnees) in Liberia under a variety of programmes including food-for-work projects, vulnerable-group feeding and also school feeding (WFP -17/12/00).
Refugees in Liberia
There are an estimated 96,000 Sierra Leonean refugees in Liberia. Some 38,000 refugees assisted by UNHCR are now concentrated in camps in Montserrado and Sinje camp in Grand Cape Mount County. It is believed that some 58,000 non UNHCR-assisted refugees reside in Grand Cape Mount, Bomi, Bong, Margibi and Lofa Counties. Should the security situation in Sierra Leone considerably improve, UNHCR will start to facilitate the return of Sierra Leonean refugees during the course of 2000 (UNHCR-27/03/00).
Sinje camps
Due to insecurity in Upper Lofa in August 1999 most of the 17,000 refugees in Kolahun were forced to flee to Tarvey in Lowa Lofa as a result of considerable harassment from soldiers. More recently, UNHCR relocated these refugees (some 11,500) to a new camp in Sinje in Cape Mount County where they joined an existing caseload of refugees who had arrived in 1998.
ACF-F undertook anthropometric surveys of both the old and relocated refugees in the Sinje camps in December 1999 (see annex). WFP provides a ration of 1100 Kcal/person/day to the more established refugees in camp I, and a ration of 1700 Kcal/person/day to the relocated refugees in camp II. The rationale behind these rations is that the more long-term refugees have obtained access to land and have had time to establish means to obtain income, hence they require less support. In contrast the relocated refugees have no access to land yet and very limited means to acquire food and other basic needs. ACF-F found a slightly higher prevalence of acute malnutrition (not significantly so) in the more established refugee camp than in the newer camp, although mortality rates were higher among the relocated refugees (ACF-F - 12/99a). In the ACF feeding programmes the progress of children originally from Sinje was poor; some even showed a deterioration.
Results of nutritional surveys in Sinje camps
|
|
Camp I |
Camp II |
|
Acute malnutrition |
9.0% |
6.5% |
|
Severe acute malnutrition |
0.6% |
0.9% |
|
CMR |
0.48 |
0.98 |
|
Under-five mortality rate |
1.05 |
1.61 |
|
Feeding Centre Coverage |
57% |
33% |
|
Measles Vaccination |
56.8% |
57.1% |
· The refugees’ food security has deteriorated since they left Kolahun. In Kolahun many of the refugees had established coping mechanisms, including personal food production through backyard gardens, rice farms and income-generating activities (petty trade, labour contracts). During the journey to Tarvey, however, the population encountered many difficulties and households were forced to spend their savings and sell their assets. At Tarvey food availability and accessibility were limited, as were income-generating activities - particularly for the households who had remained in Kolahun the longest (usually the most vulnerable such as older, single women or women with children). In addition, during this period many of the households were split up between Kolahun and Tarvey and as a result 34% of the households in Sinje are female-headed.Refugees in Vahun· There are opportunities for resource-generating activities in Sinje and its surroundings. However, labour contracts, which represented the main source of income in Kolahun, are more limited. Mining, waged work and petty trade are the major potential sources of income.
· Some 3,000 refugees (14%) are benefiting from rice, cassava and vegetable programmes. A palm oil plantation some 20 km from the camp may also provide employment/food for some of the refugees.
· At the time of the survey, the main source of food among the refugees in Sinje was the food distributions provided by WFP. To provide for the food needs not met by the ration, the majority of refugees (59%) have had to sell part of their assets, which has eroded their already fragile economic base. An estimated 14% of the population are living in extremely precarious conditions - they have no source of income and are forced to rely on begging/credit/or asset sales and they may not be able to meet their daily needs. The majority of households are involved in low income-generating activities: 64% of households are involved in petty trade (sale of small items, firewood, bush products, hand-made products, palm wine, food ration), 4% are in business, 6% have a member who has salaried work and 12% of the households rely on labour contracts.
· Bulgur wheat is the staple food in the ration and is consumed every day as a substitute for their preferred Sierra Leonean staple food - rice. Part of the vegetable oil in the ration is bartered or sold to have red palm oil, which is preferred. Access to protein rich sources of food is determined by the purchasing power of the family (the peas in the ration are not eaten regularly, but instead are cooked in bulk every few days).
· The main sources of expenditure include food, soap, household items, health, clothes, tools and credit repayments. The poorer refugees spend a higher proportion of their money on food (80-90%) than those involved in business or waged work (40-60%).
· An immediate decrease in the ration provided to the relocated refugees, to the level of that received by the more established group, was not recommended until increased opportunities for agricultural activities and self-sufficiency were obtained. Any decrease in the ration could severely affect the nutritional situation of these people, who have no source of food other than the general distribution. This is particularly true for households without an adult capable of working, or those who are headed by women.
· The relocated refugees are not ethnically similar to the local population in Sinje and difficulties integrating with the local population are anticipated.
There is no new information on the nutritional situation of the refugees in Vahun.
Overall, even though the refugees relocated to Sinje have been subject to considerable harassment and extremely difficult conditions, most are still managing to meet their food requirements. However, a deterioriation in their nutritional situation was reported. Their situation continues to be precarious and therefore they are considered to be at moderate risk (category III). It is assumed that the nutritional situation of the refugees in Vahun remains non-critical (category IV).
Recommendations and Priorities:
From the ACF survey and assessment in Sinje Camps:
· Maintain the current level of ration for all refugees for the next three months.· Re-evaluate the number of vulnerable households (those relying entirely on food distributions) and increase food assistance to this group.
· Continue nutritional surveillance; including food security assessments, anthropometric surveys and assessments of the coping mechanisms.
The civil war in Sierra Leone began in 1991. A Peace Agreement Accord was signed on 7 July 1999 in Lome. While some progress has been made towards the implementation of the accord, there are indications that the process is troubled. Security has improved in the south and west (particularly where the UN troops have been deployed), but the overall situation remains tense and volatile. Reports of atrocities against civilians continue to be received. The process of disarmament, demobilisation and rehabilitation of the rebels is slow. Achieving unhindered humanitarian access, one of the first major agreements signed by the parties to the conflict, has proved difficult. Despite the formation of the Government of National Unity, former RUF/AFRC (Revolutionary United Front/Armed Forces Revolutionary Council) fighters continue to lay claim to large areas of the country, obstructing free movement (OCHA - 07/03/00; RI - 01/03/00).
Humanitarian access
At this time humanitarian agencies still do not have unhindered and safe access to 7 out of 12 districts, which make up 80 of the country’s 149 chiefdoms, with a total population of 2.4 million from a total population of less than 5 million (according to 1997 projections). Current operations in these areas (mainly in the northern and eastern parts of the country) are carried out under very difficult circumstances, characterised by frequent disruptions and uncertainty. In contrast the Southern Province, the Western Area and some parts of the Eastern Province are relatively stable (OCHA - 07/03/00). As parts of the country that were previously closed are now accessible, assessments and deliveries of assistance are underway.
Returns, resettlement and reintegration
Estimates of IDPs living both in camps and with hosts vary from 750,000 to 1,000,000. Resettlement assessment committees have been established at district and national levels to undertake assessments (based on national criteria) that will determine whether chiefdoms can be declared safe for resettlement and reintegration. The phasing down of IDP camps in the Western Area has begun and food aid will be stopped to IDPs from safe areas. Resettlement rations, food-for-work, food-for-training and related projects will be provided to those who wish to resettle. Those that are from unsafe areas will retain the right to continued accommodation and support services within an IDP camp. Low-cost housing schemes are being set up for those IDPs whose homes have been destroyed (OCHA -07/03/00; WFP-10/02/00).
There are more than 450,000 Sierra Leonean refugees living outside their country. UNHCR has reported a small, but steady, increase in spontaneous refugee returns, mainly from Guinea and Liberia. According to the most recent estimates nearly 10,000 people have returned to the major towns in the southern and eastern provinces. UNHCR has made projections (based on the security situation and other factors including logistics, and the coming rainy season) for 108,000 refugees to return in the course of 2000. However, the implementation of the repatriation operation is closely linked to the progress made on the peace agreement (OCHA - 07/03/00; UNHCR - 27/03/00).
Agriculture
An FAO/GIEWS assessment mission to Sierra Leone in December 1999 (the first since November 1996) reported that the war has caused extensive disruption of the agricultural sector throughout the country including the southern region, which is currently peaceful. Only 12-15% of the total arable land is under crop-production. The staple food crop, which is rice, covers slightly less than half the cropped area. Other cereal crops grown include maize, sorghum, millet and benniseed. Cassava and sweet potatoes are now commonly accepted substitutes for rice as “crisis crops”, particularly in rebel-controlled upland areas. During the war the production of cassava increased by 70%, while that of sweet potato increased by about 20% (FAO - 04/02/00).
Sierra Leone, which was almost food self-sufficient before 1990, has become highly dependent on imports and food aid. Over the years, farmers have lost their productive resources including seeds, implements and other capital assets. There has been large-scale destruction of the marketing infrastructure and rural institutions (e.g.: agricultural research stations). As many rural farm families have been displaced, the availability of labour for planting and harvesting is a major constraint to recovery. Also, farmers’ holding capacity for whatever small harvest they have is low due to financial constraints and the fear of looting by rebels. Practically all farmers are dependent on the government or NGOs for the supply of seeds, and thus the amount of land planted is partially determined by the capacity of these agencies (FAO-04/02/00).
Southern Province
Freetown
No new reports on the nutritional situation of the population of Freetown have been received by the RNIS. WFP currently assists some 28,320 IDPs in six camps around Freetown. This assistance will be phased out as the displaced return to their communities. Those from areas that are declared unsafe will qualify for further assistance in Freetown (WFP -10/02/00).
Bo District
Bo, the largest district in the Southern Province, is an agricultural area. Most of the population are involved in rice farming. Other activities include cocoa and groundnut farming for cash and mining. An inter-agency verification of non-camp IDPs in Bo indicated that only 4,000 of the original 6,000 registered IDPs remain in Bo (most of whom live in Bo town). Not all of these people are considered vulnerable. A further 14,000 IDPs are registered in camps in Bo (OCHA -16/01/00).
ACF-F undertook a nutritional survey in Bo town among children aged 6-59 months in November 1999 (see annex). Thirty percent of the sample population were IDPs. The prevalence of acute malnutrition was estimated at 7.2%, including 0.7% severe acute malnutrition. Oedema was recorded in one child. No statistically significant differences were recorded in the prevalence of malnutrition for the displaced and residents. Retrospective CMR in the three months prior to the survey was estimated at 0.74/10,000/day and under-five mortality at 3.1/10,000/day. Bloody diarrhoea and malaria were the main causes of death in the population above five years old. Malaria was the primary cause of death in children under five. (Mortality was partially estimated during the rainy season, when the incidence of malaria is highest). Measles vaccination coverage was estimated at 33.6% according to card and increased to 87.3% if the child’s carer’s history was taken into account. The feeding centre coverage was low at 9,7% (ACF-F -11/99).
The prevalence of acute malnutrition (defined using z-scores and/or oedema) in Bo
Although not alarmingly high, the prevalence of malnutrition was higher than that estimated in the same, post-harvest, season in 1998 (see graph). This slight increase was attributed to continuing population movements in the area and an increase in the prices of basic food and nonfood items compared to 1998 (e.g.: local rice has increased by 60%, imported rice by 20%, cassava by 15%, and palm oil by 30%). The price increases were due to the devaluation of the Leone, excessive informal “payments” on the highway between Bo and Freetown, poor road networks and infrastructure and subsequent high transport costs. Analysis of the admissions to the feeding clinics in the town suggested that many of the malnourished were from the northern and eastern regions (ACF-F -11/99).
Eastern Province
Kenema
There are currently approximately 13,000 registered IDPs at the Lebanese camp. MERLIN has reported that the number of admissions to its feeding centre has decreased compared to last summer. The NGO is expanding its programme, however, in preparation for the coming hunger gap and also an increase in numbers as access from the outlying areas around Kenema improves (MERLIN -22/03/00). An outbreak of bloody diarrhoea (shigella) has been reported in the district by MSF-F (OCHA -16/01/00, 30/01/00).
Konta
A WFP/NGO assessment mission to Konta reported that the IDPs in the area are ready to resettle, but need assistance with resettlement packages. Some have started to return home. The IDP camp in Konta lacks water and sanitation facilities, blankets, shelter and healthcare. WFP has recently provided the IDPs with food. Konta is extremely difficult to access by road and the population had not received any assistance since April 1999 (WFP - 20/01/00).
Northern Province
Current operations in this area are carried out under difficult circumstances. Appropriate programming has been disrupted and interventions, where possible, are usually limited only to emergency relief, while assistance programmes aimed at rehabilitation and reconstruction await more favourable conditions (OCHA - 07/0300).
Liberian refugees
The residual caseload of Liberian refugees in Sierra Leone is about 7,000. They are currently being screened by UNHCR (OCHA - 30/01/00). The RNIS has not received any new information on the nutritional situation of these refugees, which is unknown.
Overall, the country continues to open up to humanitarian assistance, although there is little information available about the nutritional situation, with the exception of a single survey in Bo that indicated satisfactory nutritional status. However, given the recent upheaval and the approaching hungry season, the nutritional situation of the IDPs is likely to be precarious for the foreseeable future (category II or III). The nutritional situation of the Liberian refugees remains unknown (category V).
Recommendations and priorities:
In most assessed areas, priorities for urgent interventions include:
· Agricultural support, particularly in the northern and eastern regions.From the ACF-F survey in Bo:· Close monitoring of the food security situation, especially in rural areas.
· Rehabilitation of water and sanitation facilities, and the health sector.
· Close monitoring of refugee and IDP returnees.
· Reinforce bridges and arterial routes before the start of the rainy season (April).
· Maintain the therapeutic feeding programme to treat the malnourished from Bo and surrounding zones.· Strengthen nutritional screening process in order to increase the coverage of the feeding programmes.
· Conduct a food security assessment.
Guinea-Conakry hosts approximately 489,000 refugees, principally from Liberia (120,000) and Sierra Leone (366,000). The remaining refugees are from a variety of countries, mainly Guinea-Bissau. The majority of the refugees are housed in Gueckadou, Forecariah and N’zerekore (UNHCR-12/12/99).
UNHCR has recently drawn attention to the plight of the refugees and residents of Guinea who are currently receiving a “cool response” from donors. Guinea’s population of 7 million is reported to be becoming increasingly unhappy with the refugee situation as what little aid that does come to the country is targeted directly at the refugees instead of being split with the local population (UNHCR - 20/03/00).
The RNIS has received no new information on the nutritional situation of the refugees in Guinea. The most recent reports suggested that the refugees in Gueckadou (some 305,000 people), have a poor food security outlook, although the prevalence of malnutrition is relatively low (see RNIS 29).
Overall, the refugees in Guinea-Conakry remain at moderate risk of malnutrition because of the poor food security outlook (category III).
Cote d’Ivoire currently hosts more than 100,000 Liberians and some 1,500 Sierra Leoneans. UNHCR has assisted 11,000 Liberians refugees to repatriate since August 1999 (IRIN-WA - 03/03/00). No new information is available on the nutritional situation of these refugees, which was reported to be satisfactory in the most recent reports (RNIS 27) (category IV).
The humanitarian situation in Somalia continues to be of grave concern, particularly in Bay, Bakool and Gedo regions in the south of the country. The most recent estimates suggest that approximately 600,000 people living in the central and southern regions, excluding those in Mogadishu city, require emergency food assistance until the next gu harvest in July 2000. In the northern region the situation is generally less critical.
Following the collapse of the state and a decade of civil strife, Somalia remains deeply divided. With the exception of Somaliland and Puntland much of the country has the features of a “complex emergency”. The population in northern Somalia is estimated to be about 1.75 million, comprising mainly pastoral communities and a rapidly increasing urban population (a combination of returnees and IDPs). The estimated population for the whole of southern and central Somalia is approximately 4.4 million, including approximately 1 million people who live in Mogadishu. In these areas there are high levels of insecurity, abuse of human rights and frequent population displacements (OCHA-11/99).
It is difficult to estimate the number of IDPs in Somalia, but the most recent estimate is between 300-350,000, the majority of whom are in Mogadishu. Approximately 50,000 of these people were newly displaced in 1999 (OCHA -11/99).
Southern and Central Somalia
The deyr crop assessment showed an increase in area cultivated in Bay, Lower Shabelle, Gedo and Middle Juba, but a drastic reduction was reported in the already highly vulnerable Bakool and Middle Shabelle. (FSAU - 01/00). Maize yield from irrigated farms along the rivers were expected to be favourable, whereas production of rain-fed sorghum suffered from failure of rains. It was anticipated that the deyr production will not solve the problems of the already vulnerable areas of the sorghum belt. Food shortages were expected in Bay, Bakool, Hiran, Gedo and part of Middle Juba.
International staff presence has been re-established in Bay and Bakool Regions following the capture of Baidoa and Hudur by the Rahanwein Resistance Army (RRA), with Ethiopian support, in June 1999. WFP re-established its office in Baidoa in January 2000. Terms of trade for the poorest and displaced throughout southern and central Somalia have deteriorated significantly between January 1998 and September 1999 (including in Gedo, Lower and Middle Shabelle, Hiran, Bakool, and Middle Juba). This has led international agencies, in particular ICRC, WFP and CARE, to distribute food to these groups (ICRC -02/00; Jaspars - 02/00).
During the reporting period, an upsurge in violent attacks and continued militia and factional rivalries, as well as an increase in militarisation, have seriously impaired the delivery of humanitarian assistance in many areas of southern Somalia (SACB - 07/02/00).
Bakool
The food security situation in Bakool region, which borders Ethiopia, is very precarious. An estimated 65-70,000 people are food-insecure in Hudur, Wajid and Rabdure districts. Poor deyr season rainfall over large areas of the Bakol region has led to extreme crop losses. This represents the seventh consecutive poor harvest in the area. Of particular concern are the poorest agro-pastoralists who depend on crop production for both food and income. The Rahanwein farmers of Bakool and Bay Regions are among the worst affected by the war. Their inability to build up food stocks or assets has made them particularly vulnerable. Serious water shortages were reported in February. Terms of trade between cereal and cattle have deteriorated due to poor cattle condition, and an increase in livestock sales. Collection of bush products and hunting has increased. IDPs from Bakool have arrived in Dollo, joining the existing IDP camps (Gedo Region). There are reports of increased rates of malnutrition (FSAU -26/01/00; FSAU-9/03/2000).
Hudur town
Hudur town, the capital of Bakool Region, continues to be one of the urban centres most severely affected by the civil war. A UNICEF survey in Hudur town among children aged 6-59 months in September 1999 estimated the prevalence of wasting at 21.2%, including 5.7% severe wasting (see annex). Oedema was recorded in 1.5% of the children measured. Seventy-four percent of severely malnourished children were in the 24 - 59 month age group, indicating a problem of acute food insecurity. High incidences of diarrhoea (38%) and acute respiratory infections (ARI) (17.1%) were recorded. Sixty-two percent of the households surveyed were recent returnees to Hudur (UNICEF - 09/99). More recent reports suggest that the prevalence of acu
