Afghanistan Region
Tajikistan
Bhutanese Refugees in Nepal
Indonesia/East Timor Region
Indonesia
Ongoing conflict between the ruling Taliban government and an alliance of factions drawn mainly from Afghanistan’s minority communities based in the north, has forced repeated displacement, both internally and externally, particularly to the neighbouring countries of Iran and Pakistan. The Taliban, who are drawn from the Pashtun majority, control 90% of Afghanistan. Twenty years of conflict have left the economy and infrastructure in ruins.
Afghanistan is in the grip of a third successive year of countrywide drought, which is being hailed as the worst for thirty years. The combined effects of the drought and ongoing conflict have resulted in the internal displacement of an estimated 600,000 people over the last year alone. Many of them have moved from badly affected rural areas to the large cities of Mazar-E-Sharif and Faizabad in the North, Herat in the West and Kabul and Jalalabad in the East. At least 170,000 of those displaced have fled over the border into the North West Frontier Province of Pakistan (OCHA 05/03/01).
Drought
The nation wide drought and resultant food crisis in Afghanistan has particularly affected the rain dependent farmers of the northern provinces destroying nearly all the rain fed crops and decimated livestock. The drought has been further exacerbated by a very harsh and extended winter. Estimates suggest that 12 million Afghans are affected by the drought with three to four million severely so (UN 2001). The cereal deficit has now exceeded 2.3 million tons. The next harvest is due in May to June but it is already clear that it will not meet the food needs of the people. A WFP survey conducted in 24 provinces shows that almost a third of farmers intend to plant less than half of the land they normally sow, citing lack of seeds and fear of continued drought losses as the main reasons (FAO/WFP 08/06/00; UN Inter Agency- 2001, OCHA 14/03/01 WFP 16/03/01; WFP 27/04/01).
Eighty five percent of Afghanistan’s population depend on agriculture. Land ownership tends to rest with a relatively rich elite with many of the poorer and more vulnerable groups depending on agricultural labour for an income (for example the landless, sharecroppers, and wage labourers) (FAO/WFP - 08/06/00).
The wide scale displacement is a clear indication that many people have chosen to leave the land and move to densely populated urban centres in an attempt to get casual labour work. This is a trend that is rapidly depopulating drought affected rural areas and which many agencies are currently desperately trying to prevent. There is a lack of detailed knowledge on food security at the household level but it would seem that many families rely on remittances from relatives working outside of Afghanistan, as well as the highly refined redistribution network, called zakat (FAO/WFP -08/06/00; ACF-F - 2000).
From February to December 2000, ACF conducted seven nutritional surveys among children and their mothers in the six main cities of Afghanistan. Where there were IDPs in the cities, they were included as part of the sample. These provide information on the nutritional status and also the underlying causes of malnutrition related to food, health and care. They are summarised below together with the other available reports.
Central Region; Kabul City
The number of displaced in Kabul has increased markedly since the last RNIS (No 31), from about 81,000 IDPs in August 2000, to between 100 -500,000 estimated by WFP in December, 2000 (WFP 15/12/00).
ACF have a nutritional surveillance system in Kabul city based on bi-annual surveys, and since the last RNIS have conducted nutrition surveys in February and again in October, 2000. The February survey estimated the prevalence of acute malnutrition at 2.8 % with 0.2 % severe acute malnutrition. No difference was found between the nutritional status of children of the displaced and residents children. According to ACF this represents a surprising improvement in nutritional status as compared to the past five years, which was attributed to greater economic and political stability since the Taliban took over Kabul following the Taliban conquest of the south eastern regions of Afghanistan 1996/1997. This had allowed increasing NGO activity including the reopening of 18 ACF supplementary and 17 therapeutic feeding programmes. Despite this good result, ACF expected nutritional status to decline in the summer months, as a result of a seasonal increase in diarrhoea which coincided with an increase in admissions to feeding programmes (see Figure below). By October the prevalence of acute malnutrition had increased to 8 % with 0.6 % severe malnutrition. The coverage rate of the feeding programmes were estimated was 22.2%. (ACF-F - 02/00; ACF-F - 10/00; WFP -15/12/00).
In February 2000, the main source of income was casual or daily labour, with more vulnerable households without an able-bodied man relying on handicrafts, processing of dried fruits, child labour and begging as the main source of labour. Other sources of income include food assistance - including WFP cereals through WFP bakeries, remittances from relatives in other regions, sale of assets, and borrowing of money (ACF - 02/00). Price of wheat and bread did not rise in Kabul City between Feb and October, 2000.
Eastern Region;
Nangahar Province, Jalalabad
Jalalabad is on the road between Kabul and Peshwar and has always been an important trade centre. This contributes to better food security, as does agricultural production from the rural hinterlands, market gardening, and good job opportunities in agriculture, commerce or with international organizations. Health services are also more available from NGOs or the government. However, ACF report that the health environment was extremely poor - with narrow streets, overflowing open drains, piles of litter etc. Families hygiene practices also seemed to be extremely poor. A large influx of IDPs from rural areas increased population density.
A recent ACF-F nutritional from December 2000 estimated the prevalence of acute malnutrition at 5.8 % with severe malnutrition at 0.3 %. The CMR for the preceding month was estimated as 0.57/10,000/day and the under five mortality as 0.58/10,000/day. Both rates are below acceptable limits (ACF-F - 12/00). The CMR is approximately two times normal rates, while the under five mortality is within the expected range.
Southern Region;
Kandahar
Latest figures put the IDP population at 42,000 people. ACF-F conducted a nutritional survey in Kandahar city in May 2000 and estimated the prevalence of acute malnutrition at 5.7 % with 0.7 % of severe acute malnutrition. MSF-Holland have nutritional programmes in the province and are conducting systematic nutritional screening during measles vaccination (see table below). The RNIS does not have dates for the screening but they are believed to be from this year.
Results of nutritional screening during measles vaccination campaigns
|
MUAC |
<125 mm |
<110 mm |
Number of children |
|
Maywand |
9.3 % |
2.0 % |
10,920 |
|
Damam |
8.5 % |
3.1 % |
6,903 |
North Eastern Region;
Badakhshan province, Faizabad
Faizabad, the regional capital, is reportedly one of the most food insecure cities in the country. The province is relatively remote and is in general a food deficit area, and vulnerable to food shortages, irregular food supplies, and high prices. The price of wheat in Faizabad, has reached an all-time high and few can afford it. Terms of trade between wheat and labour deteriorated since September 1999 (ACF - 09/00).
The latest reports suggest that there are 44,000 displaced in the area. In September 2000 ACF-F estimated the prevalence of acute malnutrition at 8.9 % with severe malnutrition of 0.6%. The same survey also estimated a CMR of 0.68/10,000/day and an under five mortality rate of 1.1/10,000/day (ACF-F - 09/00) The under five mortality rates are above normal for Asia (0.7/10,000/day).
Takhar province
MSF-Holland conducted a nutritional survey in Khodja Baodine, Northern Takhar province, in November 2000 amongst displaced children, and The survey estimated the prevalence of acute malnutrition at 5.9 % with 0.3 % severe acute malnutrition. A retrospective mortality survey showed a CMR of 1.66/10,000/day and an under five mortality rate of 5.97/10,000/day. The anthropometric results do not indicate a serious nutritional problem, but the under five mortality rates are several times normal (0.7/10,000/day), and easily exceed the threshold of 2.0 for ‘an emergency out of control’. However, MSF indicates states that more recent prospective mortality monitoring of the same area has not revealed such catastrophic figures (MSF-H - 11/00).
Northern Region;
Balkh Province, Mazar-e-Sharif
Mazar-E-Sharif is the main city in the north of Afghanistan. Although traditionally a rich trading and business center, since 1997 when fighting broke out between rival opposition forces, the economic situation in Mazar has taken a massive downturn. The Taliban took the city in 1998. Based on figures compiled by UNCHS/HABITAT ACF estimate the population at 467,000 (ACF -11/00). The areas around Mazar have been badly affected by the drought or by fighting in neighbouring provinces, hence the influx of an estimated 30,000 IDPs in the last four months.
Acute and severe malnutrition by ACF survey, Afghanistan, 2000 (with 95% confidence intervals)
WFP bakeries have provided bread for 20,000 families in Mazar. Other food assistance projects include a ‘pasta’ project run by Habitat, whereby low income women produce pasta in a wheat or cash or food for work framework, and this pasta is then distributed to over 2000 vulnerable families. Habitat also run a school feeding programme, where 1500 children are given breakfast and food-for-work programmes for some 1,500 men over 2 months (ACF -11/00).
A nutritional survey by ACF-F in November 2000 estimated the prevalence of acute malnutrition at 5.6% with 0.6% severe acute malnutrition. Eight percent of the sample were IDPs, although there was no statistical difference between the nutritional status of IDPs and residents. The survey also estimated a crude mortality rate of 0.68/10,000/day and an under five mortality rate of 0.96/10,000/day, both of which are approximately normal. Measles vaccination coverage was estimated at 18% by card and 41.9% by history. ACF report that the general health environment in Mazar is better than other Afghan cities, with less rubbish heaps, clearer waste water channels and fewer livestock defecating in the streets, where children play (ACF 11/00).
A more recent survey by MSF-Belgium, which focused on the IDP population, estimated the prevalence of acute malnutrition to be between 10-13 % although the RNIS has no further information regarding the survey methodology employed. These results have caused some controversy, as they would appear to be at odds with the acknowledged food crisis.
Faryab Province
MSF-Belgium undertook a rapid nutritional assessment in south east Qaisar, Faryab province at the beginning of the year, in response to reports of cases of severe malnutrition in the MSF supported clinics in Qaisar town. Eight severely affected villages were chosen, in which 554 families were living. A systematic MUAC screening of 697 children under five indicated a prevalence of 13.6 % acute malnutrition (less than 125 mm) and 3.4 % severe malnutrition (less than 110 mm). A CMR of 2.1/10,00/day and an under five mortality rate of 5.2/10,000/day indicated a very alarming situation. Villagers presented a dire picture of exhausted coping strategies; livestock was sold or died, valuables had been sold, young men had left for the cities or to Iran, daughters were sold and families were surviving on wild foods (MSF-B -01/01)
A recent rapid assessment by SC-US in March in Kohistan District, has further highlighted the plight of people in the district. This has destroyed the primary source of income for the area and left people highly dependent on a series of coping mechanisms that have severe long term consequences. These include the selling of primary assets such as animals and land. For many the primary source of income is from borrowing cash and food against their expected harvest in July. The survey also showed clear evidence that children were being preferentially fed over adults. The most concerning discovery of the assessment was overt micronutrient deficiency in the form of scurvy (vitamin C deficiency). People presented with blackened legs, gum swelling and bleeding and joint pain. There was also presentation of angular stomatitis suggesting a complex of vitamin deficiencies. Anecdotal reports from the population suggested that the outbreak had been higher two months before the assessment but that the people had resorted to wild foods that may contain some vitamin C. MSF-B have conducted follow up assessments and have provided a clinical confirmation of scurvy in the village of Khaja Khan (MSF-B 03/01; SCF-US 03/01).
Western Afghanistan;
Herat city
Herat city has received among the highest numbers of displaced. Current estimates put the total of IDPs at 150,000 individuals, with 1,500 arriving each day. In the first half of December 130 families were arriving daily. A recent WFP/UNHCR/IOM food security assessment was carried out to identify the reasons for the massive out migration from Badghis and the initial observations indicate very poor crop prospects with an acute shortage of water forcing people to travel up to 15 km a day to meet their daily needs. The wide scale sale of productive assets such as livestock was also noted.
ACF-F conducted a nutritional survey in July 2000 and estimated the prevalence of acute malnutrition at 7.3 % with severe malnutrition at 0.5 %. The survey also showed a retrospective CMR of 0.98/10,000/day and an under five mortality rate of 3.2/10,000/day. The under five mortality rate exceeds the threshold of 2.0 for a very serious situation. The survey report remarked on the wide disparity in economic wealth within the sample, but did not disaggregate the data for IDPs. MSF-Holland, has conducted nutritional screenings using weight for height in Maslagh camp which is for new arrivals. Based on two screening exercises of 460 and 157 children, they found prevalences of acute malnutrition of 5 % and 6.5% and severe acute malnutrition of 0.7 % and 0 % respectively. The reports are currently unavailable to the RNIS. Despite obvious acute food insecurity in the area the anthropometric data does not yet point to an acute food crisis (ACF-F -07/00; MSF- -02/01; WFP-05/01/01; 27/04/01).
Opposition held areas:
Panjshir Valley and Shamalle Plain
The Panjshir valley is one of the strongholds of opposition forces to the Taliban. Food supply and trade are limited by the front line to the south, the harshness of the climate, and the tense political position in the north.
The most recent nutritional survey was conducted by ACF-F in August 2000 in the southern part of the valley and the northern part of the plains. Fourteen percent of the sample were displaced people. The survey estimated a prevalence of acute malnutrition of 18.2 % and 2.8% severe malnutrition. The crude mortality rate was 2.3/10,000/day and the under five mortality rate of 5.5/10,000/day, which are several “times greater than normal” and well above the rates classified as “an emergency out of control”. ACF attribute this to the high seasonal incidence of diarrhoea amongst the population, with half of the reported mortalities being from diarrhoea. (ACF-F -08/00). Water and sanitation are reported to be deplorable, with the river as the main source of drinking water.
Measles vaccination was 6.8% (by card) or 22.6% (by history) and partly attributed to the proximity of the frontline limiting the activities of aid agencies. The very low measles vaccination coverage and high incidence of diarrhoea are major cause for concern, and most likely contributing to the exceptionally high mortality. ACF have two supplementary feeding centers in the Shamalle Plain and three in the Panjsheer Valley. Given the difficulties of access the low coverage of selective feeding programmes at 17.3% was expected (ACF - 08/00).
The part of the sample drawn from Charikar District in the Shamali plains had a significantly worse nutritional status (6% severely malnourished as compared with 2% malnourished). Only 2.7% of mothers had a BMI less than 16.0 (chronic energy deficiency grade III), which is similar to other survey results in Afghanistan. The frontline in the Shamalle Plains, combined with the tense political situation in the north, and the harsh climate restricts the supply of food and other products (ACF - 08/00). These results are by far the highest found in any ACF nutritional surveys in Afghanistan since 1995 (ACF - 08/00).
Afghan refugees in Pakistan
Pakistan has long been host to about 2.1 million Afghan refugees, most in the North West Frontier, Baluchistan, Sind and Punjab provinces. The largest concentration of the most recent refugees is around the northern town of Peshwar, with reports of 170,000 having crossed into the country since September last year when a Taliban offensive in north east Takhar province displaced upwards of 70,000 people. Many of the most recent arrivals are in camps such as Shamshatoo and Akhora Khattak. There are an estimated 72,000 people in the transit camp of Jalozai, however the speed of the influx suggests that some may be from the resident refugee population in the surrounding area. As a result of the substantial increase in numbers of Afghan refugees entering the country, the government of Pakistan has halted efforts to officially register the refugees and is insisting that they should return to Afghanistan, leaving them temporarily in limbo (WFP-05/01/01; WFP-02/02/01; OCHA-01/03/01)
The speed and rate of the influx has threatened to overwhelm resources and there has been much concern over the fate of Afghan refugees. The RNIS has received some survey results from the camps near Peshwar. An MSF-Holland survey from Shamshatoo camp, in November 2000, estimated the prevalence of acute malnutrition at 7.7% with 2.0 % of severe acute malnutrition. A later survey in February found a prevalence of 6 % acute malnutrition and 1.1% severe but the details and methodology of the survey are unavailable to the RNIS. The results do not indicate a nutritional emergency but given the likelihood of further influxes as the spring thaw opens fresh routes into the country, it is important to follow the situation closely (MSF-H - 11/00).
The Government of Pakistan’s insistence that the 70,000 IDPs in Jalozai camp are not registered as refugees and forced to return to Afghanistan, has hampered efforts to supply relief in the camp. Rapid nutritional screening based on MUAC was conducted by MSF-Holland during mass measles vaccination campaigns, and found an estimated 16.4% acute malnutrition (based on a MUAC <125 mm) and 5.6% severe acute (based on a MUAC <110 mm). Given the general food distribution in the camp the situation would appear very serious and is likely to deteriorate further (MSF-H - 02/91).
Afghan refugees in the Islamic Republic of Iran
There are an estimated 1.4 million Afghan refugees in the Islamic Republic of Iran and some 580,000 Iraqi refugees. An agreement on February 14th, 2000 was made on a joint programme between UNHCR and the Government of the Islamic Republic of Iran. The joint programme is designed to facilitate the voluntary repatriation of refugees or to normalise the status of those with legitimate claims of asylum. The drought and continued conflict in Afghanistan have prompted an influx of new Afghan refugees into the country, which has prompted attempts by the government to close the border areas with Afghanistan. There are no recent reports on the nutritional situation of refugees in the country but it seems likely that numbers will continue to grow and the vulnerability of refugees would seem likely to increase.
Tajikistan has not received large influxes of Afghan refugees in the past. On the border between Afghanistan and Tajikistan there are 10,000 Afghan refugees stranded on two islands in the Pyandj river, Island #9 with 9000 people and Island #13 with 1026 people. The lack of access to the refugees and the supposed poor conditions has rasied concerns. An assessment from January 18 - 21 reported that the situation seemed to have stabilised and that families had been able to bring assets with them. Relief operations were commenced but have subsequently been suspended for fear of supporting armed fighters within the population. The RNIS has no nutritional survey information for the population (OCHA - 13/03/01)
Overall
IDPs in Afghanistan are extremely nutritionally vulnerable as a result of a severe drought situation superimposed on continued conflict and a state of near economic collapse in the country. In general the food security indicators show a very serious nation wide food crisis, with particularly worrying rises in the cost of basic foodstuffs and the almost total saturation of labour markets in cities. The appalling food security situation is not reflected in rising prevalences of acute malnutrition in the cities at least, and several reports suggest a more in-depth and localised analyses of food security is needed. In addition many of the surveys were based on representative samples in cities, of which only a relatively small proportion were IDPs. Little information is available about the differential nutritional vulnerability of the population. The IDPs in the Panjshir valley and Shamalle Plain are at very high nutritional risk (category I). Of particular concern is the recent discovery of micronutrient deficiencies that highlights the poor nutritional quality of the diet in many regions. It is important to note that nutritional data on the under five population in cities seems to be a very poor predictive indicator of acute food insecurity in Afghanistan.
There is less information on the nutritional situation of Afghan refugees in other countries in the area, but the high rate of influx and a perceived reluctance on the behalf of recipient governments to address the increasing burden of the refugees, means that the situation should be followed closely.
Recommendations and priorities
· From WFP and FAO reports
· Provide assistance to drought affected populations to prevent further deterioration of the situation.· From the ACF Afghan city surveys (ACF-F 2000)· Focus assistance on rural areas in an attempt to prevent further mass depopulation of rural areas and attract people back to the land.
· Collect detailed information on food security at the level of the household and to identify particularly vulnerable areas in cities.· From the survey in Panjshir Valley and Shamalle Plain (ACF-F 08/00)· Encourage systematic screening of children in MCH clinics.
· Organise health education campaigns targeted towards hygiene and the reduction of diarrhoeal morbidity.
· Encourage families to have kitchen gardens and to use the products for their own consumption.
· Invest in water and sanitation projects.
· Maintain existing feeding centres and open new where necessary.· From the survey in Khodja Baodine, North Takhar Province (MSF-H11/00)· Continue nutritional surveillance through regular village screening
· Improve access to Primary Health Care.
· Improve the water and sanitation situation
· Focus on the promotion of food security through the distribution of seeds and FFW programmes.
· Continue close monitoring of the nutritional situation.· From the rapid assessment in Faryab Province (MSF-B 01/01)
· Gather food security information for the area.
· Lobby for sufficient and regular general food distributions.
· Implement an immediate blanket food distribution in the region to assist the population until at least the next harvest.· From the SCF-US Rapid Assessment in Faryab Province (SCF-US 03/01)· Establish a seeds and tools distribution to provide material for subsequent harvests.
· Support the population with emergency food distribution.· Provide treatment to those with clinical deficiencies.
· Boost people’s coping strategies to mitigate the detrimental long term impacts.
· Develop and understanding of the inter and intra village differences between livelihood systems.
Refugees from southern Bhutan, began to arrive in Nepal towards the end of 1990 following the Bhutanese authorities enforcement of restrictive immigration and citizenship laws. The birth rate in the camps is over two percent and it is estimated that the current camp population is around 98,500 people. Since the beginning of the refugee operation there have been 16,000 registered births in the camps.
The situation in the seven camps has been stable for some time and the most pressing concern now is how to resolve their plight. Negotiations are underway between the Nepalese and Bhutanese governments and the decision has been taken to conduct a verification exercise to check the validity of refugee claims for Bhutanese citizenship. The verification process is seen as the prelude to the ultimate repatriation of the refugees. The verification process began on the 27th of March of this year and will take some time before it is completed. The RNIS has not received any new information on the nutritional status of the refugees but the last survey (see RNIS 28) indicated less than critical levels amongst children under five and there is no reason to believe that the situation has changed. One nutritional problem of concern has been the presence of angular stomatitis (Vitamin B2 deficiency), but increased awareness of the problem and qualitative changes in rations have resulted in far lower levels of the deficiency. For details of a recent WFP/UNHCR Joint Food Assessment mission see RNIS 31.
Priorities
· Unless substantial changes in the humanitarian situation occur the RNIS will not report further on the Bhutanese refugees.
East Timor
Since the crisis of 1999, the security in East Timor has largely stabilised. There have been reports of various security incidents, but most have been along the border areas with West Timor. To date the security in East Timor is described as stable. In the wake of wide scale humanitarian interventions in Timor, most of the internally displaced populations returned spontaneously to their places of origin and there are no official IDPs left. There continues to be a return of refugees to East Timor from Indonesian West Timor, but refugee fears over their safety and wide scale intimidation by pro Indonesia militias, have meant that many have not yet returned.
The UN Transitional Authority in East Timor (UNTAET) has taken responsibility for establishing a functioning administration and the transfer of administrative power to Timorese hands. UNTAET, in conjunction with other international organisations, has also taken on the responsibility of rebuilding the shattered infrastructure. The scale of the destruction in 1999 has left the Timorese people and the various organisations working there with a huge task. Most of the infrastructure has to be rebuilt from scratch and those elements that still stand suffer from long term neglect. One of the biggest problems facing the reconstruction teams is the lack of human capital. On the arrival of UNTAET there were fewer than 30 doctors left to tend the needs of the entire population. The East Timorese civil service once employed 34,000 people and is currently staffed by less than 10,000. This leaves a great deal of work to be done in all spheres (UNICEF 15/01/01).
Reports indicate that the overall food security situation in East Timor has improved markedly in the last year. Maize and rice crop yields were satisfactory in 2000 and recent reports indicate relatively good maize and rice harvests for the year 2001. The reason for increased yields are; an extended period of regular rainfall, the increased availability of seeds and a larger area of planted agricultural land. There are also encouraging reports of an increased numbers of farm animals. The development of the agricultural sector is hampered by a poor market for produce, largely as a result of the change from the Indonesian protectionist market system to the current market driven system, which has left many farmers confused over prices and market outlets. Farmers are unlikely to grow more until they understand and feel assured of market outlets. There is also a great deal of cheap imported rice from Thailand and Vietnam which makes the production of surplus rice unprofitable (ACF 4/05/01).
The RNIS has not received any new information about the nutritional status of people in East Timor. There are reports that many of the clinics have stopped collecting routine screening information on children, which makes the routine surveillance of the nutritional situation extremely difficult. There are no reports of wide scale acute malnutrition and there has been nothing to suggest that nutritional status in the population is declining.
There are still considerable economic problems in East Timor, related to the shattered infrastructure and the high rate of unemployment. This has created a large group of economic migrants who have moved to Dili in search of job opportunities. The harvest outlooks are good and agricultural improvements are noted (NRC 2001).
Recommendations
· Encourage the resumption of routine nutritional surveillance at the local level.· Try to identify areas of particular vulnerability to assist in the provision of assistance.
· Continue with income generation programmes, particularly in urban areas containing a high number of economic migrants.
Large scale conflict-induced displacement is a relatively recent phenomenon in Indonesia. The toppling of Suharto and his 30 year dictatorship in 1997, closely followed by the Asian economic crisis of 1998, has left Indonesia in turmoil, politically, economically and socially. Since 1999 there has been a general worsening of the humanitarian situation in the country with the spreading of religious and ethnic violence along with increased calls for separatism in different regions of the country. The hoped for stability that democratic elections and the inauguration of President Abdurrahman Wahid would bring has failed to materialise and there are presently increasing calls for the impeachment of the president on charges of corruption (NRC 2001).
The number of people displaced as a result of conflict has almost doubled since the beginning of 2000 and the WFP/VAM unit in Jakarta have estimated the total number of IDPs as of February 2001 as 1,182,571 which represents an increase of 367,515 since January. A great proportion of the displaced are in the eastern Provinces of North and Central Maluku with others located in Aceh, Kalimantan and Central Sulawesi.
West Timor
The humanitarian situation in West Timor has changed drastically as a result of the killing of three UNHCR staff members at the beginning of September 2000. The killings took place in Atambua on the 6th of September and were carried out by pro Indonesian militia members who have retained a strong hold on the camp populations in the area. Tensions between the militias and the international community had been high for some time and had created an extremely difficult humanitarian environment. As a direct result of the killings there was an immediate cessation of humanitarian activities and the evacuation of humanitarian field staff. Only a few assessment missions have been undertaken since the withdrawal of humanitarian agencies and the vast majority of the agencies have not returned to the area as a result of the Indonesian governments inability to actively assure their safety. The UNHCR has lain out very specific conditions that have to be met by the Indonesian authorities before it will consider a redeployment in the West Timor (UNHCR 06/09/00; UNHCR 03/05/01).
The Indonesian government estimates that there are currently 151,159 East Timorese refugees left in the camps in West Timor although the army puts the figure at 119,092 people. It has been reported that up to 70 %, or 80,000 people, would like to return to East Timor, but many are concerned for their safety if they are perceived to have been pro Indonesian supporters during the separation clashes. It is estimated that up to 40,000 people will chose to remain in West Timor, including pro Indonesian militia members and those closely involved with the Indonesian administration and state infrastructure of pre independence East Timor. Repatriations have continued and a total of 5,000 people are reported to have returned since the start of the year as of 24th of April. The month of March saw a particularly high rate of return but there are reports of reduced rates in April and the continued intimidation of refugees in the camps to prevent large scale returns (AFP 19/04/01; 18/04/01; UNHCR 13/03/01; UNHCR 03/05/01).
Despite assurance by the Indonesian authorities that the general security situation has improved, it would appear that little has changed and that militia activities continue in many of the camps. As a result the UN security phase V, which prevents the return of the UN staff, still remains in place. This has also meant that many of the aid agencies have also not returned, which has drastically effected the coverage of aid to the refugees, in terms of both quality and quantity. There has not been a large scale food distribution since the withdrawal of agencies in September 2000. Those agencies which have returned have found that access remains very difficult in certain camps (UNHCR 03/05/01).
The health and food situation of the refugees in camps remains of concern but many IDPs have become involved in local trading and farming activities, and the government assistance programmes function sporadically. Agency withdrawals have meant that supplementary feeding programmes, put in place to address nutritional needs in the under five population, have been stopped and this does raise cause for alarm given the perceived needs in the under five age group. The Jesuit Relief Services has reported that conditions in some camps in West Timor remain poor as a result of the cessation of assistance by the government of Indonesia and many Humanitarian Aid agencies. The report indicates that there is diarrhoea and vomiting in some of the camps such as Tuapukan and Noelbaki but this is remains difficult to confirm. (FAC 23/01/01; JRS 10/04/01)).
The Maluku Crisis
Hostilities broke out between Muslim and Christian communities, on the island of Ambon, the administrative capital of central Maluku, in January of 1999. Since the initial hostilities the conflict has spread to include almost all islands in the Maluku region, including both central and North Maluku. It is estimated that up to 25 % of a total population of 2.5 million people have been displaced. The enormous displacement of population has had profound effects on all aspects of the economic and social spheres in the region and has severely disrupted the complex systems of trade and livelihood activities that are such an integral part of the area. The conflict has been characterised by periods of relative calm, punctuated by periods of intense fighting. Each new round of fighting has resulted in further displacement of population, some of which is very localised, adding to the segregation of the communities on islands, and some of the displacement has been further a field to the islands of Java, Sulawesi and Irian Jaya (NRC 2001).
Maluku Province
The last major round of fighting in Central Maluku was seen in June 2000 and resulted in further dramatic population displacement and a drastic reduction in humanitarian access to the affected people. However, current reports indicate that the situation is quieter and that the Indonesian army is taking a firmer stance to disarm militias on both sides and prevent further fighting. There are an estimated 220,000 IDPs in Central Maluku province. The improvement in the security situation has once more opened up humanitarian access and allowed food distributions to go ahead as well as ensuring the stabilisation of food prices and the reestablishment of trade activities. This has positively affected the food security situation but needs still remain, particularly amongst groups in the displaced community who have lost everything as a result of the conflict. Food distributions continue although there is an increasing effort to target the most needy, boost coping mechanisms and reduce the reliance on food aid (FAC 23/01/01; UNICEF 2001).
North Maluku Province
The situation in North Maluku has been stable for some time and the latest reports indicate that IDPs, particularly Muslim IDPs who have been on the island of Ternate, are beginning to return to their places of origin. The last estimates of numbers of IDPs indicated approximately 175,000 but the governor of the province announced recently that 40,000 IDPs have returned to their homes in the districts of Halmahera, Morotai, Bacan and other islands (UN OCHA 04/01).
Nutritional situation
The biggest concern for both the displaced and non displaced populations has been the prospect of acute food insecurity and malnutrition as a result of the wide scale destruction of property and disruption of livelihoods, which have left many living in displaced camps with little or no apparent means of support. There was considerable concern that the situation had become very grave for many forced for the second or third time to flee where they were living, and have to start from scratch once more. The disruption of trade resulted in dramatic price rises in many markets, which led to fears of acute food insecurity (ACF 12/03/01).
ACF began a nutritional survey in June 2000 which had to be abandoned as a result of the deteriorating security situation, but the very tentative preliminary results, coupled with continuous on the ground observations of the situation, strongly indicate that the nutritional status of the population remains non critical. This further suggests that the coping mechanisms of the population are very robust. The food security and nutrition prospects have been further improved by a long period of relative calm in the area, which has allowed continued food distribution to take place and coping mechanisms to be established. A primary feature of the current distributions has been the increased targeting of resources to beneficiaries (ACF 12/03/01).
Other areas of Indonesia
The political and economic turmoil in Indonesia has seen conflict break out in many new areas of the country. Aceh, in north Sumatra island, is a long standing conflict area and remains extremely volatile as a result of a strong separatist movement and frequent government-separatist clashes. Currently it is estimated that there are 30,000 IDPs residing in camps in North Sumatra (UN OCHA 04/01).
The island of Sulawesi has been a large recipient of IDPs particularly from the crisis areas in Maluku. These IDPs have been focused in the north and the south of the island. However, in the early part of 2000 sectarian violence broke out in the central area of Sulawesi around the towns of Poso, resulting in enormous destruction of property and mass displacement of population with an estimated 20-40,000 IDPs reported. The food security of the IDPs remains a concern but it would appear that much of the displacement is fairly localised and many people are able to access their land and/or obtain work, whilst hosted by sympathetic host communities who also provide material support. Recent reports indicate that the insecurity continues and this could have an extremely detrimental effect on the food security of both the displaced and the host communities (UN OCHA 04/01).
Most recently there has been a fresh outbreak of violence on the island of Borneo in the province of Central Kalimantan. The violence is between indigenous Dyak populations and populations of transmigrant Madurese, many of whom have been on the island for many years. There has been low-level violence and hostility between the groups for some years, but an escalation was seen in 1999 in the West Kalimantan districts of Sambas and Pontianak. The violence of 1999 was on a scale previously not seen and for the first time involved non Dyak Malayu peoples. The recent outbreak of violence has seen many Madurese forced from their homes and there are reports of up to 57,000 having returned to the island of Madura, where their presence is placing an increased burden on the communities and economy of the island. Current estimates of IDPs in Central Kalimantan put the number at 19,600 people. The RNIS currently does not have any information regarding the condition of IDPs in Central Kalimantan (AFP 01/03/01; WFP/VAM 26/02/01).
Overall
Indonesia is an extremely large, complex and diverse country currently gripped by severe economic and political turmoil. The outlook for the political and economic stability of the country remains extremely bleak. Local and regional violence continues within the backdrop of a deteriorating political and economic crisis. The likelihood for the continuation of existing conflicts and the outbreak of further wide scale outbreaks of violence seem high. This heightens the likelihood of further large scale displacements of population and will put further stresses on the food security of affected areas. Although local coping mechanisms appear robust, the protracted nature of the violence in many areas and the spiralling political and economic crisis, mean that the possibility for a deterioration in nutritional status within affected populations is very high.
Recommendations
· the provision of food aid to IDPs in conflict affected where possible the monitor the general health and nutritional status of East Timorese refugees in the camps of West Timor.· Continue areas, whilst searching for mechanism to establish self sufficiency.
