Mortality Amongst Displaced UNITA Members in Angola
Summary of published paper1
Between April and August 2002 in Angola, as part of the post-ceasefire demobilisation, about 81,000 former members of União Nacional para a Independência Total de Angola (UNITA) and 230,000 of their family members assembled in 35 resettlement camps country-wide. Medecins Sans Frontieres (MSF) launched nutritional and health care programmes in several of these camps. They also conducted a retrospective mortality survey. The survey included all 11 camps of former UNITA members in the four provinces of Bie, Cuando Cubango, Huila and Malange.
Using a cluster sampling design, 900 households were selected (approximating to 4500 people). The recall period for assessing mortality was from 21st of June 2001 to the survey date (15th-31st August 2002). The survey found that 390 deaths occurred during this period, corresponding to an average crude mortality rate of 1.5/10,000/day and an under five mortality rate of 4.1/10,000/day. Monthly crude mortality rate increased from 0.6/10,000/day in June/July 2001, to 2.3/10,000/day in March 2002. After March 2002, mortality decreased but remained higher than in 2001. Crude mortality between 21st June 2001 and arrival in the camps was 1.4/10,000/day, and for the period after arrival was 1.9/10,000/day.
Malnutrition, fever or malaria, and war or violence were the three most frequently reported causes of death. Children under 15 years were disproportionately affected by malnutrition. War or violence was the leading cause of death in 2001, but was supplanted by malnutrition in 2002. Proportionate mortality from malnutrition rose steadily from 15% in June-September 2001, to 33% in January-March 2002 and 39% in the April-June 2002 period.
Authors of the survey assert that these data show how the nutritional emergency peaked between January and June 2002, when hunger was responsible for so many reported deaths. Furthermore, the post-ceasefire data suggest that at least for the first four months of demobilisation in Angola, medical and nutritional assistance to the former UNITApopulation was insufficient to restore mortality to normal levels. Also, United Nations appeals for Angola were vastly underfunded, reflecting a general unwillingness on the part of donor agencies to commit to relief programmes during this crisis. The authors conclude that minimum standards in emergency response were not met, and caution that military and political considerations must not come in the way of effective and timely humanitarian access to populations rendered isolated by conflicts.
1Grein T, Francesco Checchi F, Escribà JM, Abiy Tamrat, A, Karunakara U, Stokes C, Brown V, Legros D (2003). Mortality among displaced former UNITA members and their families in Angola: a retrospective cluster survey. BMJ, vol 327, 20th September 2003
Taken from Field Exchange Issue 21, March 2004