Angola
Zambia
Angola has been suffering from a protracted conflict, between the government and forces of the National Union for the Total Independence of Angola (UNITA), which has been ongoing for almost 30 years. An attempt at peace was made in 1994 with the signing of the Lusaka peace accords by the government and UNITA, however conflict continued and all out war resumed in 1998 (NRC 04/04/02). The toll on the population and the country has been enormous and has served to create a humanitarian crisis of quite staggering proportions. The total population of the country is 12 million and current estimates suggest that a quarter of the population have been displaced.
Many have argued that displacement, much of it forced, has been one of the predominant tactics in the war, with areas having been deliberately cleansed of people to remove potential subsistence base for armed units (MSF 05/03/02). The majority of those affected have been rural populations who have been displaced from their lands and means of subsistence. Many families have become separated and the proportion of female headed households is very high. Some IDPs have made their way to regional centres, where international agencies have been able to work, and have received assistance. For the remainder, they have often been forced to live in hiding in the hills and forests, with little or nothing to sustain them other than what they have been able to forage. The insecurity and the large amount of land mines in the country have restricted access to cultivable land and seriously affected food availability. Furthermore the collapse of livelihoods and the economy has resulted in grinding poverty. As a result, many have been left unemployed and the possibility of alternative income generating activities is poor. The situation has been further exacerbated by the almost total lack of infrastructure, including access to basic health care, clean water and sanitation. The result has been a deteriorating humanitarian situation witnessed by rates of acute malnutrition, morbidity and mortality that have all been above emergency thresholds.
Events in Angola took a dramatic turn in February 2002 with the death of Jonas Savimbi, the head of the UNITA rebel movement. Savimbi was widely seen as the driving force behind UNITA and his death has paved the way for direct talks between the remaining UNITA leadership and the government. The negotiated peace received a considerable impetus 14 March 2002 when the government announced a cease fire (GoA 13/04/02). The cease fire was officially recognised by both UNITA and the government at the end of March and an agreement signed at the beginning of April 2002 (ASA 09/04/02). The peace agreement is of enormous significance because it offers an end to a conflict that is at the heart of the poor humanitarian situation in the country. The agreement includes a plan to demobilise up to 50,000 UNITA soldiers who are currently still in the bush. This will require an enormous amount of commitment on behalf of the government and the international community to ensure that the fighters are effectively demobilised and reintegrated into society. The period after the signing of the agreement has generally seen a decline in the number of reported security incidents and has led to the hope of an improved situation. However, it is very early to tell whether events herald a total end to conflict in the country or not
The humanitarian situation
Despite the dramatic political changes that have taken place in the country, the humanitarian situation remains desperate. The total estimated figure for IDPs in the country has risen to 4.29 million with 1.4 million of these registered by humanitarian organisations (UN OCHA 31/03/02). This is one of the highest figures for internal displacement in the world. The reason for the increased displacement is the escalation of violence that took place during 2001. In January 2002 alone there were an estimated 49,400 displaced in direct comparison to July 2001 when there were 12,383 (UN OCHA 31/01/02). By the middle of April, the number had risen to 139,500 (UN OCHA 15/04/02). If the current trend continues it is estimated that around 300,000 people will become newly displaced during the next 6 months, which would bring the total number of displaced to approximately 4.6 million people (UN OCHA 07/03/02). Areas particularly affected are Moxico, Bie, Huila, Bengo, Malange, Huambo and Benguela.
The newly signed peace is having an effect on the overall security situation and many new areas of the country are becoming accessible to humanitarian agencies. For years, one of the chief problems for the relief community has been its inability to reach populations that were in critical need of assistance due to insecurity and poor infrastructure. One of the foremost features of the past months has been an incredible influx of people to municipal towns in the hope of accessing relief assistance. Many of these people are arriving in very poor condition and agencies are reporting that they simply do not have the capacity to deal with the rising needs. There is a shortage of land, housing, water and sanitation and food supplies and selective feeding programmes in many areas are already beyond capacity. As a result, many new arrivals are living in sub standard conditions without access to basic shelter or services.
The vulnerability of IDPs is enormous and many have been living for very extended periods in the bush without real access to food, water or medicines. Much of the male population have either died, as a result of conflict, or have been subscripted into armed forces. As a result, many of the new arrivals are women, children and the elderly, all of whom represent vulnerable groups. It is clear from various reports and assessments that there has been substantial mortality amongst the displaced population and rates are emerging that are well above emergency thresholds. There have also been reports of greatly elevated prevalences of acute malnutrition and disease and it is alarming to note that this is occurring at a time when humanitarian resources are at their most stretched.
The improved security has resulted in a general improvement in access to affected populations and this will have important implications for the ability of the humanitarian community to meet emergency needs. Until relatively recently, most humanitarian relief supplies were delivered by air due to the acute insecurity of the roads. WFP has announced that since the cease fire it has been able to shift the emphasis away from costly air transport to the road network (NRC 04/04/02). However, the presence of mines and the very poor state of much of the road infrastructure will continue to hamper access and road transportation in many areas. Furthermore, air deliveries are also constrained in a number of places by the poor condition of runaways, which are badly in need of rehabilitation.
The general food security situation of the displaced population is extremely poor and, as new areas open up and the numbers of displaced continues to grow, it is likely that the overall situation will appear to deteriorate as the highest needs are amongst the newest displaced and in newly opened areas. As a result, a very substantial humanitarian intervention is required to prevent further loss of life. Areas of apparent critical need remain the provinces of Bie, Moxico, Huambo, Huila and Benguela.
Bie Province
The situation in Bie province continues to be extremely critical. The number of displaced has increased, with new arrivals reaching the area in increasingly poor condition. In the first two weeks of April 2002, it was reported that 6,610 people arrived in Kuito, Camacupa and Cunhinga. This influx over a two week period is larger than the 5,807 IDPs registered for the whole of the month of March 2002(UN OCHA 15/04/02). This has brought the total number of IDPs in the province to over 206,000 people. However, in January 2002, 21,500 newly arrived IDPs remained unregistered. This has placed extreme pressure on the existing resources in the province and over stretched registration systems. It is reported that new arrivals in some areas reported to be waiting up to three weeks before they receive assistance (UN OCHA 07/03/02). Reports indicate that there are high levels of malnutrition amongst the displaced population and mortality rates are above emergency thresholds.
The security situation, for the moment, appears to have improved and this is facilitating the arrival of many more people in to the area. Due to poor infrastructure it is still proving very difficult to transport humanitarian supplies and reports once again stress the poor condition of the airstrip in Kuito, which has impeded the delivery of adequate assistance for more than 22 months.
Camacupa
Camacupa is situated Northeast of Kuito, with a total number of IDPs as of 15 January 2002 of 50,587, although this will have increased considerably since that time (UN OCHA 24/01/02). The influx of IDPs has greatly stretched the ability of the humanitarian community to meet the needs of all those requiring assistance and many of the camps have reached full capacity. The Afeina II camp was opened in February 2002 and had reached full capacity, with an estimated 18,000 people, by the second week of March (UN OCHA 15/03/02). New sites are now being sought and as a result of the increased demand, the capacity of the therapeutic feeding centre (TFC) in Camacupa was increased from 250 to 400 to meet the increased needs.
In July 2001 MSF conducted a nutrition survey in the camps and found an estimated prevalence of acute malnutrition of 12.5 % (W/Ht <- 2 Z scores and/or oedema), which included 1.7 % of severe acute malnutrition (W/Ht < -2 Z scores and/or oedema). The survey also indicated that the CMR was 1.8/10,000/day and the under-five mortality was 3.8/10,000/day (MSF 08/01). The data indicates that the nutrition and health situation of IDPs is extremely poor and is a result of a chronically poor diet and very little access to food sources or medical care. It is also important to note the previous high prevalence of pellagra, which is a deficiency of niacin, pyridoxine, riboflavin and tryptophan. This evidence of micronutrient deficiency is highly indicative of a very poor quality diet and is concerning because it is associated with increased mortality and morbidity. According to nutrition surveys conducted in December 2001, the rate of acute malnutrition is 13 %, with a higher observed rate amongst the newer arrivals, where figures of 28 % have been measured. The CMR is 2.9/10,000/day and the under-five mortality is 4.8/10,000/day (UN OCHA 31/01/02). Selective feeding programmes are operating at full capacity and seasonal rains in December 2001 increased the risk of water borne diseases. It is also apparent that many of the new arrivals have not received measles vaccination and so the risk of a measles epidemic is of great concern (UN OCHA 24/02/02). The situation is extremely concerning and reinforces the vulnerability of the population in this area and the need for concerted emergency interventions.
Benguela
The situation in Benguela is extremely mixed. As of January 2002 it was reported that there were 95,698 registered IDPs in the province with a reported 419,239. Many areas of the province have been inaccessible to humanitarian assistance due to poor security. As the security situation has changed there have been reports of many new IDPs arriving in towns such as Culango, where more than 3,000 arrived in January and February 2002. There are also reports of large influxes of IDPs to Bocoio town who are without adequate shelter, clothing and food. (UN OCHA 28/02/02). The needs and conditions of the IDPs vary enormously with the newer IDPs showing both the highest needs and vulnerabilities.
ACF-SP conducted a nutrition survey in the town and IDP camps in and around Ganda, in November 2001. The town is situated to the south east of the province and contains approximately 5,300 IDPs who fled insecurity in the surrounding area. The town is more or less an enclave and both the residents and the IDPs have very little access to the surrounding area, greatly constraining their access to cultivable land. They have received an intermittent general food distribution. The survey investigated the prevalence of malnutrition in the displaced and non-displaced communities and found that prevalences did not differ markedly and were not elevated above emergency thresholds (see table below). This did not of itself indicate a concerning situation. However, the survey rates of both the crude and under-five mortality were above emergency thresholds and highly indicative of an extremely poor health situation. This is a result of a poor food security situation and the lack of access to good water, sanitation and primary health care (ACF-SP 11/01).
Table of ACF-SP survey in Ganda, Benguela Province (ACF-SP 11/01)
|
|
Residents |
IDPs |
|
Acute malnutrition < -2 Z scores +- oedema |
4 % |
5.2 % |
|
Severe < -3 Z scores +- oedema |
0.7 % |
0.6 % |
|
CMR |
1.2/10,000/day |
1.3/10,000/day |
|
< 5 mortality |
2.9/10,000/day |
3.9/10,000/day |
Catholic Relief Service (CRS) conducted a nutrition survey on both resident and IDP children under five years of age in the town of Balombo in March 2002. The survey found an estimated prevalence of malnutrition of 11 % (W/Ht < -2 Z scores and/or oedema), which included 1.3 % of severe malnutrition (W/Ht < -3 Z scores and/or oedema). The survey also found a crude mortality rate of 1.4/10,000/day and an under-five mortality rate of 3.2/10,000/day. The results indicate that the situation for both IDPs and residents in the town is extremely precarious and, although not statistically significant, observations indicated that the condition of newly arrived IDPs was worse than that of the residents and the longer term IDP population. It is alarming to note that the mortality rates are elevated above emergency thresholds indicating a very poor situation. The reasons for this are believed to be acute food insecurity, the poor conditions within the town and the lack of access to adequate medical care (CRS 03/02).
Huila Province
The general situation in Huila province is extremely poor with an estimated 164,000 IDPs as of March 2002. There are estimated to be 1,000 new IDPs arriving in centres such as Caconda and Matala each week, placing pressure on the already limited resources of the area (UN OCHA 07/03/02). As the security situation has improved and the area opened up to humanitarian agencies, some areas of very acute needs have been highlighted. In particular, the situation in Bunjej has been confirmed as a disaster. MSF has conducted some assessments in the area and found mortality rates of between 4 and 6/10,000/day and a prevalence of acute malnutrition greatly in excess of emergency thresholds. This is indicative of a very serious humanitarian situation and has arisen as a result of the insecurity of the area and the inability of people to access even the simplest of subsistence needs. Similar situations have been found in other areas of the province and are indicative of the immense needs and vulnerability of much of the population (UN OCHA 31/03/02).
Caconda
ACF-Spain conducted a nutritional survey in the town and IDP camps of Caconda, in January 2002.
The area has been considered to be extremely vulnerable for some time as a result of poor food security and an increasing number of IDPs. The results of the surveys (see table below) indicate that the humanitarian situation in Caconda is critical and effects both the displaced and the non displaced populations.
Table of ACF-SP survey in Caconda, Huila Province
|
|
Residents |
IDPs |
|
Acute malnutrition < -2 Z scores +- oedema |
11.2 % |
20.7 |
|
Severe < -3 Z scores+- oedema |
2.7 % |
5.3 |
|
CMR |
2/10,000/day |
3.8/10,000/day |
|
< 5 mortality |
6.8/10,000/day |
12.6/10,000/day |
Kuanza Sul
The province of Kuanza Sul is in the west of the country above the provinces of Huambo and Benguela. The province has suffered from poor insecurity and contains a number of IDPs, particularly in Wako Kungo where the numbers are reported as having reached 13,000 in February 2002 (UN OCHA 15/02/02). ACF-Spain conducted a nutrition survey in the municipality of Sumbe in December 2001 to determine the prevalence of acute malnutrition amongst IDP and non displaced children under five years of age. The survey indicated an estimated prevalence of acute malnutrition of 3.4 % (W/Ht < - 2 Z scores and/or oedema), which included 1.2 % of severe acute malnutrition (W/Ht < - 3 Z scores and/or oedema). The survey also estimated a crude mortality rate of 0.9/10,000/day and an under-five mortality rate of 4.1/10,000/day (ACF-SP 12/01). The prevalence of acute malnutrition is not high and of itself is not indicative of an emergency situation. However, the mortality rates are elevated with the CMR just below the emergency cut-off of 1/10,000/day and the under-five mortality above the emergency cut off of 4/10,000/day. The mortality rates indicate that the situation in the municipality is extremely poor and the causes would appear to be the very poor public health environment. The survey notes that the number of IDPs has placed great pressure on housing and that as a result houses and shelters are built very close together with no room given to the construction of latrines. This has led to a very poor hygiene situation where infections are very easily spread (ACF-SP 12/01). Both the IDPs and the non-displaced population remain vulnerable and, although the nutritional status was not deemed to be severe, the risk of further declines, particularly with the arrival of new IDPs, is large.
Lunda Sul
The situation in Lunda Sul is variable with areas of great need emerging as the security situation allows for increased access to needy populations. In March 2002, UN OCHA reported that the areas of Alto Chicapa, Xassengue, Cucumbi and Cacolo were experiencing critical shortages of food and medicines (UN OCHA 15/03/02). Many of these IDPs are reported to be making their way to the town of Saurimo where various camps and reception centres have been established. In Saurimo itself, the number of IDPs is growing and there are reports of increasing cases of diarrhoea among both children and adults. This has been linked to inadequate access to clean water and the consumption of seeds that have been treated with chemicals for conservation purposes (UN OCHA 28/02/02).
ACF-Spain conducted a nutrition survey on children under five years of age amongst the displaced and resident communities in Saurimo during January 2002. The results indicated that the prevalence of acute malnutrition did not, in itself, indicate a problem of public health significance. The prevalence appeared to be higher in the IDP population but the results were not statistically significant. However, the survey also showed that the mortality rates in both groups were above emergency thresholds, indicating that the overall situation for the population was extremely poor (see table below).
Table of ACF-SP survey in Saurimo, Lunda Sul
|
|
Residents |
IDPs |
|
Acute malnutrition < -2 Z scores +- oedema |
3.5 % |
6.9 % |
|
Severe < -3 Z scores +- oedema |
0.7 % |
1.8 % |
|
CMR |
1.1/10,000/day |
1.8/10,000/day |
|
< 5 mortality |
2.2/10,000/day |
6/10,000/day |
Moxico Province
Moxico has been the sight of much insecurity over the reporting period and was the province where Jonas Savimbi, the leader of UNITA, was killed in February 2002. The provincial city of Luena has been particularly badly affected by a huge influx of IDPs that have placed enormous pressures on the existing poor infrastructure. It has also been reported that the poor condition of the airstrip has made the delivery of emergency aid all the more difficult. In February 2002, it was estimated that the total number of IDPs in Luena was 89,000 (IRIN 12/02/02), however this figure is likely to have grown considerably.
Reports indicate that many of the IDPs have arrived at the town in military helicopters and the government has been accused of depopulating the surrounding countryside in an attempt to remove the subsistence base from the UNITA rebels known to be in the area. The problem has been that the sheer number of IDPs has simply overrun the resources of the town and of the humanitarian agencies ability to deal with the influx. Many of the new arrivals are women and children who are reported to be in critical condition. Both the supplementary and therapeutic feeding programmes have exceeded their capacity (UN OCHA 31/01/02). The government of Angola has reported that another 50,000 people could arrive in the town over the next few weeks (UN OCHA 07/03/02). The RNIS does not have any recent nutritional surveys from the town but it is reported that a nutritional screening in February 2002 indicated extremely high rates of acute malnutrition. The population should be assumed to be in very poor condition and at risk of further nutritional decline.
Overall
The reporting period has seen some major political changes in Angola but these have yet to have an affect on the critical humanitarian situation. Insecurity appears to be reduced, although it continues in some areas, and the presence of large numbers of landmines will continue to constrain access and ensure that many areas are regarded as insecure for some time to come. There has been a great increase in the number of IDPs, all with very acute humanitarian needs. The increase has surpassed the humanitarian community s ability to cope with the numbers of people and the depths of their needs. In terms of vulnerability, it is evident that the new IDPs are at greatest risk (category I) with some of the resident population and older IDP communities being at marginally reduced risk (category II).
Recommendations
From the MSF survey in Camacupa, Bie Province
· Continue general food distributions for all displaced to include a fortified blended food such as CSB.From the ACF-SP survey in Ganda town, Benguela Province
· Improve access to primary health care and vaccination coverage.
· Improve shelters with plastic sheeting to protect against the rainy season.
· Continue the general food distribution to the population.From the CRS survey in Balombo, Benguela Province
· Tackle the problem of diarrhoea and malaria through education and community teams.
· Expand the capacity of the Supplementary Feeding Centre.From the ACF-SP survey in Caconda, Huila Province
· Extend the Therapeutic Feeding Centre to include a 24 hour facility.
· Give particular support to the newly arrived IDPs.
· Improve the general food distribution to 2100 Kcals/day with appropriate coverage and targeting.From the ACF-SP nutrition survey in the Municipality of Sumbe, Kuanza Sul
· Increase the capacity of the existing selective feeding centres.
· Improve the access and availability of water and sanitation services.
· Support the local health facility and conduct essential vaccination programmes.
· Establish a system of home visits in order to detect vulnerable children.From the ACF-SP nutrition survey in Saurimo, Lunda Sul
· Conduct nutrition and hygiene education programmes for mothers of vulnerable children.
· Support breast feeding in the community.
· Improve access to potable water and sanitation.
· Implement a therapeutic feeding centre in the provincial hospital.
· Improve the system of registration for newly arrived IDPs.
The humanitarian situation in Zambia is considered to be critical for much of the population as a result of a food crisis that has hit much of the south of Africa. The country is facing a severe maize shortage after a crop failure in the 2000-2001 season which led to a 30 % drop in agricultural output.. In December 2001, WFP launched an appeal for 18 million dollars to distribute food to 1.2 million people (UN OCHA 19/01/02). The response to the appeal is so far reported to be slow.
The general emergency in the country has placed extra pressure on the more than 300,000 refugees located in various areas of the country. The refugees are primarily from Angola and the DRC and many have been in the country for more than 30 years. The country received 28,000 Angolan refugees from the neighbouring provinces of Cuando Cubango and Moxico during the year 2001. Consequently, some of the camps have reached their maximum capacity and the creation of new camps is currently a priority. The situation for many of the refugees is poor due to over crowding in camps and a lack of employment or farming opportunities. This was further exacerbated in March 2002 with a court ruling that any refugee caught starting an illegal business would be deported (Xinhua 27/03/02). The current nationwide food shortages and the increasing number of refugees has meant that there were breaks in the food pipeline in January 2002 with refugees receiving half rations. The level of dependency on food aid is a problem and future programmes will focus on areas such as agriculture, health and sanitation. The cessation of violence in neighbouring Angola could potentially signal a dramatic change in the refugee profile in the country if Angolan refugees decide to return to their places of origin. However, it is currently uncertain whether returns will be possible. Any large scale return of Angolans would significantly reduce the refugee burden in Zambia. The RNIS does not have any recent nutrition surveys from refugees in Zambia, however the situation is not deemed to be critical.
Overall
The current humanitarian situation in Zambia as a whole has worsened as a result of a regional food deficit. This has impacted on the allocation of resources to refugees and some breaks in the food pipeline were observed. This places refugees at elevated risk. However, their current situation is not deemed to be critical (category III).
Recommendations
From the RNIS
· Support the Consolidated Appeal process.· Encourage further self sufficiency in the refugee population with a focus on income generation schemes.
· Provide access to agricultural land.
