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RNIS 42, August 2003 SUB-SAHARAN AFRICA
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| Acute malnutrition(%) (95% CI) |
Severe acute malnutrition(%) (95% CI) |
CMR (/10,000/day) |
<5 MR (/10,000/day) |
MVC1 (%) |
|
| Fik and Hamero districts, Fik zone |
34.0 (30.0-37.9) | 6.4 (4.5-8.2) | 1.36 | 4.6 | 27.6 |
| Segeg, Duhun and Garbo districts, Fik zone |
31.3 (27.8-34.8) | 3.8 (2.6-5.1) | 1.08 | 4.00 | 19.6 |
Underlying determinants of nutritional status and mortality, Fik zone, Ethiopia, March 2003 (SCF-UK, 03/03)
| Household food security Food distribution Food distribution to 114,000 vulnerable people Difficulties of targeting Increased number of people coming into the area for distributions Diminution of food rations Market availability Decreased availability of milk and cereals due to drought Cereal prices increase Prices of imported (from Somalia, Somaliland) food items increase because of cross-border trade restriction Sources of income1 Livestock condition poor or very poor according to 95% of the people interviewed Terms of trade deteriorating for the pastorals Main sources of income1 Sale of livestock 28% (45%); petty trading 26% (12%); sale of firewood/charcoal 19% (12%); sale of wage labour 15% (16%) Poorer and IDPs were mostly relying on daily labour and petty trade; middle and better-off were almost completely reliant on income from livestock products Public health Social and care |
1 According to household interviews; first figures refer to Fik and Hamaro districts, figures in brackets refer to Segeg, Duhun and Garbo districts
Gubalafto district, North Wollo
A nutrition survey showed an acceptable situation in Gubalafto district (see table) (SCF-UK, 03/03). North Wollo has not been too badly hit by the recent drought and the nutrition situation seems to have remained the same since 2001.
Tenta district, South Wollo
A nutrition survey showed a precarious nutrition situation, whilst mortality rates were under-control (see table) (WV, 06/03). 70% of the families interviewed were relying on their own production, whilst 30% were purchasing food. The main sources of income were the sale of grain (50%), waged labour (11%) and the sale of livestock (10%). About 10 % of the families did not have any source of income. Only 15% of the population had received food distribution during the two weeks prior to the survey. Only 11% of the children had been ill during the 15 days prior to the survey.
Results of nutrition surveys, Amhara region and SNNPR, Ethiopia, March - June 2003 (SCF-UK, 03/03; WV, 06/03)
|
Acute |
Severe acute |
CMR |
<5MR |
MVC1 |
|
|
Amhara region |
|||||
|
Tenta district, South Wolo zone |
11.9 (9.1-15.3) |
1.2 (0.5-2.8) |
0.3 |
0.6 |
37.3 |
|
Gubalafto district, North Wollo zone |
3.8 (2.2-5.3) |
0.2 (0.0-0.5) |
0.18 |
0.29 |
45.9 (34-57.3) |
|
SNNPR |
|||||
|
Omo Sheleko district, Kembata and Timbaro zone |
12.9 (10.0-16.4) |
1.7 (0.4-2.6) |
0.25 |
0.4 |
60.8 |
|
Kedida Gamilla district, Kembata and Timbaro zone |
6.9 |
1.1 (0.41-2.7) |
0.17 |
0.61 |
79.5 |
1Measles vaccination coverage according to cards and mothers' statement
Kembata and Timbaro
The zone has not been too strongly affected by the current drought. The results of nutrition surveys in two districts of the zone showed average to precarious nutrition situations (see table) (WV, 06/03). Mortality rates were under-control (see table). In Kedida Gamilla district, 54% of the families interviewed have received food aid in the last two months, whilst 29% of the children have received supplementary food. In Omo Sheleko district, 40% of the families have received food aid and 21% of the children have received supplementary food.
North Showa
The nutrition situation is precarious in Hidhabu Abote district, although mortality rates are under-control (see table) (WV, 06/03). Twenty-two percent of the families have received food aid in the last two months. The main source of food and income were own production.
East Showa
East Showa has been badly affected by the current drought. However, in Fentale district, the nutrition situation is under-control and has gradually improved since July 2002 (see figure) (GOAL, 05/03).
Mortality rates were, however, of concern.
Almost all households have received regular general food distribution and supplementary rations (for the under-five -year olds, pregnant and lactating women) in the previous four months. About 90% of the households were relying on relief food as their primary source of food and 50% of the households reported that they do not currently earn any money.
In the rural area of Adamitulo district, the nutrition situation is far worse (see table) (MSF-H, 06/03). Almost all households have received food aid the month prior to the survey; 98% of the households have received food aid in the form of food for work. Whilst the food distribution should be targeted, it appears that almost all households have received food. This has led to the diminution of the food ration received: 7.5 kg of cereals/pers, on average, instead of the intended 12.5 kg/pers.
Acute malnutrition, Fentale district, East Showa, Ethiopia
West Hararghe
A nutrition survey was carried out in the lowland area of the zone in June 2003 (CARE/WFP, 06/03). The survey revealed an improving nutrition situation (see table), although it has remained stable since the beginning of the year and has slightly improved, compared to September 2002. The nutrition situation in the highland agro-ecological zone was average in February 2003 (acute malnutrition: 7.7% (6.1-9.6) (CARE/WFP, 02/03).
West Hararghe has been particularly affected by the drought. Food grain prices have remained high and income opportunities were limited, but there has been significant relief (including food distribution and nutrition rehabilitation) and long-term programmes in the zone.
In Daro Lebu district (of which parts were included in both of the above mentioned surveys), the nutrition situation was under-control (GOAL, 06/06).
East Hararghe zone
The nutrition situation in the lowlands (which are more vulnerable than the highlands) of four districts of East Hararghe is serious (see table) (CARE/WFP, 05/03). The mortality rates were also high, maybe due to the high prevalence of malaria. Care has been implementing a distribution of supplementary food to under-five year olds, pregnant and lactating women since May 2003.
Results of nutrition surveys, Oromoyia region, Ethiopia, June 2003
|
Acute |
Severe acute malnutrition |
CMR |
< 5 MR |
MVC1 |
|
| Hidhabu Abote
district, North Showa zone |
14.2 (11.2-17.8) |
3.3 (1.9-5.6) |
0.31 |
0.78 |
48.5 |
| Fentale
district, East Showa zone |
5.2 (3.9-6.9) |
0.5 (0.2-1.4) |
0.91 |
1.74 |
94 |
| Zigway, Admitulo, Jido districts, East Showa zone |
17.1 (13.7 - 20.4) |
4.8 (2.5-7.2) |
0.54 |
1.51 |
48.0 |
| Daro Lebu district, West Haraghe zone |
5.1 (3.8-6.8) |
0.3 (0.1-1.0) |
0.72 |
2.13 |
86 |
| Rural areas of lowlands and dry midlands, West Haraghe zone |
10.1 (8.2 - 12.2) |
1.3 (0.7 - 2.3) |
0.33 |
0.88 |
- |
| Kurkfa Chelle, Grawa, Bedeno and Meyu, East Haraghe zone |
14.9 (12.7-17.5) |
1.5 (0.9-2.6) |
0.67 |
1.56 |
- |
1
Measles vaccination coverage according to cards and mothers' statementZone 3
Zone 3 of the Afar region has been badly affected by the drought over the past years and populations have almost exhausted their coping strategies. The health infrastructure is among the worst in the country. A nutrition survey carried out in April 2003 revealed a nutrition situation still precarious but which has improved since August 2002 (GOAL, 04/03). In June 2003, the prevalence of acute malnutrition was 11.6% (9.6-13.9), including 1.0% (0.5-2.0) severe malnutrition, compared to 17.9% (15.5-20.6) and 2.9% (1.9-4.3) in August 2002. Whilst it did not seem that the contextual food security situation has improved since the last survey, quantities of food distributed have increased. The intended amount of cereal distributed has increased from 12.5 kg/pers/month to 50 kg/pers/month. Oil and CSB are also distributed. The coverage of supplementary food distribution for under-five -year olds, pregnant and lactating women, has also been spread out. Measles vaccination campaigns have also been implemented. On the other hand, mortality rates have remained high (CMR= 1.83/10,000/day, under-five mortality rate=3.66/10,000/day). Main causes of under-five mortality were fever/malaria and cough/cold/ARI.
The different surveys showed highly different nutrition situations, varying from acceptable (category IV) to dramatically high (category I). This is probably due to a combination of factors: the effect of the current drought, the underlying vulnerability of the population and the adequacy of the humanitarian and long-term response. The provision of food aid in sufficient quantities seems to play a major role in the short-term improvement of the nutrition situation. Long-term programmes are also needed to break the vicious cycle of crises and destitution.
Fik zone, Somali region,
from the SCF-UK surveyShort term:
Long term:
South Wollo, Amahara region,
from the World Vision survey:North Wollo, Amhara region, from the SCF-UK survey:
Short term:
Long term:
Rural areas of Lowlands, West Hararghe zone, Oromiya region,
from the CARE/WFP survey:East Hararghe zone, Oromyia region,
from the Care/WFP survey:Zone 3, Afar region,
from the GOAL survey:The Somali reconciliation conference, attended by representatives of the Transitional Government (TNG), armed factions, which control different parts of Somalia, the regional administration of Puntland and civil society groups, has continued in Eldoret, Kenya, over the reporting period. An agreement was signed by the delegates in early July 2003, to establish a federal government to rule the country over the next four years, and a 351-member transitional national assembly. The agreement was, however, soon rejected by the President of the TNG and one of the faction leader (AFP, 06/07/03; OCHA, 16/07/03). The President of the TNG has subsequently left peace-talks (OCHA, 30/07/03). Despite the signing of an agreement stipulating cessation of hostilities, in October 2002, there are still outbreaks of violence throughout the country (OCHA, 09/06/03; OCHA, 11/06/03; OCHA, 10/07/03). Civil society has manifested its protestation against continuing violence in Mogadiscio, through demonstrations and strikes by medical workers (OCHA, 30/06/03; OCHA, 07/07/03).
The first presidential election took place in the self-declared republic of Somaliland in April 2003. The incumbent president, Dahir Rayale Kahin, won by only 80 votes. According to the international observers election monitoring team, the election process was peaceful, orderly and transparent (Vanguard, 22/04/03). The opposition parties have also recognised the verdict of the ballot boxes. The International Crisis Group, encourage the government of Somaliland to fully demonstrate its involvement in democracy by taking some more action (ICG, 28/07/03).
Somaliland faces several political and economic difficulties; it is not recognised as a state and its reintegration as part of the Somalia State, as it was before 1991, is often asked by the international community and the southern Somalia leaders. Somaliland's main economic activities are trade through the port of Berbera (taxes from the port account for 80% of Somaliland overall budget) and livestock. The ban imposed by the Arabian states on livestock import from Somalia, since 2000, has led to a 40% drop in the state revenues. Remittances from abroad play a major role as income sources for a significant proportion of the population (AFP, 21/04/03).
Gu 2003 cereal crop forecast is average (FSAU, 07/03). Erratic and unevenly distributed rainfall, insect and rodent infestation, and regional insecurity are responsible for crop limitation. It is, however, expected that the Gu cereal production will be similar to production in 2002 and 28% more than the post-war average. In comparison with last year, a substantial decline in production is expected in Bay and Middle Juba. The final crop establishment evaluation will take place by late August.
In the northern pastoral areas, the western part of Sool plateau and the Lower Nugal valley are especially vulnerable due to poor rains (FSAU, 07/03).
Lower Juba
Buale district
There has been report of a precarious nutrition situation among the returnees who fled the fighting which took place late 2002/beginning 2003 (FSAU/N, 06/03). About 7 % of the children screened had a MUAC < 110 mm and 21.5% had a MUAC < 125 mm. The fighting has resulted in severe loss and destruction of properties, food stocks and crops. Despite a cease-fire signed in March 2003, not all displaced have returned.
Kismayo district
A random sampled nutrition survey was conducted in Kismayo district in May 2003 (UNICEF/MUSLIM AID-UK, FSAU/SRCS, 05/03), including Kismayo town, rural areas and IDP camps. The nutrition situation was of concern and mortality rates were higher than alert thresholds (see table). This survey is not directly comparable with previous surveys done in 1995 because the surveys did not cover the same population. However, the nutrition situation in May 2003 seemed to be slightly better than in Kismayo town in 1995 and within the same range of the nutrition situation in IDP camps in the same year (see RNIS 12). The food security situation was considered as normal but people had access to few coping strategies; health services were lacking with no hospital or health post functioning; only one quarter of the population had access to safe drinking water and sanitary conditions were especially poor in the IDP camps and the poorest districts of Kismayo town; child feeding practices were inadequate (see boxes).
Results of a nutrition survey, Kismayo district, Lower Juba, Somalia, May 2003 (UNICEF, 05/03)
|
Acute malnutrition(%) |
Severe acute |
Oedema(%) |
CMR |
< 5 MR |
MVC1(%) |
|
12.3 (9.6-15.6) |
1.9 (1.1-3.0) |
0 |
1.9 |
2.2 |
70 |
1
Measles vaccination coverage according to cards and mothers' statementImmediate determinants of nutritional status, Kismayo district, Somalia, May 2003 (UNICEF/MUSLIM AID-UK, FSAU/SRCS, 05/03)
| Food intake Sources of food Purchase 81%; household crop production 9% Favourable terms of trade to the different FEZ, including the displaced Diseases |
Underlying determinants of nutritional status, Kismayo district, Somalia, May 2003 (UNICEF/MUSLIM AID-UK, FSAU/SRCS, 05/03)
| Household food security Market availability Locally produced cereals, milk and imported food commodities available in the markets Sources of income Main sources of income Casual work 51%; petty trading 21% Coping strategy Borrowing 43% Purchase 41% Public health Social and care |
Basic determinants (recent events at local level), Kismayo district, Somalia, May 2003 (UNICEF/MUSLIM AID-UK, FSAU/SRCS, 05/03)
| Juba Valley Alliance (which took over control of the region in 1999) has
ensured a fairly stable environment for the delivery of humanitarian assistance Food economy zones 2000 was considered as a normal year, 2001 as slightly below average, |
Galkaio town, Mudug region
A random sampled nutrition survey was carried out in Galkaio town (excluding the south section for security reasons) in April 2003 (UNICEF/MOSA/FSAU, 04/03). About 76% of the families surveyed were resident families, whilst 17% were internally displaced, 4% were refugees and 2% were returnees. The survey revealed an average nutrition status. The prevalence of acute malnutrition was 8.3% (6.7-10.4), including 2.3% (1.4 - 3.5) severe malnutrition, and was in the same range as in March/April 2002 when the prevalence of acute malnutrition was 8.2%, including 2.1% severe malnutrition. These rates are among the lowest recorded in Somalia in recent years, but are disappointing in regard to the positive economy of the town and the food security situation, which was considered as favourable at the time of the survey (FSAU/N, 07/03). The public health environment also seemed to be positive (see boxes).
Child feeding practices were mixed with an early stop to breast-feeding and early weaning, but high feeding frequencies (see boxes). One of the things which may explain this relatively high level of malnutrition in regard to the favourable context is that the most vulnerable population (the poorest, the displaced and returnees, which are a significant part of the population) present a higher risk of malnutrition.
The rate of malnutrition found in Galkaio town is respectively within the range and slightly below the rates found in Jeriban district and Galgodob town in Mudug region in December 2002 (see RNIS 41).
About 69% of the children were vaccinated against measles, according to cards and mothers' statement; 75% of the children received vitamin A within the last six months.
Immediate determinants of nutritional status, Galkaio town, Somalia, April 2003 (UNICEF/MOSA/FSAU, 04/03)
| Food intake Sources of food Purchase 99.5% Diseases |
Underlying determinants of nutritional status, Galkaio town, Somalia, April 2003 (UNICEF/MOSA/FSAU, 04/03)
| Household food security Market availability Thriving trade town Sources of income* Main sources of income Casual work 43%; business 30%; salaried employment 13%; remittances/gifts 10%; begging 3% Coping strategy Borrowing 84% Remittances/gifts 9% Public health Social and care |
Basic determinants (recent events at local level), Galkaio town, Somalia, April 2003 (UNICEF/MOSA/FSAU, 04/03)
| Inflation IDPs (17% of the families interviewed), refugees (4% of the families interviewed) Livestock ban (population outside the town is pastoral and there are exchanges between the rural and urban areas) Recurrent rain failures Rainfall has recently improved |
Returnees in Hargeisa
The results of the under-five mortality survey, which was carried out in February 2003 (see RNIS 41) have been revised; the revised under-five mortality rate was 2.9/10,000/day (instead of 3.7/10,000/day) (FSAU/N, 06/03). The crude mortality rate was 1.9/10,000/day. Both rates were higher than alert thresholds.
Sool plateau
The Sool plateau has been identified as at risk of food insecurity for months. Successive dry seasons for three years have led to water shortage and poor pastures in this mostly pastoral area. The 2003 Gu rains have also been delayed and sparse. High number of livestock deaths have been reported as well as a degradation of the condition of the remaining livestock. Livestock trade has become difficult and the poorest pastoralists have adopted coping strategies, such as charcoal collection, which has further deteriorated the environment. More than half of the population has moved in search of water and pasture but the middle and poor wealth groups had no choice other than to stay on the plateau. They are facing hardship conditions: little access to water, high prices of water, poor livestock conditions leading to low livestock productivity and saleability, poor employment or self-employment opportunities and poor social support (FSAU/FS, 07/03). It is estimated that poor households are facing an annual food deficit of 25-35% of their energy requirements (FSAU/FS, 07/03).
A random sampled nutrition survey carried out in May 2003 revealed a nutrition situation of concern (FSAU/N, 06/03). The prevalence of acute malnutrition was 12.5% (10.5 - 14.9), including 1.8% severe malnutrition (1.1 - 3.0). The under-five mortality rate was also of concern: 1.9/10,000/day. Measles vaccination coverage was very low: 26% when taking into account cards and mothers' statement.
Despite food security conditions considered favourable, the nutrition situation in Galkaio town is average (category III), and is of concern in Kismayo district (category II). Chronic vulnerability may partly explain this fact. The food security situation has degraded in the Sool plateau, leading to a precarious nutrition situation (category II).
Sool plateau, from FSAU/ MOHL/Ministry for pastoralism and the environment/UNICEF/ WFP:
Kismayo district, from the UNICEF survey:
The agreement of cessation of hostilities, which was signed in October 2002 by the Government of Karthoum and the Sudan People's Liberation Movement/Army (SPLM/A), was renewed for a period of three months, in late June 2003 (OCHA, 30/06/03). On the over hand, the last round of negotiations, which ended in mid-July, failed to produce a draft peace deal (AFP, 13/07/03). Negotiations should resume by mid-August (AFP, 25/07/03).
Fighting has intensified in Darfur area, between the Sudanese army and the Sudan Liberation Movement, which is not part of the on-going peace negotiation in Kenya (AFP, 15/07/03).
Repatriation of the Eritrean refugees resumed in June 2003, after a one-year break caused by border tensions. About 1,600 refugees have been repatriated. The repatriation process will be halted during the rainy season and resume in October (UNHCR, 05/08/03).
Food security has deteriorated over the past few months in parts of southern Sudan. In highly food- insecure areas of Bieh, Gogrial, Aweil West, Latjor, Ruweng, Shilluk, Boma and Leech, the hunger gap has begun earlier than usual (WFP-TSU, 04/03).
In the Lokongole area of Pibor county, food security has also deteriorated with reports of widespread livestock deaths, because of poor rains in April/May (FEWS, 04/07/03). Prevalence of acute malnutrition seemed to be dramatically high (FEWS, 04/07/03).
Whilst the current rainy season helps to restore livestock conditions in Bahr El Gazal and Lake, rains are below normal in large areas of Upper Nile and Jonglei. The situation will not improve in the food- insecure areas until the next harvest, expected from September 2003 onwards. Even then, people who were on the move during the planting season will have nothing to harvest. This is especially the case for 17,000 people who have recently moved from Tambura and Liech into Wau and Gogrial, and for an unknown number of people returning from northern Sudan (FEWS, 17/07/03).
100,000 to 150,000 of 300,000 people living in Kassala town and surroundings, northern Sudan, are estimated to be at risk, following heavy floods (OCHA, 31/07/03).
A collapsed bridge on the main supply route has hampered adequate delivery of food aid in the most highly food- insecure areas (FEWS, 17/07/03). There has been a steady decline of deliveries against needs, over the past few months (67% in April, 57% in May and 36% in June) (FEWS, 17/07/03).
Moreover, as a consequence of funding shortfall, WFP has been obliged to cut the food rations distributed in August by 50% (WFP, 01/08/03). WFP operations in Sudan are only 30% funded (WFP, 01/08/03). This will have dramatic consequences for populations in desperate need.
On the other hand, it seems that a significant improvement has been made over last year in seed distribution before the planting season; some gaps have, however , been identified (FEWS, 12/05/03).
At mid-year, the consolidated inter-agency appeal (CAP) for Sudan was only 29% resourced. This is, however, better than in previous years, where the percentages of the requirements which were covered, were below 15%.
A random sampled nutrition survey was carried out in accessible areas of Malakal, Balliet, Tonga and Fashoda provinces (GOAL, 05/03). The results showed a poor situation; the prevalence of acute malnutrition was 18.4 % (14.8 - 22) including 2.6% severe malnutrition. These rates are in the same range as that found in Malakal town, IDP camps and surroundings, in August 2002 (see RNIS 41).
Old Fangak district, Phou state
The nutrition situation has gradually deteriorated in this area since 2001, and the mortality rates have almost doubled since September 2002 (see graph).
Prevalence of malnutrition, Old Fangak district, Phou state, Sudan
The prevalence of malnutrition and the mortality rates were incredibly high in March 2003, as revealed by a random sampled survey (see table) (AAH-US, 03/03). About 65% of the families surveyed were resident families, whilst 17% were settled in cattle and fishing camps, which is a traditional coping mechanism during the dry season, and 17% were displaced.
The desperate situation can be attributed, as in most parts of the southern Sudan, to food insecurity, due to weather hazard and volatile security conditions, and to poor access to basic health services. Although NGOs are present and carry out food security, health and education programmes, and WFP distribute food, this is not sufficient to improve the situation. Main causes of mortality for the under-fives were bloody and simple diarrhoea, fever, malnutrition and measles. However, measles vaccination coverage has improved since the last survey (from 8.3% to 32.5%) but is still far too low.
Pagak district, Latjor state
A random sampled survey, carried out in April 2003, showed dramatically high rates of malnutrition and mortality (see table) (AAH-USA, 04/03). The major presumed cause of death for the under-fives was malnutrition. As in most parts of Southern Sudan, populations' access to food and basic services is not guaranteed.
Results of nutrition surveys, South Sudan (AAH-USA, 03/03; AAH/USA, 04/03)
|
|
Acute |
Severe acute |
Oedema |
CMR |
<5 MR |
MVC1 |
| Old Fandak, Phou state, Upper Nile |
35.9 (31.2-40.9) |
8.2 (5.8-11.5) |
0.5 |
5.3 |
9.4 |
32.5 |
| Pagak, Latjor state, Upper Nile |
24.6 (20.6-29.8) |
5.9 (3.9-8.6) |
1.9 |
3.7 |
7.8 |
5.4 |
1
Measles vaccination coverage according to cards and mothers' statementInternally displaced persons
Two random sampled nutrition surveys have been undertaken among IDPs in Kassala state (GOAL, 04/03). One survey has been done in the displaced camps, which host IDPs who arrived in 1999 (about 43,300 people); the other survey was done in the camps where IDPs have arrived from October/November 2002 onwards (about 13,500 people).
The nutrition status was uncertain for both IDP populations (see table) and was similar to the situation found in a previous nutrition survey done in old IDP camps in Kassala in August 2002 (see RNIS 41).
The mortality rates in the old IDP camps seemed under control; they were not investigated in the new IDP camps.
It is likely that the IDPs have also been affected by the recent floods in Kassala state.
Acute malnutrition, IDP camps in Kassala state, Sudan, April 2003 (GOAL, 04/03)
|
Acute malnutrition(%) |
Severe acute malnutrition(%) |
Oedema(%) |
|
| "Old" IDP camps |
15.7 (12.3-19.1) |
1.7 (0.5-2.9) |
0.1 |
| "New" IDP camps |
19.6 (16.0-23.4) |
2.6 (1.1-4.1) |
0 |
Wau town and IDP camps
Wau town has been a Government of Sudan enclave for the past 19 years. The town remains extremely isolated. In case of insecurity or a food gap, people from nearby villages seek refuge in the IDP camps, located in the surroundings of the town. Surveys have been conducted in Wau town and in the surrounding IDP camps in February 2003 (ACF-F, 02/03). The results revealed high rates of malnutrition, especially in camps (see table).
Results of nutrition surveys, Wau town and IDP camps in surrounding areas, Bahr el Gazal, Sudan (ACF, 02/03)
|
Acute malnutrition(%) |
Severe acute |
> 5 MR |
|
|
Wau town |
14.4 (11.3-18.0) |
0.8 (0.2-2.3) |
1.2 |
|
Eastern Bank displaced camp |
24.5 |
2.6 |
1.4 |
|
Marial Agieh displaced camp |
23.4 |
1.9 |
0.4 |
|
Bar Yar displaced camp |
16.7 |
2.0 |
2.4 |
|
Salvation displaced camp |
12.1 |
0.0 |
0 |
In addition, the number of admissions to AcF therapeutic feeding centre tripled between February and May 2003. The deterioration of the situation was attributed to new arrivals of populations, especially from Gogrial and Warrap, who were experiencing high food insecurity due to the early hunger gap period (ACF, 28/05/03).
The situation is far worst than in 2000 and 2001, when prevalence of malnutrition in Wau town and IDP camps were lower (see figure).
Results of nutrition surveys, Wau town and IDP camps in surrounding areas, Bahr el Gazal, Sudan (ACF, 02/03)
Langkien, Nyirol district, Bieh state
The nutrition survey conducted in Langkien in June 2003 showed alarmingly high prevalence of malnutrition: 28.8% of the children under-five were acutely malnourished, including 5.6% (3.3-9.2) who had severe malnutrition (MSF-H, 06/03). The nutrition situation was the same as in July 2002 (see RNIS 39). Measles vaccination coverage was only 9.3% (according to cards and mothers' statement), and has not improved, compared to July 2002. High food insecurity, due to poor rains and insecurity, and poor access to health care and water, are all contributing factors to the desperate nutrition situation. Despite the existence of health and nutrition programmes, and food distributions, humanitarian actions have been insufficient to improve the nutrition situation. The survey also revealed inadequacy of the food distribution. The food distribution was intended to reach 25% of the population with a 50% ration. However, among the 223 families interviewed during the survey, 55% reported to have received the last distribution in April 2003, and not all the families have received all the food items which should be distributed. Whilst 98% of the families have received maize, only 68% have received pulses, 70% have received oil, 65% have received CSB and 22% have received salt. Moreover, the average amount of food received per person represented only about 130 Kcal/pers/day, which is only a tenth of the intended 1,050 Kcal/person/day, corresponding to a 50% ration. The rations received are far too low to have a significant impact on the food security of the families.
All the available indicators, ie food security, prevalence of malnutrition and rates of mortality, indicate a steady decline of the situation since 2002 and a major humanitarian crisis (category I). Unless sufficient humanitarian interventions are implemented, it is likely that this trend will continue and the situation will further deteriorate. Despite the great complexity in implementing programmes in Sudan, there is a urgent need to put in place or strengthen programmes in all of the sectors which will permit the reduction of deaths and especially access to food, health care and potable water.
United Nations System 