GREATER HORN REGION OF AFRICA
WEST AFRICA
GREAT LAKES REGION
SOUTHERN AFRICA
Eritrea
Ethiopia
Kenya
Somalia
Sudan
The last three months have seen the continued improvement of the humanitarian situation in Eritrea. As a result of both the past war with Ethiopia and the regional drought of last year, the WFP have been targeting 1,048,404 war affected persons that include IDPs, expellees, vulnerable host communities, returning refugees from Sudan and demobilised soldiers. (FEWS 06/09/01). The number of people requiring humanitarian assistance is expected to increase by as much as 100,000 by the end of the year because of the number of refugees currently being repatriated from Sudan. The repatriation is a good indication of the improving situation but it will mean that the need for food assistance will continue until returnees are able to return to their places of origin or are resettled.
The security situation has greatly improved and Eritrea and Ethiopia remain separated by a Temporary Security Zone (TSZ) manned by over 4,000 peacekeepers and observers from the United Nations Mission in Ethiopia and Eritrea (UNMEE) (ICC 16/08/01). UNMEE plays a crucial role in monitoring the peace agreement between Eritrea and Ethiopia and recently helped to dispel tension from Ethiopian claims that Eritrea was once again preparing for war. On September 14th the UN Security Council voted to extend its mandate until March 15th, 2002 (UNDP-EUE 22/10/01).
A recent crack down on alleged dissidents by the government resulted in the arrest of eleven Eritrean journalists as well as former senior government officials and soldiers (UNDP-EUE 22/10/01). The arrests have been widely condemned and in a related action the Eritrean government expelled the Italian ambassador on September 29th. The expulsion of the ambassador, who is also a key representative of the European Union, is believed to be a result of a letter of condemnation of the arrests that he had written. It is now feared that his expulsion will adversely affect future EU funding to the country (IRIN 19/10/01).
War-affected displaced
The improvement in security within the country and the alleviation of drought conditions have allowed more of the war-affected displaced to return to their places of origin. It is estimated that over 170,000 IDPs have returned to their home areas since the end of June 2001 (FEWS 06/09/01). Current figures for remaining camp based IDPs indicate that there are 43,995 IDPs in nine camps in the Debub and Gash Barka zones (ICC 30/09/01). The remaining IDPs are currently not able to return to their places of origin. This is a consequence of either insecurity from mines and unexploded ordinance, or the absence of basic infrastructure such as health, water or education facilities. Infrastructure was heavily destroyed during the war. The government, the UN and NGOs are all helping to facilitate the safe return of IDPs by securing areas and helping to reconstruct infrastructure and basic services.
The RNIS has not seen any new nutrition surveys on the war-affected displaced but FEWS reports on a survey carried out in August by SCF-UK, in conjunction with the MOH and ECHO, amongst under- five children in the Gash Barka Zone. The survey indicated that rates of acute malnutrition were not alarming and were below emergency thresholds, as were both the crude and underfive mortality rates (FEWS 06/10/01). The low rates of acute malnutrition and mortality were attributed to the fact that the survey population came from camps that were well supplied with general food rations, supplementary feeding programs, health care, water and sanitation. However, these results cannot be extrapolated to all IDPs in camps in Eritrea and it should be stressed that the IDPs remain highly dependent on external aid.
Drought affected populations
Successive years of drought in the Horn of Africa, culminated last year in widespread acute food insecurity as failed harvests left people with very little resources to fall back on to meet their nutritional needs. The RNIS reported in July that the short azmera rain season, normally starting in April, had all but failed. FEWS reports that the main kremti rain season starting in August, proved to be one of the wettest on record. The extreme weather has delayed the planting of some crops and severe storm damage has been reported in some areas of Debub, Northern Red Sea State and Makel. The adverse affects of the unexpectedly high precipitation are concerning but despite this the Ministry of Agriculture has issued a preliminary crop estimate that is considerably higher than last years’ figures. The expected production is 223,978 MT, while last year’s yield was only 85,000 MT (FEWS 06/09/01). FEWS also points out that the high precipitation levels will fill reservoirs and replenish chronically low water tables. This will have beneficial effects on the quantity and quality of grazing for the country’s many livestock owners.
Returnees
UNHCR reports that there were 376,400 Eritrean refugees in Sudan at the end of 2000 (UNHCR 02/10/01). Repatriation of the refugees began in March 2001 after an agreement between the Sudanese and Eritrean governments. 160,000 refugees have been identified for repatriation by the end of 2002 and the exercise began in May 2001 but had to be halted at the end of July because of the onset of the rainy season, making transportation of the refugees impossible. A further agreement between the two governments and UNHCR was signed on September 22nd and as of 20th October 2001, a total of 21,417 refugees have been repatriated. UNHCR hopes to assist the repatriation of a further 40,000 refugees by the end of 2001, with an additional 90,000 expected to follow in 2002. Many of the refugees have been in exile for some time, arriving with very little to help them restart their lives, and will need considerable assistance before they are resettled and are able to be self sufficient. To facilitate their reintegration each family will be given up to two hectares of arable land, a cash grant, a food ration and household and agricultural supplies (UNHCR 22/10/01). The RNIS does not have any nutritional information on the returnees.
Overall
The improved security and crop prospects have all contributed to a general improvement in the humanitarian situation in Eritrea. High levels of precipitation have caused some crop damage but will do much to alleviate the chronic water problems in the country. The fate of the displaced and the newly returned is highly dependent on their ability to return to their places of origin or other areas and re establish their livelihoods free of any dependence on external assistance. This will be highly dependent on the continuation of a good security situation and the de contamination of war affected areas from mines and other forms of unexploded ordinance. In view of the current security state and the improved food security outlook in the country the IDPs are not considered to be at high risk (category IV).
The number of people estimated to be in need of humanitarian assistance as a result of drought conditions in Ethiopia as a whole has continued to decline as a result of good Belg rains in many areas. This has significantly contributed to a good Belg harvest and improved access to pasture and water in many areas of the country. It is currently estimated that 4.6 million people will require relief assistance from August to December 2001 (FEWS 25/09/01). In particular it is noted that the number of people estimated to be in need of emergency assistance is at its lowest for seven years at 1.1 million people. This is 63% lower than last year (FEWS 25/09/01). However, the situation remains critical in the pastoral areas of the South Eastern Somali region. Poor rains over the course of the year have left pastoralist populations of this area highly food insecure, with the number of vulnerable people remaining unchanged at approximately one million. WFP reports that 60% of food aid requirements are for the Somali region from October to December (WFP 12/10/01) are not included in resources. A break in the food pipeline is expected sometime in November and WFP reports that the outstanding need is for 30,000 MT.
Refugees
The situation for the Somali, Sudanese and Eritrean refugees remains mixed largely as a result of a high dependence on humanitarian assistance. At the end of August 2001 UNHCR report that there were 86,153 Somali refugees (18,263 families) in the Eastern camps and 84,180 Sudanese refugees in the Western camps. Repatriation prospects for the Sudanese refugees remain poor as a result of ongoing conflict in Sudan but repatriation of the Somali refugees is reported to be continuing with 6,522 repatriated during August and a further 6,412 per month planned for September and November (UNDP-EUE 08 and 09/01).
UNHCR/WFP/ARRA conducted a series of nutrition surveys of Sudanese refugees in the Western camps of Bonga, Sherkole, Fugnido and Dimma in May 2001 (UNHCR/WFP/ARRA 31/05/01). At the time of the surveys, the total Sudanese refugee population was 74,486. Programs to create income-generating activities do exist but little information is available regarding the relative contribution they make to household food security. However, the restrictions on refugee movement and the relatively small numbers of refugees involved in the income-generating schemes suggest that refugees remain heavily dependent on food assistance. The survey notes that there were no major delays or breaks in the pipeline for the six months prior to the survey. The food basket largely conforms to international recommendations, for Bonga and Sherkole, which also benefit from a blanket supplementary ration to all under- fives. However, the ration falls significantly below international recommendations for Fugnido and Dimma, which also do not benefit from a blanket feeding program (see table below).
Table showing food basket per person per day in Sudanese refugee camps
|
Camp |
Wheat (g) |
Oil (g) |
Pulese (g) |
Salt (g) |
Energy of ration (Kcal) |
|
Bonga |
475 |
30 |
50 |
5 |
2000 |
|
Sherkole |
475 |
30 |
50 |
5 |
2000 |
|
Fugnido |
400 |
30 |
50 |
5 |
1756 |
|
Dimma |
400 |
30 |
50 |
5 |
1756 |
The high rate of acute malnutrition in Fugnido is concerning, with one of the causes for this cited by the survey as being the presence of unregistered “new arrivals” sharing food with registered refugees.. In all camps there appears to be very little opportunity to complement the ration through other sources, with this apparently the problem in Fugnido and Dimma because of the reduced ration received. This is exacerbated by the absence of blanket supplementary rations for the under-five populations in these camps (UNHCR/WFP/ARRA 31/05/01). A UNHCR report from July reported that the crude mortality rate in the Sudanese camps was 0.08/10,000/day and the under-five mortality rate was 0.15/10,000/day. Both rates remain below emergency thresholds and suggest that observed malnutrition is not a result of an unusually poor public health environment (UNHCR 07/01). The RNIS does not have any nutritional information for other refugees in Ethiopia.
Table showing results of surveys done in Sudanese Refugee camps
|
Camp |
Acute (W/Ht < -2 Z-score and/or
oedema) |
Severe (W/Ht < -2 Z-score and/or
oedema) |
|
Bonga |
9 |
1.7 |
|
Sherkole |
9.8 |
1.1 |
|
Fugnido |
20.7 |
3.0 |
|
Dimma |
10.8 |
0.7 |
As a result of continued peace between Ethiopia and Eritrea, the security situation in Tigray and Afar has remained stable. This has permitted many to return to their places of origin and begin cultivation once again. The continued presence of the United Nations Mission in Ethiopia and Eritrea (UNMEE) is helping to facilitate returns by assuring that the security situation remains stable and by facilitating the removal of mines and unexploded ordinance, the presence of which has rendered many areas too dangerous for returns. The RNIS has received no new nutrition information on the war displaced in Tigray and Afar but a report by UNHCR on the situation of IDPs in Tigray, in April 2001 indicates that the nutritional situation of IDPs at this time was not cause for concern (UNHCR 28/04/01). The report indicates that there were 287,500 IDPs in March, all of whom were receiving a full ration of 2,138 Kcal comprised of wheat, pulses and a vegetable oil. The report stressed that the IDPs were all heavily dependent on the food aid to meet their nutritional needs as the vast majority had been unable to cultivate crops for the previous three years. IDPs reportedly were able to supplement their diet by selling small parts of their ration to buy alternative foodstuffs. The report also observed that the nutritional status of the IDPs had remained stable for some time (UNHCR 28/04/01).
More recent reports from the Afar region indicate that it has been affected by poor rainfall and that pastoralists in the area remain vulnerable because many of their traditional migration routes have been disrupted by the war. As a result, over grazing and livestock diseases have become largely endemic (UNDP-EUE 15/08/01). This is likely to hamper the return of some IDPs and ensure that a high dependency on food assistance remains.
Somali Region, Eastern Ethiopia
Drought displaced
Whilst the drought situation appears much improved in Ethiopia as a whole, the Somali region is still reeling from three years of drought, chronic under development, the Gulf livestock ban and a break down in the general security network. This has prevented any form of recovery by the drought affected populations, who remain highly food insecure and vulnerable. The number of beneficiaries requiring assistance have remained unchanged at one million (FEWS 25/09/01).
The general food security of the area is extremely poor as a result of another season of poor rains. Much of the region’s population are nomadic pastoralists and rely heavily on the Gu rains to replenish water sources and vegetation for their livestock. According to a UNDP-EUE report, a total of sixteen districts in the south east are most severely affected including Warder, Korahe, Jijiga, Fik, Gode, Liben and Afder zones (UNDP-EUE 09/01). Water shortages have been widely reported and emergency water tanking has been taking place in some areas. The lack of water and the need to find pasture has prompted unseasonably early migration of pastoralists to unusually far places. In some cases, this migration has left women and children without access to milk, which is an important source of nutrition during this season. There are also reports that many coping mechanisms are exhausted, in particular the collection of wild foods. The unavailability of wild food plants, even those consumed only at times of severe hardship, is an indication of the seriousness of the situation in the area (UNDP-EUE 03/08/01).
In September 2001, MSF-B conducted a follow up survey in Denan in Gode zone. Denan has had a sizeable displaced population in a camp outside of the town for over a year and has experienced high rates of acute malnutrition. The last survey in April 2001 indicated 51% of acute malnutrition with 9.1% severe (see RNIS 32/33). The recent survey was conducted in the camp and the town at a time when the humanitarian situation appears to be deteriorating in the area. MSF report that there is livestock in the area once again and that both milk and meat is available in the market, but it seems likely that the current drought conditions will reduce the availability of this food source. Water points around the town have already dried up and MSF has begun trucking water to the general population. The Deyr rains are already late and had not begun at the beginning of October (MSF-B 10/09/01).
The town has an estimated population of 8,000 residents and the camp 8,500. The survey indicated that 98.8% of people were receiving the monthly food distribution of 15 Kg of wheat/person/day since May 2001. The survey showed a prevalence of acute malnutrition (<-2 Z-scores and/or oedema) of 30% including 2.4% severe acute malnutrition (<-3 Z-scores and/or oedema). Mortality figures indicate that mortality rates remain well below emergency thresholds with a crude mortality of 0.1/10,000/day and an underfive mortality of 0.27/10,000/day (MSF-B 10/09/01). The acute malnutrition rates show a marked and statistically significant improvement from April 2001. MSF suggest that the regular general food distribution has played an important role in this improvement. The malnutrition figures are greatly improved and with the low mortality rates indicate that the situation in Denan is not deteriorating. However, a figure of 30% acute malnutrition is still cause for concern, particularly as the deteriorating humanitarian situation in the region at large is likely to make the population more dependent on food aid and external assistance.
In the last issue, the RNIS reported on surveys done in April 2001 by UNICEF and an NGO called Mother and Child Development Organisation (MCDO). As an update, the RNIS would like to report that the survey, conducted by MCDO in April, which showed a rate of acute malnutrition of 31%, was conducted in Hartisheikh camp and not Fafan as originally reported. The high rate of malnutrition to the camps was probably a result of irregular or even non existent food distributions for many months prior to the surveys (Grellety 05/09/01).
Overall
Ethiopia remains an area of endemic food insecurity. Limited recovery has been possible over the summer as a result of a good Belg crop harvest, but full recovery from a succession of droughts will take a long time and it is likely that food insecurity will remain the norm. Within this context of food insecurity, the nutrition situation of drought displaced and refugees remains mixed. Whilst malnutrition rates have dropped in some areas they have increased in others and dependency on humanitarian assistance remains extremely high. The refugees in the country appear to be highly dependent on food assistance and remain at moderate risk (category III). For the war affected displaced in Tigray and Afar the situation appears to be stable with more able to return (category III). The results of a recent survey on drought displaced indicate that their nutrition situation has not deteriorated, despite an increasingly alarming situation in the Somali region of the country. However, they are considered to be at an elevated risk (category II) as a result of a deteriorating humanitarian situation in the Somali region.
Recommendations
From the UNHCR/WFP/ARRA survey (UNHCR/WFP/ARRA 31/05/01)
· Increase the general food ration in Fugnido and Dimma to include a full ration of at least 2100 KcalsFrom the MSF survey in Denan (MSF-B 10/09/01)· Improve the understanding of underlying causes of malnutrition
· Ensure the continued provision of the general food distribution and improve the ration with the addition of oil and pulses· Ensure the provision of sufficient clean water to the population
· Lobby for “long term” solutions to the chronic problems of the area (income generating activities, seeds and tools etc)
Kenya has been suffering from the regional drought in the Horn of Africa and has seen acute food insecurity emerge in many areas of the country. The current outlook is for an improved situation in the traditional arable districts and highland areas of Western Kenya but the outlook in the north and east of the country remains poor. Pastoralists continue to be most at risk with areas of Turkana, Wajir, Garissa and the Tana River district being the worst affected (FEWS 07/09/01). There are wide spread reports of poor pasture and water availability, animal deaths and unseasonal migration. The situation is extremely concerning and a deterioration in nutritional status amongst affected populations is likely.
WFP is currently running an enormous food aid program all across Kenya and has suffered from poor funding, resulting in ration cuts in an attempt to avert breaks in the food pipeline. WFP recently announced that their drought relief programme is currently less than 50 percent funded and requires in excess of 34 million US dollars to meet shortfalls (WFP 02/11/01). As a result, a possible break in the pipeline is expected from November onwards. The current food basket is primarily cereals with shortfalls in pulses, critical for their protein content, beginning in October.
Refugees
In July 2001, UNHCR reported that there were an estimated 213,610 refugees in Kenya living in camps around Dadaab and Kakuma in the north east and north west of the country. The refugee populations remain highly dependent on food aid as a result of their inability to engage in economic activities and because the camps are situated in some of the areas most affected by the drought, precluding any agricultural activities. In Dadaab the food ration was substantially reduced, although it is reported that it was increased to 1,700 Kcal from the 1,399 Kcal that were distributed from mid April (OCHA 31/07/01). The RNIS has not received any new nutritional information from Dadaab but the continuation of drought conditions and problems of funding the food pipeline make the refugees extremely vulnerable.
In the last update the RNIS reported on a nutritional survey conducted by IRC/UNHCR and ICH in Kakuma refugee camp (see RNIS # 34). The survey had two components; the first being the assessment of acute nutritional status by anthropometry and the second the assessment of micronutrient status using biochemical indicators. As reported in the last RNIS, nutritional status is poor, with levels being above emergency thresholds. However, a series of surveys over the past few years indicate that the level of acute malnutrition in the population appears to have remained fairly constant at around 17%. The measurement of micronutrient status marks an important departure from the norm, where the focus has traditionally been on the supply of sufficient dietary energy (macronutrients) and has tended to see dietary quality as a secondary concern. The issue of dietary quality is of particular concern in longterm refugee communities. Refugees tend to be heavily dependent on food aid, particularly when in closed camp environments such as Kakuma. This results in very restricted access to food sources other than the general ration and this tends to result in poor diet quality.
The Institute of Child Health (ICH) performed a biochemical analysis on blood samples taken from amongst the refugee population. The biochemical survey indicated very high rates of anaemia in the under-five population with 61.3% of children having a haemoglobin level of below 11.0 g/dl of blood. Anaemia, although an indicator of iron deficiency, can be caused by numerous factors including infection, malaria and other parasitic infections. In order to control for this ICH performed a number of other tests, concluding that the high rate of observed anaemia was a result of iron deficiency (IRC/HCR/ICH 12/04/01). Vitamin A status was also assessed and it was estimated that 47% of children assessed had a serum retinol level below 0.7 µmol/L and were therefore classified as suffering from vitamin A deficiency. It is alarming to note that both the prevalence of iron deficiency anaemia and vitamin A deficiency are both well above emergency thresholds and are indicative of a problem of severe public health importance (WHO 96.10; 2000). The results highlight the need to focus on dietary quality particularly for long-term recipients of food aid. It is also concerning to note that the current deterioration of the humanitarian situation in Kenya with regards to the inadequacy of the existing food pipeline, and the deterioration in food security in the areas where the refugees are situated, means that the refugee populations will remain highly vulnerable to further deteriorations in both macro and micronutrient status.
Overall
There has been an improvement in the food security of some areas but further deterioration in the food security of pastoralists in the north east and west of the country have taken place. Refugees remain highly dependent on humanitarian assistance, with shortages and possible breaks in the pipeline, coupled with the deteriorating food security situation in areas where they are staying, contributing to their extreme vulnerability (category II).
Recommendations
· Support the global appeals for KenyaFrom the IRC/HCR/ICH survey in Kakuma
· Continue to administer high levels of vaccination coverage· Improve the micronutrient content of the general ration preferably with the distribution of fresh food
· Ensure adequate fortification of the main components of the general food ration
· Implement food basket monitoring to ensure effective and equitable distributions
Increased insecurity, poor rainfall and the continued disruption of economic activities have severely impacted on the humanitarian situation in Somalia, and as a result WFP have announced that more than 500,000 Somalis face a serious food crisis (WFP 24/08/01).
Until the creation of the Transitional National Government (TNG) in August 2000, Somalia had been without a government for eleven years. It was widely hoped that the creation of the TNG would bring some form of order and stability to the country and allow the process of reconstruction to begin. However, many groups refused to recognise the legitimacy of the TNG and this opposition has grown over the 13 months of its existence. This has effectively curtailed its influence in many areas even within the capital Mogadishu and has lead to increasing reports of armed conflict. In August, heavy fighting was reported in the south of the country between the Juba Valley Alliance (JVA), allied to the TNG, and the militia of the Somali Reconciliation and Restoration Council (SRRC), which has remained heavily opposed to the TNG (IRIN 03/08/01). Fighting in the southern region has continued intermittently over the summer and there are renewed fears of a large offensive in the area (IRIN 22/10/01). Fighting also erupted within the capital Mogadishu on October 13th, between TNG forces and those of an opposing Somali war lord, resulting in the death of 22 people (AFP 13/10/01). The upsurge in insecurity is having serious impacts on humanitarian access, particularly in areas in the south of the country where the humanitarian situation is at its worst. Concern has been expressed that current humanitarian access is at its worst point since the redeployment of UNSOM forces in 1995.
Dissatisfaction within the TNG over its inability to promote reconciliation and establish regional councils within the country, came to a head at the end of October. The parliament passed a critical no confidence vote against Prime Minister Ali Khalif Galaydh and his 84 member government. The president, who is himself not officially recognised by some elements within the country, will appoint a new government, but without wider recognition from other factions within the country, it is not certain what future it has. In order to facilitate dialogue between the TNG and opposition factions, the Kenyan government has organised a meeting to facilitate peace talks. However, the potential for further insecurity remains one of the greatest challenges to the humanitarian situation (AFP 28/10/01).
This year’s Gu rains are being described as the worst in seven years and earlier warnings of a possible food crisis have, if anything, been under estimates (FSAU 10/01). The most badly affected areas have been the main sorghum producing areas of Gedo, Bay and Bakool where production has dropped by 90% compared to average (FSAU 10/01). In a normal year, the rains play a vital role in the agricultural cycle and also serve to replenish vital water points used by both humans and their livestock. The rains also serve to regenerate pasture essential to the pastoralist and agro-pastoralist populations. Crucially the rain failure has come on the back of a succession of drought years and for many, the ‘normal’ coping mechanisms are no longer viable due to the essentially chronic nature of the shock. As a result, people are becoming increasingly food insecure. The FSAU is reporting an increase in the price of cereals and a reduction in the terms of trade in many areas. The situation is also made more severe by the poor economy and particularly the continuation of the livestock ban by some Gulf countries (FSAU 10/01).
Malnutrition rates in Somalia have remained unexpectedly high for a number of years and, within this context of worsening food security, the situation is alarming. WFP have estimated that over half a million people are at risk, and the FSAU recently calculated that the number could be as high as 800,000 if the Deyr rains are poor (FSAU10/01). In a recent alert ACF have reported that 385,000 people could be at risk in the Gedo region alone (ACF 29/10/01). The forecasted food gap is currently 55,000 MT of staple cereals and this raises concerns as the WFP appeal in July asked for 20,000 MT. As of 16th October, only 4,300 MT had been pledged, according to the Somalia Aid Coordination Body (SACB 16/10/01).
Southern Regions
Gedo
The situation in Gedo is critical. Three years of poor rainfall have affected agro-pastoralists and pastoralists alike and the food security situation has been deteriorating for some time. The total production of this year’s harvest is only 13% of the post war average, with cereal prices increasing dramatically whilst livestock prices are extremely low.
Large scale and unusual migration is being reported with people either moving out of the area or congregating around towns and water points. This is creating huge pressure on already limited resources, with great concern over the possibility of disease outbreaks in these over crowded environments. The majority of those leaving the area are the wealthier groups and the FSAU calculates that 60% of those pastoralists remaining are from the poorest group. There are also increasing reports of wide scale livestock deaths from lack of water and pasture and the resultant food deficit is expected to be a third of total food needs. In energy terms this means that people will have access to 1,450 Kcal where the recommended minimum energy intake is 2,100 Kcal/person/day (FSAU 10/01). The deteriorating situation has been further exacerbated by the affects of the recent closure of the Kenyan and Ethiopian borders because of fears by the respective governments over arms smuggling. Traditionally, people have traded across the border and taken their livestock to better sources of pasture. Ethiopia has also been a source of cheap food in the form of humanitarian rations that have found their way into the markets of southern Somalia as cheap food sources (FSAU 10/01). Reports from clinics within the area also indicate that both moderate and severe malnutrition observed in children screened are on the increase.
Luuq
ACF continued to report increasing numbers of beneficiaries in both its supplementary and therapeutic feeding centres (TFC) over the course of the summer. The TFC in Luuq was originally designed to accommodate 150 people but received 236 admissions in July, with the numbers increasing every week. The increase in beneficiaries prompted ACF to open a second supplementary feeding centre (SFC) in Elbon, near Luuq, in September. ACF report that the numbers of beneficiaries in their two SFCs jumped from 3000 to 4200 in the last two weeks of October (ACF 29/10/01). The rate of admission is extremely concerning and indicates a very serious situation that is far beyond normal patterns for the time of the year. The ACF data suggests that people are at the end of their coping mechanisms and are turning to the centres in Luuq to obtain food. It is also concerning to note that there is currently no doctor in the Luuq hospital and that the town continues to act as a magnet for people too destitute to remain in the outlying areas. The increasing density of people in the town will add to the burden on existing resources and increase the likelihood of outbreaks of communicable disease. The ACF selective feeding centres are currently the only ones operating in the Gedo area.
Bulla Hawa and El Wak
The situation in the two areas remains critical. Health services are almost non-existent and sources of milk, the main source of protein for pastoralists, have dried up. CARE is currently doing a food distribution in the areas but no selective feeding facilities exist, although ACF report that there is a continued high attendance in their SFC on the Kenyan side of the Somali-Kenyan border. The FSAU reports on pre-distribution screening carried out by CARE. The screening used MUAC to assess the nutritional status of children under five and showed that out of the 1208 children screened from five villages in El Wak, 97% were categorised as acutely malnourished (MUAC <12.5 cm) including 14% who were severely malnourished (MUAC < 11 cm). In Bulla Hawa 1635 children were screened, of which 65% were acutely malnourished (MUAC < 12.5 cm) with 7% severely malnourished (MUAC <11 cm) (FSAU 10/01). The RNIS has not seen the reports but the figures indicate an extremely alarming situation and the FSAU have called for an immediate increase in the level of food aid (FSAU 10/01).
Bay and Bakool
There are no permanent rivers in the two regions and all farming depends entirely on rainfall. The failure of the Gu rains has very severely impacted on the food security of the populations of the area. The FSAU has calculated that a typical ‘poor’ household will suffer a food deficit of between 35-45%, with the figure rising to between 50-70% for the very poor (FSAU 10/01). Nutrition reports from health facilities in the areas show consistently high numbers of malnourished children. This is associated with the massive crop failure compounded by the continuing drought, which has affected both water quality and quantity. One of the responses has been the migration of livestock, with the men leaving women and children without one of their chief sources of nutrition. The closure of the border with Ethiopia has also constrained the cross border movement of cereals. Use of wild foods is also reported to be on the rise (FSAU 10/01).
In August the FSAU, in collaboration with the local health committee and IMC Rabdure, conducted a quick MUAC assessment of 400 IDP families around the town of Rabdure. The IDPs had newly returned from Ethiopia and have been out of Somalia since the early 1990’s. The assessment showed that nearly 40% of the children measured were acutely malnourished (MUAC <12.5 cm), a figure corroborated by local health facilities (FSAU 08/01). It is also worrying to note that the assessment identified three children presenting with Bitots spots (eye signs), indicating advancing vitamin A deficiency. This is particularly concerning as it probably indicates a far higher percentage of non-clinical deficiency which is associated with a greatly elevated risk of morbidity and mortality. There was a high level of reported morbidity amongst the IDP population and the lack of water, sanitation and poor quality of shelters were further causes for alarm.
Juba Valley
In general the food security outlook for the Juba valley region remains better than most parts of Somalia. This is largely a result of the near normal Gu rainfall. Insecurity in the area forced some people to move temporarily and the closure of the Kenyan border has restricted trade and remittances from relatives. The area has also seen a great deal of in migration from pastoralists seeking food and water for livestock, which will inevitably create competition for scarce resources. Food deficits will occur for the very poor groups but data from health facilities indicate that there is no major nutritional deterioration in the population. The RNIS has no new nutritional information for the area.
Lower and Middle Shabelle
The RNIS has received no new nutritional information from Shabelle but the FSAU indicates that the situation is not critical (FSAU 10/01). The region is highly diverse and contains one of the highest populations in Somalia. It is a major maize producing area and harvest, although below average, was not too low. Currently water levels and access are reported to be near normal. The area has suffered some insecurity resulting in displacements and the general disruption of livelihoods but, generally, the situation is considered to be relatively good compared to other areas of the country. The area thought to be more food insecure than others is Afgooye, where cereal stocks are reported to be low. Access to food is expected to decline as a result of increased competition for agricultural jobs from people migrating in from other regions, and general increases in the price of staple foods (FSAU 10/01).
Mogadishu
The RNIS does not have any new nutritional information from Mogadishu but the situation is expected to be poor as a result of the increased number of people seeking employment and assistance. This will put pressure on already depleted resources. There has also been a great deal of insecurity in the city as a result of conflicts between the TNG and opposing militia groups. The capital has also suffered from hyperinflation and the importation of Somali bank notes. Earlier in the year, many traders refused to accept the 500 Somali shilling bank note. The resultant demonstrations turned violent and seriously disrupted the working of the markets and many businesses (IRIN-HOA 12/10/01). The food security of the poorer groups is expected to be poor.
Northern Regions
The Gu rains were poor in most regions and this has adversely affected the predominantly pastoralist communities in the north by threatening livestock conditions and productivity through reduced access to water and pasture. The affects of the rain failures have been exacerbated by the livestock ban by the chief importing countries in the Gulf region. The ban has been in place for nearly a year and looks set to be continued. The main effect of the ban has been to seriously reduce household incomes for groups normally selling livestock or relying on jobs or petty trade associated with livestock marketing (FSAU 10/01). The ban has left many livestock owners with too many livestock, particularly unproductive males, and there is apparent over stocking in some areas. Alternative economic possibilities have also been constrained by the closure of the Djibouti border and the closure of two large refugee camps in Ethiopia that provided a source of cheap cereals. The latest report indicates that some Deyr rains have fallen in the northern regions and that water sources are being replaced. However many people remain acutely vulnerable, particularly the poorer groups in Goldogob in Mudug, Buhoodle in Eastern Toghdeer and areas in Awdal and West Galbeed.
Somaliland
General food security in Somaliland is poor but better than other areas, particularly in the south of the country. Nutrition data from health facilities indicate relatively low proportions of malnourished children screened in comparison to previous years. However, certain pockets of vulnerability remain, particularly the Haud areas along the Ethiopian border and the returnees in Hargeisa town. UNICEF, MOHL and FSAU carried out a nutrition survey in resettlement camps of Somalis who had returned from being refugees in Ethiopia. The survey indicated a rate of acute malnutrition over 15% with over 5% classified as severely malnourished (FSAU 10/01). The survey also indicated that families were surviving on two meals a day that were insufficient in both quality and quantity. The RNIS has not had access to the survey report. These factors, combined with poor shelter, sanitation, access to health care and poor economic prospects, make this population group extremely vulnerable.
Puntland
Puntland has suffered from insecurity over the course of the year as a result of fighting over the control of the commercial capital Bosasso. The fighting has added to the problems faced by populations in the area and for a time the FSAU reported that it was difficult to get information on the health situation of people in the town (FSAU 08/01; IRIN-HOA 07/08/01). The primary problem in the region is one of water scarcity that is severely affecting livestock condition.
The majority of pastoralists have moved livestock away from the worst affected areas leaving only the very poorest groups. IDPs and urban poor have been highlighted as being at particular risk because of the sharp economic downturn in the area as a result of the livestock ban, the resultant loss of work and the inflated prices of food.Bosasso and Galcayo towns have been highlighted as being particularly at risk, with health facilities reporting high rates of malnutrition.
Overall
The failure of the Gu harvest has brought about a deterioration of the humanitarian situation for a country suffering from chronic food insecurity and the situation is now extremely critical. The rain failure has been compounded by the faltering economy of the country and the Gulf livestock ban, which has severely reduced normal income activities for many pastoralists in the north. The most severely affected areas remain the southern regions, which suffered the greatest production losses this year. Within the southern regions it is the poorest income groups including IDPs who are least able to cope with the situation and who are suffering a sharp decline in nutritional status (category I). Other groups of concern remain the returnees in and around Hargeisa town in Somaliland, who live in very poor conditions and do not have access to sufficient mechanisms for attaining food sources (category II).
Recommendations
· Immediately increase the emergency humanitarian response and in particular the amount of food aid to affected populations· Decentralise the aid distribution network to try and prevent build ups of large amounts of displaced people
· Expand the system of selective feeding centres to provide urgently needed nutritional support to populations in crisis
· Support traditional livelihood coping mechanisms such as migration
· Support peace and reconciliation moves between opposed factions and the TNG
The humanitarian situation in Sudan continues to be extremely precarious as a result of ongoing conflict and insecurity, particularly in Bahr-el-Ghazal and in Unity State, and as a result of adverse weather conditions, including successive years of drought and recent flooding. The results have been increasing levels of acute malnutrition, particularly amongst displaced populations, and concern that the hunger gap over the summer period would further deepen the developing humanitarian crisis. The current food security situation indicates a general improvement as a result of good and widely distributed rainfall. This has improved cereal availability in some areas and filled up rivers, making fish an exploitable food source. Wild food sources are also reported to be improving. However, it is important to note that areas of acute food insecurity remain largely as a result of physical insecurity. This has continued to displace large amounts of people and constrain normal livelihood activities. The United States Committee for Refugees has estimated that in excess of 150,000 people have been displaced in the first eight months of 2001 (USCR 02/10/01), bringing the total number of displaced to over 4 million people, the largest displaced population in the world.
At the beginning of October, a peace envoy from the Khartoum government met with Kenyan president Daniel Arap Moi who is currently the chairman of the regional peace process on Sudan, under the auspices of the Inter-Governmental Authority on Development (IGAD). At the meeting, the peace envoy reiterated the commitment of the Sudanese government to the IGAD peace process but emphasised the need to rejuvenate the process. The latest round of talks were meant to have begun on September 24th but have been delayed (IRIN 03/10/01). The Khartoum government has expressed its frustration with the talks, stating that it is “fed up” with the lack of progress and could pull out of negotiations if progress is not seen at the next round of talks (IRIN 08/10/01). One of the main sticking points in the talks remains the issue of oil extraction in Unity state, which has been the scene of heavy fighting over the past year. The SPLA/M have announced that they aim to shut down all the oil fields run with government backing in south Sudan (IRIN 23/10/01).
Humanitarian access
In light of ongoing humanitarian needs in many areas of the country, it is concerning to note that humanitarian access is still a problem, severely affecting the humanitarian community’s ability to provide much needed aid to vulnerable populations. Areas in the south of the country are still experiencing conflict based insecurity, particularly in Bahr-el-Ghazal, which has been the focus of both SPLA and Government of Sudan offensives in recent months. The offensives have resulted in the mass displacement of populations, resulting in the disruption of normal livelihood activities and the collection of large numbers of displaced in areas unable to support them. The insecurity often results in the evacuation of humanitarian personnel and the resultant cessation of aid activities. The town of Raga in western Bahrel- Ghazal has been the site of fierce fighting in recent months, driving many people into the Aweil counties.
Humanitarian activities have also been severely affected by the use of aerial bombing by the Sudan government in southern Sudan. IRIN have reported an escalation in the use of aerial bombing with almost 100 air strikes reported in the first six months of the year, particularly in Bahrel-Ghazal. There have been numerous examples of bombing near to food distribution sites, which have resulted in the suspension of distribution activities. WFP recently announced the forced suspension of food distributions to IDPs displaced by recent fighting in and around Raga town in Bahrel- Ghazal. The suspension occurred as a result of a series of air raids on the town of Mangayanth, which currently hosts 20,000 IDPs. The raids, which took place on the 5th and 8th of October, bombed around the UN distribution site and one of the raids came minutes before a UN cargo plane was scheduled to air drop food to the area (UNDP-EUE 22/10/01).
Access to vulnerable populations has also been constrained by the denial of permission for some essential relief flights, such as to Bararud in Wau County, where flights were denied in June due to SPLA offensives in the area. Other flight denied areas are in western Upper Nile, where population displacement around the oil fields is increasing. In some areas, flights have been re-directed to alternative airstrips and food has got through to affected populations. However, in recent months heavy rainfall has further complicated access by making some airstrips and roads inaccessible to humanitarian agencies (IRIN 23/08/01).
Drought and floods
The effects of more than three consecutive years of late rains have resulted in acute water shortages and crop failures in most parts of Darfur and Kordofan regions, as well as parts of east Equatoria and parts of Bahr-el-Ghazal. The drought conditions and their affects continue in some areas but, in general, recent months have seen an increase in rainfall. The most recent predictions until the end of the year are for near to above normal rainfall over southern Sudan (FEWS 14/09/01). The rains have resulted in a general improvement in crop prospects although their distribution has not been uniform. The improved rainfall will also beneficially affect pasture for livestock and access to other food sources such as fish. However some crop damage has also been reported and flooding in some areas has resulted in crisis conditions, particularly in northern and eastern parts along the Nile. IRIN reports that at least 200,000 people have been affected, with many stranded without food, drinking water or medical supplies (IRIN 03/09/01). Despite heavy rains in some areas, the effects of the drought continue to be felt either due to uneven distribution or through the rains arriving too late to save already parched crops and a badly disrupted agricultural system. As a result, the harvest in many of the most severely drought affected areas is likely to remain poor.
Humanitarian response
Despite various security and donor constraints, the response to the crisis in Sudan has been good and WFP report that their emergency relief operation is 80% funded (WFP 07/09/01). This is crucial as FAO have reported that the food aid requirement after commercial food imports to the country is 244,000 MT (FAO 22/08/01). The pipeline for cereals and pulses was described as good in July but concern was expressed over poor supplies of vegetable oil. Stocks of Corn Soya Blend (CSB) were also low, although new stocks were expected (IRIN 23/08/01). In response to the increased rainfall, WFP has also been forced to conduct more of its food distributions by air, substantially increasing the cost of aid deliveries by as much as 500,000 USD (IRIN 03/09/01).
SOUTH SUDAN, NON-GOS CONTROLLED AREAS (OLS SOUTHERN SECTOR)
September has seen the ending of the hunger period with preliminary findings of the Annual Needs Assessment (ANA) teams indicating that the food security situation in south Sudan is likely to be improved in the 2001/2 year over that experienced in 2000/1. However, areas of acute food insecurity are expected to remain largely as a result of conflict related insecurity, which continues to displace populations and severely disrupt livelihood activities.
Bahr-el-Ghazal
September has seen the end of the hunger gap due to the beginning of the crop harvest and improvement in the crop outlook. Food security remains of concern but is generally expected to improve as a result of better rainfall over the majority of the region. In southern Bahr-el-Ghazal, rains are reported to have been above normal and, although there have been no reports of flooding apart from in Ajiep, Gogrial county, the possibility of flooding remains. Water levels in the major rivers are high and this has improved access to fishing as a viable source of food. Recent months have seen the continuation of heavy fighting by both Government of Sudan and SPLA troops, especially in Raga County, with reports of continued population displacement.
Aweil East and West
The RNIS does not have any new information on the nutritional status of populations in Aweil East or West: however, recent surveys by Tearfund (see RNIS 34) in Aweil East have indicated alarmingly high rates of acute malnutrition. Insecurity and drought delayed the planting of crops in both areas, usually done in May until June and July, and there were fears that poor crop performance coupled with insecurity and large amounts of displaced could lead to a deterioration of the situation. However, the latest reports indicate that the cereal availability is currently good as a result of good rainfall on top of improved availability of seeds and agricultural inputs (FEWS 18/10/01). This will have gone some way towards improving the availability of food and is also likely to have improved access to fish and wild foods. As a result of the improved food security outlook, the nutritional status of populations is not likely to deteriorate further but, given the high rates of malnutrition experienced earlier in the year, is still of concern.
Aweil South
In late July and early August, Tearfund and Action Against Hunger (AAH) USA conducted a nutritional survey in Aweil South. The survey was conducted to investigate the level of malnutrition amongst households suffering from drought, insecurity and a prolonged hunger period. The survey estimated a prevalence of acute malnutrition of 21.9% (<-2 Z scores and/or oedema) including 3.1% severe acute malnutrition (<-3 Z scores and/or oedema) (Tearfund/AAH-USA 11/08/01). The survey also indicates that the majority of the children classified as being not malnourished (i.e. >-2 Z scores), were only marginally above the cut off point and would be likely to become acutely malnourished should the situation deteriorate significantly. The level of acute malnutrition is alarming being significantly over emergency thresholds and is comparable to levels found in Aweil East in June (see RNIS #34). The survey also estimated the under-five mortality rate to be 3.86/10,000/day, which is above alert levels and also gives rise for significant concern. The reason given for the high levels of malnutrition were the poor food stocks from the previous year’s drought conditions and the elongation of the hunger gap. This was a result of the expected harvest being put off from early August to September (Tearfund/AAH-USA 11/08/01). The survey also draws attention to the poor access to health facilities for the population. The level of measles vaccination was very low at 13% of surveyed children, and certainly reinforces this observation. It is also likely that the poor security seen in the area has also contributed to the food insecurity of the population. It is important to note that whilst these levels of acute malnutrition are often regarded as normal in south Sudan, they are very significantly above emergency thresholds and indicative of a very serious situation. The harvest in September and October has been relatively good in the Aweil counties and it is hoped that the increased availability of food will significantly improve the food security in the area and contribute to an improvement in the nutritional status of the population.
Raga (Mangayath)
Raga County has been the scene of some of the fiercest fighting in south Sudan this year. The fighting began as part of an SPLA offensive in May/early June, which resulted in the capturing of the town from government forces. This pushed tens of thousands of people northwards into Darfur and into the Aweil counties. Government forces have subsequently retaken the town, and fighting in and around the town is still taking place. It is estimated that at least 20,000 people have been displaced within the area to the town of Mangayanth, which is located some 22 km to the south east of Raga town (FEWS 18/10/01). There is concern over the conditions of the IDPs because of the large numbers who are living in a camp with very little access to food, sanitation or clean water. The Mangayanth area is also suffering from food insecurity and food prices in the market are high. The presence of large numbers of displaced also almost certainly compromise the food security of the non displaced population in the area. The area has received repeated attacks by government of Sudan forces and access to the vulnerable displaced population is currently very poor. The RNIS has no nutrition information on the IDPs but they are considered to be extremely vulnerable and their situation should be carefully monitored.
Equatoria
The situation in Equatoria is not deemed to be critical, particularly in the west where crop performance is described as good. In the east there are some reports of crop damage as a result of the drought, followed by too much rain at the critical flowering stage of the crops. In total, the yield for maize and sorghum is considered to be an improvement on last year (FEWS 18/10/01). The RNIS has not seen any recent nutritional information from the region but Equatoria is considered to be a relatively food secure area. In the absence of major insecurity in the region the food security situation of the population is assumed to be relatively good.
Upper Nile/Jongolei
The RNIS has not received any new nutritional information from Upper Nile or Jongolei and there has been concern over high rates of acute malnutrition seen in Phou and Bieh states (See RNIS # 34). The general food security outlook appears to be improved as a result of a good rainy season. This has resulted in some flooding and destruction of crops but it will also have contributed to replenished water supplies and increased fishing and wild food opportunities. The harvest is expected to finish at the end of October and threshing will normally take place in November and December. However, the biggest constraint on food security remains the conflict in the oil rich areas of western Upper Nile, which continues to displace populations and disrupt the normal pattern of livelihood activities.
SOUTH SUDAN, GOS CONTROLLED AREAS (OLS NORTHERN SECTOR)
The government controlled areas of south Sudan have continued to see increased levels of conflict, particularly in the region of western Bahr-el-Ghazal.
Aweil town and camps
Aweil town and camps are a government held enclave in northern Bahr-el-Ghazal and have suffered from insecurity over the course of 2001. As a result, there have been many evacuations of humanitarian staff from the town with no access between June to August 2001. This has resulted in a suspension of the general food distribution (ACF 15/09/01). Food security is considered to be poor because the inhabitants of the town have very little access to the surrounding area and depend on flights to northern Sudan for any commercial exchanges. The fighting in Bahr-el-Ghazal has displaced a large number of people to Aweil town and its camps and WFP estimates that there are currently in the region of 5,919 IDPs in two official camps. IDPs also live in the town amongst the non-displaced population (ACF 15/09/01).
ACF conducted a survey in the camps and the town in September 2001 and found a prevalence of 26.4% acute malnutrition (W/Ht < -2 Z scores and/or oedema) including 5.4% severe malnutrition (W/Ht < -3 Z scores and/or oedema) in the camps. In the town, the prevalence of acute malnutrition was estimated to be 15.9% (W/Ht < -2 Z scores and/or oedema) including 2.4% severe malnutrition (W/Ht < -3 Z scores and/or oedema). The levels of acute malnutrition in both the camps and town are above emergency thresholds although the levels were significantly higher in the camps. The seriousness of the situation is further reinforced by the underfive mortality rates of 6.5/10,000/day in the camps and estimated to be 1.25/10,000/day in the town. The high underfive mortality rate in the camps is further cause for concern, although the authors indicate that confusion over the recall period may have biased the results. The causes of the high malnutrition rates are linked to the poor food security of the area compounded by months of no general food distribution, the hunger season and the generally poor security of the area. The survey also draws attention to the very poor quality of water sources and a critical lack of access to health facilities (ACF 15/09/01). The hunger season has now ended and the general food distribution has resumed and as a result, access to food is assumed to have improved. However, the poor water quality, the lack of health facilities and continuing insecurity combine to make this population extremely vulnerable.
Unity State
Unity state has suffered continued insecurity over the year and as a result there has been a massive displacement of population, with many people coming to the towns of Bentiu and Rub Kona seeking assistance. The populations of the towns have received food assistance but it has been irregular as a result of insecurity and did not take place from March to June 2001 (ACF 23/06/01). ACF conducted two nutrition surveys in June 2001 in the two towns to assess the level of acute malnutrition. The survey in Bentiu estimated a prevalence of acute malnutrition of 28.9% (W/Ht <-2 Z scores and/or oedema) including 4.8% severe malnutrition (W/Ht <-3 Z scores and/or oedema). In Rub Kona the prevalence of acute malnutrition (W/Ht <-2 Z scores and/or oedema) was estimated to be 38.4% with 6.8% severe malnutrition (W/Ht <-3 Z scores and/or oedema) (ACF 23/06/01). The results of the survey indicate very alarming rates of acute malnutrition that are well above emergency threshold and indicate a very serious situation. It is hoped that the general improvement in food security as a result of better harvests will improve access and availability of food. However, the insecurity in the area continues to restrict livelihood activities and prevent access by humanitarian agencies. As a result this population can be assumed to be extremely vulnerable.
Juba
Juba is a government held enclave in south Sudan that has received enormous amounts of IDPs over the course of Sudan’s 11 year civil war. As a government enclave it depends on supplies from the north of the country and as a result of ongoing insecurity in the Upper Nile and Unity states, the normal supply barges from Khartoum have been unable to get through. This has resulted in a reliance on air support and as a result many food items are extremely expensive. WFP is conducting targeted food distributions to IDPs and other vulnerable groups and the daily ration is composed of cereals, pulses, oil and CSB to give a full ration of 2,155 Kcal/person/day. ACF conducted two surveys in July, one in the town and one in the surrounding area. The surveys indicated that the prevalence of acute malnutrition amongst the under-five population in Juba town was 12.1% (W/Ht <-2 Z scores and/or oedema) including 1% severe malnutrition (W/Ht <-3 Z scores and/or oedema). In the surrounding area the prevalence of acute malnutrition was 9.3% (W/Ht <-2 Z scores and/or oedema) including 0.8% severe malnutrition (W/Ht <-3 Z scores and/or oedema) (ACF 17/07/01). The under-five crude mortality rate was calculated as 2.3/10,000/day and 0.68/10,000/day in the town and surroundings respectively. The results of the survey indicate that the nutritional situation is precarious with IDPs in the town appearing to be slightly more vulnerable than those outside. However, the situation is not currently not critical. It is likely that the good food distribution targeted at the vulnerable groups such as IDPs has helped to prevent a slide in nutritional status. It is important to note that the area is isolated and prone to insecurity and the population remains at risk.
NORTHERN SUDAN. TRANSITIONAL ZONE
The Transitional zone has suffered from drought and insecurity, which have resulted in large amounts of people being acutely food insecure. The rains and harvest period are thought to have alleviated some of the problems of food availability but the problem of insecurity remains a large constraint to the food security of the populations of the area.
Darfur
Darfur has been suffering from a very serious drought that has led to very high rates of acute malnutrition(see RNIS # 34). The RNIS does not have any new information on the droughtaffected populations but a recent SCF-UK assessment investigated the condition of IDPs from Bahr-el-Ghazal who had fled fighting in Raga county. The population fled with very little in the way of resources and have inadequate access to food and clean water. The assessment was conducted in July amongst camps of IDPs in south Darfur with an estimated population of 20,500. The assessment took the form of a weight for height screening of under-fives in three of the camps and indicated that acute malnutrition was a problem of public health significance with a prevalence of over 15%. The immediate causes were identified as the inadequacy of food intake, poor access to clean water and a high burden of disease (SCF-UK 10/07/01). The prevalence of malnutrition is high and gives cause for alarm, particularly given the lack of resources of the IDP population and the food insecurity of the populations around them. The population remains at high risk.
Refugees
The RNIS has no new information on the nutritional status of refugees in Sudan. UNHCR estimates that there are currently about 440,300 refugees from Uganda, Ethiopia, Eritrea, DRC, Kenya, the Central African Republic and Chad (USAID 28/09/01). The repatriation of Eritrean refugees is continuing and it is hoped that 61,000 will have returned by the end of 2001.
Overall
The situation in Sudan remains extremely precarious despite a slightly improved food security outlook in many areas. The reason for this is the ongoing insecurity, particularly in the south, which continues to displace populations and constrain both access and availability of food sources and humanitarian relief. The RNIS also notes that alarmingly high levels of acute malnutrition are still observed in some areas and although the overall situation appears to have improved, it remains extremely seriously for many displaced populations (category II).
Recommendations
From the ACF survey in Bentiu and Rub Kona (ACF 23/06/01)
· Improve the general food ration and ensure regular delivery to beneficiariesFrom the SCF-UK assessment in South Darfur (SCF-UK 10/07/01)
· Continue to treat severe and moderate malnutrition with selective feeding
· Increase measles vaccination coverage
· Ensure the distribution of a full ration on a monthly basisFrom the ACF survey in Aweil town and camps (ACF 15/09/01)
· Provide adequate supplies of clean water
· Conduct vector control exercises to control malaria
· Improve access to adequate water and sanitation in the camps
· Implement selective feeding to treat both moderate and severe malnutrition
· Improve the access to health facilities
Guinea
Liberia
Sierra Leone
The overall humanitarian situation in West Africa has seen a marked improvement over recent months, primarily as a result of the continued successful implementation of the Abuja peace accord. However, the level of funding for humanitarian activities is considered to be very low and WFP have announced that as of October 24th the current PRRO that ends at the end of 2001 faces an immediate shortfall of 4,200 MT (2,805 MT of cereals, 985 MT of pulses, 306 tons of oil and 165 MT of sugar). There is also considerable concern over the new PRRO for 2002, which requires 104,943 MT of food. In light of the lengthy process for procurement and shipping leading to delays, there is an urgent need for donors to pledge funds immediately (WFP 02/11/01).
The Mano River Union area has been the scene of repeated violence over the years, however the relative stability within Guinea has meant that it has received a great number of refugees from the neighbouring countries of Liberia and Sierra Leone. Many of these refugees were traditionally located in the south eastern Forest region of the country. The traditional stability of the area was broken at the end of 2000 by armed incursions into Guinea that resulted in the displacement of tens of thousands of both the local population and refugees. This resulted in a crisis at the beginning of 2001 with many people being cut off from humanitarian relief by ongoing insecurity. However, over the course of the summer the security situation has greatly improved in all regions of the country, mostly as a result of greatly increased stability and the continued disarmament of rebel groups in neighbouring Sierra Leone. Crucially, the areas along the border with Sierra Leone, notably the Parrot’s Beak and Gueckedou, remain secure. The return of stable security has greatly improved the humanitarian access to affected populations and allowed for a considerable improvement in the humanitarian situation within Guinea.
Recent months have seen a considerable worsening of relations between the government of Guinea, led by president Lansana Conte, and opposition groups within the country. The reason lies in a proposed referendum designed to seek approval for changes to the constitution. These changes include controversial plans to change the length of the presidential term from five to seven years and to allow the president to run for a third term of office. The proposals have not been well received by the opposition and there is a planned boycott of the referendum (IRIN 26/10/01).
Internally displaced
Fighting on the borders of Guinea, particularly in the south east Forest Area, resulted in the displacement of around 190,000 people to areas further into the country (OFDA 03/10/01). The displaced were extremely vulnerable but the stability of the current situation has allowed many to return to their homes and begin to reconstruct their lives. The increased security in the south east has led to the partial reestablishment of the major market town of Gueckedou, increasing the demand for crops and encouraging many farmers to return to their land with the hope of selling their crops. However, the conflict has severely disrupted the agricultural cycle in the affected areas and large amounts of crops were destroyed in the fighting. As a result, the 2001 harvest is expected to be poor. This follows on from good harvest years in 1999 and 2000. The harvest nationally has also been affected by flooding in the north, which is estimated to have destroyed 2,000 hectares of farmland and affected 220,000 people (IRIN 22/10/01). The reduced harvest is likely to increase demand for humanitarian food assistance. In response to the reduced harvest prospects in the south east, agencies have been implementing agricultural recovery and seed distribution programs. However, it is widely considered that their introduction was only possible too late in the season and that their affect will not be felt until next year (OFDA 03/10/01). The RNIS does not have any recent survey information on the IDP population but the situation is not considered to be critical.
Refugees
Fighting in the south eastern Forest area of Guinea has seriously affected the resident refugee communities. For some time, there was considerable concern for refugees trapped in the Parrot’s Beak area. The lack of humanitarian access to the population was of great concern and, when security permitted, 57,000 were relocated to new camps further within Guinea during May 2001. The main areas of new settlement are in the Albadaria and Dabola Prefectures in Upper Guinea, where the majority of the refugees are of Sierra Leonean origin. The Albadaria area has three camps; Boreah with 13,000 refugees, Kountaya with 26,000 and Telikoro with 11,500 (OFDA 03/10/01). The Dabola area has Sembakounya camp with a total of 7,500 refugees. There is also a group of predominantly Liberian refugees in the Macenta and N’Zerekore areas of the Forest area. The two active camps are Kouankan with 13,500 refugees and Kola with 4,100 (WFP 12/10/01). Some refugees are currently being moved from Kounkan to Kola to relieve over crowding. There are also a substantial number of refugees who have not registered with UNHCR and who have moved into host families or established their own settlements, however there is very little information concerning their condition.
The security situation for the refugees has remained good allowing for continued humanitarian access. The only area reported to be suffering from some insecurity is the town of Kissidougou, with access to the area remains difficult. Reports indicate that the refugees are still heavily reliant on humanitarian assistance and improved security has allowed regular food distributions and health activities to take place. UNICEF reports that the under-five mortality rates have remained at non-alert levels in the camps and that rates of infectious diseases are low. The RNIS has not received any new nutritional information on refugees but WFP report that the nutrition situation in camps has remained stable, hovering around the 5% level, for this year. This is probably due to the greatly improved security situation, which has increased both the availability and accessibility of food. The only point of concern lies with the poor situation in neighbouring Liberia, which is still forcing Liberians over the border into Guinea.
Repatriations
Repatriation of Sierra Leonean refugees continues to take place with an estimated 50,000 having been repatriated by sea to Freetown and a further 20,000 having crossed the border, making their own way back to their area of origin, or the various returnee camps within Sierra Leone. It is likely that the number of returnees will increase if the situation in Sierra Leone continues to improve and new areas open up.
Overall
The stabilisation of the humanitarian situation is largely a result of the improved security within the country and, to some degree, in neighbouring Sierra Leone. The continuation of fighting in Liberia, close to the Guinean border, is concerning and is likely to result in an increase in the number of Liberian refugees. The refugees currently in established camps are not considered to be in a critical condition (category III). The condition of IDPs is also thought to have improved (category III).
Recommendations
· Continue nutritional surveillance activities within the camps· Continue food and health assistance to refugees in camps
· Provide agricultural support to populations moving back to areas destroyed by the fighting earlier in the year
The humanitarian situation in Liberia continues to deteriorate as a result of fighting between government troops and dissident groups in the north of the country, particularly Lofa County. The country was crippled during the civil war between 1989 and 1996, which destroyed the economy, infrastructure and social fabric of the country. Today, Liberia is classified as one of the least developed countries in the world and its Human Development Index (HDI) places it 174th out of 175 countries (UNSC 05/10/01). Mortality rates and life expectancy are believed to have remained little changed in the last twenty years, largely as a result of the collapsed economy and lack of even basic medical care. It is estimated that 80% of the population live in poverty, on less than one US dollar a day, and half of these live in absolute poverty, classified as those surviving on less than half a US dollar a day (UNSC 05/10/01).
The governments of Sierra Leone and Guinea have been accusing the Liberian authorities of supporting anti government forces within their countries, particularly the RUF forces in Sierra Leone. This has led to very tense relations between the Mano River Union (MRU) countries and also led to the imposition of sanctions on the Liberian regime by the UN in May 2001. The sanctions were targeted at the Liberian authorities and particularly at the sale and supply of arms to the regime and the trade in diamonds. A recent report by the Secretary-General of the UN highlighted the fact that the continuation of sanctions was likely to have adverse and unintended affects on the general population and the report suggested the establishment of a committee to monitor these affects (UNSC 05/10/01). These potential affects are particularly concerning because they are likely to further reduce people’s ability to cope with the already poor humanitarian situation.
Despite traditionally poor relations between Liberia and the neighbouring MRU countries of Guinea and Sierra Leone, the past few months appear to have seen a thawing in diplomatic relations with meetings between security ministers from the three countries. The meetings are an important step towards a regional security process and will hopefully lead to a full MRU summit at the beginning of 2002 (IRIN 28/09/01). In a further show of improved relations with the other MRU countries, Liberia also announced the dropping of restrictions on diplomats within Liberia and the future opening of the border with Sierra Leone and Guinea, which were shut in March (AFP 01/10/01).
The past few months have seen the continuation of fighting in Lofa County and more recently in Gbarpalu, closer to the capital Monrovia. There are estimated to have been 40,000 people displaced, mostly from Lofa County in the north of the country. The majority of the displaced have fled southwards to Bong, Cape Mount and Gbarpolu counties where they are in a variety of different camps. MSF reports that the displaced are arriving in the camps in an extremely weak condition because they have been forced to walk extremely long distances without access to food and through extremely insecure zones. Indeed, it appears that families have been forcibly separated, with men forced to remain behind in Lofa, presumably as a way of preventing opposition groups from moving into other areas. There is also a great problem of access to the areas most severely affected. MSF also report that they have been able to make very few assessments in Lofa but those that have been made have shown wide scale destruction of property and crops. MSF have also been forced to evacuate their expatriate staff from Jenna Mana camp in Cape Mount County (MSF 17/10/01). The lack of access and the high dependence of IDPs on food aid is particularly concerning. It is important to note that there has been a lack of donor interest in the country and the programs remain under funded, resulting in concerns that there could be possible pipeline breaks. The RNIS has not received any new nutrition information from Liberia but the situation is assumed to be extremely poor.
Overall
The situation for both displaced and nondisplaced populations continues to deteriorate in Liberia. The displaced remain particularly vulnerable and their dependence on humanitarian relief is extremely high (category II).
Recommendations
· Support the Inter-Agency appeal for Liberia· Improve access to displaced populations in order to ensure that relief reaches those in need of assistance
· Conduct nutrition and food security assessments of the displaced to determine and prioritise needs
The reporting period has seen the continued improvement of the situation in Sierra Leone. Regionally there have been encouraging signs of a thawing of relations between the Mano River Union countries and closer cooperation. An indication of the greater cooperation between the countries is the announcement that Guinea, Liberia and Sierra Leone would deploy joint patrols along the border areas in an attempt to stop the proliferation of small arms (WFP 12/10/01). There has been no cross border fighting reported between the Revolutionary United Front (RUF) and Guinean forces since fighting earlier in the year. This is largely a result of the ongoing disarmament of the RUF within Sierra Leone. The Abuja peace agreement of November 2000 has continued to be implemented and the ceasefire has held.
The peace process has not been without its problems and on October 4th the UN Security Council expressed concern over the slow pace of disarmament by the RUF in the Bombali zone of northern Sierra Leone (IRIN 04/10/01). The Process has also been strained by an announcement by the Sierra Leonean government that elections would be delayed until May 14th 2002 and that the government would extend its current state of emergency, for the second time, by a further six months (OCHA 30/09/01). The announcement prompted the RUF to boycott tripartite peace talks in protest, however the talks have since been rejoined. Despite some tensions, the programme of disarmament has continued all across the country with OCHA reporting on October 15th that 20,284 combatants from various fighting factions had disarmed since May 18th 2001 (OCHA 15/10/01). This has been greatly facilitated by the presence of UN peacekeepers in the form of UNMASIL. As new areas have opened up, UNMASIL have deployed across the country and, in recognition of their roles in the disarmament process and in the facilitation of the delivery of humanitarian assistance, the UN Security Council has extended their mandate for a further six months from the end of September 2001 until March 31st 2002 (OCHA 30/09/01).
The most important affect of the disarmament has been the opening up of areas of the country, which have been largely inaccessible to humanitarian actors, some for a number of years. For example, in August UNMASIL deployed peacekeeping troops to the northern district of Koinadugu, which had been occupied by the RUF since 1996 (IRIN 09/08/01). This has enormous implications for the development of the humanitarian situation within Sierra Leone because it allows access to vulnerable populations and is promoting the increasing return of displaced to their places of origin. The current security within the country is also allowing people to access their land and conduct farming activities and this combined with improved economic opportunities is likely to have a positive affect on the food security of the population in general and the IDPs and newly returned in particular. It is also important to note that the opening up of new areas is also revealing areas of acute need where infrastructure, particularly the health system, has been destroyed for some years as a result of fighting. Despite the increased access and higher demands for assistance, the consolidated appeal for Sierra Leone remains badly under funded at just over 40% by midyear. WFP have announced that they are expecting food pipeline breaks in December, with an expected shortfall in cereal of 3427 MT (WFP 12/10/01). This has created concern because it will constrain the ability of humanitarian agencies to respond to both the short and long term needs of the population (UNSC 07/09/01).
Displaced Populations and Returnees
The displaced population remains hard to estimated but OCHA reported at the beginning of August that 127,000 IDPs remained in camps, with a further 120,000 living with host communities (OFDA 03/10/01). The majority of the registered IDPs are in or near urban areas such as Freetown, Kenema, Bo and Daru and also in the Tonkilili and Port Loko districts. The number of people returning from Guinea has also increased and it is currently thought that an estimated 75,000 returnees have arrived back in Sierra Leone since the beginning of 2001. The majority of those officially repatriated by UNHCR and IOM have arrived in transit camps around Freetown. Concern has been expressed over overcrowding in the camps as a result of the numbers of returnees. UNHCR and the Sierra Leonean government have taken the step of asking 8,000 returnees in Jui, Waterloo and Lumpa camps in the Freetown area to relocate to resettlement sites in eastern and southern Sierra Leone. The move is an attempt to alleviate the overcrowding in the transit camps (IRIN 13/08/01). However, MSF have warned that the influx of returnees could potentially trigger a new emergency in the country as many return to areas of the country which are deemed secure. They point out that nine years of civil war has almost totally destroyed the health facilities in many areas, leaving low rates of vaccination and regular outbreaks of infectious diseases such as malaria, yellow fever, lassa fever, cholera and measles (IRIN 28/09/01). The fear is that the lack of infrastructure in many areas will contribute to high morbidity and mortality rates and ongoing food insecurity. This will slow down the rates of return and serve to maintain a high dependency on external humanitarian assistance.
Northern Province
The RNIS does not have any new nutritional information from the northern province but the situation is assumed to be stable as a result of the greatly improved security and access to the area by humanitarian agencies. The districts of Kambia, Bombali and Koinadugu have all seen disarmament take place and as a result IDPs have continued to return to their areas of origin. A local NGO Community Action Project have registered 15,000 IDPs moving from Port Loko to their home towns in Samu and Magbema chiefdoms in Kambia district. In some cases the areas of return have been inaccessible for a number of years and concern does exist that little infrastructure remains to support the increasing numbers of returning people. A recent UNICEF assessment in the Tonkilili district, on the existing water and sanitation facilities available to the population, indicated a very high incidence of diarrhoea. Many of the communities lack protected water sources and as a result many existing sources are supposed to be suffering from contamination (OCHA 30/09/01). These findings are concerning because of the need for good and adequate sources of clean water to support the increasing numbers of returnees to newly opened areas.
In an effort to start the reconstruction of essential infrastructure UNDP has started the construction of 400 houses and various public facilities in the Kambia district. There is also considerable work going into the rebuilding of medical facilities, including the re training of medical staff. WFP and its partners are also supporting returnees to resume farming activities with the distribution of seeds and tools and the implementation of a program called Food for Agriculture. It is hoped that the improved access to land will positively affect the food security prospects for the area.
Western Province
The RNIS has not received any new nutrition surveys on displaced populations in the western province. The large number of IDPs still remaining in camps in and around the capital Freetown remain dependent on food assistance and the over crowding in some of the camps has caused concern that the public health of the displaced could suffer. However, the overall security in the country will hopefully allow many of the displaced in the west to return to their areas of origin and become less dependent on humanitarian assistance.
Southern and Eastern Provinces
The security situation in the south and east has remained good despite some delays in the disarmament process. Notably the diamond mining zone of Kono is no longer under rebel control and it is hoped that this will go some way towards diffusing one of the chief sources of conflict in recent years.
Kenema district
Goal conducted a survey in Kenema district in August 2001. The target group of the survey was not specifically IDPs but the results give an important indication of conditions in an area that is likely to receive continued influxes of returnees seeking to re-establish themselves. Some areas of the district were not accessible to the survey teams as a result of insecurity or of rain blocking road access. The survey was conducted on children under the age of five and estimated a prevalence of acute malnutrition of 6.2% (W/Ht <-2 Z scores and/or oedema) including 1.6% severe malnutrition (W/Ht <-2 Z scores and/or oedema). The survey also measured mortality and estimated an under-five mortality rate of 1.8/10,000/day. Both the acute malnutrition and mortality rates are below alert thresholds and the situation is not deemed to be critical (Goal 08/01). WFP report that both Merlin and Goal have seen a drastic drop in the number of admissions to their selective feeding programs and it is thought that this indicates an improvement in the overall situation in Kenema (WFP 02/11/01).
Kailahun
The situation in Kailahun is considered to be precarious as a result of its proximity to the conflict- ridden Lofa County in neighbouring Liberia. This has resulted in a stream of Liberian refugees entering the country, often in extremely poor condition. It is currently unclear how many have crossed into the country but the number is believed to be in the thousands with UNHCR reporting that over 2,500 are being temporarily accommodated in the township of Bandajuma before being moved to a new camp in Pujehun district. WFP have expressed concern over the fragility of the food security situation in the Kailahun district and in August reported that there was little or no rice in the major trading centres of Kailahun and Pendembu (IRIN 22/08/01). In a recent move, UNAMSIL have deployed in the district and it is hoped that this will enhance the security in the area and allow greater access by humanitarian agencies (IRIN 26/10/01). The RNIS has not received nutrition reports from the area but the nutrition situation is understood to be extremely poor.
Overall
The reporting period has seen an improvement in the humanitarian situation in Sierra Leone with the continued implementation of the Abuja peace accords and the disarmament of various rebel groups. This has led to the crucial opening up of many areas of the country to both returnees and to humanitarian agencies. As a result of the improved security and access, the food security outlook in the country is good although many still rely on humanitarian assistance. In general the situation of IDPs remains fair (category III) and if the security situation permits continued returns, the situation is likely to improve further. However, concerns about the poor infrastructure within the country and the affect this may have on returning populations still exist. Fighting in Liberia and the resultant flow of refugees into the east of the country has left some areas of acute vulnerability (category II).
Recommendations
· Increase support of the inter agency appealFrom the Goal nutrition survey (Goal 08/01)
· Support efforts to rebuild the infrastructure of newly secured areas
· Phase out existing feeding centres when the number of beneficiaries drops sufficiently
· Conduct a program of health promotion and in particular on malarial prevention
· Implement water and sanitation activities.
Burundi
Democratic Republic of Congo (DRC)
Tanzania
Uganda
Burundi has been suffering the affects of a crippling internal conflict since 1993, resulting in massive displacement of population and erosion of basic essential infrastructure. The result has been wide scale acute food insecurity and a rise in levels of acute malnutrition, exacerbated in recent years by severe drought conditions and high levels of infectious diseases such as malaria. Latest OCHA figures indicate that out of a population of 6.65 million people, 432,818 are registered as internally displaced. This is an increase of over 50,000 people since May and, with insecurity continuing in western provinces, the numbers of displaced can be expected to increase. The majority of IDPs are resident in the south of the country with an estimated 106,540 in Makamba, 104,986 in Bururi and 78,840 in Rutana province. Burundi also has a refugee population estimated to be 28,800, mostly from the DRC (OCHA 12/10/01).
The reporting period has seen significant developments in the ongoing Arusha peace process started in August 2000. On 23 July 2001, a deadlock in negotiations was broken as Nelson Mandela, chosen to mediate the discussions, managed to garner agreement on a decision that Pierre Buyoya and Domitien Ndayizeye should be president and vice president of Burundi for the first phase of a transition government (ICG 14/08/01). The creation of the transition government is an opportunity to bring together opposing groups and establish a government that can bring peace to the war torn country. The biggest stumbling block to this remains the failure of the negotiators to bring two rebel factions, the Force de Defence de la Democratie (FDD) and the Force Nationales de Liberations (FNL) to the negotiating table. Within the transition government itself there was disagreement over the creation of an interim protection force for the institutions of the transitional government and for the protection of returning political exiles. The transition government was installed, as planned, on November 1st and its significance lies in its potential to see a lasting peace develop within the country. A successful peace process could lay the way for the repatriation of over 400,000 Burundian refugees in Tanzania and open up many areas of the country to humanitarian assistance. However, concern remains that there is potential for the continuation of violence. It is noted with concern that there have been two attempted coups in April and July 2001, clearly indicating dissatisfaction with the current political discussions. Further attempts could further undermine the ongoing peace process (ICG 14/08/01).
Humanitarian outlook
In general the humanitarian outlook in Burundi is still very precarious. Despite indications that the 2001A harvest had been reasonable and that prospects for the B harvest were also good, the food security situation in many areas remains poor. Particularly affected areas are Bujumbura Rural, Gitaga, Karuzi, Kayanza, Kirundo, Muramvya, Muyinga, Ngozi and Rutana (OCHA 17/09/01). One of the major reasons for the food insecurity is the continued conflict between government forces and rebel groups. It is currently estimated that seven out of a total of seventeen provinces are currently on UN security phase IV (I is the most secure and V the least). Fighting is regularly reported in Bujumbura Rural province as well in Cibitoke and Bubanza. The fighting at best limits access to farms and at worst forces displacement away from land and property. It is also widely recognised that armed groups freely loot food crops. This serves to constrain both the access and availability of food sources (WFP 27/07/01). Looting may be one of the reasons for large numbers of people tending to sell their produce rather than storing them. The sale of food produce is also used to generate much needed cash and is an indication of a possibly nonsustainable coping mechanism (WFP12/07/01). In response to food insecurity the FAO has maintained its seeds and tools distribution program and aims to distribute to 207,900 families (1,039,500 individuals) in preparation for the 2002 A harvest. WFP will also conduct Seed Protection Rations (SPR) to ensure that the distributed seeds are not eaten.(WFP 12/07/01)
The presence of high rates of infectious disease has also had an adverse affect on the humanitarian situation. The year 2000 saw very high rates of malaria infection, which resulted in high mortality rates and contributed to a declining nutritional status observed in affected populations. 2001 has not seen the crisis levels of malaria or malnutrition seen in 2000 but UNICEF warn that the number of malaria cases could climb as a result of the development of similar environmental conditions as those seen during the outbreak in 2000 (UNICEF 22/10/01). Official statistics place HIV/AIDS as the first cause of adult mortality in Burundi with 40,000 HIV/AIDS related deaths in 2000 alone. UNAIDS estimates that there are over 230,000 HIV/AIDS orphans in the country (OCHA 17/09/01). Agencies also point to the lack of access to appropriate medical facilities by much of the population as being of particular concern. It is also worrying to note that many communities have very little access to sources of potable water and adequate sanitation facilities. This is very likely to be linked to the high rates of diarrhoeal morbidity seen in many areas.
Very high rates of acute malnutrition have been seen over the past year but recent reports indicate that rates appear to be declining. The RNIS has not received any new nutritional surveys from Burundi but in August IRIN reported that a survey in seven provinces had indicated 10% of acute malnutrition (IRIN-CEA 02/08/01). The RNIS has not seen the survey report but 10% of acute malnutrition, whilst not suggesting a critical situation, is still suggestive of a precarious situation particularly given the ongoing insecurity and the affects of the drought. The improvement in the general nutritional situation is also suggested by figures for the number of beneficiaries in Supplementary Feeding Centres (SFC), which appear to have fallen significantly from 94,554 in April 2001 to 42,227 in August. The decrease is being attributed to the humanitarian response by the UN and NGOs, including the timely general food distributions to affected populations, the implementation of selective feeding programs, increased access to medical care and the distribution of seeds, tools and protection rations (UNICEF 22/10/01).
Bujumbura Rural
The situation in the province continues to be very poor with continued clashes between the FNL and government forces. There are also reports that crime is rising in the capital, particularly robberies of NGO offices. This is largely fuelled by the poor economy. WFP report that the food insecurity of the rural areas continues to be affected by the looting of crops by armed groups (WFP 27/07/01). At the beginning of October the Burundian Government requested assistance for an estimated 18,762 households comprised of both new and old IDPs (UNICEF 22/10/01). Whilst much of the rural population remains vulnerable a recent assessment in the Buterere Zone of Bujumbura Mairie indicated that the Batwa community, displaced from Bujumbura Rural, were facing a precarious food security situation as a result of a lack of access to farming land, water, sanitation and shelter (OCHA 17/09/01). The RNIS has not received any recent nutrition reports from the province but the situation is assumed to be precarious despite ongoing food distributions to the affected populations.
Karusi and Ngozi
Both provinces have suffered from the affects of drought, insecurity and infectious disease epidemics and as a result they both saw high rates of acute malnutrition in 2000 and the beginning of 2001. The food insecurity continues to be a problem as a result of insecurity but the drought and infectious disease episodes have largely improved. Food distributions to affected populations are continuing but access due to the insecurity is often a problem. The RNIS has not received any new nutritional information from affected populations but it is assumed that high levels of food insecurity remain, leaving the populations extremely vulnerable to nutritional decline.
Bubanza
The province continues to suffer acute insecurity as a result of its proximity to the border and incursions by Interehamwe and ex-FAR forces from DRC. The RNIS has not received any new nutritional surveys but the last survey in March (see RNIS # 34) indicated a possibly deteriorating situation, although levels of acute malnutrition fell below emergency thresholds. The observed rates of under-five mortality were, however, raised and gave cause for alarm. It is assumed that the reasonable crop prospects for the country will benefit the province but the food security of the population will be constrained by insecurity.
Refugees and returnees
Burundi is currently estimated to host 28,800 refugees, from various east and central African countries. The long history of conflict in Burundi has also driven up to 500,000 people across borders to become refugees, mostly in Tanzania. The sheer number of refugees in Tanzania has created a considerable burden on the country and has resulted in cooling in diplomatic relations between the two countries. There is little chance of an organised return of Burundian refugees until a ceasefire and lasting peace settlement have been reached. However, in the first eight months of 2001 it is estimated that almost 20,000 spontaneous repatriations took place with the majority settling in the eastern provinces of Ruyigi and Rutana. The RNIS has no nutritional information on either the refugee population in Burundi or returnee Burundian refugees from Tanzania.
Overall
The situation in Burundi remains extremely precarious for displaced and non-displaced alike. There are signs that the food security situation of some areas is improving and agencies are not recording the extremely high rates of acute malnutrition or malaria that were seen last year. However, the continuation of insecurity, despite ongoing peace efforts, means that populations remain extremely vulnerable (category III). It is hoped that the current peace efforts, seen in the installation of the transition government, will help to reduce the conflict related insecurity in the country and allow the process of rebuilding to begin.
Recommendations
· Support the UN Interagency Appeal· Implement food security analysis to understand how IDPs are coping with the current situation
· Support agricultural activities with the continued distribution of seeds and tools and seed protection rations
In 2001 there have been significant strides forward in the peace process with increasing attempts to involve some of the key rebel groups whose absence from the talks has proved to be one of the key obstacles to their progression. To this end, talks were scheduled for October 15th in Addis Ababa, to include delegations from government, rebels, opposition parties and civil society to start a national reconciliation dialogue (UNICEF 23/10/01). The talks represent a potentially ground breaking commitment to move forward in the peace process; however, they broke down after a week, with the walk out of the DRC government delegates. Whilst the initial failure of the talks is indicative of the many obstacles to peace in DRC, all parties have indicated their commitment to join further talks, probably at the beginning of 2002.
In general, the cease-fire along the front line is still largely respected and forces have continued to disengage. In particular, Ugandan forces have largely withdrawn from Equateur province but will maintain a battalion in the East and Namibia has withdrawn its troops (UNSC 16/10/01). However, warring factions, ethnic groups, and increasingly isolated non-state actors continue to clash in the east of the country and the general security situation is very poor. MONUC recently reported that armed groups and soldiers from Rwanda, Burundi and the Congolese Rally for Democracy (RCD) are taking part in intensified clashes around Fizi in south Kivu (UNDPI 27/09/01). There are also indications that remaining Ugandan and Rwandan troops are likely to clash over disputing front line positions in Kanyaboyanga inNorth Kivu province (PANA 26/10/01). These and other smaller clashes continue to have a very profound affect on the ability of humanitarian agencies to access many areas containing populations with acute needs.
The reporting period has seen the continued deployment of MONUC troops and observers in numerous areas of the country and as of October 15th, 2001, there were a total of 2,408 military personnel in the country. To date, MONUC has deployed in many critical areas within the country, particularly to cities such as Kisangani, Mbandaka, Kalemie and Kananga. From the areas of deployment they have been able to oversee the disengagement of troops and monitor the cease-fire, however there are still many areas where they have no access. MONUC deployment has three phases, the first two being the disengagement of troops from the front line and the preparation of plans for the withdrawal of foreign troops. In a recent report, the Secretary-General of the UN has indicated that it is time to move to phase III which is the organisation of the disarmament, demobilisation, repatriation, resettlement and reintegration (DDRRR) of warring parties (UNDPI 27/09/01). The Secretary-General stressed that MONUC has neither the means nor mandate to carry out many of the practical tasks of the DDRRR but the intention to move to phase III is an indication of how far the peace process has come. It is important to note that should fighting continue the future of phase III is likely to be jeopardised.
Numbers and distributions of IDPs
The current caseload of IDPs is estimated to be 2,045,000 IDPs. This represents an increase of 35,881 since April 2001 (OCHA 12/10/01). However, much of this increase is likely to be a result of IDPs from newly accessible areas and not as a result of new displacement. Many of the displaced remain in the eastern areas of the country where fighting is still ongoing and where access is still often extremely difficult. There are also currently an estimated 361,720 refugees (OCHA 12/10/01).
Table showing distribution of IDPs by province
|
Area |
Dec 2000 |
Apr 2001 |
Sept 2001 |
|
Equateur |
300,000 |
170,524 |
85,000 |
|
Orientale |
160,000 |
220,000 |
230,000 |
|
North Kivu |
640,000 |
620,000 |
760,000 |
|
South Kivu |
350,000 |
373,158 |
225,000 |
|
Katanga |
305,000 |
354,000 |
415,000 |
|
Maniema |
137,000 |
132,000 |
160,000 |
|
E. Kasai |
30,000 |
114,000 |
130,000 |
|
W. Kasai |
80,000 |
29,000 |
|
|
Kinshasa |
N/a |
N/a |
40,000 |
|
TOTAL |
2,002,500 |
2,012,682 |
2,045,000 |
Despite the peace process and the resultant cease-fire and disengagement of armed groups, the humanitarian situation remains critical. There has been increased international awareness of the crisis and the overall humanitarian response has been good. However the humanitarian needs are huge. A study by WHO and UNICEF shows that the vast majority of the population can be classified as living in absolute poverty, surviving on the equivalent of 0.20 US dollars a day and consuming less than two thirds of the daily food energy needed to maintain good health. Approximately 70% of the population have little or no access to health care and up to sixteen million people, or one third of the entire population, have critical food needs as a result of prolonged displacement, isolation, lack of market outlets, severed food supply lines, price increases and declining purchasing power. Within this grim humanitarian context, acute food insecurity and malnutrition are widespread, along with rates of morbidity and mortality that are routinely well above emergency thresholds (UN 2002; UNSC 16/10/01).
Given the scale of the needs within the country it is concerning to note that there is still an enormous problem of access to many areas. Part of the reason for this lies in the physical isolation of many areas, which creates enormous logistical problems to the supply of aid. It is estimated that out of 58,000 Km of road network only 3,000 Km remain in working order and over 80% of the rail network has been destroyed (Moreels 07/01). The other major constraint to access has been the insecurity seen in many areas, which has made it impossible for humanitarian agencies to work in any safety. The scale of the needs makes the inability to access vulnerable populations extremely serious.
Kinshasa
Kinshasa has not experienced the insecurity seen in the east of the country but has been gravely affected by the collapse in the economy and the break down in the supply of food from the east, which traditionally supplied the markets. As a result, the population remain extremely vulnerable, and WFP announced that it was considering distributing food to 81,000 vulnerable people (WFP 27/07/01) in the province. It is currently estimated that there are 40,000 IDPs in the province (OCHA 12/10/01) with numerous other vulnerable groups including 28,262 malnourished children (WFP 28/09/01). The RNIS has not received any new nutrition survey information from Kinshasa but the situation is understood to be extremely poor.
Eastern DRC
The crisis in DRC is at its most acute in the east. The area is the scene for some of the fiercest fighting and is home to countless armed militias allied to different countries and regimes, but whose allegiances often shift. The fighting has tended to be concentrated around the two Kivus and Maniema province, particularly around the larger towns Uvira, Bukavu, Goma, Kisangani, Kindu, Punida, Kampene, and Kalima. However, the entire area is considered insecure. The fighting has taken an enormous toll on the civilian population and it is most starkly seen in a mortality survey conducted by IRC which calculated that over 2 million people have died as a direct result of the fighting in eastern DRC since the start of the war in 1998 (see RNIS # 32/33). The situation in eastern DRC remains extremely critical.
Orientale
There are currently estimated to be 230,000 IDPs in Orientale, an increase of 10,000 from figures released in April (OCHA 12/10/01). The province is headed by the important city of Kisangani, which has been the focus and source of much fighting. The province is under rebel control and is largely split between factions that are loyal to either Uganda or Rwanda. It has also been the source of bitter ethnic conflict between Lembu and Hema, which has left thousands dead and displaced. The RNIS has no recent nutritional information from the province but the situation is thought to be serious.
Kisangani
MONUC have continued to be deployed in the town, which remains firmly under the control of the RCD rebel group. The RCD have rejected calls to demilitarise the town and maintains forces there allegedly to counter the threat of attack by the Mai-Mai and Interahamwe. There have been no reports of recent conflict in or around the town, but the RNIS does not have any recent nutritional information on the situation of IDPs in the area.
North and South Kivu
The situation in the Kivus remains extremely precarious. There are currently estimated to be 985,000 thousand displaced in the region, but numbers are hard to verify and are likely to change frequently as a result of continued conflict between the many different rebel groups in the area. The insecurity and lack of infrastructure in the region continues to obstruct humanitarian access and reports indicate that there have been numerous incidents of humanitarian workers being ambushed. On Oct 15th a WVI car was ambushed and the occupants robbed on the road from Beni to Bunia in north Kivu (OCHA 22/10/01). WFP operations have also been severely hampered by insecurity in the plains of Ruzizi and Uvira and all field missions have been suspended. There have also been extensive movements of troops in Bunyakiri, Hombo and Nyabibwe that have resulted in new population displacement towards Walungu, Kabare, Shabunda and Ninja (OCHA 06/11/01). There has also been a considerable escalation of violence around the town of Fizi and reports indicate that up to 6,000 people have fled across lake Tanganyika to Tanzania in order to escape the violence (RI 25/10/01).
The insecurity in the Kivus is extremely unpredictable and changeable. As a result, large sections of the population are displaced and suffer from poor access and availability of food. There is also a considerable problem of lack of access to health facilities, which has led to outbreaks of disease. There is currently a meningitis outbreak in Katana in south Kivu but OCHA estimates that only seven out of fourteen health zones are currently accessible and so vaccination is not possible for much of the population (OCHA 22/10/01). On Oct 16th MSF announced that it was launching a healthcare program in Shabunda, which is the first time that international aid has reached the place over the last 18 months (MSF 16/10/01). The RNIS does not have any recent nutritional information from the area but the population is considered to be extremely vulnerable to nutritional decline.
Maniema Province
Maniema province continues to suffer from extreme insecurity. There are currently estimated to be 160,000 IDPs in the area. The last survey from the area of Kalima town indicated that levels of acute malnutrition had improved and this attributed to improvements in the overall security situation of the province. The RNIS has not received any new reports on the nutrition situation but notes that WFP reports that they suspended their activities in the area of Kindu as a result of violent clashes (WFP 05/10/01). This again highlights the unpredictability of security in the area and it is unlikely that any large-scale return of displaced will take place until there are concrete indications of a working cease-fire and demobilisation of armed groups. There are also plans for MONUC to develop an operational and logistics base at Kindu as part of plans for Phase III of the MONUC mandate, which includes the disarmament, demobilisation, repatriation, resettlement and reintegration (DDRRR) of warring parties. This would make Kindu the main hub of activities within the east of the DRC. In order for the plan to go ahead there will have to be considerable improvements in the security situation and it would be necessary to rehabilitate the rail and river link between Kisangani and Kindu. At the moment, all supply is done by air but this will limit the size of any possible operations due to cost (UNSC 16/10/01).
Katanga
The north of Katanga is an extremely fertile area that used to produce a surplus of food and supply other areas. However, the presence of the front line running across the province, has shut down much of the agricultural activities and cut off access to markets for both producers and consumers. There are indications that the security situation is stable in some areas and there are reports that civilians are now travelling across the front line. However, many areas remain cut off from assistance and on Sept 28th WFP started an appeal to airlift food to 25,000 people in North Katanga who remain cut off by war (WFP 28/09/01). There is particular concern over the people of Mulongo and Kiambi who have been unreachable by air or road due to the insecurity.
Whilst the situation in north Katanga remains critical, World Vision also highlight desperate needs in south Katanga in the town of Kalomeno, where 3,000 IDPs remain acutely food insecure and in need of food and agricultural inputs. World Vision stress that the population appears to be heavily dependent on food distributions to meet their food needs (WVI 27/09/01). The RNIS also notes with concern that there is currently an outbreak of cholera in Ankoro in north central Katanga and on October 14th there were 221 recorded cases. Access to the area is very difficult and is constraining efforts to bring the outbreak under control (OCHA 22/10/01). The RNIS has not received any new nutritional information from the area.
Equateur
It is currently estimated that 85,000 people remain displaced by conflict and the presence of armed militias in the area (OCHA 12/10/01). There have been reports of looting of food crops and the presence of land mines and both have served to drastically reduce both the availability and accessibility of food. There have also been problems of ethnic violence particularly between the Landus and the Hemas, which has lead to a deterioration in the security situation (WFP 12/10/01). WFP have reported that the situation in the Mbandaka area is serious. The RNIS does not have any recent nutritional information for the area.
Refugees
There are currently estimated to be 361,720 refugees from surrounding countries in DRC (OCHA 12/10/01). The largest recent influxes of refugees have come from the Central African Republic (CAR) and from Angola, where recent fighting has continued to send streams of people into the country. The RNIS has not seen any recent survey on the various refugee populations but those in registered camps have access to humanitarian assistance. However, the reliance of refugees on humanitarian assistance is generally high and they remain affected by issues of humanitarian access in the same way as both IDP and nondisplaced populations.
Angolan Refugees
There is a large Angolan refugee population, which has been resident in the country for some years, but recent months have seen increased fighting in the northern Angolan province of Makela D’Nzombo. The fighting has resulted in a rush of new refugees who have crossed the border into Bas Congo province and beyond. It is now estimated that the recent caseload in and around Kimvula is around 20,000 people (WFP 05/10/01). The RNIS does not have any information on the nutritional status of this group but they are assumed to be extremely vulnerable.
Central African Republic (CAR) Refugees
An attempted coup in May 2001 sent thousands of refugees from CAR across the border into Equateur province. The refugees have collected in the town of Zongo where there is currently estimated to be caseload of 25,000 people. In September WFP established a sub-office in Zongo from which it commenced food distributions and is preparing to deliver additional food by barge from Kinshasa (WFP 02/11/01). The RNIS does not have any nutritional information on the refugees.
Overall
The reporting period has seen the continuation of the peace process. This has served to improve the humanitarian situation in some areas. However the situation remains extremely volatile and IDPs, refugees and non-displaced populations remain extremely vulnerable. The situation of war displaced remains both critical and