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close this bookScurvy and its Prevention and Control in Major Emergencies (WHO; 1999; 70 pages)
View the documentAcknowledgements
View the documentScurvy: definition
open this folder and view contentsIntroduction
open this folder and view contentsScurvy
open this folder and view contentsVitamin C
open this folder and view contentsRecommended Daily Allowance (RDA)
open this folder and view contentsSources of vitamin C
close this folderStrategies to prevent scurvy in large refugee populations
View the documentBackground
close this folderMain approaches
open this folder and view contentsDistribution of fresh foods
close this folderExchange of rations/extra rations
View the documentAdvantages
View the documentDisadvantages
View the documentFeasibility
open this folder and view contentsFortification of relief food
View the documentFortification of cereals
View the documentFortification of sugar
open this folder and view contentsFortification of blended cereal-legume foods (blended foods)
open this folder and view contentsSupplementation
open this folder and view contentsPromotion of kitchen gardens
open this folder and view contentsOther options
View the documentCosts
open this folder and view contentsConclusions and recommendations
View the documentReferences
View the documentAnnex 1
View the documentAnnex 2
View the documentAnnex 3
View the documentBack Cover

Since food aid, which provides very little vitamin C, has not been helpful in preventing or controlling scurvy, especially in Africa, the main source of this vitamin has been local markets. Experience from around the world repeatedly confirms that refugees trade donated foods in a way that significantly improves their overall diet. Large amounts of some foods are sold, whether inside or outside refugee camps. Some sales are made by individuals while others are made by households or even by camp-wide committees. For example, Hansch (1992) reported that 10% of soy-blended flours were sold to outsiders and 60% swapped within camps. The flour was also fed to swine and poultry.

Donors often feel that people who sell relief foods do not need them. In fact, it is the poorest, most desperate refugees who have to sell some part of their rations. In contrast, relatively well-off refugees have other sources of income and are thus afforded the luxury of being able to consume their food rations (Mason et al., 1992).

As the 1988 conference, Nutrition in Times of Disaster, concluded:

Attempts to manage the problem [of micronutrients] have not been successful. The obvious solution is either to provide a nutritionally full and adequate ration or to permit trade that will aid recipients to obtain other foods to make up an adequate ration. Trading for spices and condiments should be permitted to break the monotony of the diet and to improve the palatability of donated foods.

Referring to Mozambique, Wilson (1989) reported that:

Refugees exchange food rations as part of their quest to improve the quality of their ration: to turn several dried commodities into a diet that is physiologically and culturally acceptable, and biochemically balanced. Generally, this need undermines the calorific, and sometimes even the protein and fat content of the diet, due to poor exchange rates. However, it remains essential to understand refugee exchanges in the light of an absolute requirement to make up for items missing in the diet, such as fresh vegetables. In all camps and in the self-settled areas one of the main means by which refugees obtain green vegetables is through exchange of food aid, generally flour...

Christensen (1982; 1984) noted that refugees in Pakistan, Mexico and Somalia obtained access, by trading, for other types of food such as fresh fruits and vegetables.

In conclusion, refugees themselves often solve their micronutrient problems by selling food to enhance dietary variety. Problems have arisen where refugees do not have access to markets and are entirely dependent on food aid, particularly when the general ration is substantially short of requirements.

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