United Nations System
Standing Committee on Nutrition

Southern Africa

Angola

Delivery of humanitarian aid has been greatly hampered over the reporting period. The rainy season exacerbated the already poor transport conditions, which were due to the inadequate road infrastructure and presence of landmines. Food aid air drops were planned in order to reach inac- cessible areas, where 40,000 people were isolated (OCHA, 10/01/03).

As of December 2002, WFP estimated that be- tween 2.1 and 2.4 m people might be in need of food aid until the next harvest in April/May 2002, but warned that a pipeline break might oc- cur due to a lack of funds (WFP, 19/12/02). Seeds and tools were distributed to at least 300,000 families throughout the country before the 2002 September/October sowing season (FAO, 02/12/02).

IDP and refugee movements

As of December 2002, it was estimated that about 2.8 m people remained displaced, including 290,000 who settled in camps or transit centres, whilst between April and November 2002, 1.1 m returned to their areas of origin. Only 15% re- turned under an organised plan. It is estimated that only 30% returned to areas where living con- ditions were in accordance with the pre- conditions that should be met during the reset- tlement and return process, as defined by the An- golan government (OCHA, 19/12/02).

About 39,000 ex-UNITA soldiers and family members were moved from the Quatering and Family Areas, where they were settled, to their areas of origin. It was intended that they be given land, the equivalent of US$ 100 and basic items such as blankets, seeds and tools. Some may also benefit from training. The World Bank is to provide Angola with US$ 100 m over three years to help with the re-integration programme (OCHA, 22/10/02). About 425,000 ex-UNITA soldiers and family members still remain in the QFAs (OCHA, 19/12/02). The fate of former rebel combatants will be a key factor in national stability.

It seems that about 86,000 Angolan refugees spon- taneously returned between January and November 2002; 61,300 have been registered (OCHA, 19/12/02). Organised repatriation by UNHCR will only begin at the end of the rainy season, in May/ June 2003 (UNHCR, 15/11/02).

Nutrition situation

Living conditions have stabilised in all except four of the 14 areas where acute needs were found dur- ing rapid assessment of critical needs (USAID, 31/10/02). MSF also reported that living conditions have generally improved over the past weeks, ex- cept in Mavinga, and in Huambo in Huila Provinces. Measles outbreaks and improving the coverage of measles vaccinations were particularly challenging (MSF , 13/11/02).

A joint rapid assessment in Cassongue, Kuanza Sul province, found a serious situation which required urgent humanitarian interventions (WFP, 31/10/02). World Vision also reported high malnutrition rates in newly accessible areas in Huambo and Huila prov- inces (WV, 21/11/02).

On the other hand, COSV reported a 60% reduc- tion in malnutrition rates since July 2002, in Fazenda Santa Cruz and Mimbota, Bengo province (WFP, 10/01/03). Admissions to therapeutic and supplementary feeding centres have also decreased in Luena, Moxico province, probably as a result of development of income-generating activities and distribution of seed protection rations. MSF-B was planning to hand over the treatment of malnutri- tion to Luena central hospital (WFP, 25/10/02).

Luanda Norte

A nutrition survey was carried out by MSF-H in Cumbulo QFA, Xa-Muteba municipality, Luanda Norte Province, in October 2002 (MSF-H, 10/02). The camp hosted approximately 5,000 people. The prevalence of acute malnutrition was 3.9 %, in- cluding 0.9% of severe malnutrition, which indi- cated a satisfactory nutrition situation. However, the under-five mortality rate was very high at 5.5/10,000/day.

Kuando Kubango

Two nutrition surveys were carried out by MSF- CH/Epicentre in Mavinga Town and in Matungo and Capembe Quatering and Family Area (QFA), Kuando Kubango province, in November 2002 (MSF-CH, 11/02). Although the prevalence of mal- nutrition was average, the crude and under-five mortality rates were of concern, especially in Mavinga town (see table).

Fever/malaria and diarrhoea were the two main causes of deaths. Measles vaccination coverage was good in the QFAs, but low in Mavinga town (see table). Most of the households surveyed in Mavinga town arrived in August and September 2002, whilst the population of QFAs arrived mostly in May and June 2002. The nutrition situation has improved notably since the last survey done in July 2002, when the prevalence of acute malnutrition was above 25% in the QFAs and above 12% in Mav- inga town, both including high levels of severe mal- nutrition (see RNIS 39). MSF-CH has been running supplementary and therapeutic feeding centres.

Result of two surveys, Mavinga area, Kuando Ku- bango province, Angola, November 2002 (MSF-CH/ Epicentre, 11/02)

Trend in admission to therapeutic and supplemen- tary feeding centres

The trend in admission to therapeutic feeding centres throughout Angola shows that the number of admissions in May 2002 was the highest re- corded since the end of 1999 (see graph). The number of admissions rose from January 2002 until May 2002 and decreased thereafter. This pattern may be explained by different factors. At the beginning of 2002, population displacement increased as a result of renewed fighting and be- cause of the Angolan army policy to move people within controlled areas. Following the April agree- ment between UNITA and the Angolan govern- ment, wider access to the population was possible. Improved humanitarian aid delivery may explain the drop in admissions since June 2002. The trend in admissions saw the same pattern in Hambo, Bie, Huila, Benguela, and Malanje. The highest number of admissions was reported in Bieh and Huambo Provinces, in May 2002.

Admissions and outcomes in therapeutic feeding centres, Angola, September 1999 - August 2002 (MOH/ UNICEF Angola, 10/02)

Overall - The nutrition situation seems to have greatly improved in some areas of Angola, probably because of the efforts to deliver massive humanitarian aid, but mortality rates remained high. People are still highly dependent on relief aid, which needs to continue to be delivered. Rehabilitation of infrastructure and de-mining are also crucial for the country re- construction.

Recommendations and priorities

From the MSF/Epicentre survey in Mavinga:

• Improve access to quality health services
• Urgently carry out a measles vaccination cam- paign in Mavinga town
• Implement and support active mortality and morbidity surveillance
• Improve access to potable water
• Continue existing nutrition programmes
• Monitor the general food distribution
• Update the population figures of Mavinga

From the MSF-H survey in Cumbulo QFA:

• Implement curative and preventive health care
• Implement and support active mortality and morbidity surveillance