Responding to the start of the repatriation process of Angolan refugees from the Democratic Republic of Congo and Zambia, MSF has begun work in primary health-care centres (PHC) in two transit camps in Moxico Province in the east of the country. The process of repatriation, underway since mid-June, is setting about the re-integration of up to 440,000 refugees driven from their homes by 27 years of civil war.
Situated in Luau and Cazombo, the transit camps provide a base for the returnees for a period of three days before they return to their homes. Within the camps, MSF has so far carried out 1,222 consultations in the PHCs and is currently also maintaining water and sanitation and medical screening facilities.
After the departure of returnees from the camp, MSF will provide follow-up, as well as ongoing health care services for the rest of the local population. In addition to those in the transit camps, MSF maintains thirteen other mobile and fixed PHCs across Moxico province, as well as a 40-bed hospital in Luau.
"Unfortunately, the journey home is fraught with difficulties," explained Kostas Moschochoritis, MSF Operational Co-ordinator for Angola. "Many of the villages to which these people are returning barely have the capacity to care for their present population. Coping with this influx is going to prove to be far from straightforward. Although at the moment, how they will even get to their homes in not clear, since the means of onward transport from the transit centres is not yet assured."
"Our objective during the next few months is to begin an outreach programme in the Moxico region," explained Moschochoritis. "But not only does the poor quality of the transport routes hamper our work - especially in rainy season - but there are 9-12 million landmines still littering Angola. That is more than one landmine per person. And as a result, access to the people most in need is extremely limited."
The threat of mines is especially acute for the returnees, many of whom, having lived across the border, have little experience or knowledge about their danger. This is exacerbated by the fact that the majority will rely on agriculture to survive after their return.
Clearly, while the ceasefire of April 2002 may have brought an end to the conflict, the after-effects of Angola's war will be felt for years to come.
Within the camps, MSF has so far carried out 1,222 consultations in the primary health-care centres and is currently also maintaining water and sanitation and medical screening facilities.