Practical experience with the management of a cholera outbreak in a refugee cAMP in eastern Sudan, 1985

From May to November 1985 most refugee camps in Eastern Sudan were affected by cholera. This article summarizes the experience from the refugee camp Wad Sherife with the emphasis on the practical aspects of management of cholera in a refugee context. Paramedical personnel from the refugee community were used to a great extent both in curative and preventive measures. The home visitors played an important role in the early detection of the cases and in trying to prevent the spread of cholera in the camp. A total of 1793 cases were admitted during a three month period. The results show a case fatality rate of 1.8%. A significantly higher number of women were affected in the age group 15–44. As seen in other refugee camps in Eastern Sudan, there was a relatively high intravenous fluid consumption with an average of about 6 litres in adults.     

6.12. Insect pest control in refugee camps

This paper is intended as a practical guide to help camp administrators with insect pest control problems. It has been neccessary to mention certain types of proprietary chemicals by name as examples of the types of compound available for various control purposes. Similarly, it has been necessary to include the names of certain items of equipment. However, the inclusion of a compound or item should not be regarded as a recommendation that this is the best, or only, one available for the particular purpose described.     

A test of stress theory: relief workers in refugee camps

The purpose of this paper is to apply a stress model drawn from the literature to the relief and social service workers who have been active in refugee camps for a prolonged period of time. Working in difficult environments, social service workers deliver essential services to refugee populations around the world. A model of four work-stress determinants--tasks, management, appreciation and collaboration--was tested on 274 social workers in five regions of the Middle East (Jordan, Lebanon and Syria, as well as the occupied Palestinian territories of the Gaza Strip and the West Bank). Statistical fit indices were adequate but two relationships were statistically insignificant. The collaboration variable was dropped to create a modified model with tasks indirectly and management and appreciation directly affecting work-related stress. The five direct relationships and two indirect relationships of this modified model are consistent with stress theory, and all relationships--direct and indirect--are statistically significant.     

An outbreak of scurvy in Somali refugee camps*

Between June and October 1982, an outbreak of scurvy occurred in the refugee camps of Somalia. An epidemiologic investigation eventually detected more than 2,000 cases. The outbreak came at a time when the relief programme had been well established and the general health status of the refugees had otherwise stabilized. We report on 72 of the cases. Joint pain of the lower extremities and gingivitis were prominent features in the majority. Hemorrhagic phenomena were not observed and no deaths occurred. The outbreak primarily affected the poorer refugees who were unable to purchase locally available Vitamin C-containing foods. This outbreak demonstrates the vulnerability of a large population of displaced persons who are dependent on imported relief supplies for survival.     

Malnutrition and anaemia among Somali refugee children in long term camps

In a long term Somali refugee camp where nutritional and general health status of children is now considered satisfactory and stable, a randomized community based survey of 300 children under five years was undertaken. Results indicate that the prevalence of protein-energy malnutrition is rising again: 17.3% of children are <80% median weight/height and 1.7% are <70%median weight/height. In addition, there is a high prevalence of anaemia: 50.5% have a haemoglobin level <9g% and 10.8%≤6g%. This cannot be explained by chronic malaria as the spleen rate is only 2%. Stool examination of 161 children show 29.8% to have evidence of Giardia Lamblia infection but this is not statistically correlated with either anaemia or with protein-energy malnutrition. Other potentially pathogenic parasites are uncommon and no hookworm is seen. Examination of blood films of anaemic children shows hypochromia as a striking feature.
It is concluded that nutritional deficiencies are a likely major factor in the aetiology of the anaemia. Both protein-energy malnutrition and anaemia seem related to the weaning period. Food rations for refugees, although adequate for short term needs, may be qualitatively deficient for long term subsistence, especially as regards young children.     

Pests and donors in mali, 1985-90

Between 1985 and 1988 large-scale spray campaigns were carried out against migratory crop pests in the Sahel. The Malian government and its donors subsequently adopted this emergency response to a natural disaster as a long-term strategy for crop protection in Sahelian Mali. This is financially unsustainable, probably economically wasteful and stunts the development of other plant protection strategies. A similar process has occurred in Burkina Faso, Niger and Senegal. Donors should therefore exercise critical, collective control over the release of pesticide aid and should subject it to economic evaluation.     

An Ethiopian refugee village in Sudan: the question of employment

Abstract— There are some 460,000 Eritrean and Tigrean political refugees in Sudan. The numbers have increased dramatically since the mid-1970s, and as yet there are no convincing signs of peace which would allow the prospect of a speedy return home. Sudan is thus faced with one of the Third World's largest populations of long term refugees, and the capacity of the economy to absorb such numbers into its labour force is an acute and potentially violent issue. Discussion and planning has been hindered by a lack of specific information on the proportion of refugees who are of urban or rural origin and the proportion of those who might undertake skilled or unskilled employment. The following report of a census and survey of a refugee village in eastern Sudan offers some insight into the problem and suggests steps towards its solution.     

From food aid to livelihoods support: rethinking the role of WFP in eastern Sudan

Despite more than 20 years of distribution of free emergency food in eastern Sudan (38 years in the case of refugees) Global Acute Malnutrition rates are currently the highest in the country. There has been no real improvement in the chronic livelihoods vulnerability that affects people in the region—particularly pastoralists. Food security must be seen from an informed livelihoods perspective. While food aid may still be required as part of transition, WFP must rethink its assistance strategy and advocate for complementarity in the efforts by development actors working across a range of sectors. Alternative models and interventions focused on the rehabilitation of markets and the development of' cargo nets' for the destitute, including cash transfers, must be developed and tested. Land tenure issues should be given particular attention. Food aid will probably remain an important element in the overall response, but its significance relative to other less developed forms of interventions should be reassessed.     

From emergency to social security in Sudan - part I: the problem

This is the first part of a two-part article which stresses the need to move away from short term emergency measures to a more general system of social security. A weakness in much of the thinking on food security in Sudan is its conception of a normally self-provisioning peasantry which is pushed into distress only as a consequence of exceptional external conditions. Food catastrophes are therefore seen as, essentially, temporary phenomena requiring emergency interventions. This article proposes a different view: that the commercial development of Sudan has engendered a crisis of subsistence synonymous with the collapse of indigenous support systems, the spread of absolute poverty and the erosion of the country's resource base. In the North this situation has come about through economic means and in the South through war. The spread of absolute poverty and the resulting vicious struggle for scarce resources cannot, however, be separated from the decay in governance. Part I of the article attempts to establish the interconnections between these elements and thereby to indicate the problems which a system of social security would have to overcome. Part II will examine the institutional consequences of the crisis, namely the imposition of a donor-led system of social security.     

From Emergency to Social Security in Sudan - Part II: The Donor Response

In the first part of this article I examined the crisis of subsistence in Sudan resulting from the commercial development of the North and the war in the South. An attempt was also made to relate the deepening impoverishment that this represents to a decay in governance. There is a tendency amongst donor and government officials, which is reflected in the literature, to regard the unfolding crisis as the transitory result of exceptional circumstances rather than as irreversible and therefore warranting a major revaluation of policy. As a consequence, social security and emergency planning has generally been of an emergency type. In this, the final part of the article, I examine the donor response in more detail. In particular, I argue that the decay of governance is so extensive that a donor-led system of social security has been imposed on Sudan. This system has a number of characteristics, the most important of which is that it exists in the absence of the political renewal and democratisation that would be necessary for the technical solutions it advocates to be implemented. The result is that donor-led security, which is typical of the Horn of Africa, proceeds in a relation of antagonism to the sovereign power, a situation which significantly reduces the efficiency of the measures undertaken.     

Conflict, camps and coercion: the ongoing livelihoods crisis in Darfur

This paper presents the findings of a study commissioned by World Food Programme (WFP) in early 2006 to enhance understanding of how the conflict in Darfur has affected livelihoods and markets, and of the effects of food aid. The livelihoods of many in Darfur were devastated early on in the conflict, principally through the widespread looting or destruction of assets and highly restricted population movements, which struck at the heart of pre-conflict livelihoods. Livelihood strategies for most people are now restricted, poorly remunerated and often associated with high risk of attack. Patterns of coercion and exploitation have also become entrenched; and markets and trade, the lifeblood of Da fur's economy pre-conflict, severely disrupted. Against this backdrop the impact of food aid on livelihoods in Darfur has been overwhelmingly positive. The paper proposes a number of preconditions for investment in recovery in Darfur, and recommends ways in which livelihoods can be supported in the current context of ongoing conflict.