Eritrea
Ethiopia
Kenya
Somalia
Sudan
Eritrea continues to suffer from the affects of the war with Ethiopia and the regional drought of 2000. Both constituted considerable external shocks to the population, resulting in huge disruption of livelihoods and culminating in mass internal displacement of population. The Annual Needs Assessment for Eritrea concluded that 1.3 million persons remained vulnerable and would require continued food and other forms of assistance during 2002 (FEWS 04/12/01). This figure includes war-affected displaced, drought-affected populations, deportees and returning refugees (see table below).
The number of people in need of assistance remains high but the general humanitarian outlook is improving. Many people have returned to their areas of origin, with the chief constraint to further returns remaining the wide scale destruction around border areas and the presence of large amounts of mines and unexploded ordinance (UXO). The drought affected population make up the largest vulnerable group, with the areas of Anseba, North Red Sea and Southern Red Sea being the worst affected. It is important to note that less than 1 % of Eritrea s humanitarian needs of 120 million US dollars has currently been met (FEWS 25/03/02). The country has no emergency food resources to fall back on and there is a very real possibility that Eritrea will not be able to meet the food needs of its vulnerable populations. As a result, the government has had to redefine vulnerable groups and heavily target those considered most vulnerable.
Table of Vulnerable groups receiving food
aid
(UN 2002)
|
Number of IDPs in camps |
50,239 |
|
Number of IDPs in host communities |
14,199 |
|
Number of IDPs outside camps |
9,311 |
|
Total number of IDPs |
73,749 |
|
Expellees/deportees |
13,694 |
|
Total number of drought affected persons |
524,098 |
|
Total number of refugees expected to return from Sudan in
2002 |
90,000 |
|
Number of refugees in Eritrea |
1,922 |
|
Total number of food aid beneficiaries in
2002 |
800,000 |
Another important development, which could affect the humanitarian situation, is the evident concern of donors over the perceived reluctance of the government to embrace democratisation. Donor countries have expressed concern over the blocking of opposition parties and the expulsion of the Italian ambassador to Eritrea in September 2001. Italy has traditionally been one of the biggest donors to the country. In January 2002, Denmark announced that it would radically reduce assistance in 2002 and end its bilateral cooperation in 2005 as a result of government assaults on democratic principles and human rights (UNDP EUE 05/03/02).
War-affected displaced
The stabilisation of the security situation has seen many people who were internally displaced during the war with Ethiopia return to their places of origin. However, the presence of land mines and UXO, and the sensitivity of some areas close to the TSZ, has meant that some IDPs still remain. There are an estimated 73,749 IDPs, with 50,239 remaining in camps in the Gash Barka and Debub zones. The remainder are living either with host communities or in scattered groups. These groups have very little access to land or livelihood opportunities and remain highly dependent on food aid, at least for the duration of 2002 (FEWS 04/12/01). Nutrition surveys in July/August 2001 indicated that the nutrition status of IDPs was relatively good and appeared better than non-displaced populations in similar areas as a result of the emergency assistance IDPs received. However a series of surveys conducted over the last quarter of 2001 indicate a decline in the nutritional status of both displaced and non-displaced populations.
SCF-UK conducted three surveys in August, October and December 2001. The surveys revealed that the proportion of children under five was above 30 % and therefore higher than expected. A national demographic survey in 1995 indicated that the proportion of under-fives was 20.6 % (SCF-UK 12/01). The reason for this appears to be the large number of adults, particularly men, who are missing from families either because they are fighting at the front or because they have moved in search of employment. As a result, the number of female-headed households was high and is a risk factor for food insecurity and for nutritional status decline. The results of the surveys can be seen in the graph below. The first survey in August 2001 indicated a prevalence of acute malnutrition below emergency thresholds. However the two subsequent surveys show preva-lences that are raised above emergency thresholds and are indicative of a decline in the overall nutritional status of the population in the surveyed areas.
SCF Nutrition Surveys in Gash Barka Region, Eritrea
In the first two surveys the IDP population showed a better nutritional status than the non-displaced population due to the better provision of resources to IDPs. However, this was no longer the case in the third survey as a result of a decline in emergency assistance and essential services. The reasons for the decline in nutritional status appear to be related, primarily, to a decline in food availability. This is largely because the general ration was cut to 60 % where the resultant ration was 1553 Kcal as opposed to the 2100 Kcal recommended for populations dependent on food aid. WFP food monitors noted that relief food makes up 95 % of all food found in the community (WFP 04/01/02). The ration cut was carried out on the assumption that the November harvest would be good, which proved not to be the case. Crude and under-five mortality was also measured and in all three surveys was well below emergency thresholds (see table below). The surveys also indicated a decline in access to water and health services.
Table showing mortality rates in Gash Barka
region
(SCF-UK 12/01)
|
|
August 2001 |
October 2001 |
December 2001 |
|
Crude Mortality |
0.3/10,000/day |
0.43/10,000/day |
0.39/10,000/day |
|
Under-five mortality |
0.5/10,000/day |
0.57/10,000/day |
0.12/10,000/day |
Drought affected populations
The drought affected population make up the largest group of vulnerable people. They currently number 524,098 persons and are located in Anseba, North and South Red Sea zones. The vulnerability of these groups is a result of acute food insecurity, stemming from successive crop failures and the decimation of livestock herds. Even if there were to be series of good harvests, it is likely that it would take some time for this group to fully recover. The situation has been exacerbated by the failure of the Bahri rain season, which normally starts in October and carries on until March. This year s season has been delayed by three months. The North Red Sea zone has been particularly badly hit and, as a result of the total absence of rain during the first three months of the season, farmers have abandoned crop planting and are concerned about the fate of their livestock (FEWS 08/01/02). Recent rainfall estimates indicate that the situation could improve but drought-affected populations will remain highly vulnerable and dependent on external assistance.
Returnees
As a result of the recent conflict with Ethiopia and previous episodes of drought, there has been a large body of Eritrean refugees in countries such as Sudan. A series of agreements between the Eritrean and Sudanese governments were established during 2001 and the task of repatriating refugees, some of whom have been in Sudan for years, was started. The original plan was to repatriate 62,000 refugees by the end of 2001. However, the actual figure was 32,648 (FEWS 08/01/02). The reasons for this were firstly that the harvest season in eastern Sudan, where the refugees have been residing, coincided with the repatriation and refugees were reluctant to move before harvesting their crops. Secondly many of the refugees are Muslim and the repatriation fell during the Holy Month of Ramadan when refugees were also reluctant to move. It is estimated that 121,000 Eritreans still remain in refugee camps in Sudan s Kassala and Gedaref states. The problem for many is that they have very little to return to and will require substantial assistance. They will be helped in part with a return package of food and non-food items.
Overall
The humanitarian situation in Eritrea has generally improved as a result of improved security with neighbouring Ethiopia and an improved food outlook. However, it is important to note that very large proportions of the population remain extremely vulnerable to food insecurity as a result of the systematic erosion of livelihoods through both drought and conflict. As a result, dependence on external assistance is high and will continue for at least the duration of 2002 and very probably into 2003. Given the situation, it is alarming to note that the response by the international donor community to the humanitarian needs has been very small and, as a result, there are likely to be severe pipeline shortages. The improvement of the humanitarian situation is contingent on continued good security with Ethiopia and good rainfall. This will help facilitate returns and the reestablishment of livelihoods. Given the dependence of the vulnerable population on external assistance and the poor funding response, vulnerable groups should be regarded as being at moderate risk (category III).
Recommendations
From the SCF-UK nutrition surveys
· Supplementary food rations should be provided to all women and children who are malnourished.
· The general food ration should be maintained at 100 % for at least the next 6 months.
· The capacity to measure and monitor the food and nutrition situation should be improved.
The humanitarian situation in Ethiopia has improved considerably since the drought crisis of 2000. The number of people in acute need of humanitarian assistance continues to decrease, with current estimates indicating that there are 5.2 million people in need (see table below). This represents about 9 % of the total rural population of the country (FEWS 14/02/02).
Table of Population in Need of Relief in
2002
(FEWS 14/02/02)
|
Region |
Number of |
Percentage |
Population in |
|
Tigray |
917,200 |
17.7 |
26.8 |
|
Afar |
225,400 |
4.3 |
20.3 |
|
Amhara |
1,724,800 |
33.3 |
11.0 |
|
Oromiya |
1,051,400 |
20.3 |
5.0 |
|
Somali |
894,800 |
17.3 |
28.9 |
|
Benishangul- Gumuz |
9,000 |
0.2 |
1.7 |
|
SNNP |
303,300 |
5.9 |
2.5 |
|
Gambela |
32,800 |
0.6 |
19.7 |
|
Harari |
13,000 |
0.3 |
20.0 |
|
Dire Dawa |
10,000 |
0.2 |
10.5 |
|
TOTAL |
5,181,700 |
100 |
9.2 |
This has led to improved crop yields and substantial drops in the price of staple cereals. However the overall improved picture tends to conceal areas of increased vulnerability. The greatest needs remain in the Amhara, Tigray, Oromiya and Somali regions, which are chronically food insecure and have suffered from repeated poor harvests and unpredictable rainfall, eroding the population s capacity to cope with further shocks. Even in so-called normal years, many people in the worst affected areas have a dietary intake well below the minimum requirements. The overall figure includes 67,000 refugees in camps in the eastern part of the country as well as 75,000 war-affected people in the Tigray region.
Another important development has been the lifting of the livestock ban imposed by Yemen as a result of an outbreak of Rift Valley Fever. The ban has had an important effect on pastoralists, as the Arabian Peninsula had been a major place of export for Ethiopia. Whilst the lifting of the ban has been good, the ban from the Saudi Arabian market still continues and will continue to weaken the viability of pastoralist livelihoods (FEWS 19/12/01).
The Somali region has been particularly hard hit by drought, economic shocks and insecurity, with reports of a deteriorating situation. However the most recent Gu rains appear to have relieved immediate problems, but the chronic needs of the population remain. The chronic nature of food insecurity in Ethiopia is likely to mean that needs for assistance will remain high in the worst affected regions, despite good harvests and improved rainfall. FEWS has demonstrated that there is a continuing heavy bias towards food aid as the primary instrument of humanitarian response at the expense of support to mitigation and recovery activities such as capacity building and agriculture (FEWS 18/12/01).
Refugees
Ethiopia has two main groups of refugees with approximately 84,000 Sudanese refugees in camps in the west and about 67,000 Somali refugees in camps in the east. The situation remains extremely mixed, with nutrition surveys in the western camps indicating that needs remain high and dependency on food assistance continues (See RNIS #35). The continuation of fighting in Southern Sudan means that it is unlikely that there will be any substantial return of Sudanese refugees in the short term. Repatriations have been taking place of Somali refugees from the eastern camps to northwest Somalia. The repatriation effort has seen the closure of three of the original eight camps in eastern Ethiopia and it is estimated that a total of 51,216 Somalis from Camaboker, Darwanaji, Daror, Rabasso and Teferi Ber camps voluntarily repatriated to Somalia (UN-EUE 16/01/02). The returnees have been supplied with a nine-month food package as well as non-food items. This has left a remaining 66,900 refugees in the five camps of Hartisheik, Ke-bribeyah, Camaboker, Rabasso and Aisha. It is expected that a further 35,000 refugees will repatriate during 2002 (UN-EUE 16/01/02). The RNIS does not have any recent nutritional information from this group but they must be considered to be extremely vulnerable as a result of the ongoing food insecurity in the Somali region.
War displaced population in Tigray and Afar
The border war between Ethiopia and Eritrea in 1998 resulted in large a displacement of population from Tigray and Afar. The security of the area has remained stable and it is hoped that the ruling of the border commission on the position of the border will bring an end to the threat of hostilities between the two countries. The UN Mission in Ethiopia and Eritrea (UNMEE) has been present on the ground for some time and will continue to monitor the situation until September 2002. UNMEE has helped to facilitate the return of displaced by concentrating on the removal of mines and other forms of unexploded ordinance (UXO). However, mines and UXOs still pose a considerable threat to returning farmers and pastoralists and mean that some areas are considered too dangerous for returnees.
A large proportion of the approximately 300,000 IDPs in the two areas reported in RNIS #35 have now returned to their place of origin. All registered IDPs received food rations until the end of 2001, but this has been significantly altered for 2002 to include only those who cannot return because of security constraints and those who have resettled but who have no access to cropping or pasture land (UN-EUA 19/02/02). As a result, approximately 75,000 people still qualify for the IDP-food-assistance-program (WFP 15/03/02). The RNIS has no recent nutritional information for this group.
Somali Region, Eastern Ethiopia
Drought displaced
The Somali region remains highly affected by years of drought, poor economy and insecurity. In particular, 2001 saw the continuation of poor rains affecting the availability and access to water and pasture for the mainly pastoralist population of the area. The main causes of food insecurity have been successive episodes of drought where rainfall is low, unreliable and unevenly distributed. Any agriculture practised tends to have a very low productivity and the average household economy of pastoralists, the urban poor and IDPs are very narrowly based, with little access to technology, knowledge or markets. The area has also been affected by insecurity, which has driven people from their homes, disturbed existing markets and depleted assets.
The situation has been further exacerbated by the Arabian Gulf livestock ban imposed as a result of an outbreak of Rift Valley fever. Pastoralists from Somali region have always traditionally relied on Arabian peninsular as a major market for their livestock and have been very badly affected by the market s closure. Markets have also been affected by the sharp devaluation of the Somali shilling, used by many of the pastoralists. The hardest affected population categories are those not receiving remittances, the urban poor, migrants from Somalia and the internally displaced living around the main towns (SCF 11/01).
It is estimated that up to 90,000 drought displaced remain dependent on relief assistance in 2002 (UN-EUE 16/01/02). The majority lie around some of the main towns in the region. The RNIS has reported particularly on those around Denan where there are approximately 8,500 IDPs (see RNIS #35). The last nutritional reports available to the RNIS indicated that the prevalence of malnutrition remained high but had fallen significantly over the course of 2001. As a result of the falling prevalences, NGOs have pulled out of the area and the last selective feeding programmes closed in October 2001. Subsequently, there have been reports of a deteriorating situation in the area. This led to the resumption of general food rations and supplementary feeding in January 2002. The RNIS does not have any recent nutritional information from Denan, but it is assumed that the population remains highly vulnerable.
The immediate prospects for the area have improved as a result of good Gu rainfall in all parts of the Somali region and the resultant picture is encouraging for both crops and livestock. Consequently, it is expected that the immediate food security crisis will be alleviated, but it is important to stress that the population as a whole, and the drought displaced in particular, remain chronically food insecure and will certainly require the continuation of relief assistance (WFP 19/04/02).
Overall
The immediate outlook is improved as a result of a good Gu/Belg rainy season. However, humanitarian needs remain high because the majority of the most needy are chronically food insecure and will struggle to meet their subsistence needs even during periods of relatively improved access and availability of food. Both refugees and the war affected populations in Tigray and Afar remain moderately food insecure (category III), although their situation appears relatively stable. However, the drought displaced in the Somali region are considered to be at high risk of nutritional decline (category II) and are likely to remain so for the foreseeable future.
Recommendations
From the RNIS
· Maintain an adequate general food ration to all populations requiring assistance.· Focus on long term solutions to address the root causes of chronic food insecurity such as income generating activities, capacity building and agricultural programmes.
Kenya has been suffering from the regional Horn of Africa drought and as a result many, areas of the country have experienced episodes of acute food insecurity. The situation has improved over the course of 2001 and early 2002 with the advent of better rainfall and improved crop yield. This improvement in the general food security outlook has been particularly important for the pastoralist populations of the arid and semi arid marginal areas in the north of the country. However, the drought has extended over five seasons, substantially eroding the pastoral livelihoods of populations in the northern regions. This has left many chronically food insecure and ill able to cope with future shocks. As a result, needs in some areas are likely to remain high.
WFP has been conducting an extensive food aid programme across the country but has suffered from considerable budgetary restraints, making the food pipeline extremely precarious. General food distributions will be confined to an estimated one million persons in nine pastoral districts, requiring approximately 85,708 MT of food to last from April to September 2002. There is currently a shortfall in the food pipeline of 77,396 MT, consisting mostly of maize (FEWS 08/03/02).
Refugees
The number of refugees in Kenya is steadily increasing as a result of continued influxes from people fleeing the war in Southern Sudan. UN OCHA estimated that there were approximately 215,000 refugees at the start of 2002 with some 132,000, mostly Somali refugees, in Dadaab camp in the northeast and over 83,000 in Kakuma in the northwest (UN OCHA 22/03/02). However, it is reported that numbers are increasing steadily, particularly in Kakuma camp where it is estimated that numbers will increase to 90,000 during 2002 (ACT 08/01/02). The majority of new arrivals are women and children.
The camps are situated in the arid and semi arid northern zones of the country, with the situation for refugees made worse by the lack of a local settlement policy. As a result, there is 100 % dependence on the international community for food aid. The refugees are not permitted to herd livestock and their freedom of movement is restricted, further curtailing the possibility of developing coping mechanisms to facilitate alternative access to food sources. This has forced a high level of reliance on food aid, which is concerning due to funding shortfalls for the WFP food pipeline. WFP have reported that their programme faces a shortfall of 8,200 MT of food until the end of 2002 and urgent pledges are required to ensure that refugees continue to receive an adequate diet (WFP 26/04/02). The funding shortfalls have resulted in cuts to the general ration to around 1400 Kcal, which can detrimentally affect refugee nutritional status due to the high dependence the general ration. (WFP 20/02/02). WFP are hoping to be able to raise the ration but this will depend on future pledges.
The RNIS has not received any recent nutritional surveys from the refugee population but it is assumed that they remains extremely vulnerable to nutritional decline due to their dependency on food aid and lack of options for alternative livelihood activities. In particular it is alarming to note that nutritional surveys in 2001 indicated elevated levels of acute malnutrition and a high prevalence of micronutrient deficiency. This would strongly indicate that the diet quality of the refugees is poor and the continuation of sub optimal rations is likely to result in further deteriorations in nutritional status (see RNIS # 35).
Overall
There has been an improvement in the humanitarian situation as a whole in Kenya, however refugees remain highly vulnerable as a result of their dependence on food assistance and the lack of alternative livelihood options. As a result, the insecurity of the food pipeline due to funding shortfalls is alarming and the refugees should be seen as being at high risk of further nutritional decline (category II).
Recommendations
From the RNIS
· Lobby for increased funding to the refugee PRRO.· Assure continued food distributions of sufficient quality and quantity through the use of fortified foods.
Somalia has arguably one of the most systematically poor humanitarian outlooks in the world. This is a result of years of conflict and the lack of a centralised government. Somalia has also suffered recurrent episodes of drought, which has lead to poor agricultural harvests as well as lack of pasture and water for pastoralists. Rainfall levels are systematically lower and more irregular than in any other area of sub-Saharan Africa outside of the Kalahari (SACB 2001). As a direct result it is estimated that one in every five harvests will be a partial failure, one in ten will be a total failure and pastoral livelihoods are uncertain from year to year (UN 2002). Drought and insecurity have lead to the disruption of the economy and a lack of basic infrastructure in almost all areas of the country. The result has been a hugely impoverished population suffering from chronic food insecurity and, even in years of relative plenty, rates of acute malnutrition are amongst the highest seen anywhere.
Current humanitarian situation
Somalia is once again facing an extremely poor humanitarian outlook. The failure of the Gu rains in 2001 heavily affected the food situation by reducing agricultural harvests and the availability of pasture and water for livestock. The more recent Deyr harvest has been considerably better and has alleviated the situation in some areas. However, the southern regions of Gedo, Bay and Bakool, as well as the northern pastoral areas of Somaliland and Puntland, remain very badly affected and are heavily reliant on humanitarian assistance. The country is currently nearing the end of the dry Jilaal season and is awaiting the arrival of the crucial Gu rains. The current forecasts are for near normal rainfall in the majority of the country, however it is expected that the southern areas are likely to suffer from a normal to below normal Gu season, which is concerning given the chronic vulnerability of the population in the area.
The prevailing drought conditions have severely affected livelihoods by reducing the availability of pasture and water for livestock. As a result, many livestock have lost condition, lowering livestock prices and reducing the availability of milk. There have also been reports of wide scale livestock deaths in some of the worst affected areas. The wide spread water insecurity has also had profound implications for human health. Surveys have noted high rates of diarrhoeal disease and it is reported that there is a cholera outbreak, which began on 12/03/02 (WHO 23/04/02). Cholera is endemic to Somalia and tends to surge during the dry period from December through to May. It is important to stress that outbreaks are more likely to occur in crowded situations such as are found when the extremely poor humanitarian situation forces people to collect in areas, particularly towns, where they hope to be able to access food and employment. The lack of water and poor sanitation in these areas greatly increases the risk of disease outbreaks and results in high case fatality rates and a rapidly deteriorating nutritional status.
The ability of people to cope with the drought conditions has been heavily affected by ongoing insecurity in the country as a result of conflict between the Transitional National Government (TNG) and opposition groups, most noticeably the Somali Reconciliation and Restoration Council (SRRC). This has resulted in outbreaks of fighting in various areas of the country. particularly conflicts over control of strategic sea ports such as Kismayo in the south as well as increasing instability in the Gedo region in the south west over the town of Bardhere (IRIN 15/02/02). There have also been outbreaks of violence in the capital Mogadishu, illustrating the fragility of the control that the TNG has over the country. The insecurity has very profound affects on the humanitarian situation. It has resulted in widespread displacement of population, particularly in the Gedo area, and has prevented the usual coping strategies of both pastoral and agricultural groups. The conflict has resulted in loss of assets, the destruction of property and has restricted access to water, pasture and humanitarian relief.
The ability of the international community to reach needy populations has been severely curtailed in some areas and the UN has announced that it is still too dangerous for them to have a long-term presence in the capital (IRIN 01/03/02). It is difficult to predict developments in the security situation but it is likely that opposition to the TNG will continue, bringing fresh conflict to various areas of the country.
The effects of 11 September 2001 have been felt in Somalia with the closure of Al Barakat, the largest remittance firm in the country, in November 2001. Al Barakat was closed as a result of alleged links with the terrorist organisation Al Qaeda and the implications of the closure to the Somali economy and to individual households is extremely serious. Remittances refer to money sent to Somalia by Somalis in the Diaspora. They are believed to be the largest foreign exchange contributor to the Somali economy and are estimated to be worth almost one billion dollars to the country as a whole (FSAU 12/01). Remittances are particularly important during periods of extreme hardship as they support coping mechanisms. Other remittance companies exist but will struggle to fill the gap left by Al Barakat. As a result of a reduction of hard currency, the Somali shilling is likely to devalue further and the purchasing power of urban populations is likely to be affected. The reduction in remittances comes on top of an existing poor economy and it is likely to affect the ability of the poorer population groups to access food and essential services (FSAU 12/01).
A further shock contributing to the seriousness of the current humanitarian situation has been the continued ban on the export of livestock to the Arabian Gulf. A substantial part of the Somali population relies on pastoralism as a primary livelihood activity and the removal of the major livestock export market has been a huge blow to pastoralists, particularly in the north, where access to alternative markets is poor. The ban had been introduced in September 2000 in response to fears of a link between livestock from the Horn of Africa and outbreaks of Rift Valley Fever in the Arabian Gulf. The ban was lifted by Yemen at the beginning of December 2001 and offered the prospects of crucial livestock sales. However, the ban was reinstated at the end of December 2001 and resulted in the return of 1,700 livestock to the Northern regions. The implications are likely to be reductions in the demand and prices of livestock, resulting in reduced income and labour opportunities. This would adversely affect terms of trade for pastoralists. Fewer livestock sales have also means that herd sizes have remained high, particularly with unproductive male animals, and this has put increased pressure on poor pasture and water resources (FSAU 11/01/02). The effects of the ban are all the more serious because they come at a time when other external shocks have contributed to a deterioration in the humanitarian situation.
The effects of the current situation have been a reduction in both the availability and access to food. As a result, it is estimated that about 500,000 people are in need of emergency relief assistance, although this is likely to decrease in June if the Gu rains are good in most areas of the country. Areas of particular vulnerability are the southern regions of Gedo and some districts of Bay and Bakool. The northern regions of Somaliland and Puntland are also considered vulnerable, particularly for the returning refugees from Ethiopia.
Southern Regions
Gedo
The situation in Gedo remains critical as a result of continued drought and insecurity. Despite a reasonable Deyr harvest in surrounding areas, Gedo has received very little rain and increasing numbers of people are in dire need of emergency assistance. The FSAU estimate that there are 56,700 beneficiary households that require 2,840 MT of food per month (FSAU 11/03/02). Even in times of relative food security, rates of malnutrition are routinely between 15-20 %. The current crisis is mostly due to a lack of pasture and grazing rather than poor agricultural production and reflects the fact that pastoralists account for three quarters of the population of the area. In response to the crisis, many households have taken their livestock in search of water and pasture, leaving only women, small children, the sick and the elderly. With the breakdown of coping mechanisms, many have chosen to go to towns in search of assistance (FSAU 12/01). The food deficit is calculated to be up to 70 % for the poorest households (FSAU 11/03/02). The most affected areas are in the north.
The situation has been exacerbated by acute physical insecurity, which has escalated in recent months and resulted in the displacement of thousands of people away from border towns such as Luuq and Bulla Hawa (BBC 26/04/02). This has made it increasingly difficult for humanitarian agencies to access the area and has raised concerns that the situation could deteriorate further should assistance not reach those most in need.
Bulla Hawa (Belet Hawa)
FSAU/GHC/UNICEF/CARE took a window of opportunity in the poor security situation to conduct a survey in Belet Hawa district in December 2001. The survey clearly corroborated previous observations that the situation in the area was critical. The area is one of the most densely populated areas in Gedo and has suffered from poor access to water, the failure of the Gu rains, the closure of the Kenyan border, a high disease burden and heavy insecurity. As a result, it was found that the prevalence of acute malnutrition (W/Ht < -2 Z scores and/or oedema) was 37.1 % and included 8.3 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema). These prevalences are very high and indicate a catastrophic situation. The survey also indicated that diseases such as acute respiratory infection, diarrhoea and malaria were extremely common and had a statistically significant relationship with the observed malnutrition. Only 43 % of children had been vaccinated against measles in the previous six months. The main causes of malnutrition were the limited availability of food and the high burden of disease. It was also noted that childcare and feeding practices were poor, with children fed infrequently and with inadequate amounts. This is most likely a result of reduced time spent in the home by the mother because of the need to search for food and water (FSAU/GHC/UNICEF/FSAU 12/01). The survey also notes that the area was surveyed not because it was more vulnerable than other districts in the north but because the security allowed for access.
There has been a considerable response to the situation in Belet Hawa and a general ration distribution has been ongoing monthly since December 2001, as well as supplementary and therapeutic feeding. The FSAU reports that the interventions have brought the situation under control but that dependency on food distributions remains extremely high (FSAU 11/04/02).
Luuq
The situation in Luuq is also considered to be extremely critical and ACF has been experiencing hugely elevated numbers of people being admitted to their selective feeding centres. ACF conducted a nutritional causal analysis between January and March 2002. The analysis indicated that malnutrition showed a stronger relationship to inadequate food intake than it did with disease and that household food insecurity was the primary underlying cause of malnutrition in the area. The study also revealed that income opportunities are very limited resulting in a severe reduction in purchasing power. As a result, people have been selling household assets and the proportion of households without assets is increasing (FSAU 11/04/02). The RNIS has not seen nutritional data from the area but the causal analysis reveals that the population remains highly vulnerable and dependent on external assistance.
Bay and Bakool
Bay and Bakool suffered from a very poor Gu harvest, which particularly affected the production of sorghum in the area. It was estimated that sorghum production was reduced by as much as 90 % in some areas. The results of the Deyr harvest were considerably better and have gone some way towards making up the food deficit in the areas. However, there are parts of the areas that did not receive good Deyr rains such as Berdale in Bay and Rabdhure in Bakol. These areas can be considered to be extremely vulnerable, as are the neighbouring areas of Gedo district. The RNIS does not have any recent nutritional information from the area.
Juba Valley
The overall food security situation in the Juba valley is considered to be normal, however the long Jilaal season is resulting in a deterioration in livestock condition as a result of poor pasture. It is therefore concerning to note that the area has also received a great deal of livestock from the Gedo area, which has put increasing pressure on existing resources. The situation benefits from the wide range of income opportunities and good livestock prices. The FSAU report on a nutritional assessment carried out in the towns of Afmadow and Hagar, which indicated that the number of children with acute malnutrition was around 10 % (FSAU 04/02). The situation is not currently thought to be critical.
Lower and Middle Shabelle
The RNIS has not received any recent nutritional data from the Shabelle region, but the FSAU reports that the situation is reasonably good as a result of adequate Deyr rains. The area is helped by the existence of a variety of crops and exchange possibilities. For example, there is a good market for fodder, which is providing a good income for the riverine group, and employment opportunities are generally good. The FSAU also reports that data from MCHs indicate that the malnutrition rate amongst screened children is not highly elevated.
Mogadishu
The RNIS does not have any recent nutritional information from Mogadishu, but the situation is assumed to be of concern, particularly for the poorer population groups. This is largely as a result of increased pressures on employment and the downturn in the economic situation, particularly as a result of the closure of Al Barakat, which was one of the chief sources of employment in the city. There has also been a great deal of insecurity in the capital, with reports of conflict between various rival Somali factions. It is likely that the insecurity and poor economy will have adverse affects on the food security of poorer groups within the city, including IDPs.
Northern Regions
Somaliland
The situation in Somaliland is extremely poor as a result of continued drought conditions, the effects of the livestock ban, trade restrictions between Somaliland and Djibouti and the closure of Ethiopian refugee camps. The camps traditionally provided an important source of cereal grains in the area. The main Hays rains have failed for the third time in a row and have resulted in a significant reduction in the amount of available pasture. Access to water is also reduced and there are reports that livestock conditions are deteriorating, exacerbated by a high burden of endemic disease. The severity of the situation was confirmed in November 2001 by a nutrition survey conducted by UNICEF/MOHL/SRCS. The survey indicated that the rate of acute malnutrition (W/Ht < -2 Z scores and/or oedema) was 27 % including 3 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema) (FSAU 01/02). The RNIS has not seen the survey methodology but the results certainly indicate an alarming situation. The survey also reported that the majority of people relied on food purchase and were therefore reliant on accessing sources of income. The area has been targeted for assistance but the population remains extremely vulnerable as a result of continued acute food insecurity.
Returnees
The relative peace in Somaliland has encouraged the return of thousands of Somali refugees from countries such as Ethiopia. The numbers of returnees have been increasing recently as a result of repatriations from Ethiopia, resulting in the closure of five camps in the Ethiopian Somali region. By Mid December 2001 UNHCR had supported the return of 6,000 people to Burao. The returnees receive a repatriation package containing food to last nine months and a variety of non-food items. However, returnees face the fact that there is very little for them to return to and their presence is placing an extra burden on the already fragile war-torn infrastructure. Many have been placed in temporary camps away from existing water sources or economic centres. The returnees have little other than their repatriation package and are totally dependent on external assistance as they are unable to access the usual forms of social support and remittances (FSAU 03/02). The RNIS does not have any nutritional information for this group but they are considered to be extremely vulnerable to nutritional decline, particularly in light of the ongoing drought and lack of employment opportunities.
Puntland
The situation in Puntland remains extremely poor as a result of continued drought, poor economic possibilities and insecurity. It is estimated that between 70-80 % of the major dry season pasture did not receive rain and, as a result, water sources are greatly reduced and water prices have increased (FSAU 07/02/02). It has been observed that livestock condition has also deteriorated. Food access remains poor as a result of poor livestock condition and the low price of livestock. The RNIS does not have any nutrition information for the area but the population is considered to be at elevated risk of nutritional decline.
Overall
The humanitarian situation in Somalia continues to be extremely precarious. The occurrence of a reasonable Deyr harvest has helped to alleviate conditions in many areas but areas of acute needs remain and are likely to do so for a considerable time to come. Somalia is chronically prone to poor rainfall and the vulnerability that this causes for much of the population is exacerbated by the poor economy and by continued insecurity. Areas of particular concern remain the Gedo region and the pastoral regions of the north, with the population suffering from a critically poor nutritional status (category I) and chronic food insecurity. Other groups of concern are the returnees who are highly dependent on outside assistance and should be considered to be at elevated risk (category II).
Recommendations
From the FSAU/GHC/UNICEF/CARE survey in Belet Hawa
· Facilitate a secure environment in which humanitarian organisations can operate.
· Ensure an adequate general ration as a matter of primary importance.
· Implement a decentralised Supplementary Feeding Programme for the entire district.
· Introduce Therapeutic Feeding.
· Address the issue of water availability for human consumption and for livestock.
· Intensify disease and nutrition surveillance.
Sudan has been locked in a cycle of conflict between the government and rebels in the south for the last 18 years. The conflict has taken place within the backdrop of repeated droughts, famines and disease, which have led to the deaths of an estimated 2 million civilian lives (USAID 06/03/02). The combination of conflict and natural disaster has also resulted in the displacement of an estimated 4 million people, which represent the largest internally displaced population in the world. The results have been a sustained high needs for humanitarian relief, with many left unable to meet their basic subsistence needs due to the systematic erosion of livelihoods and resultant chronic food insecurity. The current humanitarian situation in Sudan continues to be extremely poor despite an overall improvement in crop yields over last year due to improved rain and harvest in many areas. The main impediment to an improvement in the situation remains the continuation of conflict, particularly in the southern regions of Bahr al Ghazal, Western Upper Nile and Eastern Equatoria. Drought conditions have also continued in areas of Darfur, Kordofan and the Red Sea State, although it is important to stress that physical insecurity remains one of the major determinants of food insecurity in southern Sudan and the transitional zones.
Given the duration and effects of the conflict there have been numerous peace initiatives aimed at bringing about lasting cease-fires between the government and rebel groups. The longest running process has taken place under the auspices of the Intergovernmental Authority on Development (IGAD), involving Kenya, Ethiopia, Eritrea and Uganda. In an attempt to facilitate the process, the United States has put forward a humanitarian agenda focused on the establishment of a cease fire in the Nuba region, the creation of zones of tranquillity for humanitarian interventions, the cessation of government bombings of civilian and humanitarian targets and the cessation of slavery and abductions (USAID 06/03/02). A cease-fire was formally signed on 19 January 2002 and, despite tensions, has held. However, there are claims that this has released forces to fight in other areas and, unfortunately, violence has escalated in other areas and has led to further population displacement and a deterioration in the food security and nutritional status of affected groups.
The conflict continues to affect food security and the ability populations to cope with the resulting food deficits. As a result, there has been an increase in acute malnutrition in areas of Sudan with rates routinely observed to be above emergency thresholds. The annual needs assessment for 2001/2 estimates that there are 1,558,545 people in need of emergency food assistance in southern Sudan alone. It is extremely difficult to determine how many are IDPs because of continued population movement but it is estimated that there were 163,294 registered IDPs in south Sudan from 2001 alone (WFP/SCF 10/01).
Humanitarian access
The scale of current needs in Sudan has meant that many affected population groups are heavily reliant on the provision of humanitarian assistance to meet their basic subsistence needs. It is therefore extremely concerning to note that the reporting period has seen the continuation of multiple restrictions to humanitarian access for international relief agencies. There are numerous reports of military engagements between the Government of Sudan (GoS) and the Sudan People s Liberation Army (SPLA), particularly over the rich oil reserves found in the Upper Nile province (Unity State) and in northern Bahr al Ghazal around the infamous railway track that supplies the garrison town of Wau. The insecurity has displaced populations away from established centres of humanitarian activity, often into inaccessible areas, and has also routinely forced the evacuation of humanitarian workers from affected area to the considerable detriment of existing programmes (UN OCHA 19/04/02).
Humanitarian access has also been affected by the GoS use of aerial bombing and helicopter gun ship attacks that appear specifically to target civilians and humanitarian workers. The RNIS has already reported on attacks in Bahr al Ghazal during relief distributions (see RNIS #34) and despite a GoS concession to halt attacks (UN OCHA 15/01/02), they have escalated alarmingly. On 2 February 2002, offices of the NGO MSF were looted in Nimne, Western Upper Nile, followed by aerial bombardment on the 9 February 2002, which killed five civilians including one MSF worker. On 10 February 2002, bombs were dropped in Akuem, Bahr al Ghazal, just after a WFP food distribution, resulting in deaths and many injuries. There have also been helicopter gun ship attacks in Bieh, Western Upper Nile at a food distribution site, which resulted in the death of more than 17 civilians (UN OCHA 21/02/02). The direct targeting of civilians and aid workers is in gross contravention of international humanitarian law and has often resulted in the withdrawal of agencies from areas at a time when needs are highest. The constant threat of further attacks also provides a major obstacle for humanitarian access.
The size and lack of infrastructure in much of south Sudan means that relief agencies are wholly dependent on air transportation for the movement of staff and relief items. All air flights into Sudan have to be cleared by the GoS and, on average, the government denies access to about 25 locations each month. This represents about 10 % of total requests. However, the last few months have seen a considerable increase in the number of flight denials and UN OCHA report that 42 locations had been denied flight access, representing 20 % of access requests. The flight bans are extremely serious and could affect the delivery of humanitarian assistance to about 1.7 million people in acute need of assistance (UN OCHA 08/04/02).
South Sudan, non-GoS controlled areas (OLS Southern Sector)
The humanitarian situation in south Sudan remains critical despite improved rain and harvest outlooks. The main factor behind the ongoing crisis in the area is the continuation and escalation of conflict between the GoS and the SPLA. This continues to cause large-scale displacement of population and systematically disrupts possible coping mechanisms that might alleviate the acute food insecurity of the area. However, in areas where insecurity is less prevalent, populations are benefiting from improved access to important sources of wild foods and fishing. Many traditional trade routes remain blocked and, as a result, the area is divided into separate regions that are largely unable to interact economically.
Aweil East and West
The Aweil counties have suffered from repeated insecurity linked to raids by the Popular Defence Force (PDF) employed by the GoS to guard the train that supplies the government enclave of Wau. As a result, the counties have seen a great deal of population displacement both into and away from these areas, placing increased pressure on existing subsistence resources. Tearfund conducted a nutritional survey in the counties in October and November 2001. The survey was conducted towards the end of the harvest period, which is reported as one of the best of recent years. The survey found an estimated prevalence of malnutrition (W/Ht < -2 Z scores and/or oedema) of 19.1 %, which included 1.6 % of severe acute malnutrition (W/Ht < -3 Z scores and/or oedema) (Tearfund 11/01). The survey also indicated that the under-five mortality rate was 2.2/10,000/day. Both the prevalence of acute malnutrition and the rate of under-five mortality are above emergency thresholds and indicate a serious situation. The reasons for this situation are a combination of the long dry spell in the region that led to a very poor harvest last year. There were also high rates of infection with little access to medical facilities or sources of potable water. This is further corroborated by the survey s observation that the measles vaccination coverage in the area was also extremely poor.
However, the main constraining factor on the ability of the population to cope with this was insecurity in the area. The annual needs assessment notes that the food security improves with distance from the railway line (WFP/SCF 11/01).
The outlook for the coming year is mixed and heavily contingent on the prevailing security situation. However, the availability of food is improved in the current season as a result of a good harvest, wild foods and fishing.
Aweil South
The populations in Aweil South are particularly affected by their proximity to the railway line and it is reported that population displacements and the looting of livestock and food stores occurred during the months of November and December 2001 (Tearfund 02/02). In RNIS # 35, a Tearfund survey in August 2001 indicated high levels of acute malnutrition in the under-five population. A follow up survey in January 2002 has indicated that the level of acute malnutrition (W/Ht < -2 Z scores and/or oedema) was 17.8 % including 1.4 % severe acute malnutrition (W/Ht 3 Z scores and/or oedema). The rate of under-five mortality was estimated to be 2/10,000/day. The data suggests that the situation remains extremely serious and is attributed to the insecurity, drought conditions and lack of access to medical care. As a result there has been a high dependence on food aid provided by WFP. The survey notes that the ration has been very poor, ranging from 25 % to 50 %, meaning that potentially some people have been receiving a ration of 460 Kcals/day as opposed to the recommended 2100 Kcal/person/day required for a population heavily dependent on food assistance to meet their nutritional requirements. The food outlook is improved over last year but the population is considered highly vulnerable and in need of assistance for much of the year (Tearfund 02/02).
Raga County
Raga County has suffered repeated bouts of conflict and conflict related displacement over the past year and it is estimated that a total of 30,000 people have been displaced. The displaced have fled in two directions, some to the north to camps in the transitional zone of Darfur and some to the west. In October 2001, WFP was able to deliver some food to the IDPs in Mangayanth, despite the food distribution site being bombed by the GoS. Soon after the distribution, fighting continued in the area and many left. The annual needs assessment reports that as of 5 December 2001 there were over 10,000 IDPs moving towards Tambura on the border with the Central African Republic. Their condition is reported to be very poor and more recent reports from FEWS have indicated that many cases of acute malnutrition have been observed (FEWS 15/02/02). The RNIS has not received any nutritional information on the IDPs but they are considered to be highly vulnerable.
Twic County
Twic County has benefited from a period of relative security over the past year and as a result has received numerous IDPs and returnees seeking safety and shelter. It is noted that IDPs are particularly from Western Upper Nile and Abyei and are moving in order to protect their cattle from looting. This has tended to put extra pressure on existing subsistence resources. In the past the RNIS has observed high a prevalence of acute malnutrition in the county as a result of continued food insecurity (see RNIS # 34). Goal conducted a nutritional survey in January 2002 to investigate the nutritional situation in the payams of Wunrok, Turalei and Aweng, which had all been classified as food deficit areas by the 2002 Annual Needs Assessment. The survey indicated that there was an estimated rate of acute malnutrition (W/Ht < -2 Z scores and/or oedema) of 16.9 % including 1.6 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema) (Goal 31/01/02). The survey observed that both the crude and under-five mortality rate was well below emergency thresholds. The prevalence of acute malnutrition gives cause for alarm and is probably a result of poor access to clean water and high rates of morbidity, coupled with poor child feeding practices where children were routinely receiving only one to two meals a day. In terms of future outlook, the survey does note that access and availability of food appears to be increasing with considerable increases in the number of people able to produce their own food and owning some livestock. Given that the Annual Needs Assessment predicts improved food security, it is hoped that the nutritional status of the population is likely to improve over the course of the year.
Equatoria
The RNIS has not received any recent nutritional information from Equatoria but the situation is not deemed to be critical in the west as a result of good harvests and a lack of insecurity. However the situation is more critical in the East as a result of insecurity between the Ugandan Lord s Resistance Army (LRA) and the Sudanese Army and it is feared that further displacements could take place. The population, including the IDPs, are mostly pastoralists and the pasture is reported to have improved in 2002 as a result of good rains. This is likely to improve access to food sources such as milk. Trade is also an important source of income and the position of the area bordering Kenya and Uganda has offered the possibility of increased trading activity. Insecurity appears to be increasing and UN OCHA have reported that thousands have been displaced as a result of a joint Ugandan/Sudanese military operation against LRA rebels in Eastern Equatoria. Many of the IDPs are reported to have sought sanctuary in the government held stronghold of Juba (UN OCHA 19/04/02).
Jongolei
The situation in Bieh state, Jongolei region has been described as highly food insecure by the Famine Early Warning System Network. The reasons are the poor harvest of 2001, coupled with large and highly exceptional population movements that took up to 90 % of the Lou Nuer, many from Diror state, towards Akobo and Nandit to the south east. The reasons for the movement were the fear of water shortages, food insecurity, increased physical insecurity and the influence of a prophet who promised to lead people towards the promised land (UN OCHA 22/02/02). The result was large collections of people around Akobo who have all been extremely food insecure as a result of limited coping mechanisms. Food insecurity is likely to continue as many were unable to plant last year. MSF-Belgium conducted a nutritional survey in Akobo and Nyandit in February 2002 and discovered an estimated prevalence of acute malnutrition (W/Ht < -2 Z scores and/or oedema) of 32 % including 9 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema). Unusually for Sudan, there was also 4.5 % of bilateral oedema (Kwashiokor) (MSF-B 03/02). These figures are indicative of a very severe situation with a particularly high rate of severe malnutrition, which significantly raises the risk of associated mortality. The under-five mortality rate was not raised above emergency thresholds but the survey noted that people were extremely reluctant to discuss mortality and it is possible that this has been under estimated.
The reasons behind the very high rates of malnutrition appear to be the poor access to food, water and medical care. The measles vaccination coverage was only 50% a few days after a massive vaccination campaign (MSF-B 03/02). It was noted that the population had received a 50% food ration the previous month but that the majority of people were surviving on fish and wild foods, as no other food was available. The population can be considered to be extremely vulnerable.
Upper Nile
The Upper Nile region is the site of some of the heaviest fighting in Sudan over the oil reserves in the area. The reporting period has seen the escalation of insecurity, with direct attacks on humanitarian workers, civilians and active distribution sites. The government has been accused of attempting to clear the area of people to pave the way for increased oil extraction. The rebel SPLA has vowed to directly target oil platforms. The attacks continue to displace population and result in the destruction of the already minimal food stocks of the population, serving to constrain other forms of coping mechanism (IRIN 29/03/02).
ACF-US conducted a nutrition survey in Old Fangak district, Phou State in October 2001. The area had suffered high levels of physical insecurity and had also lost much of the sorghum harvest to flooding earlier in the year. Those households still with fishing materials were able to fish but many lacked the necessary equipment. Food distributions to the area had been stopped in July as a result of the theft of 47 MT. The survey found an estimated prevalence of acute malnutrition (W/Ht < -2 Z scores and/or oedema) of 28.6 %, which included 6 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema). The survey noted that 41 % of the survey population were between 2 and 1 Z scores and could easily become malnourished should the situation deteriorate. Rates of both crude and under-five mortality were above emergency thresholds. The data indicates that the nutrition situation is extremely poor as a result of poor food availability, health factors and insecurity. It was also observed that any form of preventative health measures were notably lacking (ACF-US 31/10/01). The outlook for the area is bleak, with the Annual Needs Assessment predicting that between 80-90 % of households comprising the poor and middle socioeconomic groups are likely to face food deficits of 20-30 % between November 2001 and June 2002.
ACF-US conducted a further survey in Nyadin Parish of Mearang district, Phou state in December 2001. The area has suffered extensive crop loss as a result of flooding and it was noted that an unusually large percentage of the survey population were IDPs (20 %). The survey revealed an estimated prevalence of acute malnutrition (W/Ht < -2 Z scores and/or oedema) of 18.1 % including 2.7 % of severe (W/Ht < -3 Z scores and/or oedema) (ACF-US 12/01). The survey also found a CMR above emergency thresholds. The data indicates that the nutrition situation is extremely precarious as a result of poor availability of food from heavy crop losses in 2001, poor access to potable water and resulting poor hygiene practices. It was also noted that access to medical care, in particular preventive care such as vaccination, was poor. Reportedly people had turned to eating existing crops before they were ready and had started consuming the seeds for the next planting season. The Annual Needs Assessment has predicted increased food deficits for over 50% of the population and a deterioration in the nutritional status can be expected if the food security and health situation are not addressed (ACF-US 12/01).
South Sudan, GoS controlled areas (OLS Northern Sector)
Many of the GoS controlled sectors of the south have seen increased levels of conflict over the reporting period, exacerbating the already precarious food security situation of some groups.
Wau town
Wau town is situated 800 Km south west of Khartoum and has been a government enclave in the heart of the rebel held Bahr al Ghazal for the last 17 years. As a result, the town remains extremely isolated and dependent on supplies by air and from a government supply train once a year. There is limited access to the surrounding region but the current heavy insecurity has resulted in a reduction in trade activities. ACF conducted a nutritional survey in the town during December 2001 and found an estimated prevalence of acute malnutrition (W/Ht < -2 Z scores and/or oedema) of 11.6 % including 1 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema). The under-five mortality rate was 2/10,000/day. The data suggests a precarious nutritional situation that requires close monitoring. Both the nutritional status and the mortality rate are at the emergency threshold but appear to have remained steady when compared to an earlier survey in January 2001 (ACF 12/01). The town is generally well supplied and has a number of humanitarian actors present, which perhaps explains why the prevalence of acute malnutrition is not greater. The nutritional status and food security of the population is likely to be very closely linked with the development of the security situation in the area over the coming months.
Unity State
Unity State has suffered from high degrees of insecurity over the past year, with many people fleeing to the towns of Bentiu and Rob Kona. The town of Bentiu was attacked in October 2001 and many people tried to flee the area, which still remains highly insecure. ACF conducted a nutritional survey in the town of Rob Kona in October 2001 and found an estimated prevalence of acute malnutrition (W/Ht < -2 Z scores and/or oedema) of 19.8 % including 2.6 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema). The survey also revealed an estimated under-five mortality rate of 2.6/10,000/day. The prevalence of acute malnutrition is alarming, being above emergency thresholds, however it has reduced since a similar survey in June 2001. The survey notes that this reduction in acute malnutrition has been mirrored in the reduced numbers attending therapeutic feeding centres. The malnutrition results from poor access and availability to food sources and a heavy reliance on food relief, which has been extremely inconsistent as a result of food pipeline shortages (ACF 10/01). The survey also notes that the town has poor access to clean water sources and suffers from a high burden of disease, notably diarrhoea, kala azar and malaria. It is also very likely that the high number of people who have flocked to the town put severe constraints on resources. It is encouraging to note that the situation has improved since the last survey, most likely as a result of renewed and timely food distributions. It is also noted that many of the displaced are beginning to return home. It is hoped that the nutritional situation will improve over the course of 2002.
Northern Sudan Transitional Zone
Darfur
Darfur has suffered a series of poor rainfall years which have left the population extremely food insecure and the past RNIS (see RNIS #34) reported high levels of acute malnutrition. This has left the population vulnerable to further shocks to food security. SCF report that the rain for the current season began well and on time but continued to be irregular and sporadic. As a result, the total precipitation was considered poor. This has led to high cereal prices, the stagnation of the livestock trade, the loss of income from tombac (tobacco) sales, a reduction in the availability of wild food sources and the reduction in availability of local agricultural labour (SCF-UK 10/01). These will all have an extremely detrimental effect on household food security and nutritional status. The area contains a number of IDPs from the fighting in Bahr al Ghazal, particularly from Raga, and the continuation of poor food security is likely to adversely impact on their nutritional status as well.
Kordofan
Nuba mountains region
The Nuba mountain region has been an area of conflict for some time. The area is traditionally known to be very fertile and has produced surpluses in times past. However, the conflict has destroyed traditional livelihoods and caused massive internal displacement. This has cut off much of the population from traditional farming areas. As a result, the level of food insecurity has increased dramatically. There has been little development for some years and the absence of infrastructure presents a huge impediment to all economic activity in the area (UNRC 16/02/02). The signing of a cease-fire between the GoS and the Sudanese People s Liberation Movement (SPLM) on 19 January 2001, could signal improvements in the situation (USAID 06/03/02). The removal of hostilities will hopefully allow the population to rebuild their food security and infrastructure. This is likely to be helped by this season s good harvest prospects. The RNIS has not received any recent nutritional information on the populations in the area but it is reported that the presence of micronutrient deficiencies is high. It has been noted that there is a high presence of goitre in the population, indicative of Iodine deficiency.
Overall
The situation in Sudan has seen some improvement in rainfall and harvests for 2002, however there are still areas of acute need where prevalences of malnutrition are extremely high and food insecurity is very poor. The main defining factor of both food insecurity and malnutrition is conflict and physical insecurity. This continues to result in large-scale population displacement and the erosion of coping mechanisms. In the present climate of chronic food and physical insecurity, the displaced remain acutely vulnerable to nutritional status decline (category II).
Recommendations
From the ACF-USA survey in Old Fangak District, Upper Nile
· Reinstate WFP general rations.From the ACF survey in Rob Kona town, Unity State
· Open therapeutic and blanket supplementary feeding programmes.
· Improve the quality of health care.
· Provide households with fishing material.
· Continue with monthly general rations.From the Tearfund survey in Aweil East and West, Bahr al Ghazal
· Continue treatment of severely and moderately malnourished through selective feeding programmes.
· Improve access to potable water and adequate sanitation.
· Continue the treatment of moderately malnourished children.From the ACF survey in Wau town, Bahr al Ghazal
· Refer children who are severely malnourished to therapeutic feeding programme.
· Continue general food ration to the most vulnerable.From the ACF-US survey in Nyadin Parish, Upper Nile
· Continue the treatment of severe malnutrition cases.
· Improve the coverage of feeding centres.
· Maintain WFP food distributions.From the Goal survey in Twic County, Bahr al Ghazal
· Distribute fishing equipment to improve household food security.
· Improve access to health care services.
· Increase the general ration to the population.From the Tearfund survey in Aweil South, Bahr al Ghazal
· Continue supplementary feeding programme.
· Improve access to potable water.
· Increase the general food ration.From the MSF-B survey in Akobo and Nyandit, Jongolei
· Expand the coverage of health care.
· Increase the quality and quantity of the general food ration.
· Open a therapeutic feeding centre.
· Monitor communicable diseases.
