The international medical aid organization Médecins Sans Frontières (MSF) has launched an emergency program in Amuria, in northern Uganda, where nearly 33,000 displaced people have sought refuge since June 2003. A medical team provides care, supplies water to families and structures, and ensures vital help.
The health needs are pronounced. Recent assessments by MSF have identified a lot of cases of severe malnutrition, and mortality rates (both gross rates and rates for children under five) are at twice the emergency threshold levels. Because of insecurity, the hospital staff has abandoned the only health center in the town (with a usual population of 2,000).
The water supply is failing and food supplies have not been delivered since mid-October 2003. A few families have found refuge in the town's only school, but most have had to construct makeshift homes. Without medical care, water, or aid, these people may die. They are captives in a town whose borders are insecure. Several mortal attacks have occurred on roads leading into town.
This is the fourth emergency program launched by MSF in northern Uganda, where civilians are increasingly prey to violence and insecurity. In Lira, since last November's attacks in the district, some 230,000 people have sought refuge in nearly 50 makeshift camps.
There is only access to 20 in town that shelter 80,000 people. The number of reported malnutrition cases is very high. MSF's program there consists of a mobile clinic, a 120-bed therapeutic feeding center, two supplementary feeding centers, and a water and sanitation project. The TFC has been running at full capacity (120) since the beginning of January and has often been forced to admit more patients (up to 22 additional children this week).
MSF will open a second TFC shortly. The Supplementary Feeding Program has admitted some 1,400 moderately malnourished children thus far. MSF has very limited access outside Lira town, so numbers are expected to get worse.
Further north, in Gulu, another city buried inside an insecure area, nearly 15,000 children come from surrounding areas at night to escape the kidnappings and other acts of violence. Most sleep without any shelter in the open air. Since December, MSF has provided care to almost 3,000 children, mainly treating them for parasites linked to poor hygiene. Assessments have also been carried out to the camps north and south of Gulu, aimed at providing primary health care to people that are particularly vulnerable after years of insecurity.
In September 2003, MSF brought aid to 100,000 displaced persons in the town of Soroti, in the Teso region, where several massacres had occurred since June. Fueled by the extremely crowded conditions and the poor living conditions, a measles epidemic and grave mortality crisis broke out.
As fighting between the Ugandan army and rebels of the Lord's Resistance Army (LRA) continues, hundreds of thousands of civilians are exposed to brutal attacks. Witnesses have testified to particularly violent, large-scale abuses against civilians, including murder, mutilation, abduction, and rape.
In this atmosphere of terror, civilians are forced to choose between staying, and thereby risking another attack that could cost them their lives, or fleeing to urban areas that cannot offer them even the minimum conditions necessary to survive.
Without medical care, water, or aid, these people may die. They are captives in a town whose borders are insecure. Several mortal attacks have occurred on roads leading into town.