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close this bookMedical Assistance to Self-settled Refugees (Institut Tropical - Tropical Institute, Antwerp, Belgium, 1998)
close this folder3. The refugee-crisis: between self-reliance and pragmatic assistance
Open this folder and view contentsWave 1: rural refugees from Nimba county, January-March, 1990
Open this folder and view contentsWave 2: urban refugees or returnees? May-June, 1990
View the documentWave 3: rural refugees from Loffa county, June-August, 1990
Open this folder and view contentsWave 4: refugees from Sierra Leone, March-April, 1991
View the documentA period of relative tranquillity: the refugees remain and PARLS is consolidated
Open this folder and view contentsLate arrivals: the subsequent minor waves, 1992-95
Open this folder and view contentsSettlement patterns of refugees

A period of relative tranquillity: the refugees remain and PARLS is consolidated

POPULATION MOVEMENTS. From mid-1991 till mid-1992, there was a relative status quo inside Liberia and Sierra Leone. There were no major military movements and tension eased in most areas. Peace talks went on in both countries. Humanitarian aid could reach large areas. Consequently, there was no important influx of new refugees in Guinea.

Table 6: Overview of refugees arriving in Guinea in 1990-91

Origin

Estimated numbers and status at arrival

Settlement area in Guinea (Figure 5)

Mode of settling

Wave 1 or Nimba wave, January-March, 1990

Rural Mano from Nimba county

Approx. 100,000; poor and destitute, in good general condition

Rural border areas of Yomou, N'Zérékoré and Lola

Self-settlement among kinsmen; de facto camp in Thuo (10,000)

Wave 2 or urban wave, May-August, 1990

Urban Mandingo from cities throughout Liberia

Approx. 100,000; carrying many belongings, in good general condition

Macenta city and N'Zérékoré city. Many migrated to Beyla and Upper Guinea, where they had their roots

Self-settlement among kinsmen

Wave 3 or Loffa wave, June-August, 1990

Rural Kpellé, Loma and Kissi from Loffa and Bong counties

Approx. 50,000; poor and destitute, in good general condition

Rural areas of Yomou (Kpellé), Macenta (Loma) and Guéckédou (Kissi)

Self-settlement among kinsmen

Wave 4 or Sierra Leone wave, March-April, 1991

Rural Kissi and Mende from Sierra Leone, and rural Gbande from Liberia

Approx. 100,000; poor and destitute, more malnourished, but still in fairly good general condition

Rural areas of Guéckédou

Kissi: self-settlement among kinsmen. Mende and Gbande: 'guided self-settlement' in rural areas, de facto camp at Kouloumba (26,000)

This did not, however, preclude considerable population movements both inside and between the countries. These movements depended mainly on the security situation and the agricultural season. Whenever the security situation allowed it, refugees returned to their area of origin: they were afraid that prolonged absence might jeopardise their claims on land and property. Often the men went first, leaving women and children in Guinea, where they lived in security and had access to relief aid. During the planting season, people tried to farm their land. At the same time, others, who had stayed inside their country, judged that the situation had become too difficult, and moved to Guinea. In the balance, the number of refugees in Guinea remained rather stable, or decreased slightly.

The majority of refugees had settled among the host population. Only in Thuo and Kouloumba de facto refugee camps of respectively 10,000 and 26,000 refugees had been created. This was not decided or organised by any government body or agency. It resulted from local circumstances, in particular the absence of close kinship relations between refugees and hosts, and the very high concentration of refugees at those places. Most other refugees, however, had settled among Guineans and were integrated in the local economy.

The dispersed settlement pattern and the refugee movements made accurate refugee registration virtually impossible. In the absence of an official repatriation programme, refugees who returned to their country of origin did not notify UNHCR. New refugees tried to get registered, but were often - and sometimes correctly - suspected of trying to register for a second time.

During this relatively stable period, hope existed for definitive peace-agreements for Liberia and Sierra Leone and the possible repatriation of the refugees.7 Nevertheless, everybody started acknowledging that longer-term assistance approaches should be adopted, including more support for economic self-sufficiency.8 Finally, after two years, the collective wishful thinking waned, and a more realistic time-perspective was adopted.

MEDICAL ASSISTANCE. During this period the medical assistance programme was consolidated and developed.9 Activities that were less of a priority during the first months - e.g. antenatal care and family planning - got more attention. The negative effects of PARLS on the Guinean health system also became more apparent.

In certain areas, Guineans preferred walking five or ten kilometres to get free care at newly created health posts, rather than consulting their health centres, where they had to pay. In areas with a high concentration of refugees, health centres often served three or four times more refugees than Guineans, who lost the sense of ownership of their own health centres. For the Guinean health centre and hospital staff the presence of the refugees constituted an extra workload for which they got very little extra pay. The refugees, on the other hand, were not satisfied with the health services in Guinea. In their perception, it was not only different from, but also inferior to, what they were used to in Liberia. Moreover, the refugees often considered the Guinean staff less qualified than many refugee health workers who were living among them, most of whom did not find employment in the formal health services. Lengthy negotiations took place as MSF and Mission Philafricaine insisted that refugees should start to contribute financially to the cost of medical care: free service for refugees and a fee-for-service for Guineans was perceived as an injustice. But UNHCR and MOH feared a backlash and repeatedly postponed any decision on this matter.

FOOD AID - rice and oil, rarely beans or lentils - arrived as scheduled. Refugee registration had, however, been quite fraudulent, and local officials and merchants misappropriated an important share of the food aid. This food found its way to the local markets, where rice prices dropped to an all-time low, far below the prices that prevailed before the arrival of the refugees.*

[* For several months 50 kg of imported white rice was traded at FG5,000 (US$5) at N'Zérékoré market; this was less than half the price before refugees arrived.]

EDUCATION for refugee children was provided by doubling-up classes in existing school buildings, and by constructing many new schools. Education for refugees was in English, and operated separately from the French-based Guinean education system. Teachers and headmasters were refugees. International Rescue Committee (IRC) did the co-ordination and supervision.

SOCIAL SUPPORT. Although most refugees fared relatively well with the limited aid, there were also single parent families, unaccompanied minors and elderly without their normal social support networks. For these 'vulnerables', UNHCR tried to organise a social service through the Catholic Church and the refugee committees. Neither managed to develop consistent programmes. It took several years before finally Eglise Protestante Evangélique and Jesuit Refugee Service organised reliable counselling and assistance services for vulnerable persons. 'Support for self-sufficiency' became a buzzword, but little was done, beyond carrying out several studies examining the resource basis of the refugees.10