United Nations System
RNIS 41, April 2003
WESTERN SAHRAWI IN ALGERIA
The last RNIS issue reported on the nutrition status of the Sahrawi refugee children in Algeria, based on a survey undertaken by UNHCR/WFP/CIH in September 2002. Some 155,000 to 165,000 people, according to different estimates, are settled in four camps in an isolated desert area near Tindouf, since 1975. The prevalence of acute malnutrition was average: 10.6 % of the children were acutely malnourished, including 2.2% severe acute malnutrition. The prevalence of acute malnutrition has remained stable since 1997, whilst the prevalence of stunting has decreased from 49% in 1997 to 33% in 2002 (see RNIS 40).
The latest results of the survey gave additional indications about the nutritional status and feeding patterns of this population (UNHCR/WFP/CIH, 09/02). The nutrition status of 91 0-6 month olds was investigated. The results showed a good nutritional status: 1.1% of the infants were acutely malnourished (W-H < -2 Z-scores), none of the infants was severely malnourished (W-H< - 3 Z-scores). Breast-feeding was widespread: 97% of the 0-24 months had been breast-fed at some time of their lives and 84.1% were still breast- fed at one year. However, at the time of the survey, only 2.3% of the 0-6 month olds were exclusively breast-fed; in addition to breast-milk, they mainly received water, sweetened water, and different types of (non-breast) milk: infant formula, goats/camel milk and powdered milk. The consumption of infant formula and powdered milk was particularly of concern, as it is known to carry a high risk of contamination resulting in intestinal infection. About 30% of the 0-12 months were receiving infant formula, the proportion was lower for the 12-24 month olds; on the contrary, the use of powdered milk increased with age: about 10% of the 0-6 month olds were receiving powdered milk, whilst the proportion increased to 40% for the 6-12 month olds and 60% for the 12-24 month olds. The use of bottle-feeding was not investigated.
Anaemia in children 6-59 months has decreased over the past years, but whilst it decreased in women of reproductive age between 1997 and 2001, it has remained stable since 2001 (see graph).
Anaemia, Western Sahrawi refugees in Algeria
Clinical signs of scurvy or rickets were found only in two children.
An analysis of the food distributed to the families from March to July 2002, based on the distribution records supplied by the Algerian Red Crescent, which included food from WFP but also from different other organisations, was also carried out. Calculation has been made taking into account a population number of 155,430, which has not been up-dated recently. Based on a minimum energy requirement of 2100 Kcal/pers/day and minimum macro-nutrient and micro-nutrient requirements taken from the "Management of Nutrition in Major Emergencies, WHO, 2000", the analysis showed that energy requirement was met, that fat requirement was also met and that protein content of the ration was 150% of the requirement. The content of the ration in calcium, iron, vitamin A, thiamine, riboflavin, niacin and vitamin C was also assessed. The ration contained low levels of calcium, vitamin C and riboflavin, whilst the level of the other micronutrients was adequate.
The nutrition situation of the Sahrawi refugee children is average (category III). It seems that the food distribution has been adequate in quantity, if not in quality, other the past months. In addition, the high prevalence of obesity in women observed in the 2001 survey does not suggest deficits in the quantity of food available. There is however a probable deficit in some micronutrients. The widespread use of infant formula and powdered milk also needs to be urgently investigated further as the public health consequences of the use of these products are well-known. To better understand the nutrition situation of the Sahrawi population, analyses of food security and underlying causes of malnutrition need to be undertaken.
Recommendations and priorities
From the UNHCR/WFP/ICH survey: