Severe malnutrition on the rise in refugee camps

Relief workers have reported an upsurge in severe malnutrition among Sudanese refugees from Darfur at three camps in eastern Chad. "We have registered up to 80 malnutrition cases since February, a large number of which were kwashiorkor cases reported in the Touloum therapeutic feeding centre. There have also been a few cases in Iridimi and it seems there are some too in Goz Beida," Wim Fransen, Head of Medecins Sans Frontieres Luxembourg (MSF-L) in Chad told IRIN by telephone from the capital N'Djamena. Kwashiorkor is a nutritional disease arising from protein defficiency that mainly affects children. Classic symptoms include a swollen stomach, bleached hair and flaking skin. Touloum, Iridimi and Goz Beida are three of the eleven refugee camps stretching along Chad’s eastern border with Sudan's troubled Darfur region. Until recently the United Nations refugee agency UNHCR estimated that there were 213,000 refugees from Darfur in these camps, but a registration exercise conducted in March revealed there were only 193,000, a UNHCR spokesman in Chad told IRIN on Wednesday. Fransen blamed the recent upsurge in cases of kwashiorkor on a lack of proper food in the camps, saying distributions only took place irregularly and refugees were not receiving the normal full ration. "The nutritional survey we did in the camps in October showed that food quality and quantity were not always adequate, and that there was a food shortage which lasted for an average of five and a half to seven days every month," the MSF official said. "At the time we did the survey, 20 days after the monthly distribution had taken place, only one percent of the refugees surveyed still had stocks left of all the 16 different types of foodstuff that were handed out," he noted. Stefano Poretti, the World Food Program (WFP) Country Representative in Chad, said there were probably several reasons for the increase in malnutrition noted by MSF, not all of which were related to food shortages. “There are several possible explanations, for instance the improvement in the surveillance system might have allowed for more precise screening, the lack of hygiene and water and certain cultural practices, such as preventing sick children from eating, might all have contributed to the increase in kwashiorkor cases,” he told IRIN. However, Poretti acknowledged that WFP had encountered logistical difficulties in trucking food supplies to the refugee camps across the Sahara desert from the Libyan port of Beghazi on the Mediterranean coast and this had resulted in the refugees receiving reduced food rations for several months. Poretti noted that the standard WFP food ration was 2,100 calories per day, but this had been cut to 1,800 at present and had dipped as low as 1,400 in February and November. However, this shortfall had been partly compensated for by the fact that WFP had been distributing food for more people than were actually living in the camps, as the March census had revealed. He questioned why kwashiorkor should be a particularly severe problem at Touloum, a camp housing 17,000 people situated, 200 km east of Abeche, the main town in eastern Chad. “Food distributions have been homogenous in all sites, so why is the problem so acute in Touloum and nowhere else?” he said. “The water there might be unclean,” he ventured. WFP had recently sent a nutritionist to the refugee camps to investigate the situation, Poretti said.