Food and nutrition situation for refugees from Western Sahara in camps in Algeria Ingrid Barikmo...
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Transcript of Food and nutrition situation for refugees from Western Sahara in camps in Algeria Ingrid Barikmo...
Food and nutrition situation for refugees from Western Sahara
in camps in Algeria
Ingrid Barikmo
Akershus University College (AUC)Norwegian Church Aid (NCA)
Riksdagen - Stockholm, February 2010
Refugees in harsh environments in the Sahara desert more than30 years
Cease-fire in 1991 Total dependency on food aid as well as all other
needs for survival Water: a considerable scarcity Health problems such as undernutrition, anaemia
and goitre are common
Background
Background (cont.)
Reduced beneficiaries from 158.000 to 90.000 for 8 months in 2006
In November 2006 increased beneficiaries to 125.000 which still are the number of people given basic ration
Undernutrition increased disturbingly in 2008 Indication of violation of the International
Covenant on Economic, Social and Cultural Rights – article 11 on the right to adequate food
NCA and AUC in the Saharawi refugee camps Nutrition project at the hospitals (since 2000) Iodine Survey, 2007 (report 2008) Nutritional and Food Security Survey, (report 2008) Saharawi Nutrition Strategy, (report 2009) Increased nutrition education, 2009 Cooperation with MoH, UNHCR, WFP, MdM, PNSS in
a Integral Program of Infantile Health Saharawi (PISIS), 2009
Food Basket research, 2009 Local milk research, 2009
Iodine Survey, 2007
Prevalence of enlarged thyroidgland measured by ultrasound: Women (405, age 15-45): 22 % (cut-off volume
thyroid gland > 12.5 ml) Children (419, age 6-14): 86 % (international
reference values (thyroid gland volume - Tvol) for BSA with cut-off point at the 97 percentile)
Excretion of iodine in urine Women: Median 466 µg/L (range 54-3.640) Children: Median 565 µg/L (102-3.594)
2
9
16
38
29
7
0
3
13
38
34
12
0
5
10
15
20
25
30
35
40
45
<100 100-199 200-299 300-600 601-1100 >1100
Urinary iodine excretion µg/L
%Iodine in urine, women
Iodine in urine, children
1100 µg/day: Tolerable upper level of daily iodine intake for adults (Food and Nutrition Board, USA, 2006).
600 µg iodine/day: Proposed safe upper level for adults (Scientific Committee on Food in the European Union, 2002)
Median iodine content (µg/L) in water and urine (women and children)
0
100
200
300
400
500
600
700
800
900
1000
Iodine in water Iodine in urine,women
Iodine in urine,children
Iod
ine
µg
/L 2 camps (Ausserd, El Aiune)
1 camp (Dakla)
1 camp (Smara)
Local milk
Goat milk (n=16) Content of iodine: median 370 µg/L,
(70-13.071)
Camel milk (n=3) Content of iodine in the 3 samples 540 µg/L,
4.170 µg/L and 11.980 µg/L
Sources of the iodine intake among women
Salt7 %
Water48 %
Tea water6 %
Local milk38 %
Dairy products1 %
Conclusion The prevalence of enlarged thyroid gland was severe,
especial for the children The majority of the Saharawi refugee women (74 %)
and children (84%) had excessive intake of iodine It was differences between the camps:
of those with iodine excretion more than 600 µg/L88 % of the women and 91% of the children came from the two camps Ausserd and El Ajune
The content of iodine in local milk was extremely high and need to be more investigated
The high concentration of iodine in water are affecting the humans directly and probably also indirectly through the local milk
Nutritional and Food Security Survey, 2008Prevalence of: Acute malnutrition (too thin) (wasting):
Global (total) 18.2 % Severe: 5.4 %
Chronic malnutrition (too short) (stunting): Global (total) 31.4 % Severe: 9.0 %
Anemia, children In total 62 % Severe 6%
Anemia, non- pregnant women In total 54 % Severe 11%
Anemia, pregnant women In total 66 % Severe 15%
Trend in acute malnutrition (wasting) from 1997 to 2008
10
1311
8
19 18
24
2 2 35
0
5
10
15
20
25
30
Pre
va
len
ce
%
Total (WHZ<-2,00 SD)
Severe (WHZ <-3,00 SD)
Trend in chronic malnutrition (stunting) from 1997 to 2008
46
35 3339
2631
24
1411
16
7 9
0
10
20
30
40
50
Pre
vale
nce
%
Total (HAZ<-2,00 SD)
Severe (HAZ <-3,00 SD)
Saharawi Nutrition Strategy
Saharawi Nutrition Strategy
1. To change the diet for all in line with the international recommendations of the FAO/WHO
2. To coordinate the nutritional work in the camps
3. To reduce malnutrition in children
4. To reduce anaemia and other type of micro-nutrient malnutrition, particularly among women in reproductive age, infants and young children and school age children
5. To promote healthy dietary habits in accordance with local food culture for an adequate food intake for all.
6. To strengthen the nutrition skills among the Saharawi public staff.
General objectives Focused areas
Access to food for a healthy diet
Fight against malnutrition and nutritional deficiencies
Capacity development
Food distributed
0123456789
101112131415
kg c
erea
ls/p
erso
n/m
on
th
Janu
ary
Feb
ruar
y
Mar
ch
Apr
il
May
June
July
Aug
ust
Sep
tem
ber
Oct
ober
Nov
embe
r
Dec
embe
r
Janu
ary
Feb
ruar
y
Mar
ch
Apr
il
2006 - 2007
Wheat
Sum cereal
Wheat and cereals distributed in the camps in 2006 and the first 4 month in 2007
Food distribution and acute malnutrition
The quantity of distributed cereals/person/month in 2005, 2006, 2007 and 2008 when using number of 160.000 or 125.000 beneficiaries and the prevalence of acute malnutrition
0
2
4
6
8
10
12
14
16
18
20
2002 2005 2006 2007 2008
Cereal (kg/person/month)if distributed to 160.000beneficiers
Cereal (kg/person/month)if distributed to 125.000beneficiers
Prevalence of acutemalnutrition
Women needs and food distributed in 2008
0
10
20
30
40
50
60
70
Protein, g Iron, mg Vit C, mg
Needs for a women 19 -50 year/day
Received in 2008 if125000 beneficiaries
Received in 2008 if160000 beneficiaries
0
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1000
1500
2000
2500
Energy, kcal Calcium,mg Vit A,µg
Needs for a women 19 - 50year/day
Received in 2008 if 125000beneficiaries
Received in 2008 if 160000beneficiaries
Food distributed in 2008 to 160.000 g/day
Cereals 281
CSB-blended 13
Lentils/beans 46
Oil, fortified 24
Sugar 23
Tuna fish 2
Vegetables 70
Fruit 30
Meat 5
Milk/Cheese 9
Sources to the nutrients
Nutrients in %
Energy Protein Calcium Iron Vitamin C Vitamin A
Cereals 63 66 20 39 0 0
CSB-blended 3 5 47 23 27 26
Lentils/beans 9 22 14 33 2 1
Oil, fortified 14 0 0 0 0 56
Sugar 6 0 0 0 0 0
Tuna fish 0 1 0 0 0 0
Vegetables 2 2 6 1 33 15
Fruit 2 0 4 2 38 1
Meat 0 2 0 1 0 0
Milk/Cheese 1 1 9 0 0 1
Adapted Food Basket Ration/kg/month
Food given monthly by
WFP
8 Wheat flour, fortified
2 Barely
2 Rice
1 CSB-soya, fortified
2 Lentils/beans/peas
1 Oil fortified
1 Sugar
Suggested food items that can be
given by other
organisations
1 Gofio
1 Soya beans
1 Pasta
5 Milk
1 Cheese
1 Mackerel in brine
3 Potato
3 Carrot
2 Onion
1 Apple
1 Orange
1 Tomato in tetra pack
0
20
40
60
80
100
120
Protein, g Iron,mg Vit C, mg
Needs for a women 19 -50 year/day
Adapted FoodBasket/day
0
500
1000
1500
2000
2500
3000
3500
Energy, kcal Calcium,mg Vit A,µg
Needs for a women 19 -50 year/day
Adapted Food Basket/day
Highly recommended Food Groups as support to the refugees
Vegetable and fruit Canned fish (mackerel or sardines) or meat Milk and cheese Other foods such as gofio and pasta and
soya beans
How to improve the situation?
Use the Saharawi Nutrition Strategy Increase the nutrition education Work in cooperation with MoH, UNHCR, WFP,
MdM, PNSS in a Integral Program of Infantile Health Saharawi (PISIS)
Continue to fill the Food Basket Contribute to the local milk research Other?
Hva slags matvarer og tilsetninger (forts)
0
10
20
30
40
50
60
70
80
Linse
r
Fisk
,bok
s Te
Sukke
r
Pasta Ris
Gjær
Melk Olje
Kjøtt
EggFr
ukt
Grønn
sake
r
Produkter som kjøpes
% f
am
ilie
r
Hva slags matvarer og tilsetninger For behandling av alvorlig akutt underernærte
(wasting): Før – F100 NÅ – PlumpyNut
(olje og peanutbasert) For moderat akutt underernærte:
Hvete/mais-soya blanding+ olje og sukker (CSB)
For forebygging av kronisk underernærte (stunting): Før – ingenting NÅ – olje og peanutbasert produkt
Anemi Sprinkelprodukter