US embassy cable - 05GENEVA1065

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