|Refugee Nutrition Information System (RNIS), No. 05 - Report on the Nutrition Situation of Refugee and Displaced Populations (UNSSCN, 1994, 45 p.)|
|CURRENT SITUATION (Sub-Saharan Africa)|
(see Map 9 and Figure 3E)
Increased fighting during May and June in Southern Sudan displaced many thousands and continues to disrupt relief operations. This was compounded by the onset of the rainy season. This fighting is reported to affect most of Southern Sudan with population movements throughout the provinces of Bahr el Ghazal, Equatoria, Jonglei and Upper Nile. Some international personnel have been moved into Uganda. This is the peak agricultural period so the next harvest later this year will be seriously affected. Emergency food stocks are reported "almost exhausted" in Bahr el Ghazal [WFP 2/05/94, WFP 16/05/94, WFP 27/05/94].
Many areas served by air operations from Lokichokio (in Kenya), which were severely curtailed during April due to lack of funds, have received less than 50% of projected food needs. Flights from Entebbe to Juba also ceased in April due to lack of funding. Overall, shortage of funds and food meant that only 65% of WFP planned food deliveries for April took place for a target population of 530,000 [WFP 16/05/94]. Some airlifting from Entebbe to Juba restarted in June. WFP requests donors to allocate relief food to meet the food gap for Southern Sudan (ex Khartoum) which is estimated at 24,000 MT [WFP 13/06/94].
Nutritional survey reports from several areas in the South show crisis levels of wasting with some of these areas having been directly affected by interruptions to the air-drop operation. This is described by area below. Population estimates by area are unavailable.
Equatoria The food situation in Juba remains critical with only enough food to allow 70% of those eligible for wet feeding to enrol on the programme. Furthermore, the displaced camps around Juba have only been supplied with rations of small amounts of vegetable oil and pulses with no staple foods [WFP 2/05/94].
In spite of the rains and insecurity, road convoys did manage to reach 150,000 people in 17 villages in Eastern Equatoria. Another convoy reached 35,000 people to the Eastern side of the Lopit mountains where WFP reported a serious food deficit. There were also reports of 51,000 people newly displaced from Opari, Aswa, and Pageri who were moving towards Mugale (East of Nimule) [WFP 16/05/94].
The nutrition situation is thought to be extremely bad. For example, a nutritional survey in April carried out at Labone camp (estimated population 50,000) near the Ugandan border found high levels of wasting at 37.0% including 13.8% severe wasting. Rates of oedema were measured at 4.5% (sec Annex I 9a) [AICF 19/04/94].
Bahr el Ghazal The food and nutritional situation in many areas has been reported as critical. The current crisis in the county has undoubtedly been worsened by the effects of the 1993 drought. The status of the displaced living in Marial Ajith and Eastern Bank camp is alarming as the last general food distribution in February reached only one quarter of the displaced who in turn only received 25% of cereal needs for a short period. Current reports are that wild foods are the only food now available. Local relief authorities have been reporting high mortality in the camps due to starvation and sickness, worsened by poor sanitation [WFP 2/05/94].
A nutritional survey carried out in Alek county (in the north of the province with an estimated population of 345,000) found very high levels of wasting of 45.4% with severe wasting measured at 10.3% (see Annex I 9b) (this shows a dramatic deterioration compared to October 1993 results of only 12% wasting).
Measles immunisation coverage was less than 50% which is insufficient to prevent an epidemic the effect of which would be catastrophic. How far these results apply to a wider area is not Known, but it is possible that any bias would be to underestimate malnutrition as this area is receiving some assistance [MSF-F 16/04/94].
Serious fighting was reported between GOS and SPLA in Wau and Gogrial in Western Bahr El Ghazal in the first week of May [UNICEF 13/05/94].
Upper Nile The military-political situation remains complex with mass population movements along the river making needs assessment and food aid delivery difficult. Unconfirmed reports are that tens of thousand of people have been pushed towards the Ethiopian border. In April approximately 17,000 people in Nassir received a half ration via an air drop [WFP 16/05/94].
Jonglei With reduced air lift capacity during April only limited food could be distributed to Waat town (estimated population 16,000) despite the acute need shown by a nutrition survey in March. This survey showed 24.8% wasting, with 4.9% severe wasting (see Annex I 9c). Crude mortality rates were 4.4/10,000/day (11 x normal) and under-five mortality rates were 11.2/10,000/day. We are again seeing alarmingly high mortality rates. Recent reports indicate people are eating seeds and that even wild foods are in short supply [MSF-H Mar 94, WPF 16/05/94].
In sum, the populations of Bahr El Ghazal, Labone camp in Equatoria and Juba are known to be in a critical state (category I in Table 1). The 100,000 people on the border at Nimule are thought to be in a critical nutritional condition (category IIa in Table 1) and the rest of the displaced population can be considered to be at moderate risk (category IIb in Table 1).
How could external agencies help? Food aid supplies for Southern Sudan via Khartoum for May-December are estimated to be inadequate by about half, requiring 24,000 MT; current pipeline supplies will last until August. It is hoped to transport supplies by a combination of road, rail, water, and air. A main priority for Southern Sudan is to continue funding for the air transport operation on which urgent relief measures are dependant The interruptions in the programmes due to lack of funding are directly worsening nutritional status and mortality. Once adequate food deliveries can be resumed, there is a need for greater decentralization in international agency operations, and where working through local implementing partners, to assist these in improved needs assessment and monitoring. Immunization, water/sanitation and health services are critically inadequate, both for those in camps and otherwise displaced (the majority).