Transcript of a press teleconference hosted by MSF on May 30, 2002
Transcript of a press teleconference hosted by MSF
Featured speakers:
-
Erwin van der Borght
, MSF Head of Mission in Angola -
Marilyn McHarg
, MSF Operation Director for Angola -
Randa Hassan
, MSF Program Officer for Angola -
Kris Torgeson
(moderator), Communications Director, MSF
Kris Torgeson:
Good day, everybody. We're starting a little late, so let's get started right away.
Again, this is a briefing on the current situation in Angola in regards to the humanitarian crisis that we're seeing there. We have three speakers today. First, speaking from Rwanda, is the Head of Mission for MSF in Angola. His name is Erwin Van Der Borght. The second speaker is the Operational Director of MSF, who returned from Angola earlier this week. Her name is Marilyn McHarg. She's a registered nurse. The third speaker will be Randa Hassan, Program Officer for Angola with MSF.
So we're going to start with a statement from each of the speakers, and then we'll open it up to questions. We'll start with Erwin. Please go ahead, Erwin.
Van der Borght:
Yes, good afternoon. Maybe I should just explain first what the situation was in Angola until a few months ago, when the conflict was still very intense and affecting the whole country.
Before the ceasefire there was wild violence, many military confrontations, many attacks also against civilian targets. Humanitarian organizations were able to work only in a very limited area, mainly in government-controlled provincial capitals—there was very limited access to populations and large-scale displacement and, then, regular nutritional problems and epidemics. So that was the situation which has been going on over these last two years until this March, early April.
Early April and, more specifically, on the fourth, there was an agreement signed between UNITA and the government forces on a more general ceasefire, a demobilization process and also on a general amnesty. Basically, since early April, humanitarian organizations have finally been able to move beyond those areas that were operational until then, to many of the provincial capitals, and we have been able to launch assessments throughout the whole country.
And the conclusion, or the results, of these assessments are very high levels of malnutrition among populations who have, until then, not been accessible for humanitarian assistance. Not only high levels of malnutrition, but also very high levels of mortality. We have normal benchmarks to give us an idea about how serious the situation is—specific thresholds—and in almost all areas which we assessed, the statistics were way above the threshold. We saw, for example, that we have 5 to 10 percent severe malnutrition among these displaced populations. We see malnutrition in adults, usually a sign that things are especially bad.
In regards to the mortality rates, we see very high levels of retrospective mortality with displacement, with between five and ten people dying per 10,000 people per day. We see also that in certain locations, the proportion of children, the most vulnerable, to adults is lower than you could imagine, and all this data—the information from these assessments—brought us to the conclusion that we were really witnessing pockets of famine among the populations we were now able to reach.
Another element of the humanitarian emergency is the fact that we are now also able to provide assistance to populations who were, until recently, under the control of UNITA. As part of the demobilization process, they are presenting themselves in demobilization centers throughout Angola. And also, in addition to many of the civilian populations, even some of the military people are in very bad condition. Again, the same high levels of malnutrition and mortality.
We are trying to respond to all the needs these figures represent. We are now implementing projects, mainly on the medical-nutritional side. Daily, we are increasing the capacity of MSF in Angola to deal with this.
What is important is that you see that these emergencies and these problems are not just a logical consequence of war—they have been directly caused by how the war was fought over the past years in Angola. What I mean to say is that both the government and UNITA used military strategies where the main objective was control over the civilian populations. They forced populations to be displaced, to move with them. They burnt villages. They burned houses. And people, basically, were constantly on the run, not able to settle or to cultivate.
They had no food reserves anymore, and humanitarian organizations were not in a position to assist them, because they did not have access. And those are the circumstances, the fact that over the past years, since the resumption of the war at the end of '98, neutral and impartial humanitarian organizations have only been able to work on the government side.
And this is directly caused by the fact that the whole concept of negotiated humanitarian assistance—to be able to assist populations all over the county based on need—was not pursued in Angola, because there were other political interests, because neither the government nor UNITA was really concerned about the well-being of the populations, and that, for a large extent, explains the situation we see now happening in Angola.
I mean, access and then humanitarian assistance—to allow access to such populations throughout the whole country—is one of the cornerstones of international and military law, and over the past years in Angola, they have been completely put aside and neglected.
Torgeson:
Thank you, Erwin. We'll move on next to Marilyn McHarg. Go ahead, Marilyn.
McHarg:
OK. Good afternoon. I'd like to start by just telling a story, and it's a typical story that the teams are hearing in the field while they're working with the populations in the therapeutic feeding centers.
Recently, a man came to our unit carrying his daughter on his back. She was 10 years old, and she was very bad off. That's why he was carrying her. He had walked for days, and at one point, he even had to cross a river and decide whether or not to hold onto his luggage or to her. Of course, he hung on to her. And when he brought her to the clinic, he asked the doctors and the nurses to save her, because she was his last remaining child. He had just lost his wife and all of his other children as well. Unfortunately, she had been so far on that despite the efforts of the team, they weren't able to save her, and she died that night.
The level of suffering that's going on in Angola is absolutely amazing. The stories that the teams are hearing highlight that. Recently, we did a survey in a therapeutic feeding center, and the mothers interviewed had lost 17 percent of their children since January. The number of children who were alive in January and died between January and mid-May was 17 percent. In a sense, we're already too late for a number of pockets, and it's really important that we highlight this emergency and act as quickly as possible.
Although the war itself has finished, the suffering has continued. Essentially, there are three different types of emergencies happening in Angola. There's the ongoing situation with the internally displaced populations. There's also an emergency among the civilians who have been caught in the previously-inaccessible areas and an emergency among the UNITA families.
This is a totally a man-made disaster, and I think it's important to emphasize that point. It is a result of UNITA and the government of Angola's strategies, which Erwin has already outlined. I think it's also important that we highlight that it's a result of our own failures to not be able to negotiate access to these populations previously. Certainly now, we do—we are starting to have access, and I think that it's essential that we do provide as much services to these populations as quickly as possible, in order that we can correct the failures that we've already had in the past.
In order to do this, I think, first of all, the wider international community has got to shift their sense of complacency about the situation. Even though there is peace, there is a need for increased awareness that there is a major emergency happening here and more immediate action is required. Among the international donors, they have been pushing for the government of Angola to assume their responsibilities. And although that is important—for the government of Angola to meet its obligations—this should not preclude any emergency action.
The United Nations has made some concessions, but more is required. WSP needs to speed up its assessments. It needs to increase its capacity, and it needs to do general food distributions in areas that have been identified as being severely problematic. Other NGOs also need to engage.
Some NGOs have mobilized themselves, but there's still a lot more that can be done. And as well, the government of Angola has a number of responsibilities that it needs to meet—to provide support to its population, as well to facilitate the international community in terms of very basic issues such as visas and customs procedures.
Overall, there is a need for the emergency to be separated from the political agenda and from the more developmentalist approaches and for everyone to, in a concerted way, act urgently.
Torgeson:
Great. Thank you, Marilyn. Next, we'll move on to Randa Hassan. She'll say a few words, then we'll open it to questions.
Hassan:
Thank you. From the field perspective of our operations in Angola, as Erwin and Marilyn have been saying, our strength in the field has allowed us to repeatedly raise the humanitarian situation in Angola with the United Nations, as well as the U.S. government.
Knowing that the U.S. has been one of the main political backers of the government of Angola and one of the largest funders of aid in Angola, we've spoken to the U.S. government on numerous occasions to raise our concerns about the situation there, as well as the need for negotiated access and the need to use what leverage they have on the government of Angola to ensure that access could be negotiated.
As Erwin and Marilyn have mentioned, we are not asking for anything extraordinary, just the application of international humanitarian law to allow impartial and neutral humanitarian organizations to assist Angola's population, who are in need of medical assistance, no matter where they are located in Angola.
The situation that we are seeing today in Angola is something that confirms the worse fears that we've held over the past year. For the last year, we've been encountering populations who were able to make it to our feeding centers, and we were seeing for example, 11 percent severe malnutrition rates and 28 percent global malnutrition rates in areas such as Cuemba. So we've been concerned that these populations were really the tip of the iceberg. And these fears have been confirmed now by the emergency that's currently going on.
I think it's particularly disconcerting today, knowing that these populations were in such a bad state, that the level of assistance and the response has been so late and badly positioned. At the moment, we're not in a situation where we're preparing to avert an emergency. The emergency already exists, and what we need to see, as Marilyn clarified, is much more of a response to the situation. The populations in Angola have been failed during the time of war, and it's unconscionable that now—at a time when access is possible in Angola and there is a situation of peace—that these populations are greeted with lethargy and bureaucracy and not the humanitarian response to their needs that they are entitled to.
Torgeson:
Thank you, Randa. OK. I will ask the operator now to open it up to questions.
Q:
If any one of the guests could explain a little further…why, since the ceasefire, has it been difficult to negotiate to get into the UNITA-held areas?
Torgeson:
I think—Erwin, do you want to take that one?
Van der Borght:
For MSF, we started to move into those areas by soon after the ceasefire. The strategy we used was, basically, to contact the relevant authorities, both in UNITA and in the government at the provincial level, to discuss the modalities with them, in terms of security, in terms of freedom of access, and also in terms of free access to populations. And that was—basically we received those clearances. So we were able to move in quite quickly.
The larger problem is—and this is also the cause of the delay for general humanitarian assistance—is that the UN has chosen a strategy where they wanted first to negotiate a general framework, at the central level, with the Angolan government, on the method of the UN's presence and assistance in those quartering areas. And this has basically delayed the UN—that strategy has delayed them—for six to eight weeks. They never ended this negotiation under the framework they had in place, and they continued to persist with this strategy, even though they were confronted with a large-scale nutritional emergency among the populations living in those areas.
And I'm talking specifically about those living in the quartering and family areas under the UNITA control. And then—I mean, this is failure of the UN that they hung on too long to this strategy and, basically, lost two months in terms of response time.
Torgeson:
Marilyn, did you have anything to add to that?
McHarg:
Yes, just a point about the visas and the customs procedures. I think another hampering factor is the fact that, for some countries, it takes a long time to get visas into Angola, and the procedures on the ground for customs are protracted to the extent that is does hinder the operations also.
Torgeson:
Thank you. Does that answer your question?
Q:
Yes, it does. Thank you.
Torgeson:
OK. Next question, please.
Q:
I wanted to know if you could elaborate on the UN's failure; that would be helpful. But also, how many people do you estimate remain inaccessible to humanitarian aid at this point? How large a population are you talking about here?
Torgeson:
Erwin, I'll let you take that first, again.
Van der Borght:
Yes, I'd like to start with the second question. It's true that various locations are still inaccessible, and this plainly a result of logistical constraints, like roads, which are in a very bad state. Also, for sure, there are mines along those roads. And so that means that certain number of people are still inaccessible. Sometimes we know how many there are and where they are. We can get a good understanding of what the situation is, but we can't yet go there. To put a figure on the total number of people who still remain inaccessible—the estimations we have been using is that between 300,000 and 500,000 were directly affected by very high levels of malnutrition and mortality.
In answer to your first question, when the ceasefire was signed, the memorandum of understanding was between UNITA and the government. The UN would be asked to provide technical assistance and resources in the quartering areas.
The UN has been truly trying to clarify what the government and military really meant by the phrasing of the memorandum of understanding, and, until now, they have not really been able to clarify it. One of the preconditions for the UN to move into quartering areas, to assist them and provide assistance is this framework which I mentioned earlier, which basically set forth the mode of the UN's intervention in terms of security, as well in terms of respect for humanitarian workers and assistants, et cetera. And these are all relevant issues. But this is not the point.
The point is that they waited and waited for two months before they finally realized that the government, certainly not on central levels, would not enter into such an agreement. And that is most likely for very political reasons. Knowing what happened after the Lusaka peace agreement in '94, the government knew that getting the UN into those quartering areas with a formal agreement would again create a long delay in the implementation of the demobilization process.
Now they've changed strategy, so they've agreed to move ahead with us and provide assistance. They are working much more on the provincial level, and they've agreed on some technical modalities. But it's not what they were trying to obtain initially. The result was a delay of months.
Torgeson:
Marilyn, would you like to follow up with anything?
McHarg:
Well, I think, essentially, it comes down to the—a difference between the principles versus the imperatives. What the UN was trying to do was set up a principled agreement with the government of Angola. However, this came at the expense of implementing life-saving services that were required in a timely way. I think that's the bottom line.
Torgeson:
Did that answer your question adequately?
Q:
Well, Erwin broke up about now and again, and I didn't understand. Is he saying that now the UN is working at the provincial level with much greater success, and that the central-level authorities still haven't really responded to their requests, and instead, they just wasted two months talking to the central level, which had no intention of reaching an agreement? I didn't understand that, because you faded in and out.
And the other thing that you faded out on was the first part of the question. I know you used a number—300 to 500,000. Are those the number who are inaccessible due to the roads and the mines? Or are those the total number of people who are thought to be suffering high levels of malnutrition?
Van der Borght:
OK. The 300 to 500,000 is the total number of people who are directly confronted with the high levels of mortality and malnutrition. And a large number have already been identified and assessed, and assistance is being provided to them. And from those numbers, there are still an unknown number who have not been reached. Sometimes, we know more or less where they are, but we cannot get to them.
The other question that you mentioned—this is what I mean—some discussions continued on one level, not with the highest level of the government, the presidency, but more with the technical committee of one military commission, which basically resulted in the people of UNITA being responsible for the implementation of demobilization processing.
Torgeson:
OK. I'm going to actually just ask the speakers if they could say a few words about what distinguishes the emergency that we're seeing in Angola from the southern African food crisis that we've been reading about in the paper. Maybe Erwin could address that.
Van der Borght:
Yes, I mean the difference is, the crisis in Angola is very much man-made, whereas the one in the rest of southern Africa—Mozambique, Zambia, Malawi and in Zimbabwe—is more linked to the drought and a different set of political problems. What is also different, and this is even more important, is the fact that in Angola at this moment, there is already an acute situation with very high levels of mortality and pockets of famine—with people dying because of malnutrition, whereas, the situation in southern Africa, in the other countries, is much more one of food insecurity. In that region there are huge risks for the future—people are starting to be put in a very vulnerable situation.
But the levels of malnutrition are not that high yet, and people are not dying solely because of lack of food, so that's the major difference. And it's important when we use, for example, the terminology of famine that we are very clear about what we mean. That's why we call it pockets of famine. In specific locations among the populations we see very high levels of malnutrition, combined with a high mortality rate, and we see also malnutrition among the adults—not only amongst children and the most vulnerable, and that we also see, in some locations, that the population composition is different from what you might expect in a normal situation.
What I mean to say is that, for example, in some locations, we notice that the under-five-years-old population is far lower than what you could expect in normal situations. And that is an indication, again, of the height of the mortality rate. And that kind of situation is not yet seen, as far as we know, in southern Africa.
Torgeson:
Do any of the other speakers want to add to that at all? If not, are there any other questions?
Q:
Yes, hi again. Sorry. Just to make sure about what the message is today—who needs to do what, and how quickly and how much do they need to do it with?
Torgeson:
Marilyn, would you like to take that one?
McHarg:
OK. I think, basically, what needs to happen is that the donor governments, who have been involved with Angola, need to react more than they already have and to avail the necessary resources for a more immediate response. I think the United Nations needs to step up its capacity, as well as the speed of its response—and non-governmental organizations need to start implementing more emergency services for these populations. And this includes doing more assessments, as well as implementing emergency intervention, such as food interventions and medical interventions.
Q:
I take it the reason you're providing this message is you don't think that this is happening at this moment.
McHarg:
There has been some attention to Angola, but it's small in comparison to what's happening there. And although there are some organizations that have started to mobilize themselves, what has been done so far has not been sufficient.
Torgeson:
Erwin, would you like to add to that at all?
Van der Borght:
Yes, I think it's not only important to highlight the need for increased operational response from everybody—the international community, government, military organizations, etc.. It's also important that the message gets through about what caused this emergency situation—these pockets of famine. For many people in Angola, it's already too late, because they simply died. But for other conflicts, or even for the future of Angola, the fact that such gross violations of international and military law took place, and the fact that no assistance was possible for humanitarian organizations to develop operations, that this could take place for years in such an intensive conflict in Angola—this has to recognized.
It's totally unacceptable. And, I mean, we're now at the stage of lessons learned, but that is something we have to—we have to make known to a larger public, because, it is easily forgotten here by everybody concerned.
Q:
Do you—do you have any notion at all as to what the indirect death toll from the war has been over the last three years? I mean, for example, in Sudan, there were estimates of two million plus since 1983. Do you have any notion of what this failure has meant, in terms of actual numbers of lost lives?
Van der Borght:
Certainly some of the things I think we will be looking at in the coming months is to conduct these type of retrospective mortality studies, which you can then also extrapolate from. At this moment, we only look at the retrospective mortality in specific locations over a limited period of time. I think we've put in four months, and already we see that there are huge figures for the emergency's toll. We are not yet in a position to define what happened in the non-accessible areas, and we won't be for years. But I think we would like to look into that in the coming months.
Q:
But do you have any—you know, Americans in particular, love numbers. Do you have any notion as to what this may have been? I mean, any order of magnitude.
Torgeson:
I think it's—I think what Erwin's trying to say is that it's going to take ...
Q:
It's too early.
Torgeson:
We need more access and more time to assess the retrospective mortality. It'd be premature to say. Erwin?
Van der Borght:
There are a few figures—I mean, Marilyn quoted a figure of 17 percent among children in the last four months.
Torgeson:
Marilyn, would you like to reiterate that?
McHarg:
Yes. This was in a couple of our therapeutic feeding centers, and 217 parents were interviewed, among about 500. So it's a sample. They reported that since the beginning of the '90s they had lost, in total across the group, 41 percent of their children. So the total rate of childhood deaths was 41 percent between 1991 and 2002. And then of the children who were still alive as of January 1st, 2002, 17 percent died between January 1st and May 14th, 2002.
Torgeson:
Marilyn, could you say where that survey was taken and spell the name of the place?
McHarg:
This survey was done in Malange—m-a-l-a-n-g-e. And the families that were in these therapeutic feeding centers were from the quartering areas, called Damba and Ingungazol.
Q:
Those were families who were held in the camps by UNITA and were on the run?
McHarg:
Yes. Of the women that we interviewed in this small sample, 78 percent had reported that they were originally kidnapped and enslaved by UNITA.
Torgeson:
OK. I believe that Randa Hassan would like to just add something to that.
Hassan:
Actually, just to add on an earlier point in terms of a need for assistance. The need for assistance for populations in the newly-accessible areas and those in the quartering areas didn't come at the expense of existing programs for displaced populations, in terms of food distribution. And we're concerned, because we already understand that WSP has made some cuts in assistance for existing displaced populations that were assisted before April 4th. So, just wanted to make that point.
— End of teleconference —
