|Medical Assistance to Self-settled Refugees (Tropical Institute Antwerp, 1998)|
|4. Food aid|
THE DECISION-MAKING PROCESS. Figure 16 represents the essential ingredients and the logical sequence of what would be a rational basis for decision making in food aid. Assessing the number of refugees usually requires refugee registration through an exhaustive census, but is often based on guesstimates. Humanitarian agencies usually carry out anthropometric surveys to know the nutritional status of the refugees. Information on the number of refugees and their nutritional status, together with expertise in food aid, yields an estimate of the food needs of the refugees. Based on this knowledge decisions on food aid are taken (quantity and quality of food needed, modes of purchase, transport and storage, distribution channels and control methods). When implemented, these decisions result in distribution of food aid to refugees to improve or maintain their nutritional status. Periodic anthropometric surveys and checks on refugee numbers allow for monitoring feedback of the situation, and adjustment of decisions.
CLOSED VS. OPEN SYSTEMS. For food aid to refugees, or to 'beneficiaries' more in general, there are two possible situations. The beneficiaries may be considered living in a closed system, cut off from the rest of society, entirely dependent on food aid and in need of full rations. This is the case in isolated refugee camps, where refugees have no access to land or labour opportunities. Alternatively, the beneficiaries may be considered living in an open system, partially self-sufficient, and thus only partially dependent on food aid.
In the situation of complete dependence, decisions on the quantity of food aid needed are relatively straightforward. All beneficiaries need a 'full radon' of 2,100 kcal per person per day, with a minimum of 10% of calories supplied by protein, and the essential micronutrients. The need for food aid does not decrease with time, and does not depend on the season or on good or bad harvests. The only important variable is the number of refugees, which may change with new arrivals or departures. Refugee registration has thus to be updated regularly. If food aid is delayed or insufficient, in quantity or in quality, nutritional problems, particularly micronutrient deficiencies,29 soon appear.30,31
When refugees are only partially dependent on food aid, as was the case in Guinea, decisions are more difficult. Insights in the availability of food in the society at large, and in the degree of self-reliance of the refugees, are needed to estimate the quantity of food aid needed, and the groups in need. The general refugee population and those identified as being vulnerable, often receive different rations. Coping mechanisms and needs of refugees evolve over time. Knowledge on local food production and local markets should play a role in decisions on food aid. If, however, the food distributed lacks essential micronutrients, this rarely causes problems. If food aid is delayed, this does not immediately lead to widespread malnutrition, as refugees have other coping mechanisms.
DEVELOPMENT ACTORS & RELIEF ACTORS. In comparison with most other refugee situations the number of different actors involved in the relief system in Guinea was fairly limited. During the first months of the refugee influx, the role of central government, UNHCR and WFP was minimal. UNHCR and WFP, who have an international mandate in refugee situations (Box 2), progressively played a more prominent role.
Medical aid to the refugees was mainly developed and carried out by the regional office of MOH and those agencies that were already assisting MOH before the refugee crisis: MSF, Mission Philafricaine and GTZ. The situation as regards food aid was more complex. Specialised agencies started operations in the Forest Region to implement food aid for the refugees. UNHCR and WFP took the lead. Also Red Cross,* the refugee committees,† and several NGOs intervened at various steps in the process (Figure 17). UNHCR, Red Cross and the government were involved in the registration of the refugees. MOH and the medical agencies assessed the nutritional situation. With this information, and using their expertise, UNHCR, WFP and the government estimated the food needs. These same actors, together with the donors, decided on food aid. The different implementing agencies influenced decisions on practical modalities in their respective fields. WFP imported and transported food aid to regional stores. Adventist Development and Relief Agency (ADRA), and later GTZ, managed regional stores and transported food to local stores and distribution points. The Red Cross, in collaboration with local refugee committees, distributed the general food rations to the refugees. Eglise Protestante Evangque and Jesuit Refugee Service targeted unregistered and vulnerable refugees. MOH and the medical agencies organised feeding programmes for malnourished children. Logistic constraints and lack of commitment of donors often prevented that decisions were effectively materialised.
[* The Guinean Red Cross was not active in the Forest Region before the arrival of the refugees. In 1990, it recruited volunteers, and started operations assisted by the Federation of Red Cross Societies. In the text, 'Red Cross' means 'Guinean Red Cross, assisted by the Federation'.
† Throughout the refugee-affected areas, UNHCR set up elected refugee committees as representatives for the refugees. But the election process was not clear to most refugees, and many thought that the members of the refugee committees had been appointed by UNHCR and were receiving benefits from UNHCR for sitting on the committee. Many refugees felt that the refugee committees were part of an alien bureaucracy ('the refugee system') and did not serve the interests of the refugees.53]
Box 2: UNHCR's central position in the refugee system
After the first World War, with the construction of strong nation
states in East Europe and the large flow of refugees this caused, an
international refugee regime was created in Europe.32 Since then,
international conventions have consolidated this regime, and UNHCR has been
created. It received an international mandate to protect and assist refugees
worldwide.33 UNHCR works in close collaboration with host
governments, who remain sovereign on their own territory. For food aid, UNHCR
collaborates with WFP. WFP is responsible for purchasing and transporting food,
while UNHCR is responsible for food distribution and assessment of the needs.
UNHCR and WFP usually establish contracts with implementing partners. In refugee
situations in sub-Saharan Africa, international humanitarian organisations (e.g.
Oxfam, MSF, Caritas, Red Cross associations, &c) and NGOs of the host
country play an increasingly important role, at the expense of national
governments. In some refugee situations, there are tens of NGOs, many of them
active in a limited sector (e.g. health, education, care for unaccompanied
minors, &c.). UNHCR and the host government co-ordinate activities, but each
NGO has somehow its own motives, agenda, institutional logic and
MOH and its field partners were already operational in the Forest Region before the arrival of the refugees, but had to expand considerably their staff and logistic means for PARLS. All other agencies came to Guinea, especially to assist the refugees. This influenced their attitude, judgements, priorities and time-perspective. The agencies already present had development of the Forest Region as primary objective. They can be called 'development actors'. These agencies perceived the refugees first as an unplanned interference with their development activities. For the other agencies, the 'relief actors', refugee relief was their prime objective. For them, relief aid had, somehow, to be inserted in the host society. Even within agencies, especially MSF, these two types of logic co-existed, and sometimes conflicted
CO-ORDINATION. UNHCR established an office in the capital, Conakry, to co-ordinate its activities in Guinea, and to consult the central government. In Conakry, a national refugee co-ordination committee was established, representing different ministries and law enforcement agencies. This committee decided to limit refugee assistance to the Forest Region. Beyond that, its role remained limited. The regional government and UNHCR assumed overall responsibility for PARLS in the Forest Region. UNHCR established sub-offices in N'Zkornd Guu, and held regular co-ordination meetings with relevant government bodies and implementing partners. These meetings served mainly to inform the Guinean authorities on developments within PARLS. In each prefecture, the prefect was theoretically responsible for PARLS. However, in practice, the foreign agencies often called the shots.