September 15, 2004
New York, September 15, 2004 - After providing emergency assistance to displaced people in Darfur for several months, medical teams from Doctors Without Borders/Médecins Sans Frontières (MSF) have seen its significant effect on people living in the camps, particularly in West Darfur. The situation remains precarious, though, especially in areas where people continue to flee violence that has left them destitute. And many people who lost everything during last spring's wave of attacks will remain completely dependent on international aid for many months. For these reasons, it is vital to continue the heavy mobilization of aid; to deploy aid in isolated areas; and to strengthen food distributions.
An MSF report published in late June, Emergency in Darfur, Sudan: No Relief in Sight, documented, on the basis of an epidemiological survey, the impact of violence against civilians. MSF denounced the shortage of aid and expressed a fear that a famine "resulting entirely from political causes" was imminent. Today, we observe that the arrival of aid has, for now, made it possible to stave off the worst in the areas where we are working. Relief was deployed in the key areas where people fleeing repression had gathered. With Sudanese authorities easing travel restrictions and authorizations, other agencies were able to set up relief operations in Darfur. Although the World Food Program's (WFP) general food distributions are still extremely inadequate, they have provided people with the means of survival.
Health indicators have improved in the camps of West Darfur, including Mornay, Zalengei and Nyertiti. In Mornay camp, which houses 80,000 displaced people, mortality rates have been stable and below the emergency threshold for several weeks. The crude mortality rate (CMR) is 0.4 deaths/10,000 people/day, compared to an emergency threshold of 1/10,000/day. For children under five, the mortality rate (U5MSR) is 0.6/10,000/day, compared to an emergency threshold of 2/10,000/day. The trend is similar in Zalengei, where to 45,000 people have sought refuge. The number of children admitted into our feeding centers has also gradually declined.
Violence Continues Against Civilians in Certain Areas
While insecurity in western Darfur seems to have diminished markedly, the situation is still very tense in certain areas, specifically in North and South Darfur. Twenty thousand people fleeing attacks have recently gathered in and around Shariya and Muhajariya, east of Nyala (South Darfur). An improvised camp has also been set up near Kalma camp, which already houses 80,000 displaced people and where MSF still is treating 800 children for severe malnutrition at its therapeutic feeding center (TFC). In North Darfur, in the area of Al Fasher, several thousand people fled destroyed villages in late August. These pockets of destitute people as well as the continued arrival of displaced people at Kalma camp demonstrate how fragile the situation is in many areas of Darfur.
A Fragile Health Situation
The rainy season, which began in mid-July and will continue until October, still aggravates the health situation in the areas where people have gathered. Heavy rains promote the spread of malaria, respiratory infections and diarrhea, which are the primary reasons people seek treatment in our health facilities. While malaria has been relatively under control, MSF fears a seasonal peak in October-November that could be deadly for people who are already extremely weak.
Also, since June an epidemic of hepatitis E has been rampant throughout the Darfur and in the refugee camps in Chad. The illness is particularly fatal among pregnant women (20% mortality).
MSF not yet recorded any cholera cases in the camps, but the combination of rains, poor hygiene, and overcrowding makes an outbreak a real threat. Teams have pre-positioned supplies in case the illness should appear.
Food supplies in the camps also remains a concern. The WFP's general food distributions are still inadequate. Only 16,000 tons of food were distributed in August, compared to the required 21,000 tons. Only 65% of the food needs in South Darfur have been covered (86% for West Darfur, 75% for North Darfur). This is cause for concern because general food distributions constitute the principal means of subsistence for the displaced people for as long as they lack access to their fields. The rains make it considerably more complicated to transport food, particularly to remote areas like El Genina.
Aid Must Continue and Be Deployed Independently to Isolated Areas
Displaced people who have lost everything are completely dependent on humanitarian aid. Most had their food reserves destroyed or looted and were unable to plant their fields. Their only means of survival is continued international aid. Despite harsh living conditions in the camps, they do not want to return to their home areas, mainly because they fear more attacks. It is thus imperative that aid mobilization continue, even if media coverage stops or Sudan disappears from the international political agenda. A drop in aid delivery could have serious consequences for the displaced people. MSF is particularly concerned about the WFP's general food distributions, which failed to reach their August goal and risk falling even further short in September.
Humanitarian aid has had a significant impact in the large displaced persons' camps, where the catastrophe MSF feared has been avoided. It is now urgent for aid to be deployed in villages and isolated areas where smaller groups of people remain destitute.
While displaced people are said to be returning home, MSF has not observed any such movement in the areas where we are working. The displaced are still terrified, which is why MSF continues to pay close attention to possible resettlement and how Sudanese authorities in Khartoum may implement it. Any return must be voluntary and only with adequate security guarantees. MSF's provision of humanitarian aid in home communities will be conditioned on these two requirements.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)