NEWS Somalia: aid agencies struggle to
_
cope Somalia is now the only place in the world where the entire 7-3 million population is reliant on food supplied by aid agencies, according to David Shearer of Save the Children Fund's office there. Relief workers reckon that over 500 000 people are being fed in the capital, Mogadishu, with over 200 new refugees arriving in the city eve day. The International Committee of the. Red Cross
(ICRC)estiniates that throughout the country Ib5 million people are close to starvation.
Since January this year the ICRC has been feeding 700000 people throughout the
country and has allotted $140 milion-one third of its annual aid budget-to its relief.l operation in Somalia. It is the biggest operation in the ICRC's history and is faced with enormous security problems and the theft of emergency food by armed gunmen. Camps supplied with food by the ICRC, many of which are run by the French aid agency Medecins Sans Frontieres (MSF), have sufficient food only for children under 5 years old. They receive three meals a day of high protein Unimix. Older children and adults receive only one meal a day, of rice or' lentils. While the older children in the camps_ are dying of starvation at a rate of up to 20 a day, younger children are dying of malaria,diarrhoea, dysentery, and measles at a similar rate. Up to 15 people a day are dying at Golweyn camp, a fly blown, deathly home to 3970 people along the coast south of Mogadishu. The death rate is worse in camps in other parts of the country, particularly in towns facing an even greater concentration of refugees, such as Baidoa. MSF nurses in Golweyn say that they have enough -medicine to treat at most 40 people
A.
Z
Somalia: one fifth of the population could be dead by Christmas
with malaria or diarrhoea. There are epidemics of pneumonia, tuberculosis, and measles, but little can be done to contain them. Last week in two nearby towns 15 people died of starvation or disease at MSF's feeding centres in one morning, said Sandol Abdullai, MSF's supervisor in the district. Of the 606 children at Golweyn, 570 are suffering from malnutrition. Last week 20 children died in the orphanage, all of them ~. h too old to receive the high protein food. Of _ _ the 200 who have lived in the orphanage in the past four months, only 30 are still alive. [AFRICA r . "We are already at the stage where people are dying like flies," said Patrick Vial, MSF's general coordinator in Mogadishu. "One _ fifth of the population could die within six - 7 t i ~~~months. One tenth of the children at our | -ETH1PIA feeding centres have died. It's worse than /ssv -; / t _11 ~~~~Ethiopia in 1985."
+ 1__ \ ~~~~~Worsening
- - ~~J jt__ -0 ; ; - -t ^ ^ -;* I I; .- j _ -;; KENYA -9 l-,
KENYicA
hunger in Golweyn and the ~surrounding towns stemmed from a conflict ~lasting a week in the main town of Merka, ~~~~~where the ICRC has centred its food opera~~~tion for the district. Two rival clans, into l
h
litd
ii
broke out last year, are vying to control the BMJ VOLUME 305
15 AUGUST 1992
.....
distribution of food and security in the town. Control gives access to the food, which is stolen and sold by the clan. Because of this dispute Merka was closed and distribution of food to surrounding towns halted. As a result at least 150 people died of starvation at camps in the district in four days, a measure of how total is Somalia's reliance on food aid. Similar political confficts are the main determinant of whether food reaches starving people or not. "The vital things-sanitation, water, and a good diet-plus shelter are missing in Somalia," said Gay Harper, a nurse who has worked in Mogadishu with Save the Children Fund for the past year. "There are also malnourished pregnant women who later can't breast feed. Projects which started as a primary health care system have quickly turned into emergency feeding because ofthe malnutrition."-MARK HUBAND, freelance journalist, Mogadishu Save the Children Fund urgently needs donations and can be contacted through its donations department at Save the
Childrenl Fund, 17 Grove Lane,
take credit card donations. 383
Committee finishes
Headlines t______sieving_______Zeitlin_____
to see Dr Michael Harrison, the regional
medical officer at West Health Authority, who Midlands was Dr Regional Zeitlin's employer, on 30 Octob'er.
Dr Harrison told the deputation that they would need to make a formal complaint in writing ifhe was to take . . any action. As a result, Mrs Price wrote him a A A health authority chalrwoman denied last letter dated 13 November 1990, which conweek that she had plotted with colleagues to centrated on Dr Zeitlin's handling of the get rid of a consultant haematologsit who had report on nurse staffing levels. claimed that patients were suffering because On 9 November Dr Zeitlin herself met of low nurse staffing levels, with Dr Harrison, together with her BMA Dawn Price, who chairs Bromsgrove and representative, about her work. The question Redditch Health Authority, was givig of her leaving was raised at the end of this committee of the professional eng . Departent oof Healh te disissal Health on the dismissal Department to the health authority's lawyers, According of Dr Helen Zeitlin, formerly consultant Dr Zeitlin said that she was redundant and Suing for holiday tummy: Under haematologist at the Alexandra Hospital n that she would like to be made redundant, European Community law tourists may be able to claim damages if they Reddtch.provided that she was given a large lump On 28 February 1991 Dr Zeitlin was given sum. However, Dr Zeitlin's counsel claimed can prove that ailments contracted on less than a day's notice to leave the hospital. that she had said she would resign on agreed holiday are due to dirty water. Their The reason given by the authority was that terms-these being that she would receive a success will hinge on a test case backed her job had become redundant, but she payment of two to three years' salary, a by Friends of the Earth against the British govermnent, which has failed believes that it was because she spoke out suggestion made by her BMA representative. against the hospital becoming a trust and to make Thames Water bring drinking Mr Hendy asked in his summing up water to t a'document publicised detailing shortfalls in if.. redundancy was genuinely thought towhy, p a water to EC EC standards. upu be nursing care at the hospita. *what Dr Zeitlin was seeking, did the health Dr Zeitlin, who had been a consultant at authority not initiate steps to take this Health issues in American election: Redditch since 1986, is appealig agaist her course until the first week of January, two -President George Bush and Mr Bill dismissal to Virgina Bottomley, secretary of months after her meeting with Dr Harrison? Clinton both contend that their health state for health. The committee hearing, care proposals will not require tax care Edward Bailey, counsel for the regional which was chaired by Dr Michael Abrams, health authority, said in his summing up that increases. Both would make it easier for businesses to buy insurance for deputy chief medical officer at the Depart- Dr Zeitlin herself had "in the past made it ment of Health, was the first to be held in plain that she was underemployed. A repeople with existing medical conditions. Mr Bush is proposing vouchers public, at Dr Zeitlin s request. Its recoi- dundancy situation existed irrespective of mendations, together with the advice of the how much money was to change hands," he for the poor and tax deductions for the department's lawyers,- will go to Mrs said. The regional management executive middle classes. Mr Clinton would h 1th care for f ~~Bottomley decision. Bottoe for herher dcsion. health every guaranteeuarantee had not been prepared to endorse a payment A t h l w American. of three years' pay, as had been suggested by Mrs representing Dr .Zeitlin, D Z . accused . ,. Price of ~~~~~~Dr Zeitlin's BBMA repDresentative. But if the planning with colleagues how to dispatch Dr money had been paid, Mr Bush stays firm on abortion: he said, "we would not Zeitln from her job. Mrs Price dened the be here today."-SHARON KINGMAN, medical President George Bush assured a large Catholic audience in New York last go journalist London She told the comnimittee that there had been week that he will not abandon his problems with the relationship between Dr antiabortion position, even though it Zeitlin and her consultant colleague Dr Daisy may cost him votes. He has vetoed Obeid. The Department of Health committee legislation that would have allowed heard that Mrs Price and two colleagues went federal funding of abortion in some
evidence
Oregon plan rejected: President George Bush has rejected Oregon's plan to ration health care after publicly praising it. According to administration lawyers, the plan violates the provisions of the recently enacted Americans with Disabilities Act, which stipulates that the disabled are entitled to equal access to all government services. Oregon's plan with its inherent rationing contravenes this.
md
willhnotchiredbyrequireel btax
French blood trial
cases and called the country's abortion rate "a national tragedy."
Private care often no faster: Paying, does not always guarantee faster health Idoes not II always guarantee treatment, according to a survey survey con-. contreatment, accorcding te Consumers' Associationte ducted by the ers'
by0 Cnsume
Association
_
cope Somalia is now the only place in the world where the entire 7-3 million population is reliant on food supplied by aid agencies, according to David Shearer of Save the Children Fund's office there. Relief workers reckon that over 500 000 people are being fed in the capital, Mogadishu, with over 200 new refugees arriving in the city eve day. The International Committee of the. Red Cross
(ICRC)estiniates that throughout the country Ib5 million people are close to starvation.
Since January this year the ICRC has been feeding 700000 people throughout the
country and has allotted $140 milion-one third of its annual aid budget-to its relief.l operation in Somalia. It is the biggest operation in the ICRC's history and is faced with enormous security problems and the theft of emergency food by armed gunmen. Camps supplied with food by the ICRC, many of which are run by the French aid agency Medecins Sans Frontieres (MSF), have sufficient food only for children under 5 years old. They receive three meals a day of high protein Unimix. Older children and adults receive only one meal a day, of rice or' lentils. While the older children in the camps_ are dying of starvation at a rate of up to 20 a day, younger children are dying of malaria,diarrhoea, dysentery, and measles at a similar rate. Up to 15 people a day are dying at Golweyn camp, a fly blown, deathly home to 3970 people along the coast south of Mogadishu. The death rate is worse in camps in other parts of the country, particularly in towns facing an even greater concentration of refugees, such as Baidoa. MSF nurses in Golweyn say that they have enough -medicine to treat at most 40 people
A.
Z
Somalia: one fifth of the population could be dead by Christmas
with malaria or diarrhoea. There are epidemics of pneumonia, tuberculosis, and measles, but little can be done to contain them. Last week in two nearby towns 15 people died of starvation or disease at MSF's feeding centres in one morning, said Sandol Abdullai, MSF's supervisor in the district. Of the 606 children at Golweyn, 570 are suffering from malnutrition. Last week 20 children died in the orphanage, all of them ~. h too old to receive the high protein food. Of _ _ the 200 who have lived in the orphanage in the past four months, only 30 are still alive. [AFRICA r . "We are already at the stage where people are dying like flies," said Patrick Vial, MSF's general coordinator in Mogadishu. "One _ fifth of the population could die within six - 7 t i ~~~months. One tenth of the children at our | -ETH1PIA feeding centres have died. It's worse than /ssv -; / t _11 ~~~~Ethiopia in 1985."
+ 1__ \ ~~~~~Worsening
- - ~~J jt__ -0 ; ; - -t ^ ^ -;* I I; .- j _ -;; KENYA -9 l-,
KENYicA
hunger in Golweyn and the ~surrounding towns stemmed from a conflict ~lasting a week in the main town of Merka, ~~~~~where the ICRC has centred its food opera~~~tion for the district. Two rival clans, into l
h
litd
ii
broke out last year, are vying to control the BMJ VOLUME 305
15 AUGUST 1992
.....
distribution of food and security in the town. Control gives access to the food, which is stolen and sold by the clan. Because of this dispute Merka was closed and distribution of food to surrounding towns halted. As a result at least 150 people died of starvation at camps in the district in four days, a measure of how total is Somalia's reliance on food aid. Similar political confficts are the main determinant of whether food reaches starving people or not. "The vital things-sanitation, water, and a good diet-plus shelter are missing in Somalia," said Gay Harper, a nurse who has worked in Mogadishu with Save the Children Fund for the past year. "There are also malnourished pregnant women who later can't breast feed. Projects which started as a primary health care system have quickly turned into emergency feeding because ofthe malnutrition."-MARK HUBAND, freelance journalist, Mogadishu Save the Children Fund urgently needs donations and can be contacted through its donations department at Save the
Childrenl Fund, 17 Grove Lane,
take credit card donations. 383
Committee finishes
Headlines t______sieving_______Zeitlin_____
to see Dr Michael Harrison, the regional
medical officer at West Health Authority, who Midlands was Dr Regional Zeitlin's employer, on 30 Octob'er.
Dr Harrison told the deputation that they would need to make a formal complaint in writing ifhe was to take . . any action. As a result, Mrs Price wrote him a A A health authority chalrwoman denied last letter dated 13 November 1990, which conweek that she had plotted with colleagues to centrated on Dr Zeitlin's handling of the get rid of a consultant haematologsit who had report on nurse staffing levels. claimed that patients were suffering because On 9 November Dr Zeitlin herself met of low nurse staffing levels, with Dr Harrison, together with her BMA Dawn Price, who chairs Bromsgrove and representative, about her work. The question Redditch Health Authority, was givig of her leaving was raised at the end of this committee of the professional eng . Departent oof Healh te disissal Health on the dismissal Department to the health authority's lawyers, According of Dr Helen Zeitlin, formerly consultant Dr Zeitlin said that she was redundant and Suing for holiday tummy: Under haematologist at the Alexandra Hospital n that she would like to be made redundant, European Community law tourists may be able to claim damages if they Reddtch.provided that she was given a large lump On 28 February 1991 Dr Zeitlin was given sum. However, Dr Zeitlin's counsel claimed can prove that ailments contracted on less than a day's notice to leave the hospital. that she had said she would resign on agreed holiday are due to dirty water. Their The reason given by the authority was that terms-these being that she would receive a success will hinge on a test case backed her job had become redundant, but she payment of two to three years' salary, a by Friends of the Earth against the British govermnent, which has failed believes that it was because she spoke out suggestion made by her BMA representative. against the hospital becoming a trust and to make Thames Water bring drinking Mr Hendy asked in his summing up water to t a'document publicised detailing shortfalls in if.. redundancy was genuinely thought towhy, p a water to EC EC standards. upu be nursing care at the hospita. *what Dr Zeitlin was seeking, did the health Dr Zeitlin, who had been a consultant at authority not initiate steps to take this Health issues in American election: Redditch since 1986, is appealig agaist her course until the first week of January, two -President George Bush and Mr Bill dismissal to Virgina Bottomley, secretary of months after her meeting with Dr Harrison? Clinton both contend that their health state for health. The committee hearing, care proposals will not require tax care Edward Bailey, counsel for the regional which was chaired by Dr Michael Abrams, health authority, said in his summing up that increases. Both would make it easier for businesses to buy insurance for deputy chief medical officer at the Depart- Dr Zeitlin herself had "in the past made it ment of Health, was the first to be held in plain that she was underemployed. A repeople with existing medical conditions. Mr Bush is proposing vouchers public, at Dr Zeitlin s request. Its recoi- dundancy situation existed irrespective of mendations, together with the advice of the how much money was to change hands," he for the poor and tax deductions for the department's lawyers,- will go to Mrs said. The regional management executive middle classes. Mr Clinton would h 1th care for f ~~Bottomley decision. Bottoe for herher dcsion. health every guaranteeuarantee had not been prepared to endorse a payment A t h l w American. of three years' pay, as had been suggested by Mrs representing Dr .Zeitlin, D Z . accused . ,. Price of ~~~~~~Dr Zeitlin's BBMA repDresentative. But if the planning with colleagues how to dispatch Dr money had been paid, Mr Bush stays firm on abortion: he said, "we would not Zeitln from her job. Mrs Price dened the be here today."-SHARON KINGMAN, medical President George Bush assured a large Catholic audience in New York last go journalist London She told the comnimittee that there had been week that he will not abandon his problems with the relationship between Dr antiabortion position, even though it Zeitlin and her consultant colleague Dr Daisy may cost him votes. He has vetoed Obeid. The Department of Health committee legislation that would have allowed heard that Mrs Price and two colleagues went federal funding of abortion in some
evidence
Oregon plan rejected: President George Bush has rejected Oregon's plan to ration health care after publicly praising it. According to administration lawyers, the plan violates the provisions of the recently enacted Americans with Disabilities Act, which stipulates that the disabled are entitled to equal access to all government services. Oregon's plan with its inherent rationing contravenes this.
md
willhnotchiredbyrequireel btax
French blood trial
cases and called the country's abortion rate "a national tragedy."
Private care often no faster: Paying, does not always guarantee faster health Idoes not II always guarantee treatment, according to a survey survey con-. contreatment, accorcding te Consumers' Associationte ducted by the ers'
by0 Cnsume
Association
