Afghan refugees faced with death and disease

The health status of the 10,000 displaced Afghans camped on the Pyandzh river flood plains on the Tajik-Afghan border has “significantly deteriorated” since the cessation in March of UN-sponsored humanitarian assistance, the British NGO Merlin told IRIN on Wednesday. Medical Emergency Relief International (Merlin), the lead health agency providing assistance to the population, warned that the conditions of the displaced had “worsened”, and that unless some food was distributed soon, there would be an increase in disease and deaths. The Afghans, mainly women and children, have been living on the flood plains since November when they fled the Taliban’s advance into northeastern Afghanistan. UNHCR’s relief operations for the displaced were suspended on 13 March for fear of supporting armed fighters of the Afghan opposition Northern Alliance living within the population. Initial relief efforts targeted the most vulnerable, but it was found that assistance was also reaching combatants, constituting a misuse of relief supplies intended solely for civilians. A high-level UNHCR mission from Geneva which visited the flood plains in February concluded that the refugee agency would only re-engage in future assistance if the Tajik government met three conditions: that the combatants be clearly separated from the civilians; that the civilians be moved to a safer area; and that the Tajik authorities provide free and unrestricted access to the Afghans by UN and NGOs. The consensus among NGOs is that the three preconditions set by UNHCR for the continuance of aid are unworkable. Aid workers say that despite improved access to the population, the movement of the displaced to a safer site by the Tajik authorities was highly unlikely, as was the separation of fighters from their families. Meanwhile, UNHCR head in Tajikistan, Taslimur Rahman, told IRIN on Tuesday that the Tajik government had not responded to any of the preconditions, but that active negotiations were continuing. “There has to be a little bit of willingness on the part of the host government,” Rahman said. However, UN sources told IRIN that a meeting in Geneva on Wednesday was reviewing ways by which UN agencies could provide support solely to the civilians. According to Merlin, the major need of the population is food. During a site visit on 3 and 4 April, the displaced told Merlin they had not received any food aid since a UN consignment on 7 February. “Very few families had any food stocks left, and those that exist are only wheat grains. Many families claimed to have not eaten for the past five days, others were reduced to eating grass,” said Paul Handley, Merlin programme coordinator. Nutritional deficiencies were widely evident, including scurvy and skin problems, and signs of infant malnutrition were identified, he added. Security has also deteriorated, and there are reports of an increase in shelling from the Afghan mainland over recent weeks. As a result, Merlin said, one of the population clusters had moved further up-river to a site more protected from incoming attacks. However, the newly built shelters were of an “even lower standard than the dwellings used previously”, Handley said. Merlin’s early April mission vaccinated 879 children aged between six months and five years against polio. More than 200 patients were treated for diarrhoeal diseases, acute respiratory infections, gynaecological problems and skin infections. “It was felt that there had been a significant deterioration in the health status of these people since Merlin’s last visit on 1 February,” Handley said. On speaking to some of the displaced, Merlin found that they still wished to be allowed to cross to Tajikistan, largely due to the increased attacks over recent weeks. Meanwhile, Merlin and other NGOs have stressed they wish to continue their emergency work on these sites, despite the difficult conditions. Merlin plans to operate further mobile clinics targeting women and children, and for a follow-up polio vaccination campaign. “Whilst appreciating the delicacies involved in sending food to this population, Merlin wishes to advocate on their behalf for a review of the UNHCR preconditions for the continuance of aid and minimal, yet urgent, vitamin-rich food supplies to prevent further decline in the general health situation,” Handley said.