Acute malnutrition in Chad needs integrated response, says survey

GENEVA, July 16 (UNHCR) - High levels of malnutrition and diarrhoeal diseases among Sudanese refugees in north-eastern Chad could lead to increases in serious illness and death if not treated immediately, according to the initial findings of a nutrition survey coordinated by the UN refugee agency.

The survey, conducted in mid-June in three refugee camps in north-eastern Chad and in the border area of Bahai, is an inter-agency effort involving UNHCR, the US Centers for Disease Control and Prevention (CDC), the UN Children's Fund (UNICEF), the World Health Organisation (WHO), the World Food Programme (WFP), the Centre National de Nutrition et Technique Alimentaire, Médecins Sans Frontières (MSF) Belgium, International Medical Corps (IMC), International Rescue Committee (IRC) and the Chadian Ministry of Health.

The final report on the survey is still being completed, but preliminary findings indicate a serious crisis, with malnutrition among 36 to 39 percent of refugee children under five years of age. High levels (35 percent) of malnutrition were also found among the local Chadian population. The survey also detected low levels of measles immunization among refugees at the border and high rates of diarrhoeal disease.

"While the survey was not designed to focus on the causes of the malnutrition, the experts involved in the survey note that there are many contributing factors, in addition to inadequate food rations," said UNHCR spokesman Ron Redmond at a news briefing in Geneva Friday. "High levels of diarrhoea, insufficient availability of water, and the overall lack of public health infrastructure in this remote and isolated region can all exacerbate the degree of malnutrition."

The survey team concluded that without immediate corrective action, the combination of these factors may lead to increases in serious illness and death. It called for an integrated response that includes all public health and nutrition sectors, covering food, water, medical care and shelter simultaneously.

Specifically, the team recommended that a blanket supplementary feeding programme be implemented immediately for all children under five years old and for pregnant and lactating women. It also called for expanded selective feeding programmes for malnourished children, as well as improvements in the general food ration provided to all refugees by WFP. The survey also recommended improving the quantity and quality of water available for the refugees, a longstanding challenge in eastern Chad's desert, where the refugees camped after fleeing from the conflict in their home villages in western Sudan's Darfur region.

Progress has already been made on several fronts since mid-June, when the survey data were collected. Water supply in the camps has improved and sufficient clean water is now available in the three camps surveyed. In Bahai, UNHCR has relocated more than 3,000 refugees to a new camp at Oure Cassoni since convoys started on Monday. A measles vaccination campaign was recently completed in Bahai and in Cariari further north along the Chad-Sudan border.

"But much more urgent action is still needed," said UNHCR's Redmond. "We are deploying an additional nutritionist and a senior health coordinator to the area and are working to find additional non-governmental partners to work on health and nutrition."

He added that UNHCR will also be working closely with WFP to advocate for improved general food rations and additional food commodities for selective feeding programmes for all vulnerable refugees. The refugee agency also plans to urgently purchase food commodities to fill the immediate gap for supplemental and therapeutic feeding for the refugees.

The critical situation will be discussed at a high-level meeting between UNHCR and WFP scheduled for next week.