The main approaches to preventing the onset of scurvy in emergency situations affecting large populations are as follows:
• Providing food rations containing adequate amounts of vitamin C by increasing the variety of the food basket and regularly including fresh fruit and vegetables.
• Providing sufficient food in the ration to allow refugees to sell the surplus for other purposes. It has been found that refugees with the highest value of rations received did, in fact, consume the greatest amounts of fruit and vegetables (Hansch, 1992).
• Fortifying current relief commodities with vitamin C, e.g. providing fortified blended cereal-legume food in the general ration in sufficient amounts to cover vitamin C requirements.
• Providing vitamin C supplements in the form of tablets at least weekly.
• Encouraging and facilitating, where feasible, cultivation by refugees of fruits and vegetables in home gardens.
Several of these options have been tried in various refugee settings with varying degrees of success (Berry-Koch et al., 1990). The advantages, disadvantages and feasibility of each approach are discussed below.