Rising mortality and malnutrition at Jalozai

The mortality and malnutrition rates among children at the Jalozai makeshift camp for Afghan refugees in Pakistan's North West Frontier Province (NWFP) are increasing due to deteriorating hygiene levels and a lack of clean water, aid workers for Medicins sans frontieres (MSF) told IRIN on Wednesday.

"Sanitation is still bad, and there is not enough clean water for people to take a shower or wash their clothes regularly," Jake Stringer, MSF's project coordinator in the provincial capital, Peshawar, said.

Stringer confirmed that the mortality rate had doubled over the last couple of weeks, with up to 14 deaths a week now being reported in Jalozai. The main causes of death are diarrhoea and respiratory diseases, both easily curable. He said most of the victims were women and young children. "Although this has not reached emergency levels, it is still a great worry."

Stringer also warned that there had been a rise in the number of children enrolled in the MSF supplementary feeding centre at Jalozai. Three weeks ago the number of refugees enrolled at the centre stood at 550. However, aid workers recently recorded a total of 800, a figure expected to rise even further.

Most of the malnourished children were under the age of five, as they were more susceptible, he said. Doctors at the camp said the worst-affected children were under the age of two. "These children do not have a proper balanced diet to help their growth," Dr Amin Oman of the MSF clinic in Jalozai told IRIN.

He added that of the 100 children seen at the clinic every day, at least 80 were malnourished, many of them severely so. Most of the refugees at the camp are surviving on a daily diet of bread and tea.

There are three medical clinics at the site, the one run by MSF, and two set up by UNHCR in conjunction with the Pakistani authorities. The MSF clinic offers a three-week course of supplementary food, consisting of soya, lentils and multi-vitamins, for malnourished children.

Although WFP and NGOs are regularly distributing food at the camp, the refugees complain that it is insufficient. Sirajuddin, the mother of a severely malnourished two year-old child, told IRIN: "We don't know what we will have to eat from day to day. I just feed my child whatever I can, whenever I can." She has been in the camp for seven months after arriving from the northern Afghan city of Mazar-e Sharif, and said she feared the worst for her daughter's health.

A new wave of Afghan refugees started pouring into Pakistan last September, fleeing the ongoing civil war and drought in their homeland, with many settling in Jalozai and the NWFP.

Even though the Pakistani authorities had clamped down on Afghan refugees coming into the site, aid workers said there was still a steady influx into Jalozai, putting a strain on its already stretched resources. "We believe there are between 30 and 100 new families arriving on a weekly basis," Stringer said.

He said latrines were now in place, and the refugees were now more evenly spread out in the camp, but major hygiene problems still obtained. "It is an extremely unhealthy environment," he noted.

MSF currently supplies more than a million litres of water daily to the camp, which houses 50,000 refugees, but the supply is inadequate. "There is simply not enough water," Stringer said. This, he said, had led to the spread of skin disease among children, with 440 cases registered last week. "We are distributing soap to try and stop skin disease."

Youngsters at Jalozai can be seen covered with abscesses and infections on their faces and bodies, as they roam around the dirty and dusty site. Stringer said health problems at the camp would persist unless the refugees were relocated to a more established site. "MSF is desperate for the people of Jalozai to be moved to a safer and cleaner place," he said.

UNHCR and the Pakistani authorities are currently carrying out a refugee screening programme in the NWFP to determine which Afghans can claim refugee status. Those who fit the criteria will be shifted to the established Shamshatoo camp, also in the NWFP.