Angola: MSF speaks out on illusion of normalization

Children run after the MSF water truck as it leaves a camp for displaced people outside of Luena, Angola. The truck provides water for camp residents and the MSF health post (in background).

© Alain Kazinierakis
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In November 2000, on the 25th anniversary of Angola's independence, MSF issued a report entitled "Angola: Behind the faÃ?§ade of normalization - manipulation, violence, and abandoned populations."

MSF drew on its field experience in Angola, as well as testimony from affected and displaced people, to paint a bleak portrait of the plight of the population. See the following pages for excerpts from the report.

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The report grew out of work in nine of Angola's 18 provinces. MSF supports provincial hospitals, cares for internally displaced persons (IDPs) in cities and camps, runs feeding centers and clinics, carries out nutrition surveys, supplies medicine, trains local health care workers, and responds to epidemics of cholera and other diseases such as meningitis, sleeping sickness, and pellagra, a vitamin deficiency disease.

Working to expand access to the people

In several program areas, including Luena, Kuito, Huambo, Malanje, and Caala, MSF has been pushing to reach people living beyond the officially defined security perimeter drawn a few kilometers around these provincial towns.

While during the last year access in some areas has slowly started to improve, it remains limited and the security situation fragile. MSF has been able to travel up to 15km outside of Luena, 50km south of Caala to Cuima, and 80km outside of Kuito to Camacupa. Logistical constraints and insecurity have prevented MSF from reaching the town of Mussende, near Malanje; however MSF successfully pushed for a government assessment and vaccination team to enter the town.

Ongoing medical care for IDPs and residents

The provincial cities Kuito, Luena, and Caala are magnets for people fleeing the countryside. MSF supports the hospitals in Kuito and Caala with care, training, and medicine, and carries out epidemiological surveillance. After several years of similar work in Luena, MSF withdrew from the hospital there in February 2001 and now focuses on health posts in IDP camps near the city. Mobile clinics also reach areas of the city where some of the displaced have resettled.

MSF runs feeding programs in Kuito, Luena, Uige, Camacupa, Lombe, Cangandala, and Caala. A nutrition program in Malanje ended in February 2001. While overall the instance of malnutrition has eased somewhat from that of mid-2000, in certain areas malnutrition has been on the rise and MSF has responded by opening new feeding centers as warranted.

Primary health care and training, through hospitals, health posts, or mobile clinics are provided at the above locations, as well as in Menongue, Matala, and Huambo. In Zaire province, in the city of M'Banza Congo, MSF relaunched a primary care program serving about 30,000 people.

Most of the above projects treat area residents as well
as people who have been displaced from their homes because of the war.

Focus on disease

MSF has been treating sleeping sickness in the N'Dalatando area since 1995. In fall 2001, this project will be turned over to the Angolan national sleeping sickness program. MSF hopes to establish a separate operational research project using eflornithine and nefurtimox that will lead, eventually, to their inclusion in the national protocol. These two drugs - which are not currently part of the national protocol and thus could not be used in N'Dalatando - are increasingly available and affordable, partly as a result of MSF's Access campaign. They are also much less toxic than melarsoprol, an arsenic-based drug that is the current frontline treatment for advanced stages of sleeping sickness.

In Luanda, MSF is continuing its emergency cholera preparedness program and is working to establish several cholera treatment centers.

International staff: 80
National staff: 850