A Case Study of Somali Refugees in Hartisheik A Camp, Eastern Ethiopia: Health and Nutrition Profile, July 1988-June 1990

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Abstract
During the first nine months of an international assistance programme, there was a major deterioration in the nutritional status of approximately 170,000 Somali refugees in the eastern Ethiopian camp of Hartisheik A. The acute malnutrition prevalence rate among children less than 5 years of age increased from 15% in September 1988 (three months after the refugees' arrival) to 26% in March 1989. This increase in malnutrition prevalence was associated with an elevation of both crude and under-five mortality rates. The crude monthly mortality rate doubled between November 1988 and March 1989; the under-five mortality rate quadrupled during the same time period. Diarrhoea, pneumonia, and malnutrition were the most common reported causes of death. The deterioration in nutritional status and associated excess mortality was a result of insufficient and irregular food rations, inaccurate population figures, inequitable camp food distribution, high communicable disease incidence, and relatively low selective feeding programme coverage. Major policy changes are required if the international relief community is to respond more promptly and effectively to refugee emergencies in Africa.

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