Guinea
Liberia
Sierra Leone
West Africa has suffered throughout the 1990 s from civil wars in Liberia and Sierra Leone. The conflict has led to the exodus of over a million refugees to Guinea and Cote d Ivoire over the course of the decade and internal displacement of between one and two million people (USAID 14/01/02). The effects of the conflicts have been very far reaching. The population displacement, the destruction of infrastructure and the regional economy have led to the area being consistently at the very bottom of human development tables. The reporting period has seen the continuation of the peace process in Sierra Leone and moves towards a regional peace, most notably with the meeting of the presidents of Liberia, Sierra Leone and Guinea at a three day summit in Morocco (UN OCHA 27/02/02). However, there has also been an upsurge in fighting in Liberia and there are concerns that this could adversely affect the security of the region. Another point of concern has been the very low level of response to the UN funding appeals and it is likely that there will be breaks in the food pipeline and possible ration cuts if funding does not improve. This would have a very significant impact on the refugee and displaced populations currently highly dependent on assistance. UN OCHA announced that, as of April 2002, the overall West Africa appeal was only 5.69 % funded (UN OCHA 10/04/02). This marks the continuation of low funding for the region and is of considerable concern given the acute needs of vulnerable populations.
Table showing the numbers of vulnerable groups in the
West African region
(UN 2002)
|
Country |
IDPs |
Refugees |
Returnees |
Hosts/Other |
Total |
|
Guinea |
359,000 |
111,000 Sierra Leoneans |
N/A |
300,000 |
851,000 |
|
|
|
81,000 Liberians |
|
|
|
|
Sierra Leone |
247,590 |
9,500 Liberians |
100,000 |
1,000,000 |
1,357,090 |
|
Liberia |
55,000 |
70,000 Sierra Leoneans |
30,000 |
500,000 |
655,000 |
|
Total |
661,590 |
271,500 |
130,000 |
1,800,000 |
2,863,090 |
The civil conflicts in Sierra Leone and Liberia resulted in many people entering Guinea in search of the safety the country offered. The majority of these refugees were located in camps and within communities along the borders with Liberia and Sierra Leone, including the Parott s Beak area of Gueckedou. The security of the area was disrupted in September 2000 when Sierra Leonean rebels launched a series of attacks into Guinea. The attacks were around the areas of Gueckedou, Macenta and N Zerekore and resulted in wide scale loss of life, destruction of property and crops. This lead to a period when humanitarian access was cut off from approximately 250,000 refugees in the Parott s Beak area after which many of the refugees and host populations moved inland away from the borders.
The security situation has improved dramatically over the course of 2001 and 2002 and there have been no reports of further violence. However, the violence has resulted in the relocation of refugees into camps in the interior of the country, and any that have chosen to remain along the border areas are no longer eligible for relief assistance (IFRC 20/11/01). With the advent of a viable peace process in Sierra Leone, many Sierra Leonean refugees have chosen to return, especially to vote in the upcoming elections in May. The situation for remaining refugees is uncertain and heavily contingent on the continuation of good security in the country, as well as the continuation of adequate funding to the UN appeals. Despite the internal stability, there is concern over fighting in Liberia and Guinea has already received a number of Liberian refugees over the reporting period. Steps towards a regional peace have been taken and the presidents of all three Mano River Countries met in February and have vowed to end tensions between their countries and cooperate on issues of border security (UN OCHA 28/02/02). This could have very significant implications, as the future of the refugees is heavily contingent on the development of regional security.
The funding of the UN Consolidated Appeal for West Africa has been extremely poor for a number of years. It was recently announced that the current funding level was only 4.27 % of the total appeal figure. It is also important to note that the majority of the funding so far has gone towards refugee programmes and IDPs remain underfunded (UN OCHA 10/04/02). UN OCHA reports that Guinea is likely to experience shortfalls of oil and Corn Soya Blend (CSB) in April, May and June. It is also reported that current stocks of cereals will only be sufficient for half rations in June, although WFP hopes to provide full rations for further distributions (UN OCHA 11/04/02). This is very concerning given the current level of needs.
Internally displaced
Until the insecurity of late 2000, Guinea had not suffered internal displacement. However, incursions into the country by Sierra Leonean rebels caused huge internal displacement of population who fled inland from border areas. It is currently estimated that there are 359,000 IDPs in Guinea, although many of them have been able to return to their places of origin and begin the process of rebuilding their lives. This is being facilitated by the improvement in the security situation along the border areas with Sierra Leone.
ACF-SP conducted a nutritional survey in the Gueckedou area, known as the Parrot s Beak, in April 2002. The Parrot s Beak area was particularly affected by the fighting and insecurity in late 2000, which displaced both refugee and host populations. The majority of refugees were moved to camps further inside the country, but ACF estimates that as many as 20,000 remained. ACF stress that the camps that existed prior to the insecurity are still empty and that the refugees are currently living in villages with host communities. The report also notes that 75-80 % of the people displaced by the fighting have returned and are trying to make a living in the area. The survey covered both newly returned IDPs and refugees and indicated that there was a prevalence of acute malnutrition (W/Ht <-2 Z scores and/or oedema) of 8.2 % including 0.3 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema). The survey did not measure mortality rates but did show that the coverage of measles vaccination was 75 % (ACF 04/02). This does not indicate a critical situation as the prevalence of malnutrition remains below emergency thresholds. However, the situation in the Parrot s Beak area is precarious as a result of a long period of drought in 2001 that adversely affected the harvest of staple food crops and resulted in extremely low food stores. The population is not receiving any food assistance and so must rely on trading and foraging to make up the existing food deficit. The continued food security of the population will be heavily contingent on the security situation.
Refugees
The fighting in the southeast forest area brought about a fundamental change to the location of IDPs in Guinea. This was prompted by issues of protection and security, where refugees were living by potentially unstable border areas, and the need of the humanitarian community for appropriate levels of access. The relocation movement began with the evacuation of the Parrot s Beak area by UNHCR. Refugees were moved to a variety of locations but primarily to the Albadaria and Dabola prefectures of Upper Guinea. The original plan had been to open four camps in Albadaria and three in Dabola to accommodate an expected 250,000 refugees. The actual number proved to be far less than this at around 65,000, mostly Sierra Leonean refugees (IFRC 20/11/01). There are now three camps in the Albadaria region; Boreah with 13,066 refugees, Kountaya with 25,652 and Telikoro with 11,898. The Dabola area has one active camp called Sembakounya with 7,289 refugees. The areas of Macenta and N Zerekore in the Forest region also have two camps of mostly Liberian refugees, Kouankan with 13,500 refugees and Kola with 5,900 (USAID 14/01/02).
The numbers of refugees are changing quickly as a result of influxes of Liberian refugees fleeing the violence in the north of their country, and due to the number of returning Sierra Leonean refugees. It is currently estimated that 4,700 Liberians, mostly women and children, have entered the country since January 2000 and the numbers are expected to keep growing as fighting continues. UNHCR expects a total of 10,000 to enter the country during 2002 (UN OCHA 11/04/02). Some of these are reported to be in extremely poor condition and their immediate needs are likely to be high. The return of Sierra Leoneans is still ongoing and has been facilitated by the opening of border areas, allowing refugees to return overland. It is estimated that 11,000 have returned since 27 September 2001 and UNHCR reports that a further 15,000 are registered to return from the Kissidougou area (UNHCR 19/03/02). UNHCR has estimated that by June 2002 the number of refugees in camps will be 68,400, with a further 92,000 living with host communities. By December 2002, these figures are likely to be 54,700 and 73,500, respectively (UN OCHA 11/04/02). The RNIS does not have any recent nutritional information on the refugees but the situation is not thought to be serious as a result of ongoing assistance and the improved security.
Overall
The situation in Guinea has improved over that seen at the beginning of 2001 as a result of a stable security situation. However, the continuation of fighting in Liberia is of concern and could potentially serve to destabilise the entire region. There are encouraging signs that solutions to the regional tensions are currently being pursued. The condition of both refugees in camps and IDPs is not currently thought to be serious (category III), however the situation will be heavily dependent on the development of the security situation.
Recommendations
From the ACF-SP survey in Gueckedou Prefecture
· Continue Supplementary Feeding.
· Support agricultural activity via distributions of appropriate seeds and tools.
· Continue nutritional surveillance activities.
The humanitarian situation in Liberia remains extremely volatile. The country suffered the effects of devastating civil war between 1989 and 1997, which resulted in the collapse of the economy and the wide scale destruction of infrastructure. As a result, there is rampant inflation and basic goods and services are either lacking or not accessible to the vast majority of the population. It is estimated that 85% of Liberians are unemployed due to the economic collapse and the absence of a viable employment sector. 76% of the entire population live below the world poverty level of one dollar a day, and 52% of that group live in a state of absolute poverty, surviving on less than 50 cents a day. Access to basic health services, clean water and sanitation are similarly poor (UN 2002). Liberia is currently ranked 174th out of 175 countries in the human development index. The political and economic situation has been further aggravated by the imposition of UN sanctions put in place because of the government s support of rebel groups in neighbouring countries and the continued exploitation of illegal diamond and mineral resources. The full affects of the sanctions on the population are unknown but it is suspected that they are having a detrimental impact on an already desperate situation.
These factors have greatly increased vulnerabilities and served to constrain livelihood options for much of the population. However, the situation has been further exacerbated by the continued insecurity between Liberian government forces and the opposition rebel group, Liberians United for Reconciliation and Democracy (LURD), who remain violently opposed to the government of Charles Taylor. During the reporting period there has been an escalation of violence between the groups, which has moved gradually closer to the capital city, Monrovia. This has moved the conflict out of the north western Lofa County, where it has traditionally been based, and has caused great alarm. In response, a state of national emergency was declared in February (WFP 15/02/02). There is great fear that the continuing violence could spread to neighbouring countries because rebel groups are often involved in all countries of the Mano River Union (MRU). The escalation of regional violence would spell disaster to a region already crippled by wars, particularly at a time when prospects for peace are potentially high. Despite mutual suspicions, the leaders of the MRU met together in February 2002 to discuss ways of easing regional tensions and this has born some fruit with the deployment of joint border security and confidence building units (UN OCHA 08/04/02). Internally there have also been moves towards peace and reconciliation between the government and opposition groups. However, the talks, which were held in Abuja, did not include the LURD rebels and so the likelihood of them establishing any form of usable consensus required for a peace process is extremely unlikely (IRIN 15/03/02).
The current situation
The reporting period has seen the escalation of conflict and continued, large-scale displacement of populations. The situation remains extremely fluid and it is very difficult to keep track of the changing numbers of affected people. However, there was an attack on the Sawmill camp in Lofa County, which is normally home to 20,000 people. The attack resulted in the flight of the camp s residents and those of the nearby town of Tubmanburg, which is the largest in Western Liberia. A number of the displaced fled to the town of Klay, some 47 Km north of the capital Monrovia. Unfortunately, the displaced were initially prevented for several days from fleeing, despite the sound of closing conflict. When the conflict eventually arrived at the town, the population was forced to leave in total panic, resulting in the separation of families. There are currently 9,000 IDPs in Klay but the whereabouts of the remaining displaced population is not known. The emergency nature of the flight also meant that people were unable to take anything with them in the way of food or supplies. For many of the IDPs displaced from Sawmill, their displacement is for the third or fourth time from camps in Bopolu, Jenemana and Gbarma. This repeated displacement has significantly increased the vulnerability of affected populations (ACF 31/01/02).
Access to the affected populations is extremely difficult as a result of the insecurity and the government s refusal to allow aid workers to work beyond the Klay Junction. Insecurity moved closer to Klay in February 2002 and the 10,000 IDPs there were forced to flee once again. The LURD attacks have continued and the town of Bong, which has traditionally been a safe haven for IDPs, was attacked later in February causing the displacement of an estimated 20,000 people. Bong is also only 80 Km from the capital city. The movement of the conflict towards the capital city is of grave concern and many Liberians are now trying to flee the area in search of safer zones. The city has also seen an increase in the number of IDPs seeking refuge in established camps around the city area. The numbers are fluctuating but it is estimated that there are about 5-6,000 IDPs in addition to the 8,700 refugees who were already there (UNHCR 18/02/02).
The effects of the conflict have been far reaching. It is estimated that there are over 50,000 IDPs in the country and 70,000 refugees. Many of the refugees are originally from Sierra Leone and large numbers have chosen to return directly as a consequence of the conflict. The farming season in the affected western areas normally starts in January and has been hugely disrupted this year, meaning that there will be food deficits at the next harvest. Consequently, there are huge humanitarian needs in the country as populations are simply not able to cope with the shock of displacement due to their basic level of impoverishment. Many of the most vulnerable groups, including IDPs and refugees, routinely have to spend up to 90 % of any earnings on food, leaving them with almost nothing to meet other essential needs such as health care. Humanitarian assistance has been constrained by a lack of access to affected populations due to poor security and government travel restrictions. Another huge constraint is the poor level of funding response to the UN Consolidated Appeal. OCHA reports that as of 6 April 2002, the health sector had been pledged 0.87 % of its total funding requirements.
Overall
The situation in Liberia is extremely poor for both the displaced and refugees. The country is in economic collapse and the upsurge in violence is further eroding people s capacity to cope with the already poor humanitarian situation. As a result, both IDPs and refugees should be considered to be highly vulnerable (category II).
Recommendations
· Support the Inter-agency appeal.
· Advocate for increased access to affected populations.
· Support the regional peace initiatives.
Sierra Leone has suffered the effects of a decade long civil war that has devastated much of the country, destroying infrastructure, bringing about economic collapse and destroying livelihoods. One of the foremost features of the conflict has been the mass displacement of hundreds of thousands of people as both IDPs and refugees into neighbouring countries. This has created an extremely serious humanitarian situation, where the people of Sierra Leone are amongst the poorest on earth, with the country ranking at the very bottom of the Human development Index chart. The humanitarian situation has been primarily affected by the conflict, which has resulted in the systematic destruction of people s ability to cope with the situation. Consequently, many have been simply unable to meet their basic subsistence needs. This has been further exacerbated by the lack of access to many areas of the country by humanitarian agencies, due to the conflict and insecurity. As a result, the needs of many have gone unmet.
Despite the chronically poor humanitarian backdrop, the past year has seen improvements in the overall situation in the country. This has been brought about by a peace process that took shape in May 2001 through a meeting between the government and the Revolutionary United Front (RUF). The meeting established a cease-fire agreement and set the agenda for a Disarmament, Demobilisation and Reintegration programme (DDR). The peace process, and in particular the DDR, has benefited from the firm support and commitment of the government, the RUF and the international community. The process has been greatly helped by the presence of peacekeeping troops under the auspices of the UN Mission in Sierra Leone (UNMASIL). The UNMASIL peacekeeping force is now the largest of its kind in the world and consists of 17,500 troops (UN OCHA 30/11/01).
The DDR process was not without its setbacks. The process was delayed by the RUF over their dissatisfaction with the outcome of a National Consultative Conference in November (ICG 19/12/01). The disarmament process was officially declared completed on 17 January 2002, when it was estimated that 47,076 combatants had disarmed between 18 January 2001 and 17 January 2002 (UNSC 14/03/02). This also marked the official declaration of the end of the civil war and the lifting of a curfew that had been in place for the last four years (WFP 01/02/02). Positive developments have also been seen, with the announcement of parliamentary and presidential elections to take place on 14 May 2002. Overall, the situation in Sierra Leone is extremely positive but there is call for some caution as the situation is far from stable. There is concern that the elections may be premature with the peace process still ongoing and it is feared that they may result in renewed conflict in some areas (ICG 19/12/01). It is also important to note that there is an upsurge in conflict in Liberia, with reports that some RUF fighters are currently involved in the fighting there, which could present a potentially destabilising influence (ICG 19/12/01).
Humanitarian situation
The continued development of the peace process has had an extremely significant and positive impact on the humanitarian situation. Humanitarian access is now possible throughout the country and it has been announced that all but 11 of the 150 chiefdoms are safe for resettlement. The greatly improved overall security has allowed humanitarian agencies to access many areas that have been without assistance for some time. The resultant emerging humanitarian picture is one of very differing degrees of needs, which vary from area to area. The needs appear to be particularly high in newly accessible areas where the level of destruction of housing and basic infrastructure has been very great. As agencies move into these areas they are finding that the populations are in extremely poor condition, with high rates of malnutrition, morbidities and mortality. IDPs, refugees and returnees represent particularly vulnerable groups, many of whom are highly food insecure and dependent on humanitarian assistance.
As of January 2002 it was estimated that there were 204,000 registered IDPs being assisted by the international community and, as a direct consequence of the improved security, many of these have been returning to their areas of origin spontaneously or as part of organised resettlement programmes. The organised returns have taken place in three phases to date. The first and second phases took place from May 2001 to February 2002 and resulted in the resettlement of approximately 65,000 people (UN OCHA 18/04/02). The majority of the resettlements took place in the Western Area, Southern Province and the north western districts of Port Loko and Kambia. The third phase of the resettlement process began in March 2002 and it is hoped that this will see the permanent resettlement of 155,000 IDPs in the North and in the Eastern districts of Kono, Kailahun and Kenema. There have also been large numbers of Sierra Leonean refugees in the surrounding countries that have either returned or registered to do so. To facilitate the return of refugees from Guinea, the UNHCR has negotiated a land bridge across the Guinean/Sierra Leonean border and increasing numbers are choosing to return. The conflict in Liberia is also leading to increased returns from Liberia.
The returnees are increasing the pressure on the capacity of the humanitarian community to assist those in need within the country. Many are returning to areas that have very little in the way of viable infrastructure. This includes housing, education, water and basic medical facilities. It is also concerning to note that much of the land, although now free, has been uncultivated for long periods and is likely to require a great deal of work before it is productive. This makes the returnees extremely vulnerable and will increase their reliance on external assistance. The returnees are given a two month food package to help the resettlement process, but this thought unlikely to be sufficient. The task of getting people to return is proving relatively easy but the problem will be to get them to stay. It has been reported that a great many of the newly resettled are moving from area to area in an attempt to find a place where they feel they can establish themselves. The situation is further complicated by the arrival of increasing numbers of Liberians fleeing the insecurity in the north and western areas of Liberia. WFP reports that 10,700 Liberian refugees have arrived in Jendema on the southeast border of Siera Leone. The refugees are being assisted but place an added pressure on already stretched resources (WFP 15/03/02).
Northern Province
The RNIS does not have any recent nutritional information from the northern province. However, the situation is assumed to have greatly improved as a result of the prevailing security situation. All districts in the northern district have been assessed and announced to be safe for returnees, leading to considerable returns to the area, particularly as part of the phase II of the resettlement programme. In particular, the camps at Port Loko have closed as the camp residents have moved back to areas in the Port Loko and Kambia districts. There have also been returns from the camps in the west of the country to the same area. Assessments of needs in the area reveal that there has been very great destruction of property and infrastructure and it is imperative that new housing, schools and medical facilities should be provided soon to meet the needs of the increasing numbers of people in the area. The humanitarian response has been large. In terms of immediate needs, WFP continues to supply a food ration to vulnerable groups and other emergency programmes have focused on issues such as access to clean water and the provision of housing and medical facilities. Other programmes have begun to address long-term needs by rebuilding schools and developing income generation schemes. It is hoped that this will provide the impetus for further returns and provide essential services to the populations present in the area.
Western Province
The RNIS has not received any recent nutritional information from the Western province but the situation is assumed to be stable. There have been some movements of both returned refugees and IDPs from the camps around the capital Freetown to their areas of origin and it is hoped that this will relieve some of the overcrowding. There have been reports of increased rates of crime in and around Freetown, indicative of the high rates of unemployment and poverty in the area. However, it is hoped that the upsurge in the economy, that the peace process has brought, will provide employment opportunities for many of the residents of the area. A great many IDPs remain in the area but it is hoped that the increased security of many areas will ensure that they resettle in their places of origin over the duration of 2002.
Southern and Eastern Provinces
The security situation in the south and east has remained good over the reporting period and this has encouraged the dismantling of camps and return of IDPs and refugees to the area. The conflict currently taking place in Liberia does offer some cause for alarm as some areas border conflict zones in Liberia and have received a number of Liberians seeking refugee status. UNMASIL and the Sierra Leonean Army have increased their patrolling of the border areas to insure that there are no incursions by armed groups. However, as a result of the potential insecurity, some chiefdoms in Kailahun district have not been declared safe for returns. The area has also been known as the main diamond producing area within Sierra Leone and control over the diamonds was largely responsible for much of the conflict. Despite some minor clashes, the peace and DDR programmes went ahead and do not appear to have sparked further insecurity.
Kailahun District
Kailihun district is the only district where some chiefdoms are still deemed too insecure to return. This is as a result of continuing insecurity in Liberia just over the border. As a result, there are fears that armed groups could cross the border and destabilise the area. This has affected 11 chiefdoms which all border Guinea and Liberia. Kailahun has traditionally been one of the worst affected areas in the country due to its proximity to the border and to key diamond mining areas within Sierra Leone. A recent assessment of needs in the district revealed that there were high levels of destruction in all chiefdoms, especially along the border areas. This has meant that the short-term priorities for the area are shelter, WATSAN, road repair, seeds, tools and food aid. It is hoped that a concentration on key areas of need will help facilitate further returns to the area (UN OCHA 28/02/02).
Kenema district
Kenema district has seen a great deal of violence over the duration of Sierra Leone s civil war. However, security has improved over the past few years and allowed the population to develop some coherent coping strategies. Consequently, recent nutrition surveys in the area have not shown high prevalences of acute malnutrition. Merlin conducted a series of nutrition surveys in the district during September 2001. The first survey concentrated on Kenema town where it was noted that almost 40% of the population were displaced. The survey revealed a prevalence of acute malnutrition (W/Ht < -2 Z scores and/or oedema) of 6.3% including 2.6% of severe malnutrition (W/Ht < -3 Z scores and/or oedema) (Merlin 09/01). There was also 1.5% of oedematous malnutrition. The survey also estimated the under-five mortality rate and found it to be 1.72/10,000/day. The nutritional data does not indicate a critical situation, with the prevalence being below alarm thresholds. However, it is concerning to note that there appeared to be a relatively high percentage of Kwashiokor (oedematous malnutrition), which is associated with high rates of mortality. The rate of under-five mortality rate does appear to be elevated although, again, below emergency thresholds.
The second survey took place in the three IDP camps around Kenema. The camps surveyed are Lebanese, Nandeyama and Gofer and it was determined that they contained predominantly IDPs who were long term residents of the camps for periods of over one year. The prevalence of acute malnutrition (W/Ht < -2 Z scores and/or oedema) was estimated to be 4.2% and included 1.7% of severe malnutrition (W/Ht < -3 Z scores and/or oedema) (Merlin 09/01). This indicates that the nutrition situation is stable and well below emergency thresholds. In general, the camp residents were well covered for food, medical and water. Surveys were also conducted in the near by town and camps of Blama, where the nutrition situation was found to be similar to that in Kenema. It has since been noted that the Blama camps have been closed and many of the residents relocated. It was noted that the situation in the area has been calm since 1999 and that the majority of IDPs had been in residence for over 12 months. As a result, it is likely that the population has managed to establish livelihood patterns that enable them to meet the majority of their basic subsistence needs. However, it is important to stress that the continued stability of the nutrition situation is dependent on continued good security and the improvement of markets and employment opportunities.
Kono district
Kono district is in the north east of Sierra Leone in one of the major diamond mining areas. As a result it has experienced extreme insecurity for a number of years and has been inaccessible to humanitarian agencies until the middle of 2001. The area has suffered massive destruction, and many settlements have been destroyed as well as most of the essential infrastructure such as health systems. It is reported that the area has had virtually no health care for the past 10 years. The continuation of the peace process has seen an opening up of the area and there have been large-scale returns of previously displaced populations. In September 2001, World Vision conducted a nutrition survey in three of the most southern chiefdoms of the district in order to assess the nutritional situation of the newly accessible area. The survey found an estimated prevalence of acute malnutrition (W/Ht <-2 Z scores and/or oedema) of 17.1% and included 4.7% of severe malnutrition (W/Ht < -3 Z scores and/or oedema) (WVI 09/01). The survey also indicated that the Crude Mortality Rate (CMR) was 1.4/10,000/day and the under-five mortality rate was 6.1/10,000/day. These data indicate that the nutrition situation is extremely poor in the area, with both nutrition and mortality indicators all above emergency thresholds. It is also possible that the high infant mortality rate may have resulted in an underestimation of the true malnutrition rate.
The fact that the area has only recently been accessible means that there is no baseline data to compare the survey results to. The reason for the observed high prevalence of malnutrition is the acute vulnerability of the population as a result of the violence in the area and the resultant food insecurity and lack of access to basic subsistence needs. In this respect, the results are highly alarming but not surprising. However, it is hoped that increased access to the area will facilitate the provision of emergency relief and the rehabilitation and reconstruction of infrastructure. The improved security and access to subsistence needs will hopefully result in a substantial improvement of the nutritional status of the population. However, the survey also notes that large numbers of people are returning to the area and as a result there will be increased pressure on the already poor resources, with immediate emergency needs likely to remain high for some time.
Overall
The reporting period has seen the continuation of improvements to the humanitarian situation in Sierra Leone. This has been a result of the ongoing peace process, which has allowed for the opening up of much of the country that had previously been closed to humanitarian assistance. The opening up of new areas has revealed very differing emergency needs, with newer areas generally having a poorer humanitarian situation. Peace has brought about the return of both IDPs and refugees to their areas of origin, with this process set to continue for the duration of 2002. The returnees will require continued assistance before they are able to re establish livelihood activities. They are not considered to be at high risk (category III), however some of the newly arrived refugees are thought to be considerably more vulnerable (category II).
Recommendations
From the Merlin survey in Kenema district
· Conduct nutrition and health education to address problems of child weaning practices.From the World Vision survey in Kono district
· Facilitate the reconstruction of basic infrastructure.
· Improve the coverage of medical facilities in the district.
· Rehabilitate wells and other water sources.
· Improve vaccination coverage.
