The National Nutrition Survey is quoted both in the 1992 ICN Liberian Country Paper and the UNICEF Situation Analysis for Children and Women (1993). Other studies quoted in recent literature include: the Newton study done in Monrovia in 1987 in which stunting was reported to be 12 percent and wasting 11.5 percent (ICN, 1992); the Ministry of Health survey in 1985 in which wasting in several countries ranged between 1.3 and 2.1 percent (MSF-H, 1991); and a community assessment conducted in West Point, a slum in Monrovia and 3 villages in rural Bong Country. Wasting was 1 percent and stunting 27 percent. (UNICEF, 1993)
Refugees clearly fall under the UNHCR mandate which is to provide international protection to individuals who have fled their country and to seek permanent solutions for their problems. Populations affected by internal crises, including displaced persons, are frequently more vulnerable than those who have left their own countries.
At the 1991 Executive Committee Meeting, UNHCR made clear that it was determined to act as catalyst in sensitizing and encouraging governments, development organisations and donors to help ensure that UNHCR's assistance to returness is complemented by long term development efforts. Using the label ‘returnees’, however, is not without risk, bearing in mind that the issue of repatriation is, in fact, dealing with complex social situations. “The very notion ‘returnee’ is ambiguous, implying conceptions of a homeland and of shared values within a population which may or may not exist” (Allen & Morsink, 1994).
Operation Octopus, an offensive launched by the NPFL in Liberia October 1992, aimed at capturing the capital Monrovia. Intensive fighting followed for many months.
MSF-H report extremely high rates of malnutrition in 1993 in this area in Liberia and a large number of children and adults with oedema (Ritmeiger, 1993).
Livestock are often referred to as the nomadic bank. Small stock such as sheep and goats are compared to a current account as they are easy to sell and bring in a small amount of money. Cattle and camels are referred to as deposit accounts which are only sold when large sums of money are required.
An assessment by the Centers for Disease Control and Prevention (CDC) in Ayod reported that 75 percent of children were malnourished (< -2 z-scores).
Three years ago, production in the area was low following fighting in 1991 when a large number of people fled to Zaire as refugees. At the end of 1992/1993, a number of NGOs moved into the area and supported returnees with seeds, tools and clothing distributions. In 1994, barter programmes were established by the NGOs in which non-food items were brought into the area and exchanged for grain at subsidised rates. This was the major way in which surplus production was consumed and it was a main method of providing imported commodities. NGOs initially established the barter programme to provide food for FFW programmes and relief activities in nearby camps of displaced people. However, as the camps are approaching self-sufficiency, relief needs have decreased and there is still a large surplus.
The World Health Organization's International Code of Marketing of Breast Milk Substitutes stipulates that distribution of infant formula should not be started unless adequate supplies can be guaranteed for as long as they are needed (WHO, 1981). Guidelines on feeding infants and young children during emergencies are being prepared by WHO and UNHCR, they include the following issues: breast-feeding, re-lactation and wet-nursing, breast-milk substitutes and other milks, complementary feeding, the prevention of micronutrient deficiencies, safe feeding, supporting mothers and nutritional rehabilitation and medical management.
Operation Lifeline Sudan reports a variety of MUAC cut-offs used in southern Sudan (1993). The UNICEF emergency handbook recommends the following cut-offs for MUAC: <12.5cm severe, 12.5–13.5cm moderate, > 13.5cm adequately nourished. MSF and other organisations now recommend that with cut-off points for MUAC for screening children, moderate malnutrition should be defined as 11–12.5cm and severe malnutrition < 11cm or oedema (Boelaert, et.al., 1995)
Quality of management is not only an issue in feeding programmes but can affect all programmes aimed at improving the nutritional status of children. One review of the response to the cholera epidemic in Goma highlights the “…inadequate experience of health workers in management of severe cholera” (Goma Epidemiology Group, 1995).
Operation Lifeline Sudan objectives are: to reduce mortality, morbidity and malnutrition through the provision of relief and basic services; to protect and promote the rights of war-affected civilians, particularly children and women; and to protect and enhance the lives and livelihoods of the people of southern Sudan.
Rinderpest is a threat to livestock owners not only in Sudan but in neighbouring countries as well. An epidemic can kill up to 90 percent of livestock and have a major impact on household food security. Livestock need to be vaccinated three times to eradicate rinderpest. It is estimated that there are 4.5 million cattle in southern Sudan.