Côte d'Ivoire
Guinea
Liberia
Sierra Leone
The situation in West Africa is evolving very quickly. The tracking of the displaced and refugee populations and their needs is therefore very difficult. More up-to-date information can be obtained from www.reliefweb.int
The West African region has seen a general deterioration in the humanitarian situation over the past year. Much of the renewed insecurity is along the borders of Guinea, Sierra Leone and Liberia and continues to displace large sections of population and force the return of refugees to their countries of origin, despite insecurity. There are estimated to be over 3 million war effected people in the region (see table opposite).
Côte d'Ivoire has traditionally been a beacon of stability in the West African Region, characterised by a relatively good socio-economic situation and an infrastructure that has benefited from extensive development aid. According to UNHCR there are 110,000 Liberian refugees in the country, of which some 50,000 remain unregistered. There ore also about 2,000 Sierra Leonean refugees on the Western borders. There is concern that a deterioration in either the internal security of Côte d'Ivoire or in the sub region as a whole, may force an unplanned return of over a 100,000 refugees to their country of origin (UNHCR 2001; UN 2001).
Table of beneficiaries in West Africa taken from the UN Consolidated Inter-Agency Appeal for West Africa 2001
|
Country |
IDPs |
Refugees |
Returnees |
Host/other |
Total |
|
Guinea |
150,000 |
420,000 |
NA |
3000,000 |
870,000 |
|
Sierra Leone |
500,000 |
6,000 Liberians |
100,000 |
1,000,000 |
1,606,000 |
|
Liberia |
20,000 |
70,000 Sierra Leone |
30,000 |
600,000 |
720,000 |
|
Cote d'Ivoire
|
NA |
60,000 Liberia |
NA |
NA |
63,700 |
|
|
2000 Sierra Leone |
|
|
|
|
|
|
1,700 Urban |
|
|
|
|
|
Total |
670,000 |
559,700 |
130,000 |
1,900,000 |
3,259,700 |
The RNIS has no current information on the nutritional status of refugees in the country.
Overall
The situation is not critical but there is concern that the situation could deteriorate with the increase in regional insecurity and the internal troubles that hove been affecting the country since the coup d'état of 1999. The nutritional situation of the refugees is not critical but will depend on the continued stability of the country.
Recommendations
· Improve surveillance systems for both nutrition and health at the local level.
· Ensure that contingency planning has been done for the health and nutrition sectors.
The past year has seen a major shift in the humanitarian situation in Guinea. Until recently Guinea had avoided direct involvement with the conflicts across its borders, but since September 2000 there have been increasing incursions from hostile, armed groups, into the south eastern region of the country. The south-east borders both Sierra Leone and Liberia, and fighting has focused on the thin strip of Guinean territory around Gueckedou that juts out into Sierra Leone, and is known as "the Parrot's beak" (UN 2001).
Prior to this violence, Guinea hosted about 420,000 refugees, of whom about 300,000 were from Sierra Leone, and 120,000 from Liberia (UN 2001). Many of the refugees were in the south east which was destabilized by fighting, forcing mass movements of both refugees and the resident population (ACF 02/01; NRC 2001).
One of the major ramifications of the incursions and the resultant internal instability, has been a major shift in attitude to refugees within Guinea by both the government and the general population. For years Guinea has been a willing host to the refugees within its border but increasingly, internal public opinion, fuelled by inflammatory remarks by the president, is turning against them. Refugees are being blamed for bringing fighting into the country. In many cases the backlash against the refugees has turned violent and has contributed to the increasing number choosing to return to their 'war torn' countries of origin (ACF 02/01; NRC 2001).
The RNIS has not received any recent nutrition surveys on either the displaced or refugee populations in Guinea. However reports from ACF based on the monitoring of health centres and some rapid assessments, indicate that the nutritional status of populations in the affected areas of the Parott's Beak is not alarming (ACF 02/01).
The south east Forest Region
Fighting began in the region in September 2000 and has resulted in large scale population displacement. ACF report that a UN registration in June 2000 estimated the total caseload of refugees from Sierra Leone and Liberia in Gueckedou prefecture to be 263,000 people. This was considered an overestimate by NGOs who estimated the total refugee population to be 150,000. The intensity of the fighting has severely restricted humanitarian access to the affected areas. UNHCR report that attacks on the Parrot's Beak area have continued and on March 9th the town of Nongoa was attacked sending thousands running for safety. Insecurity of the Parrot's beak areas has led to attempts to move the affected population out of the zones of conflict, to camps where their security is more assured (UNHCR 06/04/01)
As of April 20th UNHCR reported that 30,000 had been moved to the Albadaria area north of Kissidougou and the relocation continues with refugees being moved out Parrot's Beak. The numbers of people involved have severely constrained attempts to move them and relocation effort remain a race against time as the rainy season approaches after which roads become impassable (ACF 02/01; NRC 2001; UN 2001; UNHCR 06/04/00).
Many refugees have chosen to move themselves and have either headed northwards to the transit camp of Kankan to await transportation to the newly prepared camps in the Albadaria area north of Kissidougou, or they have moved towards Conakry with the aim of being repatriated to Sierra Leone. Some have even risked walking across the border with Sierra Leone into deeply insecure areas held by the rebels they initially fled from. Numbers remain extremely difficult to track as the situation continues to unfold day to day but a considerable number of people still remain in the Parott's Beak (NRC 2001; UNHCR 20/04/01). ACF conducted a rapid evaluation of the food security situation in Gueckedou in February 2001 as there has been concern that the cessation of food distributions and the ongoing conflict have adversely affected food security. ACF have highlighted that Gueckedou prefecture has received two waves of refugees in 1991/2 and in 1998. The 'new' refugees make up about 25% of the refugee population. Refugees have quickly developed coping mechanisms that often allow them to survive without dependence op food aid although ACF stresses that the 'new' refugees have more difficulty in becoming involved in agricultural activities. However, the ACF assessment concluded that the majority of refugees in Parott's Beak had been able to meet their food needs mostly as a result of an abundance of rice from the latest harvest and cheap market prices for food items. There is very limited access to external markets and the poor purchasing power of many refugees means that the long term effects of the insecurity could reduce access to food (ACF 02/01).
Forecariah Area
Latest reports from the Forecariah area put the number of refugees at 15,885 people although this number is likely to change very quickly. There have been reports of outright hostility to refugees in the area making their presence there increasingly difficult, however the Red Cross report that government authorities have finally agreed that refugees can be moved to one camp in the Kindia Prefecture which removes them from a potentially hostile border area (IFRC 19/03/01; WFP 06/04/01).
Repatriation
Issues of repatriation have taken on a new urgency as the fighting in the south east has destabilised the country as a whole and markedly changed the previous good feeling towards the refugee populations in Guinea. It is difficult to keep up with the unofficial repatriations, as many people have chosen to move themselves back across the borders into Liberia and Sierra Leone, but the transit camps in Conakry has seen large influxes of Sierra Leonean refugees wanting to be repatriated by boat to Sierra Leone. Latest figures indicate that there are some 5,598 people in the camps awaiting repatriation with more arriving every day (WFP 06/04/01).
Overall
The humanitarian situation for refugees and for the large number of newly displaced people, has deteriorated markedly since September of 2000. Of particular concern is the current hostility being shown to refugees within Guinea which affects the support they receive from neighbouring host communities. Refugees should be considered at moderate to high risk of malnutrition (Category II).
Recommendations
· Complete the relocation of refugees from the insecure border areas of the south east.· Monitor the nutrition and food security situation of both the displaced and refugee populations.
The spread of the sub regional violence to Guinea, from both Liberia and Sierra Leone, has forced the repatriation of Liberian refugees and it is feared that the further mass return of refugees would generate huge problems in a country already stretched to capacity. There are currently estimated to be a combined total of some 460,000 Sierra Leonean refugees (80,000) and Liberian returnees (360,000) in the country with many being in the volatile Lofa county. The intensification of fighting in the area has rendered it largely inaccessible to relief agencies. This makes the precise determination of numbers returning from the recently war torn south eastern zone of Guinea, extremely difficult (UNHCR 2001).
The UN is planning to implement sanctions against Liberia in response to the regime's continued funding of rebel insurgency movements in Sierra Leone and the illegal profits taken from illict diamond and timber extraction. Sanctions will be imposed on May 7th unless the Liberian government meets certain prerequisites and can prove that it has ceased illegal activities. The prerequisites include the expulsion of foreign rebel movements in the country and a cessation of funding and military support to rebel groups and the illicit trade in rough diamonds and illegal timber. With the absence of definitive proof that these criteria have been met, it would seem likely that the sanctions will be implemented. The effects of the sanctions on the populous and particularly the refugees and newly returned is difficult to predict (PANA 22/04/01).
Situation of returnees
Current estimates indicate up to 30,000 returnees over the past year. The majority of the country is safe but the area of Lofa county on the border with Sierra Leone remains extremely insecure and the scene of frequent fighting. The deteriorating situation in Guinea has also prompted the return of many but numbers remain extremely difficult to estimate. To date the RNIS has not received any new nutritional or food security data on the conditions of returnees in the country (UN 2001).
Refugees in Liberia
There are an estimated 80,000 Sierra Leonean refugees in Liberia and according to the government 5,000 have returned to Sierra Leone over the last year. About 35,000 remain in camps in Montserrado and Grand Cape Mount counties and another 45,000 are scattered throughout Lofa county with little or no access to humanitarian assistance. The political instability in Sierra Leone makes the prospect of return unlikely in the foreseeable future. The RNIS has received no new information on the nutritional and food security status of the refugees (UNHCR 2001).
Overall
There is no new information on the nutritional status of either refugees or newly returned. It is assumed that the situation remains uncritical for those currently in non insecure areas of the country. However those in the highly insecure areas of Lofa county, particularly those forced to flee insecurity in Guinea, should be assumed to have an elevated risk of malnutrition (category III).
Recommendations
· Advocate for increased humanitarian access to the insecure regions of Lofa county.· Continue to monitor the situation of refugees and the newly returned particularly those in Lofa county.
The past year has seen big changes in both the political and humanitarian contexts in Sierra Leone and the region at large. In May 2000 there was a breakdown of the Lomé Peace Agreement after the attack and detention of hundreds of UN peacekeepers by the Revolutionary United Front (RUF). This sparked a dramatic deterioration in the security situation in the country that displaced thousands of people and resulted in the evacuation of many international aid agencies and the temporary suspension of humanitarian activities. The spread of conflict to the south eastern forest area of Guinea, has resulted in the return of tens of thousands of Sierra Leonean refugees who had been staying in camps there (UN 2001).
Since the end of last year the security situation in Sierra Leone has been relatively calm with signs that rebels were seeking to re-enter the peace process and in November a new cease fire agreement was signed between the government of Sierra Leone and the RUF rebels. This has been accompanied by a more welcoming attitude by the rebels to humanitarian assistance with the RUF agreeing to allow humanitarian agencies to operate unhindered in RUF held areas of the country. However, some areas, particularly in the north and east of the country, remain humanitarian 'no go' zones. The insecurity in the north has continued to resulted in the unequal distribution of aid (UN2001).
Displaced populations
The insecurity in many areas and the fast changing situation make the estimation of numbers of internally displaced extremely difficult, but at the end of 2000 there were approximately 400,000 registered IDPs in the country with over 50 % of them newly displaced since May 2000. The critical developments on the Sierra Leone-Guinea border have prompted an armed response from Guinean security forces who have shelled Sierra Leonean territory in an attempt to prevent incursions from rebel groups. This has resulted in large-scale population displacement from the affected areas that have dramatically added to the IDP caseload. Original projections by WFP were for a caseload of 520,000 in 2001 and this has already risen to 544,050 which has major resourcing implications. There are 170,000 people in eighteen official camps in safe and accessible areas. The UN also estimates that there could be as many as a million more internally displaced, who have been absorbed by host communities. This means a current total of about 1.5 million people. Women and children make up to 70 % of the displaced caseload (NRC 2001; UN 2001; WFP 16/03/01).
The vast majority of the registered IDPs have sought refuge in the Tonkilili District (including Mile 91) and the Port Loko District (including the Lungi area). Other areas of concentration remain urban areas such as Freetown, Kenema and Bo that offer some protection from rebel attack. A registration of IDPs in Lungi has indicated 28,000 people who had fled areas in Kambia as a result of the conflict on the border with Guinea (NRC 2001; WFP 09/03/01).
In an attempt to relieve the pressure on camps, a National Resettlement Day was launched on March 20th. IDPs and returnees volunteering for resettlement will receive a two months food ration, but inertia to the idea is very great due to a perceived lack of infrastructure in the areas concerned. WFP reported that 30,921 people in the Western Area and 12,458 people in Port Loko have currently registered for resettlement but it is unclear how many will actually follow it up (WFP 30/03/01).
Returnees
The outbreak of violence in the south eastern Forest Region of Guinea is a new development in an already tense regional situation, which has created an acute humanitarian emergency for thousands of Sierra Leonean refugees. However, the development of fighting within Guinea has resulted in considerable hostility towards the refugees, by both the Guinean authorities and the general population. This has resulted in the return of an estimated 50,000 to 60,000 refugees to Sierra Leone since fighting broke out in September. It is suggested that between 2,000 and 2,500 refugees are returning to Sierra Leone each week (NRC 2001; UN 2001 UNICEF 31/03/01; USAID 20/04/01).
Total numbers of returnees are difficult to follow because some are choosing sea routes from Conakry aided by the UNHCR and the International Organisation for Migration (IOM) whilst others have made their own way across the borders of both Liberia and Guinea and have not been officially registered. The IOM report that they have transported 22,000 returnees from Guinea since January this year. The situation for many remains critical as they find themselves unable to return to their areas of origin. Many come from areas such as Kambia, Kono and Kailahun which remain highly insecure. As a result returnees find themselves in vastly overcrowded camps or staying with host communities who are themselves experiencing great difficulties, and who can ill afford the added burden of a sharp population increase. (IOM 24/04/01; NRC 2001).
Northern Province
The Northern province is the site of much of the present insecurity with ongoing conflict between rebel groups and the Guinean security forces. This has greatly restricted access to areas within the province and it is assumed that the situation for many in outlying areas remains critical. Insecurity in Kambia district continues to displace large amounts of the population. Due to insecurity the RNIS has not received any nutritional information from the majority of areas (NRC 2001).
Port Loko
ACF conducted two nutrition surveys in the Port Loko area in December 2000. The first was in the town itself and the second in the camp (see table of results below).
The prevalence of malnutrition in the town and camp are similar and not unduly elevated, however mortality rates are alarming. The main causes of mortality are ARI, malaria and measles, while malnutrition also contributes to these high death rates (ACF 12/00).
The results corroborate the general impression of poor sanitation, overcrowding and lack of access to health facilities in the country. There have been considerable further displacements since December and it is likely that there has been a deterioration in the nutritional status of the populations. The authors of the survey stress that the results cannot be extrapolated to the area at large and indicate that much of the area to the north and east remains inaccessible due to insecurity (ACF 12/00).
Table of results for ACF surveys in Port Loko town and camp (December 2000)
|
|
Port Loko town |
Port Loko camp |
|
Acute malnutrition(<-2 z scores) |
3.8 % |
3.7 % |
|
Severe malnutrition (<-3 z scores and/or oedema |
0.3 % |
0.9 % |
|
Crude Mortality Rate |
1/10,000/day |
1.3/10,000/day |
|
Under five Mortality Rate |
3.1/10,000/day |
4.1/10,000/day |
|
Measles vaccination coverage* |
76% |
48% |
* Determined from vaccination card and mother/carer reportWestern Province
The security in the Western Province remains fairly stable with deployment of UNMASIL troops. The Freetown and Lungi peninsula continues to receive large influxes of both IDPs and returnees. There are currently about 30,000 IDPs in Lungi as a result of fighting in Kambia and the influx of returnees from Guinea continues.
In February 2001 ACF conducted post distribution monitoring in the displaced camps in Freetown to look at the reliance on food aid and to assess the livelihood strategies of the displaced populations. The survey indicated that the middle and better off families which represent 50 % of the total camp population, do not rely on food aid but use it as an additional source of income. The remaining poor households do have a stronger reliance on food assistance and are often forced to borrow from the richer groups. The loaned food is paid back in kind or with money and this forces poorer households into a vicious cycle of borrowing and repaying debts that prevents them from being able to use food aid for their sole consumption (ACF 02/01).
There is no new nutritional information for this area but given the stable security and the access to humanitarian aid, it is assumed that the situation remains fairly stable.
Southern and Eastern Provinces
The southern Province has remained relatively free of fighting since the latest outbreak of violence and the same goes for the Eastern province although areas bordering Liberia can be assumed less secure. An estimated 12,500 people have arrived by foot in Daru in the south east, after fleeing Guinea and Sierra Leone and the rebels have reported the presence of 4,500 Liberian refugees in Kailihun (IRIN-WA 25/04/01).
Bo District
ACF conducted a nutritional survey in Bo district in November 2000. 2.1 % of the sample were internally displaced and 0.2 % were returnees. The survey found and estimated a prevalence of malnutrition of 3.8 % (<-2 z score) including 0.9 % severe malnutrition (<-3 z scores and/or oedema).
The Crude mortality rate was estimated as 1.1/10,000/day and the under five mortality as 5.9/10,000/day. The vaccination coverage for measles was estimated as 83.4 %, but only 39.7 % were confirmed with a card. Whilst the malnutrition rates appear acceptable, the mortality rates are extremely high. Malnutrition is again given as one of the main causes of mortality, along with, ARI, malaria, and diarrhoea.
Kenema
Merlin has conducted a series of nutrition surveys over the past year in the towns of Kenema and Blama and their surrounding camps. The RNIS has only seen summary reports, which indicate a low prevalence of malnutrition in both July 2000 and January 2001. In July, the prevalence was 3.7% in Kenema town and 2.2 in the camp. In January 2001, this remained stable at 3.8 and 1.2 respectively (Merlin 08/00).
The mortality rate in January 2001, was estimated at between 1 and 2/10,000/day. The surveys indicated a good improvement in the rates of vaccination coverage in the area (Merlin 08/00).
Overall
The humanitarian situation in Sierra Leone is extremely poor. The upsurge in insecurity continues to displace the general population and strongly effects general food security. Whilst available information on nutritional status of displaced does not indicate an alarming situation, mortality rates do indicate a health crisis (category II). All surveys presented have been from relatively secure areas and there must be grave concern for the populations currently inaccessible to humanitarian aid. No information exists for those currently inaccessible but they are considered at high nutritional risk (category V).
Recommendations
· Negotiate critical humanitarian access to populations in currently insecure areas.· Carry out more in depth investigations on the causes of high under five mortality.
· Closely monitor the health situation of the population with particular emphasis of populations in camps.
· Increase vaccination coverage in all areas.
· Livelihood activities should be strengthened to enable poor households to break the cycle of borrowing and repayment of food aid.
