GREAT LAKES REGION

Burundi
Rwanda
Republic of Congo (RoC)
Democratic Republic of the Congo (DRC)
United Republic of Tanzania
Uganda

GREAT LAKES REGION (updated by ReliefWeb 7.6.96)

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Burundi

The Arusha peace talks, which started in June 1998, resulted in the signing of a peace agreement between 19 parties of on the 28^th August 2000. However, several armed rebel groups were opposed to the peace negotiations and did not sign the agreement. These groups increased their attacks during the peace negotiations. They continue to fight government forces creating widespread insecurity in many areas of the country. The most recent round of heavy fighting started on the 25^th of February 2001 in around Bujumbura. The fighting resulted in the displacement of around 50,000 people from the suburbs of Kinama, Cibitoke and Kamenge to areas in the Bujumbura rural around the capital. Many of these displaced have subsequently been able to return but have found all of their property looted. Insecurity in the country continues with the most affected areas being Makamba, Bujumbura Rural, Rutana, Ruygi and Bururi province (NRC 00;WFP 16/03/01; UNHCR 02/05/01).

The last year has seen a number of important developments in population displacement in Burundi and current estimates of numbers indicate that there are 379,000 IDPs in the country. This represents a considerable drop in numbers from July 2000 when there was an estimated 670,000 IDPs. The reason for the drop in numbers has been the government dismantling of the regroupment camps in Bujumbura Rural in July 2000. Other areas with large numbers of IDPs are Makamba, Bururi and Rutana Provinces (NRC 00; UN 01; UNHCR 02/05/01).

Estimated Numbers of refugees, IDPs and returnees in the Great Lakes Region

	Jun-99	Sept-99	Dec-99	Mar-2000	July-2000	May-2001
Burundi	451,000	617,000	821,000	830,000	670,000	379,000
Rwanda	640,000	673,000	650,000	652,000	69,000	38,000
RoC	213,000	343,000	823,000	438,000	233,000	112,500
DRC	952,000	1,104,000	1,185,000	1,418,000	1,759,500	2,334,500
Tanzania	373,000	373,000	400,000	465,000	440,000	528,000
Total	2,629,000	3,110,000	3,880,000	3,803,000	3,171,500	3,392,000

Food Security Situation

The continued insecurity in areas such as Bujumbura rural, Gitega and Ruyigi provinces has had an adverse impact on the food security of the affected populations. Insecurity prevents farmers from accessing their land and helps to explain worrying new cropping trends. Farmers are switching from the traditional legume and cereal crops to less labour demanding, but less nutrition-ally valuable root crops. The food security situation has been further hampered by severe drought that has particularly affected the northern region of the country for the past three years (UN 2001; FAO 04/01).

Both season A and season B harvests were poor during 2000, however FAO reports that the recently harvested season A harvest in 2001 is satisfactory. A locally organised FAO/WFP/UNICEF Assessment Mission estimated food production from the season A 2001 harvest to be systematically higher than season A 2000. The area planted increased significantly during the season A 2001 season reflecting relatively better security in the west (particularly in the provinces of Bubanza and Cibitoke) and the closure of regroupment camps in Bujumbura Rural Province, allowing farmers to return to their fields. The other factor which contributed to higher plantings this season was the timely seed distribution by the Government and international agencies, mainly in Kirundo and Muyinga provinces, the areas worst affected by drought during the 2000 A season (FAO/GIEWS 04/01).

Despite a late start of the rainy season, precipitation was abundant and well distributed from October to November benefiting crop development. However, excessive rains in parts resulted in floods and crop losses and, in general, reduced yields, particularly for beans. Yields of bananas and plantains are expected to increase only from March/April as trees were seriously affected by previous prolonged dry weather. The small 2000 C season harvest in the marshlands, from mid-June to September, was poor reflecting the dry weather in previous months. Food output was estimated to be 4% below the level of the 1999 C season (FAO/GIEWS 04/01).

Food insecurity has been further undermined by a very serious malaria epidemic which saw more than 3 million cases reported in the latter half of 2000. The epidemic was particularly bad in the northern provinces and Karusi (UN 2001; WFP 20/02/01).

Bujumbura Rural

IDP numbers in the Bujumbura Rural area have dropped from 200,008 in June 2000+0 30,889 in November as a result of the dismantling of regroupment camps. The "dispersed" populations have scattered into the surrounding areas, where insecurity hampers their attempts to cope and makes humanitarian access extremely difficult. The IDPs remain as vulnerable as before and represent a priority for future humanitarian action. The RNIS has no new nutritional information on the IDP population in this area (NRC 2001).

Karusi

Provinces in northern Burundi are suffering from three consecutive years of drought and crop disease. Karusi, although badly affected by the drought, has received a lot of people from surrounding provinces such as Ngozi, who have suffered worse drought effects and are less served by humanitarian assistance. Much of the influx to Karusi is a result of the perception that conditions are slightly better in the Province (NRC 2001).

In August 2000 MSF-B raised concerns over increases in attendance at their feeding centres and a WFP rapid assessment recommended the provision of rations to families with children enrolled in feeding programmes. In October and November there was a severe outbreak of malaria where more than 75 % of admissions to health centres tested positive to malaria (MSF-B 11/00).

MSF-B conducted a nutritional survey in November 2000, and March 2001. In November 2000, the prevalence of acute malnutrition was estimated as 23.7 % (<-2 Z scores), severe malnutrition 14.4 % (<-3 Z scores), while 13.3 % had oedema. The CMR in the 76 days prior to the survey was recorded as 0.9/10,000/day and the under five mortality as 3.1/10,000/day. The cover- age of nutritional programmes was 17.7 % and 48 % of children had a card showing they had been vaccinated against measles (with a further 36 % claimed they had been vaccinated but unable to provide a card) (MSF-B 11/00).

The survey report does not explain the causes of malnutrition, apart from the malaria epidemic. However, the poor season B harvest, and the influx of displaced almost certainly contributed to this situation. In addition, in November 2000, there was no general food distribution in Karusi. The high prevalence of oedematous malnutrition, although not unknown in this population, is particularly alarming.

The survey in March 2001 showed a prevalence of acute malnutrition of 13.4 %, with 2.5 % of severe malnutrition. Oedema was reported in 1.2 % of the population. CMR in the five months prior to the survey was estimated at 1.2/10,000/day and the under five mortality rate at 3.2/10.000/day. The coverage of the feeding programmes had improved slightly to 27%. A total of 38% of children could provide a card showing positive measles vaccination status. A further 44.3 % claimed they had received measles vaccination (MSF-B 03/01).

This appears to indicate an improvement in the nutritional situation. However, RNIS is concerned that the drop in the prevalence of malnutrition is mainly due to a decrease in the severely malnourished. Given the low coverage of the feeding programmes, and the high under five mortality, the apparent improvement in the nutritional situation could be due to high death rates amongst the severely malnourished (MSF-B 03/01).

The MSF-B nutritional survey report also describes a survey conducted in Ngozi Province in February 2001 which showed an estimated prevalence of acute malnutrition of 17.8 %, 4.1 % were severely malnourished. This province has been one of the worst affected by drought, epidemics and insecurity over the course of 2000 (MSF 11/00). The situation in Karusi and the northern provinces remains very worrying with high rates of malnutrition and increasing numbers of admissions to selective feeding programmes. MSF reported on the 11^th of January that they had 16,700 people in supplementary feeding programmes which was ten times higher than the number in January 1999. In March this figure had risen to 22,000 people. The majority of these beneficiaries are children and adolescents but there are also significant problems amongst the adult population. The situation needs to be very carefully monitored.

Acute and severe malnutrition in Karusi and Ngozi provinces

Bubanza Province

Bubanza has been particularly badly affected by unrest in Burundi and until the disbanding of the regroupment camps in June 2000, had one of the largest populations of IDPs in Burundi. However, the past year has seen large reductions with numbers falling from 117,440 in June 2000 to 14,588 in November 2000. The RNIS has not received any new information on nutrition but the last survey done showed falling rates of malnutrition.

Kirundo Province

Kirundo is in the far north east of Burundi, bordering Rwanda to the north, Muyinga to the east and Ngozi to the south west. The population is estimated to be 500,000 people with 5000 being displaced. The province has suffered from four successive years of drought and there are signs that people have begun to change their eating habits. ACF conducted a nutrition survey in September 2000 and showed an estimated prevalence of acute malnutrition of 6.8 %, while 1.2 % were severely malnourished. The CMR was estimated as 0.4/10,000/day and the under five mortality as 4.35/10,000/day calculated retrospectively over the past month. The measles vaccination coverage estimated from vaccination cards was 38 % with a further 47 % claiming a positive vaccination status. The survey does not show alarming rates of malnutrition but the poor food security situation and access to health facilities mean that the situation should be monitored very carefully (ACF 09/00).

Overall

The nutritional situation in Burundi has deteriorated over the last year. This is a result of continued insecurity, successive poor harvests and a high burden of disease. A severe malaria epidemic developed over the latter half of 2000. Areas in the north of the country have been particularly badly affected. Overall, the prevalence of malnutrition in affected communities appears to have improved, but importantly, the under five mortality is alarmingly high. With the current situation IDPs should be regarded as highly vulnerable (category II). Particular note should be taken of the fact that very little information is available from the southern areas of the country due to the prevailing insecurity. However, it is likely that needs in this area remain very high and the overall situation needs very close monitoring.

Recommendations

· Closely monitor the development of nutritional status of affected populations.

· Try to assure humanitarian access to affected populations in currently inaccessible areas of the country.

· General food distribution should be established as quickly as possible to ensure that the nutritional situation does not deteriorate

· Seed and seed protection ration distributions should further cover the upcoming harvest periods.

· The coverage of feeding programmes needs to be improved.

· The causes of oedema should be determined.

· Measures should be taken for the prevention/preparedness of future malaria epidemics.

· There is a need for a widescale measles vaccination campaign.

· Conduct a study of health and sanitation problems in the region and how the coverage might best be improved.

· Evaluate the impact of the food distribution and food security programmes.

· Improve access to drinking water for the general population of Kirundo.

Rwanda

Rwanda has remained relatively stable with insurgency and insecurity no longer posing major obstacles to the provision of assistance. However, the highly volatile situation in eastern DRC is a threat to border security, and the perceived stability of the country could well result in an increase in the number of refugees from countries such as Burundi (FAO 04/01; UN 2001; WFP 20/12/00)

An OCHA report on Rwanda (covering 2000) states that "a few pockets of humanitarian needs remain in Rwanda". As a result of the stability of current situation IDPs are categorised as those who recently displaced as a result of crisis. Current numbers of displaced as of the end of 2000, following OCHA's categories, are 7,780 people. 2,480 of these are recently displaced from the Gishwati forest to Gisenyi due to security and environmental reasons and the remaining 5,300 have been displaced to Kibungo and Ruhengeri as a result of severe drought. There are also an estimated 30,000 refugees and 375,000 other drought affected people. As reported in RNIS 31 the government of Rwanda has been following a policy of "villagisation" where people formerly considered displaced have been relocated to created villages or "imidugu". This has resulted in a decrease in the numbers of displaced in the country as some 370,000 people previously registered as displaced are no longer considered to be internally displaced (OCHA 09/00, UNHCR 2001).

Refugees and returnees

Currently there are 33,500 registered refugees in Rwanda. The majority (30,000) are from eastern DRC from the Masisi and Rutshuru regions of north Kivu. They are accommodated in two camps, the Kibiza camp in Kibuye Prefecture and the Gihembe camp in Byumba Prefecture. Groups of refugees have been returning to Eastern DRC to North Kivu despite the insecurity there. OCHA reports that returning refugees have cited insufficient food rations as a major reason for concern and are hoping to survive on humanitarian aid on there return (OCHA 09/00). The refugees remain highly dependent on food aid as there is little opportunity for income generation and land availability remains very low. There are also 500 Burundian refugees in Kigeme camp in Gikongoro Prefecture and a case load of urban refugees in Kigali (UNHCR 2000).

During 2000, 24,599 Rwandan returnees arrived from DRC, passing through the transit centres of Nkamira in Gisenyi Prefecture and Nyagatare in Cyangugu Prefecture. The returnees are given a three month resettlement package. The RNIS does not have any new nutritional information on these refugees (WFP 09/02/01).

Food Security

Rwanda has suffered from recurrent drought that has resulted in crop losses and some displacement from affected areas such as the Bugesera region. OCHA reports on a food security assessment conducted in August 2000 which indicated that the season 2000 B harvest (January-May 2000) had been affected by insufficient rains which had severely affected the Prefectures of Kigali Rural, Gitarama and Kibungo. The severity of the drought necessitated an emergency intervention and food distributions began in November to the worst affected prefectures of Kibungo, Umutara, Kigali Rural, Butare and (Gitarama. (OCHA 09/00).

Preliminary indications are that food output of the recently harvested 2001 A season crop is at around or slightly lower than the good level of last year. Despite a delay to the start of the rainy season, precipitation was abundant and well distributed from mid-October to December. Although excessive rains in November resulted in floods and crop losses in parts, mainly in Gisenyi and Butare Prefectures, they generally benefited plantings and yields, particularly of cereals and pulses. Production of roots, tubers, banana and plantains was less satisfactory reflecting shortages of planting material and prolonged dry weather. Also, despite the overall positive picture, a poor harvest was gathered in the Bugesera region of Kigali Rural Province, due to seed shortages following successive reduced crops (FAO/GIEWS 04/01).

The tight food supply situation has eased with the new harvest. Prices of maize, beans and Irish potatoes have decreased from their levels of a year ago. However, despite the overall improvement in the food situation, emergency food assistance is anticipated to be needed until the next harvest for people in the Bugesera region, particularly in Kanzenze and Gashora districts (FAO/GIEWS 04/01).

The government has also closed a number of cattle markets in eight provinces affected by an outbreak of foot and mouth disease. The measures have deprived various populations of the income from cattle sales and the associated labour (WFP 01/01; WFP 01-03/01).

Overall

There is no recent information on the nutritional status of the displaced and newly resettled. However, areas of the country have suffered drought and the population at large remains extremely vulnerable and food insecure. Those currently displaced, including those newly resettled should be viewed as remaining at moderate risk of malnutrition (category III). The nutritional status of the refugees is not critical (category IV).

Recommendations

· Gather information on the nutritional and food security situation of displaced and refugees in Rwanda.

Republic of Congo (RoC)

The Republic of Congo has suffered heavily from a series of resurgent civil conflicts in the last six years that have forced hundreds of thousands of people from their homes. RNIS 31 reported that the nutritional situation has stabilized and the outlook for the future is guardedly optimistic as the fighting of the 90s appears to be at and end with the signing of a cease fire agreement on the 29^th of December 1999 (UN 2001; UNHCR 2000).

Considerable headway has been made on the road to a lasting peace settlement with broad based discussions. The first phase talks were boycotted by internal and external opposition figures who protested the agenda and the lack of security assurances afforded to them. The talks were lead by the Gabonese president and mediator Omar Bongo. Talks were designed to begin to address the subject of a draft constitution for the country which would mandate a president of the Republic to be elected for a seven year mandate, renewable only once. The draft constitution will be reviewed by referendum at the end of the year. Opposition leaders have criticised the large amount of power given to the president by the proposed constitution and have suggested the creation of two vice presidential positions (PANA 26/03/01).

Humanitarian situation

The humanitarian focus for the first part of the year 2000 was on the provision of emergency assistance to newly accessible areas but this quickly changed to the facilitation of resettlement and to the building of schools, health clinics and other basic services. One of the most positive signs has been the beginnings of demobilisation of the estimated 25,000 ex-combatants with an amnesty on small arms. To date over 16,000 small arms have been handed over, however, it is assumed that a great many probably remain in circulation (UN 2001).

Refugees

The continuation of the war in the Democratic Republic of Congo has resulted in an influx of 100,000 refugees coming over the border to RoC. Latest figures put the number of refugees at over 100,000 and they are currently spread out along a 700 km stretch of the Congo and Ubangui rivers from Bentou in the north to Njoundou and Liranga in the south. They have arrived over the past six months. This is a militarised area and access continues to be problematic. No new information is available on the nutritional status of these refugees. Should the situation in DRC deteriorate further then significant extra numbers of new refugees can be expected. The needs of the Angolan refugee population has greatly reduced over the past year as many have been integrated into local villages (UN 2001; UNHCR 2000).

Table showing numbers of assisted and non assisted refugees in RoC (UNHCR 31/03/01)

Caseload	Assisted	Non-assisted	Total
Congolese	30,000	57,200	87,200
Angolans	3,575	14,940	18,515
Rwandans/Burundians	3,485	3,370	6,855
Total	37,060	75,510	112,570

Overall

The general humanitarian situation, has stabilised over the past year. The majority of the displaced have returned home. The country remains extremely debilitated by previous conflict and much of the future work will involve the rebuilding of infrastructure. A process of establishing a constitution is currently underway, although not all potential actors are involved, which may mean more conflict in the future. The most acute needs in the country are along the border with DRC where refugees remain strung out in insecure zones and access remains problematic. Given the lack of access and insecurity, refugees should be considered to be category II.

Recommendations

· Support inter-Congolese dialogue and encourage the involvement of all opposition leaders.

· Improve access to refugees from DRC along insecure border areas.

· Support UNHCR in relocating the refugees to a safe and accessible area.

Democratic Republic of the Congo (DRC)

The past year has seen more violence in DRC. The conflict is a labyrinth of political alliances between no less than six nations and as many as ten local militia movements. On one side there are Angolan, Namibian and Zimbabwean soldiers allied with government troops controlled from Kinshasa. On the other side is a tenuous alliance between Rwandan and Ugandan troops that supports various fighters opposed to the Kinshasa regime (STRATFOR 17/04/01).

The most significant event of the past year has been the assassination of President Laurent Kabila on the 16^th of January 2001. Kabila was replaced by his son Joseph Kabila and in the months since he has taken office he has made moves to implement the stalled Lusaka Peace Agreement, first signed in August 1999. This opens up the possibility of a resolution to the conflicts currently being fought in DRC which would have important effects on the humanitarian context. Joseph Kabila has invited Ketumile Masire, the former president of Botswana, to mediate among Congolese factions (IRIN CEA 19/01/01).

The past months have also seen the beginnings of a disengagement of the armed forces of Angola, Namibia and Zimbabwe from DRC on March 29^th. This marks the first part in a four stage timetable for foreign forces to withdraw from the DRC by August 19^th. The March 29^th date coincided with the deployment of a UN mission (MONUC) to act as observers for the continued implementation of the peace accords. (STRATFOR 17/04/01; NRC 2001).

The progress in implementing the peace agreement marks the first real step towards ending the country’s three year war. The implications of the peace agreement, the deployment of MONUC troops and the disengagement of foreign armed forces on the humanitarian situation are huge. One of the major problems facing humanitarian interventions in DRC has been access to people in insecure areas and it has been very difficult to estimate the numbers of people affected as so many have hidden themselves in the jungle. As MONUC troops deploy in new areas, it is expected that more and more people will come out of hiding to seek assistance. On the 8^th of May WFP issued a warning that a very significant humanitarian crisis is unfolding, citing northern Katanga province where MONUC troops have already deployed, as an area where people are already beginning to emerge from years of isolation and poor living conditions in the forest. Similar trends are being seen in north and south Kivu as agencies continue to gain access to previously cutoff areas and are finding populations in very poor conditions (WFP 11/05/01).

Numbers and distribution of IDPs

Conflict related displacement has continued to increase from 750,000 at the beginning of 2000, to 1.4 million in June 2000 rising to 2,002,500 by the end of 2000. This is despite the return of an estimated 810,000 former IDPs to their place of origin (UN OCHA 17/04/00).

Table showing distribution of IDPs by province (July 99, June 200, December 2000)

Area	July 99	June 2000	Dec 2000
Equateur	100,000	250,000	300,000
Orientale	70,000	215,000	160,000
North Kivu	160,000	287,000	640,000
South Kivu	195,000	220,000	350,000
Katanga	150,000	250,000	305,000
Maniema	20,000	110,000	137,000
Easter Kasai	60,000	30,000	30,000
Western Kasai		140,000	80,000
Total	775,000	1,502,000	2,002,500

(UN OCHA 31/12/00)

The UN estimates that about 16 million people, or 33 % of the population, face chronic and acute food insecurity as fighting and insecurity continue in many areas of the DRC, particularly in the east of the country in provinces such as north and south Kivu, Equatoria and Orientale. The insecurity has seen large population displacement to forest areas which provide comparative safety but have seen people living in very bad conditions without medicines, safe water or systematic food supplies. The scale of the displacement and the lack of access has largely masked the extent of the crisis and it is highly likely that as access increases the humanitarian situation will appear to worsen as many isolated populations emerge to access assistance (UN 2001).

RNIS 31 reported on a series of mortality surveys conducted by the IRC that showed alarmingly high levels of both crude and under five mortality. The survey was released in May 2000. The IRC have conducted another series of surveys in eastern DRC, along with one in the rebel held area of Kasai Orientale Province As in the previous surveys the recall period was 16 months and the RNIS has converted mortality rates from deaths/1000/month to deaths/10,000/day for easy comparison with other mortality data reported (IRC 05/01).

The table of results shows extremely high mortality figures for populations in the eastern DRC, all of which are above emergency cut-offs for crisis situations. The surveys confirm the general findings of the first report that death rates remain alarmingly high and that the highest rates of mortality are seen in the under five population. The high rates of under five mortality are seen very forcibly in the far fewer young children seen relative to older children and other age groups. In Katana where the IRC has been surveying over the past three years there has been a systematic drop in the percentage of under five children in the population (IRC 05/01).

Results of the mortality studies in eastern DRC

Location	Province	Sample Size	CMR	Under 5 mortality
Kalamie	Katanga	2204	3.6/10,000/day	7.9/10,000/day
Kalima	Maniema	1958	2.5/10,000/day	5.7/10,000/day
Katana	South Kivu	1802	1.6/10,000/day	4.3/10,000/day
Kabare	South Kivu	1778	1.5/10,000/day	1.8/10,000/day
Lubunga	Orientale	2317	0.9/10,000/day	2.3/10,000/day

Cause of death varied but it is clear that violence remains a major cause in all survey sites and there appears to be a correlation between areas with more violence and areas with higher death rates from non violent causes such as infectious diseases and malnutrition. In other words, areas with increased violence also suffered from increased general mortality from all causes. For example violence was the major reported cause of death in Kalamie in Katanga province where the highest CMR and under five mortality were recorded. Equally only 59% of people were accessible to the survey in Kalima, the second highest observed rates, due to insecurity between Mayi-Mayi and RCD soldiers (IRC 05/01).

The survey also emphasises the high rates of under five mortality and stresses that not only do the rates indicate a severe public health crisis but these rates appear to have been experienced for years. A continuous under five mortality of over 3/10,000/day means that 60% of children die before their fifth birthday. In the Kalamie survey it was estimated that 38% of children in their second year of life died during the recall period. The survey points out that if these conditions have existed for the last two years, 75% of children born two years ago have died (IRC 05/01).

From the total number of households surveyed from eastern DRC, the results represent the mortality experience of 1.27 million people. Despite reservations expressed by the authors, the reported mortality rates were extrapolated to the 19.9 million people in eastern DRC to estimate the number of excess deaths in the whole of the area since the outbreak of the recent fighting. The survey estimates that 2.5 million deaths in excess of the million people who might have been expected to die, have occurred. The survey acknowledges the difficulties of extrapolation and attempts to look at the effect of worst and best case scenarios have on the final outcomes and concludes that in all scenarios the amounts are over 2 million (IRC 05/01).

Nutrition situation

The effects of the war, particularly in eastern DRC in areas such as north and south Kivu, Maniema, Kantanga and Orientale, have resulted in a steady deterioration of the nutritional situation. Further areas of poor nutritional status are very likely to become apparent as access to hitherto inaccessible areas improves.

Kinshasa

There is no new information on the nutritional situation of the population in Kinshasa but a news report from PANA on May 14^th indicates a high burden of disease with 138,350 cases of malaria reported in the first quarter of the year with outbreaks of typhoid and bacillary dysentry also reported. Measles is also on the increase despite vaccinations (PANA 14/05/01).

Orientale

The latest estimates from the end of 2000 indicate that there are 160,000 IDPs in Orientale Province along with 71,000 Sudanese and 12,980 Ugandan refugees. Fighting has continued in the province with clashes between Ugandan and Rwandan troops in June 2000, which caused substantial displacement from Kisangani. IRIN reports wide scale displacement, price rises and a general decline in purchasing power Orientale, particularly in urban centres such as Kabinda and Mbuji-Mayi (IRIN CEA 16/02/01; NRC 2001).

Ituri district

Ituri district has been the scene of repeated, violent clashes that have led to large scale displacement and the systematic targeting of civilian populations, including the destruction of food crops. The clashes are largely a result of ethnic fighting between the Lendu and Hema tribes in the area and 2001 has seen the continuation of conflict in the area. This has led to acute food insecurity with an estimated 140,000 people affected around Bunia and the surrounding area. The area has been opening up in recent months as a result of a general country wide commitement to the peace process and increasing humanitarian access. However, on April 27^th six Red Cross workers were killed whilst on a routine mission and as a result 20 aid agencies working in eastern DRC suspended humanitarian activities from the 30^th April to the 2^nd of May. The attack illustrates the dangers and unpredictability of the situation in the area (AFP 27/04/01; WFP 30/03/01; 11/05/01).

Kisangani

RNIS 31 reported intense fighting in June 2000 between Ugandan and Rwandan forces in the town of Kisangani, causing widespread destruction and displacement. Kabila’s commitment to the peace process has seen the withdrawal of foreign troops from the town and the entry of MONUC peace keepers on the 20^th of April 2001. The deployment of the Moroccan troops was initially blocked by rebel forces hostile to the peace keepers but was eventually agreed upon after some delay (UNDPI 18/04/01).

In August 2000, MSF-H conducted a nutrition survey in Kisangani town. The prevalence of acute malnutrition of 8.5 % including 3.5 % of severe malnutrition. The relatively low prevalence of malnutrition is not explained in the report. The prevalence is similar to that found in November 1999, when MSF found 9.2% and 5.2% respectively. Whilst the prevalence of severe malnutrition has decreased, it remains high. At the same time, under five mortality has also decreased. In August 2000, the under five mortality was 1.04/10,000/day, and in November 1999, this was 2.95/10,000/day. The CMR was found to be 0.57/10,000/day and mortality was highest in the zones where fighting had been most intensive. MSF has been running supplementary and therapeutic feeding centres in the town, but unfortunately the coverage was not assessed by the survey (MSF-H 08/00).

MSF-H also conducted a nutritional survey in Aire de Sante Madula in August 2000. This is a rural area close to Kisangani, some 30 km to the southeast of the town. The area was badly affected by the fighting in June. People fled the town and many were forced to seek shelter in the jungle. The survey showed a prevalence of acute malnutrition of 6.9 %, including 3.9 % severe. The prevalence of malnutrition in August 2000, was significantly lower than in August 1999, when the prevalence was 13.2%, including 3.9% severe malnutrition. This reduction is not explained in the report. The CMR increased (from 0.84/10,000/day to 1.14/10,000/day), and under five mortality remained similar (1.55 and 1.61/10,000/day) over this period (MSF-H 08/00). The RNIS does not have any new nutritional information on this population.

North and South Kivu

Fighting has continued and even intensified in the Kivus over the past year and the numbers of IDPs have increased dramatically. UN estimates of displacement at the end of last year indicated that almost a million people were displaced within the two provinces as a direct result of continued conflict and insecurity. Many parts remain inaccessible as a result of the desperate security situation although recent deployments of MONUC troops in Goma on May 14^th have increased hopes that insecurity and access will lessen (UN 14/05/01).

North Kivu

In September 2000 there were reports that large numbers of IDPs were fleeing the Masisi area and were seeking refuge in Kanyabayonga, Kirumba and Kaynas. In November IRIN reported intimidation of the populations around Goma by Interahamwe militias in the area. The intimidation resulted in many people fleeing into the deep forest in an attempt to find safer afeas (IRIN 16/11/00). A WFP report from March this year indicates an improvement in the security situation in eastern DRC and particularly in the Kivus, which has resulted in a mass return home of displaced, and there are an estimated 137,000 people in need of seeds and tools to help with restarting agricultural activities (NRC 2001; WFP 31/03/01).

In June 2000 SCF-UK did a nutrition survey in the two health zones of Butembo and Katwa in north Kivu. The survey indicates an estimated prevalence of acute malnutrition of 14.5% with 12.6% of severe malnutrition, including 11.9% oedema. The survey does not record mortality rates but the rates of malnutrition are extremely high, particularly for oedematous malnutrition. The explanations given for the high rates of malnutrition include the fact that mothers are forced to travel great distances in order to be able to cultivate crops and this leaves them little time to devote to children and often means they fail to seek medical help when it is needed. The extremely high rate of oedematous malnutrition is not unknown in the great lakes region and is described as being a result of two extremely poor harvest seasons due to drought that has greatly reduced the amount of available food and has impacted heavily of basic livelihood activities. The effects of the continuing conflict resulting in poor access to cultivatable land is highlighted as one of the main causes of the malnutrition (SCF-UK 06/00).

MUAC screenings in November/December show that the nutritional situation around Goma has remained poor. The survey results for the area, taken as a whole are alarming and are another indication of the severity of the crisis in eastern DRC.

South Kivu

South Kivu continues to be highly insecure with escalations in the fighting between various militia groups such as the Interahamwe, Mai-Mai, FDD and the RDC. The fighting continues to force tens of thousands of people from their homes into the forest to live in appalling conditions. Insecurity in the area has increased for humanitarian agencies and AAH-USA report an increase of security incidents in the area over the first part of 2000. Vast areas continue to remain inaccessible to agencies, making a thorough assessment of the situation extremely difficult. However, it is hoped that the deployment of peace keepers in the area and reduced rebel activity as of March 2001 will increase access to some of the affected populations. AAH-USA report estimates that only 40 % of the village populations in accessible areas remain undisplaced. The displaced populations rely on host communities and on what little they were able to bring with them at the time of their displacement which is often very little (AAH-USA 08/00).

Some of the fiercest fighting has taken place in Shabunda and Mwenga where the number of displaced living in the forest is estimated to be in excess of 100,000. The situation in this area is described as desperate with no shelter, medical facilities and little to eat. There are reports of very high morbidities including endemic cholera. The ongoing fighting in the Shabunda area continues to displace people who have been fleeing towards the town of Kalima in the neighbouring Maniema province (AAH-USA 08/00; NRC 2001).

Maniema Province

Merlin conducted a nutrition survey in Kalima town on children 6-59 months in January 2001 and found an estimated prevalence of acute malnutrition of 14.1 % including 8.1 % severe malnutrition. The CMR was calculated retrospectively over the past three months and was estimated at 3/10,000/day with a under five mortality of 7.9/10,000/day. The anthropometric results suggest a very high level of severe malnutrition, much of which was oedematous. The mortality rates are alarmingly high and the authors caution that there may have been over reporting, but state that even if the rates are halved they still represent dangerously high levels. The high rates of mortality and malnutrition are very probably the result of the large influx of IDPs to the area and the resultant acute food insecurity of both the displaced and the resident population (Merlin 01/01). RNIS 31 reported am estimated 110,000 IDPs in the forest in Maniema. In addition, the town was experiencing a measles epidemic at the time of the survey, and there has been no emergency food distributions for either the displaced or the resident population (Merlin 01/01).

Katanga

On the 8^th of May 2001 WFP issued a statement that a humanitarian crisis was emerging in north Katanga province as a result of an influx of previously isolated displaced people arriving in towns seeking urgent assistance. The displaced have been encouraged to emerge from hiding as the security situation improves in the region where there condition is described as extremely grave. A recent assessment mission to Kiambi town in north Katanga is reported to have revealed very high rates of malnutrition and mortality (WFP 11/05/01). The RNIS does not have access to the report. WFP is making preparations to deliver 650 tons of food into the area. The lack of air capacity is proving critical and for the time being food is being pre-positioned in Kalemie. WFP also reports that it faces a major funding problem with only 30% of its operation currently funded (WFP 11/05/01).

The last UN estimate of numbers of displaced in Katanga indicates 305,000 people. The is an increase from the last RNIS report and is a result of both continued insecurity in the northern most regions of Katanga that continues to displace population and improving security situations in other areas that have brought ‘new’ IDPs out of the forest (WFP 11/05/01). Some the worst clashes in the province have been around the town of Pweto, which is reported to have tripled in size as a result of IDP influxes from more insecure areas. MSF-Belgium reports a desperate lack of medical care in the town. The insecurity has involved looting of harvest and seeds and there is great concern over the impact that this will have on food security in the area (WFP 23/02/01). There are also 51,576 Angolan and 9,600 Burundian refugees in Katanga province.

Refugees

The total refugee population of DRC is currently estimated to be 332,000 people.

WFP and UNHCR carried out an assessment of the food economy of refugees in Katanga, Bas-Congo and Bandundu in November 2000. In Katanga, there are a total of 51,587 refugees, but only those who arrived after 1998 receive assistance. This amounts to 27,672, who live in 3 sites. Refugees who arrived before 1998, are considered to be self sufficient in agriculture. In Bas Congo, the total number was 21,504, in 3 sites. The food security of refugees in Bas Congo was restricted because they do not have access to farmland, and their movement is limited by the local authorities. UNHCR has now obtained permission for refugees to farm, and has distributed seeds and tools. In Bandundu, the refugee population doubled during 2000. About 10,000 lived in three sites, and another 15,000 live with Congolese host families. Only the 10,000 living in camps receive assistance (WFP/HCR 11/00).

The general ration distribution to all refugees has been well below recommended levels throughout the year 2000. The energy content of the ration in Katanga was best from March to June 2000, with about 1600 kcals/person/day. From July to October 2000 the ration was around 1100 kcals/person/day. For most distributions, the ration consists of cereals only. In March oil was distributed, and in September and October pulses. Refugees supplement their ration with income from farm labour, sale of non-food items, kitchen gardens, and petty trade. WVI did a nutritional survey in Kisenge in April 2000 which showed 7.8% malnutrition, including 3.1% severe (WFP/HCR 11/00).

In Bas Congo, refugees usually received a ration of cereals, pulses, oil, salt and CSB. From August 2000, the refugees received half rations because of problems with the food pipeline. Between July and August, the energy content of the ration decreased from 2035 kcals/person/day to about 1000 kcals. The assessment found that in addition to the income earning activities in Katanga, many of the refugees in Bas Congo were found to be in debt.

UNHCR and local partners conducted three nutritional surveys in October 2000; the prevalence of malnutrition was low and ranged between 5.8% in Nkondo and 3.3% in Kimaza (WFP/HCR 11/00).

Food assistance to Bandundu has been very irregular, due to severe logistical and security problems. The food aid provided has been inadequate throughout 2000. There were no food distributions in May and June 2000. From July to October the energy content of the ration was between 350 and 870 kcals/person/day. In November 2000, 18,000 Angolans were reported to be at the border but decided to stay in the forest in Angola, rather than live in the poor conditions in the refugee camps in Bandundu. For the refugees, strategies for obtaining food and income are more desperate, and include illegal acts such as theft. Refugees in Bandundu were also reported to have no clothes, blankets or cooking utensils (WFP/HCR 11/00).

Angolan Refugees

The influx of Angolan refugees continued throughout 2000 with new arrivals being accommodated in camps in Bandundu, Bas-Congo and Katanga provinces. UNHCR estimates that at the end of 2000 there were 173,000 Angolan refugees with 106,000 currently being assisted to integrate locally. However, fresh fighting in Angola’s Lunda Norte province has forced fresh waves of refugees into the Bas-Congo region of DRC (UNHCR 09/03/01).

In March 2001 UNHCR reported on a joint UNHCR/WFP assessment mission to the border areas of the southern Bas-Congo region of DRC. The assessment found nearly 2000 Angolan refugees around the town of Kimvula. Logistical constraints prevented the assessment from confirming reports of other Angolan refugee populations in the town of Popokabaka and on the other side of Angolan border in Kasongo-Lunda in Bandundu province (UNHCR 09/03/01).

Burundian Refugees

An estimated 19,000 Burundian refugees remain scattered in the forests of south Kivu, many inaccessible to international agencies. There are an expected 5000 Burundian refugees expected to arrive in DRC during 2001 (UNHCR 2001).

Congolese Refugees (RoC)

The repatriation of Congolese refugees continues and it is expected that the Kimaza camp will close by the end of 2001 (UNHCR 2001).

Sudanese Refugees

There are an estimated 70,000 Sudanese refugees in the DRC. The majority are long term located in fertile agricultural areas of Orientale Province (UNHCR 2001).

Rwandan Refugees

There are an estimated 50,000 Rwandans in DRC and up to 20,000 are expected to voluntarily repatriate in 2001. Many of the remainder are Rwandan Hutus who are unlikely to return peacefully whilst the Tutsi government remains (UNHCR 2001).

Ugandan Refugees

There are an estimated 13,000 Ugandan refugees in Irumi, Beni and Boga but they are all currently inaccessible due to insecurity.

Overall

It remains extremely difficult to draw any definite conclusions about the nutritional status of both the displaced and general populations in DRC. Reports indicate that the nutritional situation of IDPs in many areas is extremely poor but the problem remains that access to the most insecure areas, probably containing the most severe needs, remains very difficult. However, RNIS anticipates that as MONUC peace keepers mobilise in particular areas, access will improve, and the full extent humanitarian crisis will become apparent.

Areas of insecurity are widespread but are largely concentrated in the east of the country in the Provinces of Orientale, the Kivus, Maniema and Katanga. The populations in these areas can be considered to be at very high risk of malnutrition (category I) and the opportunities for the situation to deteriorate further are very great. The situation of refugees in the country varies, some of whom are at high risk (category II or III).

Recommendations

· Support MONUC in improving humanitarian access.
· Support demobilisation process
· Support humanitarian agencies to address acute needs as humanitarian access improves.

United Republic of Tanzania

Tanzania has continued to receive influxes of new refugees as continued civil unrest in Burundi and the DRC has continued to force people across the border. Tanzania currently hosts the fourth largest number of refugees of any country in the world, and has one of the lowest GDPs. The regions of Kigoma and Kagera, which currently host the majority of the refugees in the country are also amongst the poorest areas (UNICEF 31/01/01; 02/01; WFP 01/01).

The numbers of refugees have continued to grow over the last year and the current estimates of refugees in camps being assisted by UNHCR are taken from the March 2001 monthly statistics and indicate that there are 527,916 refugees in camps. This marks an increase from numbers reported in RNIS 31. UNHCR report that as of mid October 2000, approximately 90,000 new refugees had registered with UNHCR in Tanzania. The vast majority came from Burundi but some came from Rwanda and from DRC (UNHCR 2001; 03/01). The new influx has meant that Karago camp in the Kigoma region of western Tanzania near the border with Burundi, has reached full capacity. The camp was opened in December 1999 and its capacity was stretched to 50,000 people. New refugees will be accommodated in Nduta camp in Kibondo district where 2000 new plots have been made available. (UN 2001; WFP 01/01).

WFP have also reported the creation of a new camp called Kitali Hills in the Ngara district. The camp was reported operational in November 2000 with the relocation of 1,800 Rwandese refugees from Mbuba transit centre, also in Ngara district (WFP 11-12/00).

Table taken from UNHCR summary statistics for refugees in Tanzania in March 2001

	Kigoma	Ngara	Mkuyu	Total
Burundians	260,097	120,229	0	380,326
Congolese	114,954	4	0	114,958
Rwandese	0	27,845	0	27,845
Mixed	1,694			1,694
Somalis	0	0	3,093	3,093
Total	376,745	148,078	3,093	527,916

The increasing number of refugees represents a problem for both the UNHCR and the government of Tanzania who would like to see repatriations take place. Large scale repatriation is very dependent on the security situation in the countries of origin. Plans have been made for the repatriation of Burundian refugees by UNHCR. It is hoped that 75,000 will voluntarily repatriate during 2001 (UNHCR 2001).

A major problem for all actors dealing with the refugees in Tanzania is the fact that humanitarian assistance has not kept pace with the increasing numbers. Funding shortfalls for WFP and UNHCR during 2000 resulted in a ration cut of 40 % in July 2000, which resulted in the energy value of the ration dropping to an average of 1170 Kcal/day. The ration cut was a result of a break down in the food pipeline and took place in all camps, from July to December 2000 when the rations were increased to 80 % of the full ration. To minimise the impact of the ration cuts, vulnerable households, such as those headed by the elderly or the chronically ill, continued to receive full rations (UNHCR 12/00).

A nutrition survey was conducted by UNHCR in July 2000 and found a prevalence of malnutrition of between 3.3% and 5.3% (<-2 z-scores), including 0.2 to 1.2% severe malnutrition (< -3 z-scores or oedema). A cluster survey was done in each of 11 camps. Some camps indicate a slight increase in the prevalence compared to September 1999, and others a slight decrease but these are unlikely to be significant. A second survey was carried out in December but problems with the survey design mean that it is impossible to determine the impact of the ration cuts (UNHCR 12/00).

The UNHCR monthly report on health and nutrition from January of 2001 notes that there was a marked increase in mortality in December and January with 65 % of deaths being amongst the under fives. Whilst the CMR remains below emergency thresholds the under five mortality gives cause for concern. The report also indicates that a rise in the number of admissions to selective feeding programmes has been observed (UNHCR 01/01)

The reported rises in under five mortality is worrying and coupled with the evidence from nutritional surveys, would suggest that the nutritional situation could be beginning to deteriorate and should be watched very closely although more information is needed.

Overall

Tanzania continues to receive new refugees, largely from Burundi but with some influxes from the DRC. Funding shortfalls have caused break - downs in the food pipeline, ration cuts and inadequate overall humanitarian assistance.

Recommendations

· Support WFP and UNHCR in providing assistance to refugees in Tanzania.

· Discourage repatriation to Burundi and DRC, as long as conditions in these countries are not conducive to safe return.

Uganda

OCHA estimates that at the end of March 2001 there were 909,929 people affected by conflict and drought in Uganda. This included 584,942 IDPs and 225,042 refugees, mostly from Sudan, Rwanda and Congo. The number of IDPs is reduced from July 2000, whilst the number of refugees has risen slightly (UN OCHA 02/05/01).

Insecurity in north and west Uganda hampers efforts to deliver assistance to affected IDP and refugee populations. Insecurity includes insurgency by the Allied Democratic Forces (ADF) in the Rwenzori Mountains on Uganda’s western border with DRC. The south western areas of Kasese, Kabarole and Bundibugyo have been particularly affected as clashes between the ADF and government forces throughout 2000 have forced displacements. Attacks by the Lords Resistance Army (LRA) in the northern districts of Gulu, Kitgum also continued throughout 2000 and the UN reported that almost the entire rural population of Gulu had sought refuge in camps or urban centres by mid year 2000. Raids by Karimajong pastoralists caused considerable displacement in Eastern Kitgum in early 2000 but improved rains later in the year have meant that the Karimajong have not needed to move out of their area. The number of IDPs tends to change quite frequently depending on events, with people coming into the safety of urban centres during periods of insecurity and returning to their land when possible (NRC 2001; UN 2001; WFP 13/03/01).

Uganda also suffered an outbreak of Ebola in the latter half of 2000. There were 426 cases, 172 deaths and 254 discharges. The outbreak is currently thought to be under control. The worst affected area was Gulu district where there were a total of 394 reported cases and 149 deaths (WFP 11-12/00).

Food security and nutrition

The RNIS has not received any new nutrition surveys and the last available information from the northern regions reported in RNIS 30 showed rates of malnutrition below 10 %. OCHA reports that the supply of crops from the second season (August - December 2000) continues to be good and has ensured adequate access to food for households in most districts of Uganda. However, food insecurity remains in areas where there is ongoing civil strife and the effects of last year’s drought. There have been good crops in Kotido and Moroto districts and the northeastern Karamoja district. This has combined with relatively stable civil security to improve general food security, particularly the eastern areas on the Kenyan border which had been suffering from drought. The Western region of Bundibugyo and the northern regions of Kigum and Gulu are also reported to be relatively food secure (UN OCHA 02/01).

A joint WFP/UNHCR Food Assessment to the Western Nile area in February concluded that the second harvest season had not been favourable to the refugees around the Nile basin area and that crop failure had resulted from high pest infestation (UN OCHA 02/01)

IDPs in northern Uganda

It is estimated that there are 450,00 IDPs and refugees in the districts of Gulu (370,000) and Kitgum (82,645), who have been displaced as a result of frequent rebel insurgencies by the LRA and political instability in Sudan. As a counter measure to the insurgency, IDPs have been moved into military protected camps and it was estimated that 75 % of both Kitgum and Gulu was resident in camps in January (WFP 01/01). The displacement has meant that fields and farms were abandoned and only 10 % of arable land was reportedly under cultivation (WFP 01/01).

OCHA reports that in April most IDPs and refugees in Kitgum are busy clearing and opening land for the first season of the year. The area has started receiving rains. The few who managed to start vegetable production are now busy harvesting tomatoes, Irish potatoes, cabbage, eggplants, and okra seeds distributed by ICRC. The main sources of income in the camps is from sale of farm produce. During the dry season people get revenue from brick making either through paid labour or sales. Other coping mechanisms are small-scale fishing, hunting and gathering wild green vegetables. However, there is a serious land shortage with the majority unable to access suitable plots of land (OCHA 02/05/01).

The May OCHA humanitarian update on Uganda reports that the current security situation in the north is volatile and continues to hamper access to areas, as LRA rebels raid towns, accompanied by atrocities, looting and abductions. OCHA reports numerous security incidents during March 2001. The situation in Gulu was further complicated by the Ebola outbreak that began in August 2000 and that resulted in 149 deaths. Food aid continued throughout the outbreak (OCHA 02/05/01; WFP 11-12/00).

IDPs in western Uganda

The western districts of Bundibugyo, Kasese and Kabarole continue to be insecure as a result of ADF activity although reports indicate that security has improved and military escorts are only occasionally required. OCHA estimates that at the end of March 2001 there are 97,457 IDPs in Bundibugyo. The IDPs are accommodated in 53 camps throughout the district and move to their homes and fields as the security situation permits. The May OCHA report indicates that the general security situation in Bundibugyo has improved considerably with people being able to get back to normal activities with access to gardens and less fear of insecurity (UN OCHA 02/01).

The situation remains unstable in the West Nile Region in the districts of Arua, Adjumani and Moyo. Refugees continue to enter from DRC and Sudan and the presence of the LRA has prevented planned programmes aimed at refugee self reliance (UN OCHA 02/01).

Whilst the general food security has improved, the crowding in camps and inadequate water and sanitation combined with poor access to health and education facilities is concerning. The general isolation and underdevelopment of the regions has also resulted in an acute lack of skilled workers. There is currently no new nutritional information and the nutritional situation remains unclear (UN OCHA 02/01; UN 2001)

Karamoja district

The security situation in Karamoja has improved from the beginning of last year but remains unpredictable and the UN continues to use armed escorts for field monitoring or distributions in 2001. General tensions rose in the area when the government announced its intention to disarm the Karimojong warriors on February 10^th 2001. OCHA reports that the Karamojong have launched a series of attacks on the neighbouring district of Katakwi. These attacks come at the beginning of the rainy season in early April 2000. The worst hit areas are those counties bordering Moroto and Kapelebyong county. Many people have lost livestock and crops to raiders and the numbers of people displaced by the attacks continues to grow although figures are currently unavailable. OCHA reports that the rains have been steady and regular in most parts of the region since mid-March. The rain is expected to continue and has collected in ponds, easing the previous dry spell (UN OCHA 02/05/01).

In January 2001, Oxfam coordinated an inter-agency food security assessment in Karamoja. The survey indicates that there is no nutritional or food security crisis in Karamoja. However the assessment was conducted just after the harvest. Nutritional status generally deteriorates during the ‘hunger gap’ between March and July (UN OCHA 02/01).

Refugees

Uganda is presently host to an estimated 225,042 refugees including Sudanese, Rwandan and Congolese. The Sudanese are in Rhino and Mvepi camps in Arua district, Achol-Pii camp in Kitgum as well as in Adjumani, Moyo, Kiryandongo and Masindi districts. The Congolese are in Kyangwali and Kyaka II in south western Uganda and the Rwandans are in Nakivale, Oruchinga and Kyaka II in the south west (UNHCR 2000).

WFP reports the arrival of 3000 Rwandan refugees from Tanzania from September to December 2000. The refugees had settled in areas surrounding disbanded camps in Tanzania in 1997 and are now being asked to leave the land they have appropriated. No information is available regarding the nutritional status of the refugees (WFP 11-12/00).

Fighting in DRC over the first few months of 2001 with WFP reporting influxes of 6,434 Congolese refugees from eastern DRC into Bundibugyo in February and March. They are in transit camps but will be moved to Kyaka II (WFP 16/02/01).

UNHCR did a survey in Rhino camp in October 2000 and found a prevalence of malnutrition of 8.3 %, including 1.1 % severe (WFP 11-12/00; UNHCR 13/11/00). These results are similar to those found by ACF-US in April - June 2000 (see RNIS 31).

A joint Food Aid Needs Assessment Mission (JFAM) conducted in January in the Congolese and Rwandan refugee camps in western Uganda found a stable food situation in most of the camps. The mission recommended that that refugees in Nakivale continue to receive full rations due to the limited land availability, whilst those in the other camps should continue receiving reduced rations. Over 3000 refugees are no longer receiving food assistance because they are now producing sufficient food. However, 6000 remain fully dependent on external assistance (WFP 01-03/01).

Overall

The overall situation regarding nutrition for most refugees is stable (category IV), but continuing insecurity makes the situation for IDPs precarious (category III). Security in the south west is reasonably stable and the focus is largely on recovery. Insecurity still continues in the north of the country and the Karimojong raiding in April gives cause for alarm. Although tensions still remain in some area the overall situation in Uganda appears to be improved.

Recommendations

· Monitor the nutrition and food security status of IDPs in all areas.

· Maintain good nutritional status of refugees by providing adequate food distribution and agricultural support.