Eritrea
Ethiopia
Kenya
Somalia
Sudan
SUB-SAHARAN AFRICA
Refugee repatriation
It is estimated that there are about 355,000 Eritrean refugees in Sudan (see table), most of whom come from the Gash Barka region. There have been 51,683 repatriations since May 2001, mainly to the Gash Barka region (UNHCR, 10/09/02). No information on the conditions of returned refugees has been made available to RNIS. Automatic refugee status granted to Eritreans will expire at the end of 2002. UNHCR has assessed that there are no longer grounds for Eritreans to remain as refugees since the war and drought have both ended. Repatriation will continue and screening for Eritreans who wish to claim refugee status, because of a fear of persecution, will begin (AFP, 12/09/02).
Eritrean refugees in Sudan (UNHCR, 10/09/02)
|
|
Number |
|
Camp-based receiving assistance |
147,000 |
|
Registered urban-based receiving assistance |
13,000 |
|
Estimated urban-based receiving limited assistance |
195,000 |
|
Total |
355,000 |
There are an estimated 60,000 displaced persons living in camps as a result of deportation from Ethiopia or because unexploded mines prevent them from returning home (ECHO, 18/07/02). No recent information on the nutrition of this population is available to RNIS.
Drought
The government recently launched an appeal for humanitarian assistance. It is anticipated that the cereal harvest will be reduced by 84%. Crops planted in the spring cultivation season (March-May) have dried up as a result of poor rainfall. The June-September rains were delayed by about six weeks, causing a significant drop (37%) in planting surface. The estimated requirement for food aid is more than 400,000 MTs of cereals, beans and oil (ICC, 28/08/02).
|
Erithrée Environ 355 000 Erythréens sont actuellement réfugiés au Soudan. Leur statut automatique de réfugiés expirera à la fin de l’année 2002, le HCR estimant que la situation en Erythrée ne nécessite plus l’expatriation. 51 683 Erythréens ont déjà été rapatriés depuis mai 2001, la plupart sont retournés dans la région de Gar Barka. De plus, l’Erythrée compte 60 000 déplacés internes. RNIS n’a pas reçu de récentes informations nutritionnelles concernant ces populations. L’Erythrée est d’autre part touchée
par la sécheresse et la quantité d’aide alimentaire
nécessaire est estimée à 400 000 tonnes. |
Ethiopia is facing a new drought and the government estimates that 5.8 million people will require food aid (OCHA, 30/08/02).
Drought
The failure of the February-May Belg rainy season (also called Sugum in Afar and Gu in the Somali regions) and the late start of the June-September Meher rainy season (also called Karam in Afar and the Somali regions) led to serious food deficits in some parts of Ethiopia.
The affected regions are Afar, the eastern parts of the Oromoya lowlands, several areas of Southern Nations and Nationalities People’s Region and the northern part of the Somali region (WFP, 02/08/02). Since July, 142,196 MTs (including part of the government contribution of 45,000 MTs) have been allocated and distributed. 173,970 MTs will be needed for the September-December period, of which 70,387 MTs are available (OCHA, 30/08/02). WFP is experiencing a food shortage and is therefore distributing reduced rations (WFP, 23/08/02).
Somali region
Drought particularly affects the Fik and Shinile zones. North Jijiga also experienced poor rains. Rains were near normal in the rest of the Somali region. Nevertheless, the poorest, including IDPs, will not benefit fully from the rain because of a very low asset base. They will largely need support (FS/EW, 07/02).
Afar region
Veterinary experts and the Bureau of Agriculture have estimated that livestock deaths have been 14% in the Afar region, with cattle deaths as high as 44%. The most affected areas are zone 3 and 5 (UNDP/EUE, 13/09/02).
A nutrition survey was undertaken by GOAL in August 2002 in the rural area of zone 3 of Afar (GOAL, 08/02), where 90% of the population are pastoralists.
The survey showed that 17.9% of the children were acutely malnourished, including 2.9% with severe malnutrition. Only one child presented oedema.
Interviewed people reported having lost 70% of their livestock in the previous four weeks, and one half declared having sold livestock in the same period, despite low market prices, which were reduced by about 30% compared to the previous year. The use of wild food has increased from about 10% in a normal year to 35 %.
Food aid was received by 74 % of the surveyed households. The ongoing food distribution system seems to be inadequate: only 30% of the population are targeted for food distribution, however food is shared among all the population. This results in lower rations per family. Moreover, some families get as little as 7.5 kg and others as much as 100 kg per month. In addition to food insecurity, health facilities and immunization rates are the lowest in the country. Measles immunization as assessed in this survey was 17.6%.
A nutritional assessment was also undertaken by ACF in zone 1 of Afar in Ayssaita and Afambo woredas (ACF, 07/02). The assessment consists of an exhaustive survey of children under-five in seven villages. These are mainly agro-pastoralist villages, considered as particularly vulnerable during a previous assessment. The assessment showed very high rates of malnutrition; 32.4 % of the children were acutely malnourished, including 4.1% with severe malnutrition. Although this assessment is not representative of the entire area, it shows that at least some villages are already highly affected. A nutrition causal analysis found that food insecurity was prevalent in the area (see figure): food is available but very high prices make it unaffordable for a large part of the population. Moreover, the provision of food aid is impaired by lack of transportation and access difficulties to this remote area. Poor health and sanitation are also factors that contribute to and compound the malnutrition.
Internally Displaced Persons
There are 90,000 IDPs in the Somali region, as a consequence of conflicts or the 1999/2000 drought. They are particularly affected. They need basic services such as food and water but also longer-term initiatives to improve their situation (FS/EW, 07/02). The IDPs in the Afar region will be at great risk, already being one of the most vulnerable groups.
It has also been reported that about 17,000 IDPs who were settled in 11 camps near Addis Abeba have been asked by the government to move. They came from Eritrea before its independence and they haven’t received any help for sometime. Despite being given money by the government as compensation for moving, some of the IDPs who had moved out returned to the camps. They were too frightened to live on the streets once they had spent the compensation money. The Ethiopian Human Rights council has condemned the decision to close the camps (IRIN, 12/09/02).
Refugees
Somali refugees continue to be repatriated from the Somali region. It is estimated that since January, about 11,000 refugees have been repatriated from Ethiopia leading to the closure of four refugee camps (UNHCR, 15-07-02).
The RNIS does not have any recent nutritional information for the remaining Somali refugees or the Sudanese refugees in the west of Ethiopia. However, it is likely that the refugees will also be affected by the drought.
Overall The situation of the drought-affected population, in a context of structural poverty, is assumed to be at high risk (category II).
Recommendations and priorities
From the GOAL survey in Afar, zone 3
· Improve the general ration to meet the basic requirements of all the populationFrom the ACF assessment in Afar zone 1· Conduct a measles and vitamin A campaign
· Implement blanket supplementary food distribution for under-five children, pregnant and lactating women and elderly
· Improve environmental sanitation
· Put in place mobile health facilities
· Ensure delivery of food aid to these areasFrom the RNIS
· Allocate more supplementary food
· Explore the possibility to implement a feeding programme
· Continue provision of water supply
· Remove dead animals from water points
· Insure short-term food security of the affected population by effective food distributionUnderling causes of malnutrition, Afar, zone1, ACF, 07/02
· Development of long-term programmes, such as animal health and feeding programmes, aiming at stopping asset depletion and improving livelihood of the population
|
Ethiopie L’Ethiopie est de nouveau frappée par la sécheresse; les régions les plus touchées sont l’Afar, l’est de l’Oromaya, le nord de la région Somalie et différentes zones de la région SNNPR. 173 970 tonnes d’aide alimentaire seront nécessaires pour couvrir les besoins jusqu’en décembre 2002. Les quantités allouées au PAM sont pour l’instant insuffisantes. Deux enquêtes réalisées dans la région de l’Afar mettent en évidence une situation nutritionnelle préoccupante. L’enquête de GOAL, en août 2002, dans la zone 3 de l’Afar, montre un taux de malnutrition aiguë de 17,9 %, incluant 2,9 % de malnutrition sévère. La distribution alimentaire semble inadéquate, certaines familles ayant reçu 7,5 Kg de céréales alors que d’autres en recevaient 100 Kg. L’enquête d’AcF dans 7 villages de la zone1 de l’Afar, déterminés préalablement comme particulièrement vulnérables, montre un taux de malnutrition aiguë de 32,4%, incluant 4,1 % de malnutrition sévère. Cette enquête, réalisée en juillet 2002 n’est pas représentative de toute la zone mais met néanmoins en évidence le fait que certains villages soient déjà gravement touchés. L’insécurité alimentaire est la principale cause de malnutrition. La situation des populations affectées par la sécheresse est considérée comme extrêmement précaire (catégorie II). Les priorités sont d’assurer à ces populations une alimentation adéquate par une distribution de nourriture ainsi que de continuer ou de mettre en place des actions à plus long terme visant à améliorer les moyens d’existence de ces populations. Il serait d’autre part souhaitable que des programmes de réhabilitation nutritionnelle soient mis en place. Les 90 000 déplacés de la région Somalie
n’ont pas un accès adéquat à l’alimentation ou
à l’eau. Le rapatriement des réfugiés somaliens
continue; quatre camps les abritant ont été
fermés. |
Refugees
More than 200,000 refugees, mostly from Somalia and Sudan are still located in two huge camps: Dadaab and Kakuma. For a number of reasons, including restricted movement from the camps and environmental hostility, the refugees rely totally on food aid distribution. High rates of malnutrition and micronutrient deficiencies have been reported for years as documented by RNIS. This is mostly attributed to inadequate food rations both in quantity and quality, because of a shortage in the food pipeline. This has led IRC recently to raise the issue of Kakuma camp before the US senate (IRC, 06/02). Distribution of non-food items was also reported to be inadequate leading refugees to sell food to buy wood for cooking, for example. IRC was also concerned about the decrease in donor contribution to the management of the camp. The IRC testimony has perhaps had an impact: WFP have reported that due to additional donations, they will be able to provide almost full rations to refugees until January 2003. However, more food is needed for the period January-June 2003. A joint assessment mission is planed by UNHCR, WFP, Government of Kenya and potential donors at the end of September 2002 (WFP, 30/08/02).
There have been reports of increased tension and antipathy towards the refugee community. In the districts where Kakuma and Dadaab camps are located and as elections are approaching, some politicians are using the case against the refugees as part of their electoral campaign (JRS, 31/07/02). Also, some forced repatriation of Somali refugees from Mandera has been reported. (OCHA, 18-07-02).
Drought affected population
Having begun in March 2000, the Kenya drought relief EMOP is now being phased out, following an assessment mission which reported a significant improvement in the food security of the affected population. However, some pastoral and agro-pastoral areas in Eastern province are still in need of some form of relief intervention (WFP, 09/08/02). A final general food distribution took place mid-September. The food for work programme will be on-going until the food pipeline is depleted (WFP, 30/08/02).
Flood affected population
About 50 people were killed and 150,000 displaced by floods occurring in May (Xinhua, 13/05/02). The most affected provinces were Nyanza, Coast, Western and North Eastern provinces. This was followed by an outbreak of malaria in the Nyanza and Rift Valley province claiming over 500 lives in June and July (IFRC, 28/08/02). Food and non-food items have been provided by the Kenyan Red Cross Society.
Overall The nutrition situation of refugees in Kenya is still of concern (category II).
Recommendations and priorities
From the RNIS
· Continuous support in both food and non-food items is required for refugees
· Refugee situation needs to be closely monitored
|
Kenya Le Kenya accueille toujours plus de 200 000 réfugiés dans deux principaux camps, Dadaab et Kakuma. Pour différentes raisons comme la restriction de leur mouvement à l’extérieur des camps et la rudesse de l’environnement, ces réfugiés sont totalement dépendants de l’aide alimentaire. Leur situation nutritionnelle est inadéquate depuis de nombreuses années; ceci est en particulier attribué a l’insuffisance de l’aide apportée à ces populations. Cette situation a conduit l’ONG IRC à alerter le congrès américain à propos des conditions de vie précaires de ces populations. Il semble que cela ait eu un certain impact, le PAM ayant reçu de nouvelles donations et ayant réussi à augmenter les rations alimentaires. Ces réfugiés sont néanmoins toujours considérés à risque (catégorie II). Le soutien à ces populations en terme de nourriture et de matériel de base doit continuer et être amélioré. Le programme du PAM en faveur des populations kenyanes
affectées par la sécheresse est en cours d’arrêt, la
situation de ces populations s’étant améliorée.
Certaines provinces de l’Est auront néanmoins toujours besoin de
support. 150,000 personnes ont été déplacées au mois
de mai à la suite d’inondations, en particulier dans l’ouest et
le nord-est du pays. |
In key locations throughout Somalia, factional armed conflict is again on the rise to levels not seen in years, particularly in Bay region, Gedo region, Mogadishu and Puntland. This affects the population both directly and by impairing humanitarian interventions. The Somali reconciliation conference has been postponed for months now (OCHA, 11/09/02). The UN Security Council has approved a resolution to tighten the ten year old arms embargo. Recent economic shocks are further worsening the situation including inflation and reduced purchasing power as a result of the printing of a new currency; closure of the main remittance company on November 2001; and a ban on livestock imports by the Gulf states since 2000 (IFCN, 08/02). These have all contributed to a further deterioration of household food security. High rates of malnutrition have been recorded, especially in Southern Somalia where rates are often above 15% even after a good agricultural season.
The Gu rainfall has been good in most parts of Somalia, except for Northern Gedo, parts of the Hiran and Bakool regions, and parts of Somaliland and Puntland.
The UN appeal for 2002 is only 40% funded as of August 2002 (UN resident co-ordinator, 22/08/02).
Refugee repatriation
Repatriation of refugees from Ethiopia and Djibouti, mainly towards Somaliland, is on going. It is estimated that since January, about 11,000 refugees have been repatriated from Ethiopia, leading to the closure of four refugee camps in Ethiopia. 14,000 refugees in Djibouti are also already registered for repatriation (UNHCR, 15/07/02).
Southern regions
Hiran
Part of the Hiran region is considered highly vulnerable as a result of poor 2002 Gu season following two successive below normal rains since the 2001 Gu season. The prospect for the 2002 Gu harvest is 85-90 % lower than normal (FSAU/N, 09/02).
Beletweyne district
Beletweyne is one of the districts of the Hiran region currently exposed to food insecurity. The poor Gu rainfall has limited production in the rain-fed areas, while high fuel prices have prevented adequate irrigation in riverine areas. Animal out-migration was also observed, decreasing milk availability (FSAU/FS, 08/02).
Following high levels of malnutrition recorded through MCH growth monitoring, a nutritional survey was conducted in Beletweyne district in May 2002 (UNICEF, 06/02). The children surveyed were from pastoralist or agro-pastoralist groups (27%), farming groups (27%), and urban groups (53 %). Only 1.7% of the children were from displaced families. The survey revealed high rates of acute malnutrition; 21 % of the 6 to 59 months old children being malnourished, of which 2.7 % were severely malnourished. Only 52% of the children had been vaccinated against measles.
A further nutrition assessment in Belet Weyne town, which has one half of the district’s population, was undertaken in September 2002 and confirmed the poor nutrition situation. Of 589 children screened, 24.7% presented malnutrition (MUAC < 12.5 cm and/or oedema) including 5.4% severely malnourished (MUAC < 11 cm and/or oedema) (FSAU/N, 09/02).
Trends (see graph) in the prevalence of malnutrition show that malnutrition has remained high since 1996, with peaks in 1997 and 1998, probably due to the 1997 floods. Successive bad rainy seasons and the recent economic shocks have further weakened the population and the recurrent insecurity has worsened the situation. The underlying causes of malnutrition seem to be multi-sectoral including food insecurity, inadequate access to safe water, and poor child feeding practices (FSAU/N, 08/02).
Primary health care is still provided although nutrition interventions were halted in April 2001. A nutrition programme including supplementary feeding for malnourished children and food rations for their families, as well as a Therapeutic Feeding Centre, is intended for October. Medium to long term interventions have also been identified including improving water and health services and sustaining livestock (FSAU/N, 09/02). The current food for work programme will continue. Given the high level of malnutrition and the poor household food security, a larger food distribution should be considered, particularly if the forthcoming Deyr season fails.
Prevalence of acute malnutrition among 6-59 month olds in Bet Weyne, Hiran, Somalia
Bay region
Baidoa saw the onset of insecurity in July, leading to the displacement of population throughout the Bay and Bakool regions, and the suspension of humanitarian activities in both Bay and Bakool (WFP 02/08/02). By mid-August, the situation was reported to be quieter but the displaced populations had not returned at that stage.
Berdaale district
The food economy groups in Berdale district are primarily agro-pastoral (50%) and agricultural (30%).
A nutritional survey undertaken by IMC/FSAU/UNICEF in May 2002 in Berdaale district revealed poor nutritional status with a prevalence of acute malnutrition of 17.1%, including 3.5 % severe malnutrition (IMC/FSAU/UNICEF, 05/02). The nutritional situation in this high potential agricultural area has been deteriorating since 1996 (see graph), particularly as the affected population is dependant on crops for 50-60 % of their food and 15 % of their income. The prevalence of malnutrition has increased four fold since 1996 when the nutrition situation was good, with a prevalence of malnutrition of 4.6%. At the time of the survey, the population had no food stocks and their income power was generally low. Even if casual work was available for farm labourers, payment rates were low. There was a high reliance on wild food. The Gu rains have however been generally good, which has improved both the condition of livestock and milk availability, and the Gu harvest is expected to be normal.
A relatively high prevalence of disease, and poor sanitary conditions have also been reported.
MCH activities are running. Supplementary feeding was provided through MCH from August 1999 until January 2002, when it was halted after food looting. Following the results of this nutritional survey, supplementary feeding resumed in July 2002, combined with family ration distribution to households with malnourished children, but due to security problems the family food rations were not distributed in all sites in July and August (FSAU/N, 09/02). The implementation of a multi-partner TFC is currently being negotiated (FSAU/N, 07/02).
It is hoped that the resumption of the nutritional activities will help the population cope until the next harvest. The population is vulnerable due to years of asset depletion, poor rates of payment and labour opportunities, and an inability to improve farming potential due to lack of resources. Even if the 2002 Gu harvest is good, livelihood will need to be further strengthened.
Prevalence of acute malnutrition among 6-59 month olds in Berdaale district, Bay, Somalia
North Gedo
North Gedo is also experiencing a poor Gu season. In addition, the prevailing insecurity over the past months has contributed to a deterioration of the situation. WFP resumed its distribution, which had been halted since April in Garbahary and Burdhubo districts (WFP, 30/08/02).
Luuq district
Although the RNIS has not received any recent nutritional information on the population in Luuq district, the situation is presumed to be of concern. Although the security conditions have improved since a cease-fire agreement, the presence of landmines is limiting aid access. No food distribution has been possible for the last four months, despite the population being highly dependent on food aid. Food aid had accounted for 35% of their food energy requirements up until March (FSAU/FS, 08/02). Insecurity prevented planting in rain fed areas during the Gu season, and irrigation has been limited as a result of high fuel prices and pumps having been dismantled due to fear of looting. Population displacements have been reported to El Bonn and neighbouring areas in search of work (FSAU/FS, 08/02). The population of Luuq district remains of serious concern.
Belet Hawa
RNIS 36/37 reported a catastrophic situation in December 2001, i.e. 37.1 % acute malnutrition including 8.3% severe malnutrition. General food distribution and nutritional activities were then implemented. The onset of violence in March 2002 resulted in the displacement of thousands of people into other parts of Somalia and into the Mandera district of Kenya. The situation of the refugees arriving in Kenya has been reported to be extremely serious. About 2,300 were resettled to Dadaab camps in Kenya in mid June 2002 (IFCN, 07/08/02). Three thousand refugees returned to Belet Hawa in July. There has been concern about possible forced repatriation (OCHA, 18/07/02). These returnees are highly dependent on food aid. Humanitarian operations resumed in June, including food distribution, and supplementary and therapeutic feeding. The MCHs reported that 20%-30% of attending children were acutely malnourished (FSAU/N, 08/02). TFC and SFCs are operating in the zone.
Mogadishu
Because of recent economic shocks, and the intensification of fighting since the Transitional National Government was appointed, the situation of Mogadishu’s population has probably worsened, particularly for displaced people. Income opportunities are very limited and the prevailing insecurity and looting further impairs the population’s ability to cope. Food prices were reported to have increased in June and July due to insecurity in Baidoa, the main food producing area in Somalia (IRIN, 26/08/02). In addition, sanitary conditions for displaced people are generally far from adequate (FSAU/N 08/02).
A rapid assessment conducted at the end of June in five IDP camps showed that of the 487 children screened (exhaustive screening of all children in the camps), 39% had a MUAC < 12.5 cm and/or oedema (considered as malnourished) including 7.1% having a MUAC < 11 cm and/or oedema (considered as severely malnourished) (FSAU/N, 08/02). These results confirm the high vulnerability of IDPs in Mogadishu. A nutritional survey conducted in accessible IDP camps in June 2000 by ACF, had revealed that 16.1% of the children had a MUAC < 12.5 cm including 1.9% with MUAC < 11 cm (ACF-F, 06/00). Even though the two assessments are not directly comparable because they were not undertaken in the same population, the trend of nutritional status seems to confirm a deterioration. ACF TFCs are currently treating about 250 severely malnourished children. Anyway, high levels of insecurity have prevented the implementation of adequate humanitarian activities.
Northern regions
Somaliland
Somaliland remains stable and is planing to hold presidential elections in January 2003 (IRIN, 20-26/07/02). Repatriation of refugees from Ethiopia and Djibouti is ongoing.
Sahil region
Sahil region, like the rest of Somaliland, has suffered from the impact of the ban on the importation of Somali livestock. The region is mostly composed of pastoralists with an urban group of residents of Berbera and Sheikh town. A nutritional survey undertaken by FSAU/MOHL/UNICEF in May 2002 revealed a prevalence of malnutrition of 11.8% including 2% of severe malnutrition (FSAU/MOHL/UNICEF, 05/02).
The most vulnerable population appears to be drought affected residents of coastal areas who have migrated into highlands, the returnees from refugee camps, and the urban poor. On the contrary, populations normally living in the mountains appeared better off.
Sanag region
Many areas of Sanag region are experiencing food insecurity due to consecutive poor rainfalls. The region is essentially pastoral, and herds have been particularly affected by the drought with a rise in camel and cow deaths and very poor milk production. About 70% of poor pastoralists have been reported to eat only one or two meals per day instead of the normal three (FSAU/FS, 09/02). The region has also received many displaced people due to the insecurity prevailing in some areas of Puntland. A nutrition survey conducted by UNICEF in May 2002 reported 13.7 % acute malnutrition including 5% severe (UNICEF, 05/02). The incidence of oedema among children was very high: 3.3%. The main coping strategies used were borrowing, and sale of more livestock.
The measles vaccination coverage was only 19.2 %. The nutrition survey results do not show an alarming situation, but the high prevalence of oedema is of concern.
Puntland
Puntland is still experiencing heavy fighting in the main towns of Garowe and Bossasso. In addition, poor Gu rainfall has affected pasture and water availability. This has particularly affected the mostly pastoral areas of eastern Sanag, NE Sool, South and North Nugal away from the Nugal river, NE Mudug and South Bari, leading to poor pasture and livestock migration (FSAU/FS, 08/02). The poor, who are unable to migrate readily are the most affected.
Sool plateau
About 25,000 persons, particularly the poor patoralists, are reported to be increasingly food insecure, and will require assistance until the rainy season in October-November. Milk availability has fallen to 50% of baseline levels while wage rates are only 70% of normal. Reproduction rates of livestock have decreased considerably (FSAU/FS, 09/02).
However, a MUAC screening carried out in July 2002 in the Sool plateau (excepting the Bari region for security reasons) showed that 6.3% of the children had a MUAC < 12.5 cm and/or oedema, including 0.4% of children with a MUAC < 11 cm and/or oedema (FSAU/N, 08/02). Higher rates had previously been reported in Bari region in May 2002, 17 % of the children presented a MUAC < 12.5 cm and/or oedema (FSAU/N, 09/02).
Focus on displaced and returnees
A study undertaken by UNCU/UN-OCHA, highlighted the vulnerability of the IDPs in Somalia and of returnees living in the peri-urban camps of North Somalia (UNCU/OCHA, 2002). These populations experience very poor access to basic services and employment opportunities. For example, a comparison between residents and IDPs/returnees in Hargeisa showed that while only 7% of the residents were categorised as destitute, the proportion was 50% for the IDPs/returnees. The average daily income of residents was 36% higher than the daily income of IDPs/returnees, who had to rely more on their own resources as fewer of them receive remittances. Begging was a significant source of income for about 9% of the IDPs/returnees in Hargeisa camps, while in Burao and Yirowe camps in Toghdeer region, 91% of the displaced from the South were reported to depend mostly on begging because they didn’t have access to casual work.
An IDP camp on the outskirts of Bossaso with about 400 families was totally destroyed by fire at the beginning of September. Humanitarian organisations have expressed their concern at the lack of permanent settlement for IDPs in the Puntland. IDPs themselves have cited insecurity of land tenure as one of their major problems. The Sahil nutritional survey (see above) confirms the high vulnerability of IDPs/returnees. They are three times more at risk of malnutrition than the resident population.
The status of IDPs/returnees is of major concern as repatriation from Ethiopia and Djibouti to North Somalia continues.
Overall The situation of populations in areas affected by both drought and insecurity is very precarious, and access remains difficult (category I). In addition, some populations are facing food insecurity due to poor Gu rainfall (category II). Urban IDPs are also considered to be at high risk due to economic shocks that affect their opportunities of finding adequate incomes as well as their access to basic services (category I). Returnees also experience poor living conditions and this is a major concern as large-scale repatriation continues. Their nutrition situation is however not yet known (category V).
Recommendations and priorities
Bellet Weyne
From the UNICEF survey
· Resume SFP in MCH and expand it throughout the district (due to start in October)From the FSAU
· Introduce nutrition education
· Increase access to improved drinking water
· Medium-long term intervention aimed at improving water, health services and livestockFrom the RNIS
· Strengthen the food security of this population by expanding the food distribution in the event of any factors tending to prevent recovery in the Deyr season.Luuq district
From the FSAU
· resumption of supplementary feeding in the districtBelet Hawa
· increased commitment to ensure successful delivery of the essential food aid, especially if the Deyr season fails.
· continue the provision of food aid, and therapeutic and supplementary food for malnourished childrenSool plateau
· Strengthen incomes of the population at least until the next rainy seasonSanag region
· Provide water
· Do not encourage in migration
From the UNICEF survey
· Undertake further investigations on oedema cases and respond accordinglyIDPs returnees
· Establish four health centres and mobile EPI teams
· Administer selective feeding for the malnourished children
· Monitor the nutrition status of the under-fives
· Lobby WFP to expand food for work projects
From the RNIS
· Improve the overall settlement of the population and provide basic services
· Improve income opportunities
· Design a comprehensive plan for returnee integration
· Assess the nutrition status
|
Somalie La Somalie est toujours en proie à différents conflits armés. De plus, elle a été touchée par de nombreux chocs économiques comme l’interdiction des importations de bétail par les états du Golf, la fermeture de la principale agence de transfert de fonds et l’inflation due à l’introduction d’une nouvelle monnaie. Les pluies ont néanmoins été satisfaisantes dans l’ensemble du pays, excepté dans le nord de la région de Gedo, et dans certaines zones du Puntland et du Somaliland. Les régions du sud sont les plus touchées par l’insécurité et les problèmes économiques. Une enquête menée par l’UNICEF en mai 2002 dans le district de Bellet Weyne, situé dans la région de l’Hiran a révélé un taux de malnutrition aiguë de 21%, dont 2,7% de malnutrition sévère. La situation nutritionnelle dans cette région est précaire depuis 1996 (voir graphique) (catégorie II). Les déterminants de la malnutrition semblent multiples: insécurité alimentaire, conditions d’hygiène insuffisantes, alimentation de l’enfant insatisfaisante. Différentes actions nutritionnelles devraient être mises en place à partir d’octobre 2002: centres de nutrition thérapeutique et supplémentaire, distribution de rations alimentaires aux familles d’enfants malnourris. La mise en place d’actions à plus long terme telles que l’amélioration de l’approvisionnement en eau, du système de santé et de l’état du bétail représente aussi une priorité. Dans le district de Berdale, dans la région de Bay, une enquête réalisée en mai 2002 a mis en évidence des taux assez élevés de malnutrition, 4 fois plus élevés qu’en 1996 (voir graphique) (catégorie II). Cette zone a pourtant un potentiel agricole important. Suite aux résultats de cette enquête, les activités nutritionnelles dans la zone ont repris. La situation humanitaire de la population dans le nord de la région de Gedo est toujours très précaire (catégorie I). L’insécurité a réduit les potentialités de culture pendant la saison des pluies et a freiné les actions humanitaires. Une évaluation nutritionnelle, mesurant le PB des enfants de 6 à 59 mois, réalisée dans 5 camps de déplacés à Mogadishu par la FSAU, a montré que 39% des enfants pouvaient être considérés comme malnourris (PB < 12,5 cm et/ou présence d’œdèmes) dont 7,1 % pouvant être considérés comme sévèrement malnourris (PB< 11 cm et/ou présence d’œdèmes). Il semble que la situation nutritionnelle de ces enfants se soit dégradée par rapport à l’année 2000. Ces populations sont considérées comme très précaires (catégorie I). Les régions Nord de la Somalie, comprenant le Somaliland et le Puntland semblent moins affectées, même si la situation n’est pas parfaite. La prévalence de la malnutrition dans la région de Sahil, dans le Somaliland en mai 2002 était d’environ 12%, comprenant 2% de malnutrition sévère. Dans la région de Sanag, en mai 2002, la prévalence de la malnutrition était de 13,7% dont 3,3% de malnutrition sévère. Une étude menée par UNCU/OCHA a montré
l’importante précarité des populations
déplacées et rapatriées d’Ethiopie dans le nord de la
Somalie. Beaucoup ont du mal à avoir accès à des sources de
revenus et leurs besoins de base en santé, hygiène et alimentation
ne sont pas couverts (catégorie I). L’accès aux services de
base pour ces populations doit être renforcé ainsi que les
opportunités de travail. |
Despite peace talks between the Government of Sudan and Southern factions, the security and humanitarian situations remain very precarious. A peace protocol was signed at the end of July between the combatants, agreeing to a six year period of autonomy for the South followed by a referendum to decide if Southern Sudan will remain part of Sudan (AFP, 09/08/02). A second round of negotiations took place in August on a comprehensive cease-fire, reform of the central administration and oil wealth sharing but were abruptly discontinued by the GoS following the capture of the garrison town of Torit by SPLA (BBC News, 04/09/02). The Khartoum government has stated they will return to the negotiations only if SPLA agrees to a full cease-fire and pulls out of Torit (AFP, 18/09/02).
Access to the population has been denied, especially in Western Upper Nile (USAID, 14/08/02). In August, WFP could not have access to 66,500 intended beneficiaries in Western Upper Nile (WFP, 13/09/02). UN agencies in Khartoum and representatives of donor missions called for free access to the population (European Union, 14/08/02). In addition, the WFP pipeline is reported to be low (FEWS, 08/02).
GoS controlled areas
Western Upper Nile (Unity state)
The oil-rich Western Upper Nile area was badly affected by insecurity, with GoS trying to push civilians out of the area. It has been reported that at least 100,000 have been displaced from Mayom into Bahr El Gazal and at least 300 people killed (AFP, 30/07/02). The population fleeing into Bahr El Gazal and Lakes region are expected to have serious problems of food security with cereals reaching high prices during the hunger period. However, some have been able to move with their cattle (FEWS, 08/02).
In addition to insecurity and decreased access to the population, rainfall was below average, which could significantly reduce crop yields for the remaining population (FEWS, 08/02).
Bentiu and Robkona areas
In July 2002, ACF conducted two nutritional surveys, in Rob Kona and Bentiu areas, in collaboration with Care and the Sudanese Red Crescent (ACF-F, 07/02). The surveys revealed very high rates of acute malnutrition: above 20%, even though lower than last year at the same period, when levels of malnutrition were dramatically high, particularly in Rob Kona (see graph). The under-five mortality rates seem under control, near or below 1/10000/day and seem to have slightly decreased since the last survey in April 2002 (see graph). The population of Bentiu and Rob Kona have been experiencing displacement, restricted access to land, and cattle looting since 1999 due to insecurity. Access to food is very restricted for this population; the crop yields in September do not last longer than two or three months. For those who don’t have stable work with the government or an oil company, the main source of income is the collection and sale of firewood, grass, or charcoal. Due to restricted access, food distribution was very patchy during the first semester of 2002 but it seems to have improved since June 2002. In addition, the water and sanitation situation seems to be of concern. Therapeutic and supplementary nutritional programs are in place, as well as some health facilities.
OLS southern Sector
Upper Nile
Phou and Leech states
AAH-USA has conducted several surveys since the beginning of the year in Phou and Leech states. Food security is considered to be critical because of the delay in rains and planting, which will probably lead to a delayed crop season, due end September instead of August (FEWS, 08/02). The 2001 crop yield was badly affected by floods, and insecurity has led to destruction of homes and crops in Old Fangak at the beginning of the year. The traditional fishing activity during the rainy season was hampered by the lack of fishing nets. A lack of seeds at the planting season has been reported.
Malnutrition rates are very worrying, particularly in Atar and Old Fangak district where they are above 30% (see table). The nutrition situation in Old Fangak district has deteriorated since the same period last year when the acute malnutrition rate was 20.4 % (16.8 - 24.6), compared to 30.3 % (16 - 34.9) this year. Measles vaccination coverage was very low, ranging from 0.5 to 8%. In addition, very high rates of mortality have been reported in Atar and Mareang district (see table). In Mareang district, about 40% of the under-five year deaths have been attributed to measles, while in Atar, simple and bloody diarrhoea contributed to more than 40% of pre-school deaths (see table). The humanitarian situation may be considered catastrophic in those districts. The health situation is very serious as is demonstrated by the low vaccination coverage and high mortality rates. Water and sanitation are also reported to be very precarious. In addition, the food security situation is of concern. WFP is targeting between 20 and 30 % of the population with a 25% to 50 % ration. The ration is planned to be increased to 50% until the next harvest.
Results of nutrition and mortality surveys conducted by AAH-USA in Upper Nile, Sudan, 2002
|
|
Date |
Acute malnutrition |
Severe acute malnutrition |
Oedema |
CMR |
Underfive MR |
MVC1 |
|
Phou state |
|
|
|
|
|
|
|
|
Attar district |
04-02 |
31.0 (26.7-35.6) |
6.2 (4.2-9.0) |
0.8 |
3.5 |
6.0 |
8.0 |
|
Old Fangak district |
04-02 |
30.3 (26.0-34.9) |
5.7 (3.8-8.4) |
0.9 |
1.1 |
2.2 |
0.5 |
|
Mareang district |
05-02 |
23.1 (19.1-27.7) |
4.7 (2.9-7.5) |
0.2 |
6.7 |
9.2 |
1.0 |
|
Leech state |
|
|
|
|
|
|
|
|
Nyal district |
02-02 |
16.4 (12.9-20.1) |
1.6 (0.5-3.1) |
0.2 |
0.4 |
0.7 |
- |
1 Measles vaccination coverage according to mother statementCauses of under-five mortality; two surveys by AAH-USA, Upper Nile Sudan, 2002
|
|
Atar district, Phou state |
Mareang district, Phou state, |
|
Date |
04-02 |
05-02 |
|
Underfive MR (/10000/day) |
6.0 |
9.2 |
|
Cause of deaths (%) |
|
|
|
Simple diarrhoea |
27.8 |
12.2 |
|
Bloody diarrhoea |
14.4 |
17.3 |
|
Measles |
13.3 |
38.4 |
|
Malnutrition |
14.4 |
2.9 |
|
Respiratory infection |
10 |
2.9 |
|
Fever |
16.7 |
21.5 |
Ruweng County also seems at high risk of food shortage. Last year’s crops failed due to insecurity. The planting was also altered this year due to poor weather and insufficient seeds and tools; only 30% of the population had some seeds (MSF, 07/02). An inter-agency rapid assessment in Pagol in Ruweng county done on 77 preschool children showed that 26.1 % presented with acute malnutrition (weight-height < -2 Z-score and/or oedema) while 3.9% with severe acute malnutrition. Although some food security and health interventions are in place, these are not sufficient in coverage and secondly they face huge constraints because of population scattering, insecurity and restricted access.
Jongley
Bieh state
Bieh state is particularly exposed to insecurity with factional fighting and cattle raiding; the population has been dependant on food aid since 1999. The renewal of fighting in July prevented humanitarian action and then poor rainfall led to immature crops wilting. Replanting could not take place because of lack of seeds. The food security situation will probably not improved within the next year (FEWS, 08/02).
A survey conducted by AAH-USA in July 2002 in Nyirol district showed extremely high rates of 6-59 month-old child malnutrition and both under-five and crude mortality rates (see table). In addition, 12% of the mothers presented a MUAC below 185 mm, considered as malnourished and 50.3 % presented a MUAC between 185 and 219 mm, considered as at risk of malnutrition. No food was available in Lankien market and the WFP food distribution did not take place in May and June because of insecurity. Normal food distribution is a 50% ration. WFP planned to increase the ration to 75% from July until the harvest. However, due to poor weather conditions, the harvest will probably be very low. The health situation appears to be very poor, with only 14% measles vaccination coverage. The major cause of death has been reported to be bloody diarrhoea, accounting for 37% of all deaths, followed by malnutrition.
South Bor county
An AAH-USA nutrition survey carried out in May 2002 in Padak revealed an acute malnutrition rate of more than 35 %, including about 7% severe malnutrition (see table). On the other hand, under-five and crude mortality rates seem to be low. The area has experienced relative stability and a significant number of the displaced in Eastern Equatoria have returned home. Although Bor county was considered food secure by the ANA 2001/2002, it was observed at the time of the survey, that households have exhausted their cereal reserves and that little grain was available on the market. WFP distribution only targets returnees with a 50% ration and it seems that not all returnees were registered. Population burden, due to movements like IDP return and the arrival of the Murle population when the situation stabilised in the district, is given as a potential reason for the increased food insecurity. On the other hand, measles vaccination coverage is of 82 %.
Results of nutrition and mortality surveys conducted by AAH-USA in Upper Nile, Sudan, 2002
|
|
Date |
Acute malnutrition |
Severe acute malnutrition |
Oedema |
CMR |
Underfive MR |
MVC1 |
|
Lankien and Pultruk parishes, Nyirol district, |
07-02 |
28.4 (24.3-33.0) |
4.3 (2.7-6.8) |
0.8 |
7.2 |
15.0 |
14.8 |
|
Padak, Bor district |
05-02 |
37.7 (33.1-42.4) |
6.6 (4.5-9.4) |
0.6 |
0.6 |
1.7 |
81.2 |
1 Measles vaccination coverage according to mother statementLakes
Tonj
Although Tonj is generally considered food secure, higher rates of malnutrition were reported in April 2002 (15 % acute malnutrition, including 2.1 % severe) than in June 2001 (7.9 %, including 0.9% severe) and June 1999 (10.5 % acute malnutrition including 0.7 % severe) (MSFI, 07/02). This higher rate of malnutrition may be partly due to the influx of IDPs from West Upper Nile.
Bahr El Gazal
Gogrial and Wau are considered to be of concern, partly due to the recent arrival of IDPs from West Upper Nile. It is estimated that Wau has about 9,000 IDP household in the government controlled area while Gogrial has seen an influx of 50,000 people between July and August (FEWS, 08/02). They will not be able to crop anything this year and will be food insecure for at least one year. Insecurity in Gogrial county also prevented planting. Flight denial exacerbated the situation (MSFI, 07/02).
Eastern Equatoria
Torit is considered at risk because of the fighting and hampered food delivery because of bombing. The region hosted about 6,000-7,000 IDPs (FEWS, 08/02). RNIS has no recent information on the nutrition status of the population.
Southern Blue Nile
Southern Blue Nile is an SPLA-held area in northern Sudan. Following a large offensive of the GoS in May and June on the town of Geizan, it is estimated that about 12,000 people were displaced in the surrounding area in Kurmuk county. They are living with the resident population. They have lost all their belongings. A further 12,000 previously displaced people in Belatuna camps and surrounds are also considered at risk due to adverse crop seasons in past years. The IDPs are in great need of food and non-food items (ACT, 12/08/02).
Eritrean refugees in eastern states
Although repatriation of Eritrean refugees has begun with about 50,000 having been repatriated, about 91,000 still remain in camps.
Surveys were carried out in March 2002 by UNHCR and COR in 14 camps essentially hosting refugees from Eritrea, in Kassala, Gedaref, Gezira and Sennar states (UNHCR, 03/02).
In some camps, refugees have been allocated land, while others have been depending on wages earned on nearby farms, and lastly some have been relying only on food distribution. The rates of acute malnutrition vary from 5.4 % to 15.8% (see table). It seems that rates of malnutrition were not associated with the household food source. It can be noted, however, that the lowest rate of malnutrition is found in a land-based camp, while the highest rate is found in a reception camp. Malnutrition seems under control in three of the land-based camps, while in the other land-based, wage-based and reception camps, levels of malnutrition exceeded 10%. EPI coverage is generally adequate, as well as vitamin A supplementation, apart for one camp. Delayed food distribution, as well as half rations for all refugees instead of the full ration for refugees in reception camps, was reported for the months of January and February. The April-June period is reported as one of the most difficult by the refugees because there are fewer job opportunities and less food accessibility. However, June to October is also considered at risk, because it is the hunger gap period and because of the high morbidity rate over this period. MCH growth monitoring reports higher numbers of malnourished children during those months. WFP warned about the shortage of food they already face and which will be intensified if they do not receive further funding. They have already been obliged to cut the ration by half (WFP, 24/09/02). This less than normal food distribution will further undermine the nutritional status of the population.
The crude mortality rates for May and June 2002 were 0.26 and 0.31/10000/day and the under-five mortality rates seem average at 1.16 and 1.48/10000/day (UNHCR, 07/02).
Overall The humanitarian situation is desperate in Southern Sudan with very high levels of malnutrition, morbidity and mortality (category I). Some of the refugees are also experiencing bad conditions (category II), whilst the situation for others seemed under control but is still highly dependant on food aid pipeline (category III).
Acute malnutrition, Eritrean refugee camps, Sudan, UNHCR/COR, 03/2002
|
Camp |
Camp category1 |
Acute malnutrition |
Severe malnutrition |
Fully vaccinated |
Vit A Coverage |
|
UmAli |
LB |
5.4 |
0 |
63 |
65 |
|
Mafaza |
LB |
5.8 |
1.2 |
75 |
82 |
|
Aburakham |
LB |
7.5 |
0.3 |
95 |
94 |
|
Abuda |
LB |
9.5 |
0.7 |
89 |
98 |
|
UmSagata |
LB |
10.4 (8.6-12.7) |
1.4 (0.8-2.5) |
82 |
82 |
|
Karkora |
LB |
12.9 (10.8-15.3) |
0.7 (0.3-1.5) |
88 |
92 |
|
Hawata |
LB |
13.2 |
0.94 |
92 |
84 |
|
Fau 5 |
WB |
9.0 |
0.7 |
66 |
0 |
|
Kilo 26 |
WB |
9.8 (8.0-12.0) |
0.8 (0.3-1.7) |
93 |
91 |
|
Girba |
WB |
10.2 (8.3-12.6) |
1.2 (0.6-2.3) |
94 |
92 |
|
Wad Hileaw |
WB |
10.2 |
2.2 |
91 |
88 |
|
Suki |
WB |
11.3 |
1.8 |
91 |
95 |
|
Wad |
R |
10.1 (8.3-12.4)6 |
0.7 (0.3-1.5) |
93 |
96 |
|
Sherifey |
|
|
|
|
|
|
Shagarab |
R |
15.8 (13.5-18.4) |
1.3 (0.7-2.4) |
94.6 |
99.7 |
1 LB = land based: refugees provided with landRecommendations and priorities
WB = wage based: refugee access labor opportunity in nearby farms
R = reception: refugees depend on donation only
Southern Sudan
From the RNIS
· Advocate for full access to the population in needRefugees
· Provide adequate food distribution, longer term food security programmes, health, water and nutrition services to the population
From the UNHCR/COR survey
· Provide full rations to all refugees in the April-September periodFrom the RNIS· Improve food production in the land based camps
· Consider blanket supplementary food distribution for children under three years old during June-September
· Monitor the situation
· Support WFP funding to ensure an adequate food distribution
|
Soudan Malgré des négociations en cours entre le gouvernement de Karthoum et les factions du Sud, la situation sécuritaire et humanitaire reste très incertaine dans certaines zones du Soudan. L’accès à certaines populations a été empêché, en particulier dans l’ouest de la région de l’Upper Nile. Cette région a aussi été particulièrement touchée par l’insécurité et par le vol de bétail, entraînant de nombreux déplacements. Deux enquêtes réalisées dans cette zone à Robkona et Bentiu en juillet 2002 ont montré des taux de malnutrition excédant 20% (voir graphique). En raison de problèmes d’accès, les distributions alimentaires avaient été très réduites durant le 1er trimestre 2002. Il semble qu’elles se soient améliorées par la suite. Des actions nutritionnelles et des centres de santé sont en place. Dans la région de l’Upper Nile, non contrôlée par les forces gouvernementales, plusieurs enquêtes ont montré une situation nutritionnelle alarmante (voir tableau), ainsi que des taux de mortalité très élevés dans certaines zones (voir tableau). Les conditions de vie de ces populations sont effroyables, que ce soit d’un point de vue de la sécurité alimentaire, de l’hygiène ou de l’accès aux soins (catégorie I). De même, dans les zones de Bieh et de Bor (voir tableau), dans la région de Jongley, des taux très importants de malnutrition et de mortalité ont été mis en évidence (catégorie I). Certaines zones de la région du Bahr El Gazal sont elles aussi considérées comme présentant des risques importants, en particulier à cause de l’afflux de nombreux déplacés en provenance de l’Upper Nile. L’accès aux populations dans le besoin doit pouvoir être garanti et les actions humanitaires dans tous les domaines doivent pouvoir être améliorées. Environ 90 000 réfugiés Erythréens vivent
dans des camps au Soudan. Des enquêtes nutritionnelles ont
été réalisées en mars 2002 dans 14 de ces camps,
situés à l’est du pays. Ces enquêtes
révèlent des taux de malnutrition variant d’un camp à
l’autre, la situation nutritionnelle étant satisfaisante dans
certains camps (catégorie III) mais moins bonne dans d’autres camps
(catégorie II)(voir tableau). Le PAM rapporte d’autre part une
pénurie de nourriture, l’obligeant à diminuer les rations
alimentaires. Cette enquête recommande une augmentation des rations
alimentaires durant la période d’avril à septembre,
considérée comme la plus difficile pour les populations, ainsi
qu’une amélioration de la production agricole pour les
réfugiés ayant accès à la terre. |
