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UNHCR describes alarming health and nutrition situation in South Sudan camps

News Stories, 24 August 2012

© UNHCR/F. Lejeune-Kaba
UNHCR's health expert described measures being taken to counter a serious medical challenge in South Sudan.

GENEVA, August 24 (UNHCR) The UN refugee agency said on Friday it is concerned by the alarming health and nutrition situation for some 170,000 refugees in South Sudan, particularly among children under the age of five and in the two camps of Yida and Yusul Batil.

"The mortality rate for children less than five across all the camps is above the emergency threshold," said Paul Spiegel, UNHCR's health expert and deputy director for the Division of Programme Support and Management, said during a press conference. "In Batil in Upper Nile, in Yida in Unity state, they are double the emergency threshold of over four deaths for 10,000 per day, which is four times the normal rate that one would expect in sub-Saharan Africa."

Malnutrition rates are also very high, particularly in Yusuf Batil camp which hosts some 34,000 refugees originally from the Blue Nile region of neighboring Sudan. According to Spiegel, the global acute malnutrition rate in this camp is close to 40 percent among children younger than five, while severe malnutrition affects 13.4 percent of children in the same age group. These children and their mothers are currently being treated under a special feeding program.

In Yusuf Batil there are measles cases, and UNHCR's partners are undertaking a mass immunization campaign for children. With the rainy season and the cold, there is also an increase in water-borne diseases across all camps, as well as malaria and respiratory tract infections.

Many of these diseases are preventable. UNHCR and its partners are carrying out an extensive health, nutrition and hygiene promotion campaign. Aid agencies are also stepping up the delivery of food and non-food items.

UNHCR, for example, is increasing its distribution of plastic sheeting and soap. The agency is also providing refugee families with more bed mosquito nets, which are crucial in the fight against malaria. More latrines are also being built, while existing ones are being kept clean with the help of the refugee communities.

The community outreach efforts are starting to result in a reduction of diarrheal cases. Despite these efforts, Spiegel warns of the risk of a cholera outbreak due to the poor water and sanitary conditions in the camps during the rainy season.

"Cholera is a possibility. We are even considering measures that are not done so often, such as providing cholera vaccine for the refugee population and possibly the host population as well. This requires approval by the Ministry of Health," Spiegel said.

Since April, the number of Sudanese refugees seeking safety in South Sudan has swelled from 99,000 to 170,000. These refugees are settled in extremely remote and floodable land areas with little or no road infrastructure, forcing aid agencies to deliver aid by air or by barge.

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Food cuts in Chad camps expose refugee women and children to exploitation, abuse

A funding shortfall has forced the World Food Programme (WFP) to cut food rations in refugee camps in eastern Chad by up to 60 per cent. As a result, Sudanese refugees in 13 camps in the east now receive about 850 calories per day, down from the minimum ration of 2,100 calories daily they used to get. The refugees are finding it difficult to cope. Clinics in the area report a significant spike in malnutrition cases, with rates as high as 19.5 per cent in Am Nabak camp.

WFP needs to raise US$ 186 million to maintain feeding programmes for refugees in Africa through the end of the year. Additionally, UNHCR is urgently seeking contributions towards the US$ 78 million it has budgeted this year for food security and nutrition programmes serving refugees in Africa.

In the meantime, the refugees experiencing ration cuts have few options. Poor soil quality, dry conditions and little access to water mean they can't plant supplemental crops as refugees in the less arid south of Chad are able to do. To try to cope, many refugee women in eastern Chad are leaving the camps in search of work in surrounding towns. They clean houses, do laundry, fetch water and firewood and work as construction labourers. Even so, they earn very little and often depend on each other for support. In the town of Iriba, for example, some 50 refugee women sleep rough each night under a tree and share their some of their meagre earnings to pay for a daily, communal meal.

They are also subject to exploitation. Sometimes, their temporary employers refuse to pay them at the end of the day. And some women and girls have resorted to prostitution to earn money to feed their families.

Ration cuts can have an impact far beyond health, reverberating through the entire community. It is not uncommon for children to be pulled out of school on market days in order to work. Many refugees use a portion of their food rations to barter for other essentials, or to get cash to pay school fees or buy supplies for their children. Small business owners like butchers, hairdressers and tailors - some of them refugees - also feel the pinch.

WFP supplies food to some 240,500 Sudanese refugees in the camps of eastern Chad. Many have been in exile for years and, because of their limited opportunities for self-sufficiency, remain almost totally dependent on outside help. The ration cuts have made an already difficult situation much worse for refugees who were already struggling.

Food cuts in Chad camps expose refugee women and children to exploitation, abuse

Health crisis in South Sudan

There are roughly 105,000 refugees in South Sudan's Maban County. Many are at serious health risk. UNHCR and its partners are working vigorously to prevent and contain the outbreak of malaria and several water-borne diseases.

Most of the refugees, especially children and the elderly, arrived at the camps in a weakened condition. The on-going rains tend to make things worse, as puddles become incubation areas for malaria-bearing mosquitoes. Moderately malnourished children and elderly can easily become severely malnourished if they catch so much as a cold.

The problems are hardest felt in Maban County's Yusuf Batil camp, where as many as 15 per cent of the children under 5 are severely malnourished.

UNHCR and its partners are doing everything possible to prevent and combat illness. In Yusuf Batil camp, 200 community health workers go from home to home looking educating refugees about basic hygene such as hand washing and identifying ill people as they go. Such nutritional foods as Plumpy'nut are being supplied to children who need them. A hospital dedicated to the treatment of cholera has been established. Mosquito nets have been distributed throughout the camps in order to prevent malaria.

Health crisis in South Sudan

Battling the Elements in Chad

More than 180,000 Sudanese refugees have fled violence in Sudan's Darfur region, crossing the border to the remote desert of eastern Chad.

It is one of the most inhospitable environments UNHCR has ever had to work in. Vast distances, extremely poor road conditions, scorching daytime temperatures, sandstorms, the scarcity of vegetation and firewood, and severe shortages of drinkable water have been major challenges since the beginning of the operation. Now, heavy seasonal rains are falling, cutting off the few usable roads, flooding areas where refugees had set up makeshift shelters, and delaying the delivery of relief supplies.

Despite the enormous environmental challenges, UNHCR has so far managed to establish nine camps and relocate the vast majority of the refugees who are willing to move from the volatile border.

Battling the Elements in Chad

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