UNHCR REPLIES TO DEMARCHE ON MALNUTRITION IN CHAD

UNCLAS SECTION 01 OF 02 GENEVA 001065 SIPDIS ADDIS AND KAMPALA FOR REFUGEE COORDINATORS E.O. 12958: N/A TAGS: PREF PHUM CD UNHCR SUBJECT: UNHCR REPLIES TO DEMARCHE ON MALNUTRITION IN CHAD CAMPS REF: A. STATE 67874 ¶B. GENEVA 1037 ¶1. (U) RMA Officers delivered ref A demarche to UNHCR Assistant High Commissioner (AHC) Kamel Morjane and Head of Desk for Chad and Darfur Craig Sanders, who promised to investigate and reply to questions and concerns raised. DCM and RMA officer met with Director of Sudan Operations Jean Marie Fakhouri and Sanders on April 20, at which time Sanders handed over a draft copy of a reply to the demarche (faxed to PRM) which noted reduced rations had been distributed for four months prior to the increase in malnutrition, and that the statistics had improved with increased food and improved monitoring. The final report, which also elaborated on water and sanitation shortcomings in a new sector of the camp, was received April 21 and electronically forwarded to PRM Chad/Sudan group. The report, and a concurrent WFP sitrep, also stated that the malnutrition problems have been addressed and the situation resolved. End Summary. ¶2. (U) RMA officers demarched AHC Morjane on April 15 and also shared the substance of the issue with Acting High Commissioner Wendy Chamberlin, who was preparing to depart for the region the following day. Morjane was receptive to the demarche, but had limited information for immediate response. Head of Desk Craig Sanders provided some initial field input which suggested that there had been an improvement in the situation and that the malnutrition statistics had increased when improved surveillance detected facial edema, which Community Health Workers had previously not reported. Both agreed that PRM's requests that UNHCR standardize nutritional surveillance and prepare monthly camp-based nutrition reports were sound proposals and committed to provide them. They also expressed appreciation for PRM's offer to assist in establishing the surveillance system. Sanders undertook to brief Sudan Deputy Director David Kapya prior to his weekend departure for Chad, and Morjane said that he would raise nutrition with Sudan Operations Director Fakhouri, who would be in Geneva the following week. ¶3. (U) In an April 20 meeting with DCM and RMA officer (ref B),Fakhouri said he was "saddened but not surprised" by the malnutrition issue, which AHC Morjane had raised with him. He acknowledged that multiple shortcomings had occurred and cited the following as contributing factors: -- reduced ration distribution from November to February owing to shortages in food stocks; -- water and sanitation inadequacies at a new part of Touloum Camp, where most of the malnutrition had been detected. Head of Desk Craig Sanders provided a draft field report which had resulted from our demarche to Morjane, and committed to provide the report in final the following day. ¶4. (U) On April 21, Sanders forwarded the final copy of the field report, which RMA immediately forwarded to PRM. The report states: -- severe climatic and environmental conditions contributed to the development of malnutrition in the northernmost camps; -- food shortages led to ration reductions for the four month period November 2004 through February 2005; -- a poor harvest caused reduced availability of food and higher prices in local markets; -- 31 cases of light facial edema had been counted as kwashiorkor, although no clear diagnosis of malnutrition could be made; -- three children who were severely malnourished when they were detected had subsequently died; -- overall, the cure rate has been 89 percent. It also reported that: - a nutrition working group of IOs and NGOs meets regularly; - nutrition indicators are standardized, and all recommendations made by CDC for nutrition surveys are being adopted; - ACF is preparing to take over Therapeutic and Supplementary feeding at Oure Cassoni; - WFP supplies have increased and full rations are being distributed; - food distributions are now being done to each family, rather than to groups of families, providing for a more equitable distribution. ¶5. (U) A World Food Program situation report dated April 20 reported that global acute malnutrition at Touloum and Iridimi was 12 to 14 percent, and that ration distributions equivalent to 2069 kcals in April were at near-standard levels. The WFP report also states that MSF Luxembourg, the NGO which initially reported the kwashiorkor rates, now confirms that the overall nutritional situation is stable and under control in all camps. Moley