The main risk factors for refugee populations are (Desenclos et al., 1989):
• Large refugee populations dependent entirely on external food aid for long periods.
• Absence of, or greatly reduced, access to a local market and/or no purchasing power to buy fresh fruits and vegetables or animal products (milk).
• Limited possibilities for growing vegetables due to scarce land and water resources.
• Overcrowded camps where infectious diseases spread quickly, thereby increasing vitamin C requirements.
• Increased risk among older persons and among women of reproductive age, especially if pregnant.
• The dry season, with the highest incidences of scurvy usually occurring during and immediately thereafter, e.g. as in Eastern Sudan and Northern Somalia.