MSF head of mission in Angola affirms need forwide-scale international aid to malnutrition crisis

"As long as there is no, or only limited, general food distribution in the locations where we work, there is a big chance of people suffering a relapse after our teams have pulled them from the brink of death."

Since the start of the recent peace in Angola, MSF has been trying to build international awareness and action in one of the worst famines faced in Africa in the past decade. The most recent action was public criticism of the failure of the WFP (World Food Programme) and OCHA (Organisation for the Coordination of Humanitarian Affairs) along with the Government of Angola to mobilise themselves effectively in the face of the emergency. In reply, MSF has been accused of not cooperating with other aid agencies and not having shared vital information regarding the situation throughout the country.

Since the cease fire was signed between the Angolan Government and the UNITA rebel army on April 4 this year, MSF teams have gained access to populations that had been cut off from international assistance since 1998. At almost every location they have entered, the MSF staff have found horrific conditions, with levels of malnutrition and mortality that are many times higher than the levels used to define an emergency. The conditions are the worst seen in Africa in the past ten years. Prior to the recent cease fire, violence and insecurity left nearly 90% of the country outside the reach of MSF and other aid organizations.

Erwin van der Borght, one of the MSF Heads of Mission in Angola recently returned to Europe. Over the past months, van der Borght’s primary responsibility has been to save the lives of Angolans who are threatened by starvation. He has been with MSF since 1994 and has been working in Angola since February 2001. While with MSF, he has always worked in projects based in conflict zones in Africa. He has reacted with surprise to statements that MSF has not been cooperative in the light of the malnutrition crisis throughout Angola.

National staff members measuring a malnourished child in the MSF feeding centre in Kuito, Bie Province.

"OCHA states that we have failed to share information with partners," said van der Borght. "The exact opposite is true. Both the WFP and OCHA latest reports on Angola contain a lot of information that came from our teams, though we are barely mentioned as a source."

After two months of trying to mobilize other organizations towards this crisis, MSF took the unusual step of publicly criticising the failure of both UN agencies and the Angolan government to react effectively to the urgent needs there. Van der Borght was still in Angola when MSF organized a media briefing in Luanda on June 11. Now, back in Brussels, he is surprised by the counter-criticism of the UN Office for Coordination of Humanitarian Assistance (OCHA) towards the comments made by MSF on June 12.

In particular, his surprise focuses on accusations that MSF has not shared information with other aid agencies active in Angola.

"OCHA states that we have failed to share information with partners," said van der Borght. "The exact opposite is true. Both the WFP and OCHA latest reports on Angola contain a lot of information that came from our teams, though we are barely mentioned as a source. All MSF assessment reports have been shared with the UN agencies on both the provincial and central levels.

"In Angola, MSF took part in the weekly meetings organized by OCHA and have had regular contact between those meetings. We have constantly put our findings on the desks of UN agencies. One of our Operational Directors went to Rome in mid-May during the annual planning session of the World Food Programme (WFP) to raise awareness of the terrible conditions faced by the Angolans. We have been knocking on every door since April, trying to spur others into action. And if that were not enough already, we have also shared our information, through many press releases, with the media - and many have reported on the gravity and urgency of the situation in Angola."

Why is it so urgent that other organizations step in if MSF is already taking care of the Angolans who are close to starvation?

"There are limitations for MSF in both capacity and scope. We now have some 160 international staff in the country and employ close to 2,000 Angolans. We have some 14,000 people in our 44 feeding centers. We are caring for the most severely malnourished in ten of Angola’s 18 provinces.

"MSF’s feeding centres are where we care for the most severely malnourished people. But larger scale feeding programs, such as those run by the WFP, are essential to prevent a vulnerable population from becoming malnourished to the level of needing care from an MSF facility.

"But we find that, as long as there is no, or only limited, general food distribution in the locations where we work, there is a big chance of people suffering a relapse after our teams have pulled them from the brink of death. We are a medical organization. As such, we use our resources to treat the most vulnerable people. It is absolutely necessary for others to make sure that the broader population receives food so that the situation does not spin out of control any further.

"The WFP are active in Angola, but mostly in areas where they were present before the cease fire. They need to expand their operations wider and faster to reach the population in need. The impact of MSF feeding programs is limited if not accompanied by more widespread food distribution. This is what we are calling on the WFP to do take on the large scale feeding programs for those populations we are finding in newly accessed areas of Angola.

"When OCHA says that we did not engage in discussions on the food pipeline, they are wrong."

Both WFP and OCHA claim that they do not have the means to assist all Angolans who need help.

"This is exactly the point we want to make. They need to increase their attention to the emergency, recognize the needs and increase their actions. In that respect, our criticism also reflects on the governments who can give UN agencies the means to do what needs to be done. But this also means that these agencies have not been able to convey the gravity and urgency of the Angolan nutritional crisis to those donor governments.

"These agencies have failed to draw attention to the crisis, even by supporting the statements made by MSF in the media. In effect, they have failed to provide essential support in developing awareness of the malnutrition crisis there."

What about the criticism from OCHA that MSF has not been cooperative and that you did not cooperate enough with other organizations?

"It is true that we have not waited for a new UN intervention framework to be in place before starting our assistance in this emergency. But we do participate in coordination activities. We have been working in Angola since 1983 and feel a strong obligation towards its people. Therefore, when a cease fire was in place, we immediately started our assessments and, where needed and possible, set up feeding centers. Without that immediate action, many more Angolan children would have died.

"When OCHA says that we did not engage in discussions on the food pipeline, they are wrong. We are following the WFP food policies very closely and are possibly better informed than other agencies on these matters as WFP programs have a direct impact on our activities. Again, we have fed those discussions with the information from our teams. We have been part of the discussion on many occasions and in different forums including discussions with the WFP in Rome. All we have wanted is for everyone to understand that urgent action is necessary now, as well as a strong commitment for the rest of the year and possibly beyond."

Click on photo for full image.

In this MPEG, Erwin van der Borght explains the situations MSF workers are coming across in the field and both the widespread nature and duration the crisis shall have.

There was also the accusation that MSF had not taken care of children after they were dismissed from the feeding centers.

"I am puzzled by that statement. First, any relocation is done voluntarily. We arrange for them to be transported back to where they came from after having treated them in our centers. We continue to care for them until such transportation is available. We respect the choice if they decide, with their parents, to stay where they are and we make sure they get registered as that gives them access to the WFP food programs.

"If they decide to return to where they came from, we give them a food ration that lasts a week or, on occasion, a month, to help them and their families through the immediate future. It is true that often these people are returning to areas where there is often no widespread food program there. But this remark from OCHA only underscores the urgent need for a solid system of general food distribution and illustrates where OCHA and WFP are failing.

"MSF cannot prevent people from sliding back towards starvation after we have got them back on their feet. OCHA and WFP must open new food distribution programs in areas where malnourished populations have been discovered. It is an essential part of ensuring the work done now in the worst cases does not fail."

So you stand by your criticisms of OCHA and WFP?

"Absolutely. But we do not like to be so openly critical. The one thing that matters, and the sole reason why we have spoken out, is that all actors have to pull together immediately in order to prevent more Angolans to die needlessly. For many of them it is not too late. But it may be in a month from now, or even next week. We are doing what we are supposed to do and we urge others to do the same."

There are other famines in Africa that have also taken the attention of OCHA and WFP where MSF has not been active.

"When MSF talks about a famine, we talk about very high levels of malnutrition and mortality rates in both the adult and child populations. Often when media talks about famine, they are talking about food insecurity but not about increased malnutrition and not about populations that are dying. But in Angola, people are dying now. They died yesterday and shall die tomorrow."