Multi Sectoral Joint Assessment Mission (JAM) of Senegalese Refugees in the Foni Districts of The Gambia July 2013
Data collected: November 2012
Authors: Gambia Commission for Refugees, National Nutrition Agency, Ministry of Health and Social Welfare, Gambia Bureau of Statistics, Department of Water Resources, UN High Commissioner for Refugees, World Food Programme, UN Children’s Fund, World Health Organization, Gambia Red Cross Society, Gambia Food and Nutrition Association and Concern Universal
Acknowledgements
We would like to acknowledge all persons who made this assessment and its report possible, especially the heads of the two lead agencies: the UNHCR Head of Office, Mr. Sekou K. Saho, and the WFP Country Director, Ms Vitoria Ginja. We would like to thank the WFP lead consultant, Mr. Darko Petrovic, for the great amount of time and energy he has devoted to the work of the 2012 JAM assessment, especially the realisation of this report. We would like to acknowledge the members of the Technical Working Group (TWG) for their continuous contribution to the work of this assessment, all listed under Annex D. Particular acknowledgement and appreciation goes to all the enumerators, field workers, team leaders and data processors for their tireless efforts and sacrifice in collecting quality data in a challenging, fast paced and resource limited environment. Special acknowledgement goes to the refugee and host families, refugee leaders, community development workers and community leaders for their patience, commitment and kindness in creating a work friendly environment and enabling a smooth realisation of this assessment. The 2012 JAM has been made possible by the collaborative effort of 12 partners from the Government of The Gambia, United Nations System and NGO community in the country, namely: Gambia Commission for Refugees, National Nutrition Agency, Ministry of Health and Social Welfare, Gambia Bureau of Statistics, Department of Water Resources, UN High Commissioner for Refugees, World Food Programme, UN Children’s Fund, World Health Organization, Gambia Red Cross Society, Gambia Food and Nutrition Association and Concern Universal. A special tribute is extended in honour of Mr. Katim Nget, Programme Manager at the Gambia Red Cross Society, who passed away on Saturday, 27 July 2013 shortly before the publication of this report. Katim has been a true professional and devout humanitarian worker who was passionately committed to the plight of Casamance Refugees throughout the period of 2006 – 2013. May his soul rest in eternal peace.
2 Table of Contents Page
Acknowledgements 2
Acronyms 4
List of Tables and Charts 5
Executive Summary 7
1. Introduction 12
2. Background and Rationale 14
3. Methodology 16
4. Main Findings 19
Section 1: Demography 19
Section 2: Food Security 26
a) Vulnerability and External Shocks 27
b) Food Availability, Food Access, Food Utilization and Coping 31
c) Self-Reliance 40
Section 3: Health and Nutrition 51
Section 4: Water and Sanitation 60
Section 5: Shelter 65
Section 6: Education 70
Section 7: Protection 73
5. References 77
Annex A – Detailed Tables and Charts
Annex B – Draft Joint Plan of Action
Annex C – Terms of Reference
Annex D – Members of Technical Working Group and Assessment Teams
Annex E – Questionnaires
3 Acronyms
BMI – Body Mass Index CFSVA – Comprehensive Food Security and Vulnerability Assessment CRR – Central River Region EU – European Union FAO – Food and Agriculture Organization GAFNA – The Gambia Food and Nutrition Security Association GAM – Global Acute Malnutrition GBOS – Gambia Bureau of Statistics GFD – General Food Distribution GRCS – Gambia Red Cross Society GNNSP – The Gambia National Nutrition Surveillance Programme LRR – Lower River Region MAM – Moderate Acute Malnutrition MFDC – Movement des Forces Democratiques de Casamance MUAC – Mid-Upper Arm Circumference NaNA – National Nutrition Agency NBR – North Bank Region NDMA – National Disaster Management Agency OCHA – Office for the Coordination of Humanitarian Affairs SAM – Severe Acute Malnutrition SGBV – Sexual and Gender based Violence SMART – Standard Monitoring and Relief in Transitions TWG – Technical Working Group UNFPA – United Nations Population Fund UNHCR – United Nations High Commissioner for Refugees UNICEF – United Nations Children’s Fund URR – Upper River Region USAID – United States Agency for International Development VAM – Vulnerability Analysis and Mapping VDC – Village Development Committee WCR – West Coast Region WFP – World Food Programme WHO – World Health Organization
4 List of Tables and Charts
Section 1: Demography Table 1: Number and distribution of refugee households per district, comparison of planning and actual figures
Table 2: Number and distribution of refugee population per district, comparison of planning and actual figures
Figure 1: Distribution of registered refugee population per rural districts Figure 2: Refugee households, actual presence vs. expected Figure 3: Refugee population, actual presence vs. expected Figure 4: Village distribution of new refugee population, actual presence vs. expected
Figure 5: Share of refugee population / year of arrival
Figure 6: Gender of refugee population / year of arrival Figure 7: Gender of refugee population / age group Figure 8: Number and distribution of refugee population / age group Figure 9: Level of education of household head
Section 2: Food Security a) Vulnerability and External Shocks Map 1: Proportion of district population suffering from moderate or severe food insecurity, January 2011 Figure 10: Food Security Classification Map 2: Districts seriously affected by drop in crop production in 2011/2012, January 2012 Figure 11: Availability of household food stocks within 25 districts seriously affected by 2011 crop failure, March 2012 Figure 12: Development of rice prices in The Gambia (2008 - 2012) b) Food Availability, Food Access, Food Utilization and Coping Figure 13: Proportion of annual domestic cereal requirements covered by national cereal production Figure 14: Period of availability of self-grown cereal stocks for own consumption following harvest in 2011/12 Figure 15: Annual refugee household income Figure 16: Proportion of refugee population engaged in income generation, as per primary economic activity Figure 17: Share of households who devote share of expenditure to food Figure 18: Classification according to Food Consumption Groups Figure 19: Dietary Diversity Figure 20: Dietary Intake by consumption frequency of food groups with particular nutritional values Figure 21: Type of coping strategies employed c) Self-Reliance Box 1: Summary of key shortcomings of 2009 FFW activities
Box 2: Snapshot of other livelihood interventions and type of support provided
Figure 22: Access and ownership of land for livelihoods activities
Figure 23: Share of households engaged in horticulture and/or crop production per number of fields under cultivation
5 Figure 24: Ownership of livestock by district
Figure 25: Ownership of livestock by type of animal
Figure 26: Proportion of households owning livestock, by type and number of animals owned
Figure 27: Ownership of productive assets and other household items
Section 3: Health and Nutrition
Figure 28: Trends of acute Malnutrition in The Gambia, 2007 - 2012 Figure 29: Prevalence of Global Acute Malnutrition (GAM), wasting among children aged 6-59 months Figure 30: Prevalence of Stunting, children aged 6 - 59 months (for WCR and Gambia aged 0 – 59 months) Figure 31: Prevalence of underweight, children aged 6 - 59 months (for WCR and Gambia aged 0 – 59 months) Figure 32: Rate of coverage of major preventive health interventions, 2007 - 2008 Figure 33: Women access to disease preventive services, 2012 Figure 34: Pregnancy status of women in reproductive age Figure 35: Proportion of infants and children undergoing breast and complementary feeding, 2007 - 2008 Figure 36: Hand washing practices of refugee women in reproductive age, 2012 Figure 37: Incidence of infections and disease among refugee children aged 6-59, 2007 – 2008 and 2012 Figure 38: Access to basic health services Figure 39: Level of education of refugee mothers, 2012
Section 4: Water and Sanitation Figure 40: Does the water source meet your daily household needs for water? (Cooking, drinking and washing) Figure 41: Main reasons why water needs are unmet Figure 42: Proportion of households with unprotected water sources, 2007-12 Figure 43: Type of water sources used Figure 44: Type of toilet facility used by refugee households Figure 45: Main source of lightning for households
Section 5: Shelter Figure 46: Trend in tenure status of refugee households, 2008 – 2012 Figure 47: Tenure status in 2012 Figure 48: Proportion of households with access to and ownership of land for housing Figure 49: Major material of the wall Figure 50: Major material of the floor Figure 51: Major material of the roof
Section 6: Education Figure 52: Breakdown of refugee children in- and out of school, per district (2012)
Section 7: Protection Figure 53: Share of ID Coverage / arrival year Figure 54: Land access and ownership
6 Executive Summary In 2011, following deficient, erratic and unevenly distributed rainfall The Gambia experienced a severe crop failure with harvest losses averaging 60-90% in most seriously affected areas, while putting at existential risk small-holder farmers and vulnerable households throughout the country. At a scale unseen since 1980, it triggered an emergency declaration and an appeal for international assistance by the Government of The Gambia in March 2012. The Government, UN agencies and NGOs present in the country immediately mobilized emergency assistance in the form of food and non-food support to be provided during the months of May – November 2012. Even though nearly 230,000 people benefited throughout most of the districts seriously affected by the crop failure, assistance was neither specifically directed to Casamance refugees nor were logistical arrangements put in place that would enable the refugee households to access relevant assistance schemes, such as national food and seed distributions or targeted nutrition interventions, despite identical exposure to food insecurity and a comparatively higher vulnerability profile. The fifth Joint Assessment Mission (JAM) of Casamance refugees in The Gambia took place in the context of the then on-going emergency operation. With data collection conducted in November 2012 it was the first JAM that was undertaken since November 2009, which at the time resulted in the phase out of food based assistance to refugee households and the gradual introduction of livelihood based support in favour of their increased self-reliance. The overall objectives of this JAM were to assess the food security and vulnerability situation of the Casamance refugees registered in the rural districts of Foni Berefet, Foni Bintang and Foni Kansala and analyse the extent to which the drought and the resultant crop failure have led to food insecurity and undermined livelihood projects implemented since 2010. The assessment is also meant to help determine the appropriate response framework for 2013-2014 and provide a solid basis for resource mobilisation efforts by the Government and partners in the future. The findings of this JAM are based on a comprehensive household survey on food security and nutrition and related vulnerability indicators, an extensive review of secondary sources compiled by UNHCR, WFP and other partners as well as first-hand information gathered through focus group discussions and key informant interviews in the field. Contrary to previous assessments, the current JAM laid strong emphasis on the collection of primary data from a representative sample of refugee households, to address the chronic lack of reliable and up-to-date information on the food security and nutrition situation of Casamance refugees. Primary data has been triangulated with information obtained from available secondary sources, including the past JAM reports. This assessment has been conducted in accordance with the WFP JAM Report Quality Monitoring Matrix. Summary of main findings Demography: The number of refugees in the registration database often does not match with the actual number of refugees living in the respective settlements, despite major improvements in household registration methodology. The current JAM found that of the 1,075 households expected in 52 communities under
7 assessment, only 496 households have been still present, representing a drop of nearly 54%. Out of the total refugee population of 7,202 expected in these households, household listing could establish the presence of 4,793 people (67% of expected total). The spontaneous nature of refugee movement and the permeability of the Gambian-Senegalese border inhibit effective household tracking and the establishment of credible figures on the total refugee population. Based on the comprehensive village coverage, the average prevalence of household absenteeism and typical family size, the current assessment estimates a minimum of 5,600 people still living in Senegalese refugee households in the rural areas of The Gambia. The negative impact of the crop failure and the pursuit of livelihood opportunities seem to be the main reasons for refugee households to leave their community of registration in favour of a return to Casamance or a migration to other communities in The Gambia. Both migratory patterns remain currently unrecorded and hardly quantifiable. Food security: Only 16% of refugee households can be considered as food secure while 84% show some form of food insecurity and vulnerability. Nearly half of the households (45%) are able to meet only minimally adequate food consumption needs (2,100 kcal per person/day) without engaging in irreversible coping strategies that would undermine their livelihood base. The proportion of the refugee population experiencing moderate or severe food insecurity and/or engaging in damaging coping strategies is at alarming 39%. The high level of moderate and severe food insecurity among refugees can be explained by multiple factors, including constantly low food availability, highly constrained production capacity, endemic poverty and low asset ownership and the overall limited impact of food and livelihood interventions. External shocks that were experienced recently, such as a countrywide crop failure and rising food prices have played a pivotal role in exacerbating the refugee households’ level of vulnerability and undermining their food access and coping capacity. Household poverty among the refugees is high, endemic and reflective of low asset ownership and limited productive capacity, with household food production usually lasting less than three months. Income opportunities remain very limited for the majority of households who remain engaged primarily in agriculture based, low income or vulnerable employment, while the majority of households (57%) do not have access to credit / loans in times of need. More than every third household (38%) devotes 75% of their expenditure to food only, well above the national average (58% of expenditure devoted to food), reflecting the high state of moderate or severe food insecurity and a poor diversity of diet. Nearly half of refugee households have either poor (22%) or borderline (27%) food consumption, suggesting an inadequate or minimally adequate intake of food in terms of quantity, regularity and quality of diet. Refugee households have a primarily energy based diet with a high level of nutrient and vitamin deficiency prevalent across the entire refugee population, irrespective of overall food consumption. To remedy food deficiency at household level, almost 70% of the households are engaged in coping strategies that actually undermine their livelihood base and future productive capacity. The direct perception of food security among refugees is high, with 60-70% of households reporting that family members go to bed hungry or cannot be provided with sufficient food on a regular basis.
8 Self-Reliance Although ambitious in scope, asset creation and livelihood activities put in place between 2009 and 2012 had only a limited impact in enhancing refugee self-reliance and local integration. Chronic resource limitations, coupled with incomplete household coverage, delays in the implementation of several activities and insufficient coordination between key partners meant that the potential towards creating sustainable livelihoods was very limited and could hardly compensate for the phase out of food assistance or food based livelihood activities in 2009. The level of assistance geared towards the enhancement of crop production in the form of seeds, tools and particularly draught animals seems to be inadequate given over usage and high mortality of donkeys (15%), low overall farming potential (1-2 plots of less than a hectare per household) and limited quality and consumption availability of own produce (1-3 months of consumption) applicable to most refugee households. The self-reliance potential was further eroded by a crop failure and rising food prices in 2011- 2012. Access to land for farming is still not universal (85%) and access to land for horticulture activities is limited to slightly more than a third of refugee households (38%), while land ownership for productive activities continues to be an exception. Ownership of livestock is limited to only half of the refugee population, while only one out of five households owns draught animals commonly used for livelihood activities Refugees own very basic farming equipment with one out of four households being even without any tools that would enable a minimum of farming activity. Only about 15% of households own animal drawn carts or ploughs and seeders that could intensify farming activity. The vast majority of households barely possess any major household items, reflecting a high degree of poverty and very low coping potential in the event of external shocks. Main concerns raised by refugees in the rural areas are the unavailability of water and poor soil quality, limited access to medium or long term skills training and lack of access to grants or micro-credit to facilitate the establishment of income generating activities. Uncertainty over their long term status and integration opportunities seems to be a common concern.
Health and Nutrition: The nutrition situation of the refugee population has significantly deteriorated and calls for an urgent intervention. The prevalence of global acute malnutrition among children aged 6-59 months surpassed the WHO emergency threshold of 15% and stands at 18.1%, more than double the rates measured in the West Coast Region (7.5%) nearly at the same time. The level of stunting is ‘serious’ at 32.3% and the proportion of underweight children is rated ‘critical’ at 30.1%. The level of morbidity among children and women of reproductive age is high at 44.5% and 35.1% respectively, despite declining trends in incidence levels of single diseases, good overall access to health care facilities and steady progress in the provision of preventive health care services. The quality of hygiene among mothers and women of reproductive age is poor and a serious cause for concern regarding the potential of disease outbreak and poor food utilization. About 30% of women report hand washing with water only, after the use of a toilet or washing of child stools, with 28% of refugee households report unprotected wells as main source of drinking water.
9 Overall low food intake among half of the refugee households, poor dietary diversity in a majority of refugee households and generally inappropriate food preparation practices for infants point towards significant food and micronutrient deficiency among the refugee population and are the key explanatory factors behind high malnutrition rates of children under five years of age. Water and Sanitation: Overall water availability among the refugee population has not significantly improved over the past years and still remains a major challenge. Nearly a quarter of households (24.9%) report even unmet basic water needs for cooking, drinking and washing, while general water insufficiency continues to hamper productive activities (e.g. vegetable gardening, livestock rearing). Many of the refugee households (28%) continue to use open and unprotected wells as their main sources of drinking water, while most of households (76%) do not treat water in any way before consumption, thereby heightening the exposure to contamination and water borne diseases. One out of five refugee households show signs of heightened sanitary vulnerability through use of open pits or unavailability of any toilet within the compound. Shelter: The housing situation of the refugee households has improved only slightly compared to 2009 findings and much remains to be done to enhance their housing status and living conditions. Almost 40% of households are still dependent on external assistance for shelter, of which nearly half still lives under one roof with host families, while the other half makes use of separate housing structures provided by host families. Although land availability for housing is good and communities generally welcoming, over 30% of households still cannot access land to construct own houses and only 25% of households own land for housing, with much uncertainty remaining concerning the potential for local integration and their long- term establishment in The Gambia. Crowded housing conditions, very basic housing structures, limited ownership of furnishing and household assets and poor sanitation facilities are further indicators of endemic poverty, limited coping opportunities and heightened vulnerability of refugee households to food insecurity, particularly in the event of unexpected shocks. Education: Out of 1,170 refugee children identified 1,052 were registered within educational institutions, with refugee children usually making up between 3-16% of the total student population. The remaining 118 children (10% of total) were not registered in any school, the majority of which are from two communities in the Foni Kansala district and part of the new refugee influx. Despite regular provision of school-fees, a major factor identified as barring children from attending school is that either their families or the host families could not afford the overall cost of education, including the cost of educational supplies, school uniforms and in individual cases even the contributions to school meals. In 14 out of 37 schools (38%) the water and sanitary facilities were not adequate, with latrines and pumps being either in need of rehabilitation or were insufficient to cover the needs of the enrolled student population.
10 Protection Over the last four years the protection status of refugees has considerably improved with the introduction of the Refugee Act, the establishment of the Commission for Refugees and the near universal coverage of the population with identification documents, thereby enhancing their overall mobility, access to basic services and protection of fundamental human rights. However, local integration and the pursuit of sustainable livelihood activities remains hampered by incomplete access to and very limited ownership of land for housing, farming or gardening activities. Uncertainty over the continuation of land usage in the future seems to be an important barrier for refugees to agriculture based self-reliance activities and the improvement of their food security status.
Recommendations All sector based recommendations for action can be assessed at the end of each individual Section or under Annex B - Draft Joint Plan of Action.
11 1. Introduction
The fifth Joint Assessment Mission (JAM) of Casamance refugees in The Gambia took place in the context of a severe drought and crop failure not seen in The Gambia since 1980, triggering a countrywide emergency response by the Government and the humanitarian community based in the country. The assessment was the first to be conducted since November 2009, following the phase out of food based assistance and the gradual introduction of livelihood based support in favour of increased self-reliance of refugee households. The objectives of this JAM were to assess the food security and vulnerability situation of the Casamance refugees residing in the rural districts of Foni Berefet, Foni Bintang and Foni Kansala, and the extent to which the 2011 drought and the resultant crop failure have undermined livelihood projects implemented since 2009. The assessment is also meant to determine the appropriate response framework for 2013-2014 and to provide a solid basis for resource mobilisation efforts by the Government and partners in the future. More specifically, the assessment is aimed to: i) Review how far the recommendations from the last JAM (Dec. 2009) have been implemented ii) Assess the current food and nutrition security of refugees and analyse their livelihood strategies on potential for self-reliance, by evaluating their capacity to complement food assistance with other sources of food and income; re-assess their present coping strategies and their coping potential in the future; iii) Assess the future food and non-food needs of refugees (specific focus on women, children and people with disabilities), with a view to ensuring reasonable access to essential basic social services in the areas of health, education, nutrition, water, sanitation, shelter and other non- food related issues; food security, self-reliance and other livelihood issues at household level would be analysed by looking at the following factors; - expected refugees’ crop production and projections of gaps; - scope of existing income generating activities; - perspectives and development strategies of new income generating activities that may be undertaken by the refugees, aiming at addressing their basic needs; - extent to which refugees are integrated in the host communities. v) Evaluate the strategies pursued by the Government of The Gambia and its partners (including UNHCR, WFP and other partners) for the integration of refugees. Propose a strategy for partners to facilitate integration in The Gambia, while identifying possibilities to reinforce the collaboration with local partners and projects; vi) Liaise with the Government of The Gambia and identify possibilities to collaborate with partners to support a sustainable phase out strategy Scope of Study The scope of the current study deviated from approaches taken traditionally during JAM assessments by putting a strong emphasis on the collection of primary data from a representative sample of refugee
12 households and strengthening the collaborative effort between national and international stakeholders on the question of Casamance refugees in The Gambia. The approach taken is primarily addressing the chronic lack of reliable and up-to date information on the food security and self-reliance situation of Casamance refugees and the need for enabling evidence based decision making on the programming of future assistance to the affected populations. It is further aimed to benefit from the momentum evidenced recently in The Gambia in conducting multi-sectoral food security and emergency assessments, including through the availability of updated tools and trained staff. Limitations (content related) Although comprehensive in nature, the current assessment does not cover the refugee population living in the urban areas or intervention modalities related to their livelihoods and well-being. Similarly, it provides only limited quantifiable information on the migratory and settlement pattern of refugees in the rural areas. Although the survey includes a separate nutrition component, enabling an evaluation of wasting, stunting and undernutrition rates among children under-5 through anthropometric measurement, it was beyond the scope of this assessment to collect data on infant feeding and breastfeeding practices, micronutrients deficiency, care practices and workload of mothers and women in reproductive age.
13 2. Background and Rationale
The history of the Senegalese refugees in the Gambia dates back to 1982, when a rebel movement known as MFDC (Movement des Forces Democratiques de la Casamance) commenced an armed insurgency in Senegal’s southern region, known as Casamance between the borders of The Gambia and Guinea Bissau. The conflict is characterized by at times very heavy armed confrontations between the rebel movement and Senegal’s armed forces and resulted in refugees fleeing either into The Gambia or Guinea Bissau for the past 20 years, but with the majority returning home when tensions decreased. Following the permanent deployment of the Senegalese army along their side of the border with The Gambia and intensified fighting between the army and at least one of the MFDC groups in August 2006, a new wave of at least 6,500 Casamance refugees in need of assistance entered The Gambia. The number of refugees increased again by almost 1,500 through a new influx in 2011 and 2012, with the total number of refugees surpassing 8,000. For most of the time Senegalese families were received and housed by Gambian host families in nearly 70 communities, predominantly within the Foni districts of the West Coast Region. Refugee and host families share a common Jola ethnicity, language and culture and are often members of the same extended families. Throughout these years, UNHCR and partners, like WFP, the Gambia Red Cross Society and NGOs have been giving necessary support and care to the refugees and their host families in the form of food and non- food assistance, mainly through: general food distributions, food for work, provision of seeds and farming implements, construction, rehabilitation and maintenance of water sources and sanitation facilities and the provision of shelter materials. In October 2008, the Government of the Gambia passed the Refugees Act which paved the way to enhance the level of protection, mobility and access to basic services for refugee households and which established the Gambia Commission of Refugees, amongst others in charge of the issuance of refugee ID cards. In November 2009, after nearly 3 years of continuous support, food based assistance was phased out in favour of livelihood strategies, in order to reduce food aid dependency and increase households’ self- reliance opportunities. Since 2010, assistance was predominantly provided in the form of agricultural tools and implements as well as skills training in alternative income generation activities. Most of the Senegalese refugees and their host families are subsistence farmers growing identical crops and practising the same farming methods, with most of the refugee households obtaining access to land for farming and housing. In 2011, the Gambia experienced deficient and erratic rainfall, leading to a severe crop failure in most part of the country, including the refugee settlement areas. As agriculture in the Gambia is rain-fed and small- holder in nature, the crop failure had a severe impact on agriculture based livelihoods, compelling the Government of the Gambia to appeal for international assistance in support of the affected farming communities and to prevent hunger. Food assistance was eventually provided by the Government of The Gambia, the World Food Programme, The Gambia Red Cross Society and other partners to nearly 230,000 people in most of the seriously affected districts. The refugees were not specifically identified as direct beneficiaries for the food distributions and it is unclear to what extent they have benefited from the overall assistance package, including also seed distributions and nutrition interventions, even though they were equally affected by the drought and its
14 resultant crop failure and have the same livelihood profile as their host families. The drought and crop failure have also negatively affected the agriculture-based livelihood activities and refugees’ self-reliance. The current JAM was motivated by the heightened sense of vulnerability experienced by the majority of refugee households in 2012, particularly following the 2011 crop failure and the widespread inaccessibility to emergency assistance. It is the first JAM that has been undertaken since November 2009, with previous assessments being done on a nearly annual basis since September 2006. Due to a general lack of relevant secondary data on the vulnerability status of the refugee population, the large time lag since the previous assessment and the severity of the food security situation in 2011-2012 it was decided to conduct a comprehensive vulnerability assessment of the refugee population in the main rural areas, with a particular emphasis on food security, nutrition and livelihoods. Contrary to the previous assessments, which were predominantly rapid and qualitative in nature, the current JAM relies primarily on quantitative tools and methods and is multi-sectoral in scope, involving the active participation of a dozen of government institutions, UN agencies and NGO partners. In addition to food security and livelihoods, household data collection also includes a nutrition component that is based on anthropometric measurements of children under the age of 5 and covers relevant aspects of water and sanitation, shelter, education and protection. As data collection was community based, accounting for 86% of the registered rural refugee population, the current assessment can be considered as a food security and vulnerability baseline of the Casamance refugees living in the rural areas of The Gambia as at November 2012. As refugee households living in the urban areas are not within the scope of the current assessment, no qualified statements can be made on their demographic characteristics or food security and vulnerability status.
15 3. Methodology
Data Collection A joint collaboration of UNHCR/WFP/Government of The Gambia and other partners combined qualitative and quantitative data collection techniques, including primary data collection from nearly 500 refugee households in 52 communities. Primary data has been triangulated with information obtained from available secondary sources, including the previous JAM reports.1 Information was collected through a combination of: i) Collection of quantitative data from a representative sample of the refugee population through a detailed household questionnaire to determine their food security, nutrition and vulnerability situation and the effectiveness of employed livelihood strategies; ii) Desk review and analysis of relevant reports, in particular recent food security assessments and nutrition surveillance reports; iii) Focus group discussions with groups of refugees and hosts – conducted separately for men and women; iv) Key informant interviews in communities with refugee presence with personnel responsible for food, health, water, sanitation, education and community services, refugee leaders and community representatives; v) Meetings with national, regional and local authorities, NGOs, and other organizations working with refugees in food assistance and related programmes; vi) Meetings with Government, UNHCR and WFP staff, as well as with representatives from the donor community; Sampling Household data collection was initially conducted through a two stage sampling process, based on available refugee registration data from the 2010 verification exercise: Stage 1: Out of the 72 communities in which the refugee population was located, those communities were selected in which the refugee population made up at least 2% of the total refugee population, for both the old and new refugee populations separately. Data collection was initially intended in 14 communities which would host 72% of the total refugee population from the old influx and in 9 communities which would host 92% of the total refugee population from the most recent influx. The communities to be visited were all concentrated in the districts of Foni Berefet, Foni Bintang and Foni Kansala, in which 97% of the rural refugee population is registered. Stage 2: In each selected community household questionnaires were to be administered to every second listed refugee household which led to a combined sample of 551 refugee households, 468 households from the old and 83 from the new refugee caseload, making up nearly one-third (33%) of all expected refugee households in the Foni districts.
1 See reference list for available secondary information
16 Stage 3 (revision of sampling procedure during field work): During the first day of the data collection process household listing of the selected refugee communities revealed a significant drop of the number of present refugee households as against the expected records (on average by 50-80%), which led to an immediate revision and simplification of the sampling procedure. Given the high number of non-existent households at the time of data collection it was decided to instantly reallocate all the remaining communities which were outside the initial sampling frame to the field based teams and collect household data from all refugee households in all communities in which they were to be found, i.e. conduct a refugee census in the three Foni districts. In case of work related absenteeism, households would be re-visited the same or the following day. Field Work and Data Quality Data was collected on two separate components: 1) household food security and vulnerability questionnaire and 2) anthropometric measurement of children aged 6-59 months as well as health and care taking practices of mothers and women in reproductive age. A team was composed of 4 enumerators and one team leader. Three of the enumerators would collect household data on the first component (household food security and vulnerability) while the fourth enumerator, a designated health worker from the region or district, would collect anthropometric information jointly with the team-leader, the interviewed household and active community members. Tools used included a comprehensive 12 page household questionnaire for the first component, based on the CFSVA methodology but adapted to the refugee context in The Gambia, and for the second component a shortened version of the standard anthropometry questionnaire, used for the SMART nutrition survey in September 2012. Tools used for anthropometric measurement included one salter scale and shorr board per enumeration team but excluded MUAC. Since most of the enumerators and team leaders were experienced and familiar with the methodology from identical assessments in the recent past, a two day refresher training on the household forms and anthropometry tools, including pre-testing in sample refugee communities was conducted prior to data collection. Evaluation of the enumerators' work by the supervisors was a continuous exercise throughout the enumeration period. When the enumeration was over and the supervisor was satisfied with the completeness of the household questionnaires, he/she collected the completed questionnaires and filed them for eventual hand-over to data processing staff. During the enumeration quality control procedures stressed correct filling of the questionnaires, and through regular observation of a sample of interviews and consistency checks, ensured correct interpretation and presentation of questions. Areas of misunderstanding were immediately identified and clarified and remedial training was provided to those enumerators whose performance fell short of expectations. Data Entry and Analysis A coding scheme was developed to indicate how each identification item was to be coded. After the coding, questionnaires were entered into the computer using CSPro software package, which is compatible for data transfers and linkages with other statistical software e.g. the IBM SPSS Statistics and Microsoft Excel. The coding and data entry activity lasted for 10 days with the help of 6 data entry clerks and was entered into an SPSS database. An experienced data analyst from GBOS prepared the data entry screen, supervised the data entry process, cleaned and prepared the data set, and produced most summary tables for analysis.
17 Anthropometric measurements In the context of a severe crop failure and with the last comprehensive health and nutrition survey of the refugee population dating back to November 2008 it was necessary to include a quantitative nutrition component to the household survey to capture key nutrition indicators. All children aged 6-59 months (n=415) in households selected for interview were anthropometrically assessed with the goal to determine their nutritional status, based on the most recent WHO growth references for acute malnutrition, stunting and underweight using z-scores. It must be noted that this survey did not capture other important elements or indicators that were captured during the 2008 refugee nutrition and health survey, such as infant feeding practices, breastfeeding practices, micronutrients deficiencies, overweight, care practices and workload of mothers, thus leaving out a critical element of comparison between the 2008 and 2012 surveys. Although the findings point to a critical nutrition situation for the refugee children, it is worthwhile to recognize the limitations of the anthropometric data. The data set used was cleaned to levels acceptable to conduct a solid analysis but still issues of digit preference on height and weight measurements occurred while the standard deviation of the children in this survey is more than 1.2 which could be a problem in a less obvious emergency scenario. Analysis and Report Writing During consultations the Technical Working Group (TWG) developed an analysis plan to guide the report writing process. The different stakeholders were assigned areas of the report based on their comparative advantage and experience in the area. A VAM Consultant from WFP was responsible to coordinate the technical preparation of the assessment, provision of inputs and conduct the final editing of the report. The analysis plan was jointly scrutinized to ensure that the tables and figures that will form part of the report are relevant and consistent before being included in the final narrative. This report was circulated to members of the TWG for comments, after which it was revised and subject to a pre-validation exercise by the extended working group in July 2013. All stakeholders were availed with a new opportunity to critically look at the report with a view to further improving it both in terms of quality and content and provide written commentary during the final round of review of the consolidated draft. Limitations (process related) Limitations inherent in the report writing process include: late and intermittent availability of minimum logistical requirements such as Daily Service Allowance (DSA) and fuel coupons, preventing the enumeration teams to conduct data collection efficiently and without unnecessary delay; insufficient time allocated to training, testing and quality check of questionnaires, resulting in the need to ensure close supervision of several enumerators and re-train them during the data collection process; limited number of staff allocated to conduct anthropometry, resulting in overstretch of teams and the need for repeated quality control by team leaders; limited availability of and slow accessibility to secondary information, in particular on information relating to the implementation of recommendations from past JAMs
18
Section 1: Demography
Section 2: Food Security
a) Vulnerability and External Shocks b) Food Availability, Food Access, Food Utilization and Coping Strategies c) Self-Reliance
Section 3: Health and Nutrition
Section 4: Water and Sanitation
Section 5: Shelter
Section 6: Education
Section 7: Protection
19
RECAP
Findings: Recommendations: “More than 1,500 new additional refugees […] “Ensure that all refugees are registered, have their were not registered [in 2006] because they did not ID cards, or at least understand the registration understand the registration process. […] there process” (JAM 2009) were 870 newly registered refugees, during the “Update basic household demographics as the month of February 2008, bringing the total number current data is 2-3 years old and the numbers on to 7,290. […] These refugees have been in The the registration list/database do not reflect the Gambia also since late 2006 but did not partake in actual numbers on the ground” the initial registration exercises”
“Refugees move freely throughout the country” “Ensure VDC/Activity Coordinators keep an up-to (JAM 2008) date record of and regularly report on the number of refugee households that participate in FFW “The number of refugees on the registration schemes, which will help track the number of database often does not match the actual number present vs. absent refugees” (JAM 2009) of refugees living in the respective villages. […] It is
possible that this of refugees in temporary and fluid in nature […] but there are other accounts of refugees having gone back to the Casamance and returning to The Gambia for the food distribution. (JAM 2009)
CONTEXTUAL BACKGROUND Outdated refugee population figures have been a reason for concern raised repeatedly by previous assessments. It was commonplace that not all refugee households have been captured during initial registration exercises while frequent population movement made collected data outdated quickly, causing a mismatch in reporting and gaps in community based targeting of food and livelihood based interventions. Population and settlement data used for the current JAM are based on the UNHCR population database proGres. The database has been operational since 2012 and it includes a comprehensive set of personal information on the registered refugee population as established through their physical count and verification from 2010 until today. CURRENT SITUATION For programming purposes, the registered refugee population is Figure 1: Distribution of registered refugee subdivided into households who arrived to The Gambia in the population per rural district period of 2006 – 2010, amounting to 7,059 people in 1,043 3% households, and refugees who arrived to The Gambia only Foni Berefet 25% recently as part of the 2011 and 2012 influx. Refugees who 37% Foni Bintang arrived during the last two years amount to 1,266 people living in Foni Kansala 35% 210 households (15% of total refugee population), of which most Other Rural live in the district of Foni Kansala. The total number of refugees
20 registered in the rural areas of The Gambia amounts to 8,325 people living in 1,253 households, most of which are recorded in the districts of Foni Kansala (37% of refugee population), Foni Bintang (35%) and Foni Berefet (25%) with the remainder living mostly in Kombo Central and Kombo East (3%). Within these districts the refugee population is dispersed across 71 rural communities. Additional 671 refugees live in the Greater Banjul Area, according to the 2010 registration results, and are commonly referred as urban refugees. Since the current assessment did not cover the urban refugee population it can neither verify these population figures nor provide analysis of the food security and livelihood status of this sub-group. Data collection was conducted in 52 rural communities (73% of total) in Foni Berefet, Foni Bintang and Foni Kansala, with the initial expectation of covering 5,936 people (84% of total registered) in 865 households (83% of total registered). The assessment revealed that only a proportion of the population expected in the respective communities has been actually found residing there during the household listing and data collection process. Despite a comprehensive search in the targeted communities, enumeration teams were able to list only 496 households (46% of expected) representing a cumulative refugee population of 4,793 people living in the Foni districts (67% of expected population). Complete data sets were collected from 480 households with an average household size of 10 as against 8 for the country average. Under the condition that the same rate of household absenteeism and average family size applies in the remaining 19 communities for the non-assessed 17% of households, an additional 794 people are estimated to live in the rural area, bringing the estimated refugee population in the rural areas to 5,587 people.
Table 1: Number and distribution of refugee households per district, comparison of planning and actual figures Old Ref. New Ref. Total Ref. Total Ref. Presence District Communities Households Households Households Households Share (Expected) (Expected) (Expected) (Actual) Foni Berefet 13 325 0 325 119 37% Foni Bintang 29 424 0 424 166 39% Foni Kansala 22 249 210 459 211 46% Other Rural 7 45 0 45 n.a. Total 71 1,043 210 1,253 n.a. Total (assess) 52 865 210 1,075 496 46% Coverage % 73% 83% 100% 86%
Table 2: Number and distribution of refugee population per district, comparison of planning and actual figures District Communities Old Ref. New Ref. Total Ref. Total Ref. Pres. HH Population Population Population Population Share Size (Expected) (Expected) (Expected) (Actual) Foni Berefet 13 2,113 0 2,113 1,016 48% 9 Foni Bintang 29 2,917 0 2,917 1,859 64% 11 Foni Kansala 22 1,775 1,266 3,041 1,918 63% 9 Other Rural 7 254 0 254 n.a. n.a. Total 71 7,059 1,266 8,325 n.a. n.a. Total (assess) 52 5,936 1,266 7,202 4,793 67% 10 Coverage % 73% 84% 100% 87%
21 Figure 2: Refugee households, actual presence vs. expected Figure 3: Refugee population, actual presence vs. expected
211 Foni Kansala Foni Kansala 1,918 459 3,041 166 Foni Bintang Foni 1,859 424 Bintang 2,917 119 Foni Berefet Foni Berefet 1,016 325 2,113
0 100 200 300 400 500 600 700 0 1,000 2,000 3,000 4,000 5,000
Total Ref HH (Actual) Total Ref HH (Expected) Total Ref POP (Actual) Total Ref POP (Expected)
Interviews with remaining refugees and refugee representatives revealed that it was commonplace for households to return to Casamance given the recent crop failure and the households’ inability to sustain them. However, the statement could not be further qualified due to the spontaneous nature of refugee movement inhibiting any effective population monitoring and the porous nature of the border separating Senegal from The Gambia. Migration to other communities within the rural areas was also mentioned and could be partially verified through data collection during the current JAM. On the example of the refugee population from the 2011 and 2012 influx it could be observed that migration within one district is a normal occurrence. Refugee households registered in the communities of Bwiam and Buluntu and representing 1,266 people live scattered throughout the rest of the district in 12 different communities, currently accounting for only 659 people (52% of the new influx). It is unclear if the remainder of the population is living in rural communities not covered by the current assessment; has returned to Senegal or moved to the urban areas.
Figure 4: Village distribution of new refugee population in Foni Kansala, actual presence vs. expected
659 Total 1,266 Monom 41 Mandina 92 Karunor 31 Kappa 35 Actual Kantimba 50 Kanilai 38 Expected Kambong 6 Gikess Dando 110 Dobong 79 55 Bwiam 687 61 Buluntu 579 Bugingha 20 Ballen 7 Kanfenda 34 0 200 400 600 800 1,000 1,200 1,400
Migration to the Greater Banjul Area was also mentioned as a possible reason for household absenteeism, but it also remains unclear to what extent it is prevalent among the overall refugee population and how it impacts the wellbeing of households.
22 During the survey households were asked their date of arrival Figure 5: Refugee population / year of arrival in the Gambia. Of the surveyed households, the predominant number of 417 arrived in the period of 2006 – 2010 (86%). The 3% remainder of refugee households indicated either the year 11% 2011 (52 households) or 2012 (17) as their year of arrival. With a total population of 659 people, the refugee households from the 2011 – 2012 influx represent 14% of the total refugee 86% population from the Casamance remaining in The Gambia. However, almost 57% of the new refugee population and over 60% of the old refugee population could not be found at the expected place of residence, while in Foni Brefet none of the 425 refugees who arrived during the 2011/2012 influx was 2012 2011 2006-2010 found residing there any longer.2 Of the total population covered by the assessment (4,808 people) there is overall gender parity with 50.1% being males and 49.9 % being females. However, a different picture emerges when factoring in the households’ year of arrival or the age groups. Households tend to have a greater share of female members the more recent their arrival in The Gambia. In the households who arrived in 2012 and 2011, respectively over 59 % and 52 % of family members are females. The households who arrived earlier are slightly more male dominated (50.7% vs. 40.3%). When factoring in age, the refugee population is more male dominated the younger the age group. Almost 54% of children aged two or younger are males, with the same pattern applying to children aged 3 – 5 years (53% males) and 6 to 14 years (51 % males). The age cohort of 15 to 59 years, which represents almost half of the total refugee population, is however slightly female dominated (52 % females against 48 % males).
Figure 6: Gender of refugee population / year of arrival Figure 7: Gender of refugee population / age group
2012 <=2 3 to 5 2011 6 to 14 2006-2010 15 to 59 60+ Total Total 0% 25% 50% 75% 100% 0% 25% 50% 75% 100% Male Female Male Female
Overall, 4.6 % of the population covered had some kind have a condition, disease or disability that prevents them from working (4.5 % males / 4.7 % females). Generally, with age this condition tends to affect a higher share of the population with the prevalence being at 21 % among those aged 60 years or older, followed by the 18- 59 year olds (4.5 %) and the 12-17 year olds (2.3 %). The disability prevalence is at 2.1 % for children aged 5-11 years while for children under five it is 3.2 %.
2 A detailed demography overview and refugee population breakdown per district and community is available under: Annex A – Tables and Charts
23 Of the total population covered, 378 are children of 2 years of age or younger (8 % of total), 462 are aged 3 to 5 years (10 %) and 1,312 children are of school going age between 6 and 14 years (27 %). With 332 people almost 7 % are elderly of 60 years and above. Nearly half of the population is of working age between 15 and 59 years.
Figure 8: Number and distribution of refugee population / age group
Foni Kansala 168 205 556 918 139
Foni Bintang 128 172 474 967 139
Foni Berefet 82 85 282 439 54
0 200 400 600 800 1000 1200 1400 1600 1800 2000
<=2 3 to 5 6 to 14 15 to 59 60+
During the assessment 1175 children born in the last six years preceding the survey were covered, 154 of whom were not born in the Gambia (13.1%). Of the children born in the Gambia, 52% were issued with Gambian birth certificate as opposed to 48% that were not. The overall level of education and literacy within Figure 9: Level of education of household head the household is low. On the whole, 70% of household heads have no formal education 100% 91.7% while only 14.3% of household heads attained 80% 65.7% primary and 12.6% secondary level of 60% education. Lack of formal education is 40% negatively skewed towards female heads of 16.3% 20% 13.9% households (91.7%) compared to their male 3.3% 5.0% 4.1% 0.0% counterparts (65.7%). Only 3.3% of female 0% No formal Primary Secondary Higher household heads have attained primary education education, as opposed to 16.3% of their male Male Female counterparts. It has been further established that of the household heads who have no formal education, only 8.4% are minimally literate, i.e. they could read and write a simple message in any language, while this proportion stands at 91.6% for those who have attained the primary education level. CONCLUSION A mismatch between figures of the registered refugee population and households living in designated areas has been identified as a major problem during past assessments and remains as such to date, despite significant improvements in household registration methodology and recording. Population figures recorded during the official registration process mostly do not match with those found in the field during field monitoring or periodical assessments while inconsistencies have been observed between different reports when it comes to total refugee population figures.
24 The current JAM found that of the 1,075 households expected in 52 communities that were assessed, only 496 households have been still present, representing a drop of nearly 54%. Out of the total refugee population of 7,202 expected in these households, household listing could establish the presence of 4,793 people (67% of expected total).
Credible figures on the refugee population actually living in the Fonis are hard to establish due to the spontaneous nature of refugee movement inhibiting any effective population monitoring and the porous nature of the border separating Senegal from The Gambia. Based on the comprehensive village coverage, the prevalence of household absenteeism and average family size, the current assessment estimates a minimum of 5,600 people living in Senegalese refugee households in the rural areas of The Gambia.
Refugee households present in the communities and refugee leaders clarified that most of households who left the communities, have done so given the limited livelihood opportunities available and the difficult living conditions experienced, particularly following the 2011 crop failure. The return to Casamance and migration to other communities within the West Coast Region have been mentioned as primary destinations but no details could be established as to the magnitude of trans-boundary movements or the migration to urban areas.
RECOMMENDATIONS Population Assessment • Verifiy refugees’ current location and number and update database; include vulnerability profiling and analysis of migratory patterns
• Conduct a detailed assessment of the refugee population in the urban areas, to verify their population number, level of well-being and livelihood profile
25
Section 1: Demography
Section 2: Food Security
a) Vulnerability Background and External Shocks
b) Food Availability, Food Access, Food Utilization and Coping Strategies
c) Self-Reliance
Section 3: Health and Nutrition
Section 4: Water and Sanitation
Section 5: Shelter
Section 6: Education
Section 7: Protection
26 a) Vulnerability Background and External Shocks
VULNERABILITY CONTEXT In January 2011, WFP and partner agencies from government and the humanitarian sector conducted a Comprehensive Food Security and Vulnerability Assessment (CFSVA) of The Gambia. It is the first of its kind baseline survey conducted in the country, establishing the proportion of the population suffering from food insecurity, their household characteristics, location and exposure to shocks and type of coping strategies employed. While it did not assess refugees as a specific population group, inferences can be made about their level of vulnerability and exposure to shocks based on their household and livelihood characteristics and geographical location.
Map 1: Proportion of district population suffering from moderate or severe food insecurity, January 2011
The data revealed that two-thirds (67.2%) of the Gambian households Figure 10: Food Security Classification face some form of food insecurity and are vulnerable in a period of highest economic activity and directly following the annual harvest. The Gambia (2011) majority of the vulnerable population (61.5%) is classified as mildly food 5.3% 0.4% insecure, having the ability to maintain sufficient levels of food 32.8 consumption without the need to resort to negative coping strategies % that would undermine their livelihood base. Nearly 6% of the 61.5 population is made of the chronically food insecure, i.e. households % suffering from moderate or severe food insecurity. If at all, these households are able to maintain a minimum level of food consumption Refugees (2012) only when selling productive assets or otherwise putting at risk their future well-being (e.g. take children out of school, sell land). 7% 16%
The proportion of population suffering most from food insecurity in The 32% Gambia varies between districts and livelihoods. In January 2011, the 45% highest proportion of people with moderate and severe food insecurity has been recorded in the Foni districts of the West Coast Region (17.2%) in which the majority of the Casamance refugees are located. It Food secure was also established that the highest incidence of food insecurity and Mild food insecurity vulnerability affects households whose primary livelihood sources are Moderate food insecurity Severe food insecurity non-agricultural wage labor, the production and sale of cash crops and
27 self-employment/petty trade, activities that are also predominant among refugee households. Households headed by women; those with illiterate household heads; and those using unimproved sources of drinking water or sanitation facilities were also more likely to be identified as food insecure. According to this JAM, only 16% of refugee households can be considered as food secure while 84% show some form of food insecurity and vulnerability. Nearly half of the households (45%) are able to meet only minimally adequate food consumption needs (2,100 kcal per person/day) without engaging in irreversible coping strategies that would undermine their livelihood base (mild food insecurity). The proportion of the refugee population experiencing moderate or severe food insecurity is at alarming 39% as of November 2012 (during the harvest, after 2011 crop failure), compared to 17.2% in West Coast Region and nearly 6% for the Gambia as established by the CFSVA in January 2011 (near end of harvest, before 2011 crop failure). These households either have significant food consumption gaps or are able to meet minimum consumption, but not necessarily dietary needs, only by reverting to coping strategies that undermine their productive capacity and ownership of key assets, which would eventually lead to food consumption gaps.
The high level of moderate and severe food insecurity among the refugee population can be explained by multiple factors, including low food availability, highly constrained production capacity, endemic poverty and low asset ownership and the limited impact of food and livelihood interventions. External shocks that were experienced recently, such as a countrywide crop failure during the 2011/12 agriculture season and high food prices have played a pivotal role in exacerbating the refugee households’ level of vulnerability and undermining their food access and coping capacity.
EXTERNAL SHOCKS Crop failure Late, erratic, and unevenly distributed rainfall, with a precipitation deficit in some areas of the country ranging between 14 – 35% against the 30-year average, had a major impact on crop production during the 2011/12 season. Overall crop production fell by 62% compared to the 2010 season and by 50% against the 5-year average, triggering a declaration of crop failure by the Government of The Gambia on March 6th 2012 and the call for humanitarian assistance.3 The Government, UN agencies and other humanitarian partners mobilized food relief; livelihood and health support to nearly 230,000 people most at risk to food insecurity, particularly targeting small-holder farming households, children under-5 and pregnant and
Map 2: Districts seriously affected by drop in crop production in 2011/2012, January 2012
3 Multi-Sectoral Emergency Needs Assessment (GoTG, UN System, GRCS, TANGO; May 2012)
28 lactating women. The Senegalese refugee population has not been targeted as a specific population group under that support scheme and it is unclear if refugee households have benefited in any way from support that was provided nationwide, even though they were residing in districts assessed as most affected and with lowest availability of food stocks at the time (See Map 2; Figure 2). Key informant interviews revealed that the issue of Senegalese refugees was neither taken up during the emergency coordination meetings of the Food Security Council4 nor was it part of the joint UN appeal5 which covered, amongst others, emergency food and seed distribution and the provision of assistance in the areas of nutrition, health, water and sanitation. Even though the targeting scheme itself prioritized subsistence farmers and vulnerable households with pregnant and lactating women and children under the age of 5, under which most refugees could have been captured by default, it was stipulated under the distribution modalities that only households who could provide a valid identification document such as a national ID or voter’s card would benefit from the distribution. As a direct consequence, this had a prohibiting effect for refugee households to access assistance, unless indirectly through their hosts. It seems that the gravity of the emergency itself severely strained the operational capacity of national institutions and humanitarian agencies with the mandate to provide and coordinate assistance to various vulnerable groups. Insufficient staffing, multiple conflicting priorities and the change of key management positions prior to and during the emergency were common place among government and humanitarian agencies alike, thereby hampering effective planning and coordination of the emergency response operation
Figure 11: Availability of household food stocks within 25 districts seriously affected by 2011 crop failure, March 2012
100%
80% Food (3 months or longer) 60% Food (2 months) 93% 40% 66% 66% Food (1 month) 51% 20% 43% No Food
0% WCR NBR LRR CRR URR
High food prices Rising food prices appeared as a serious threat to household food security in The Gambia at the end of 2008, during the aftermath of the global spike in food prices. In December 2008, the price of small grained imported rice, the most common staple food in The Gambia, reached a record 19.5 Dalasi per kilo, up by nearly 40% in just 8 months. Rice prices have stabilized in 2009-2010 but did not reach their nominal pre- crisis levels. Instead, coupled with a reduction in national fuel subsidies, they continued a growth trend
4 The national Food Security Council is an inter-agency forum chaired at the time by the Office of the Vice President of The Gambia, comprising all relevant ministries and government bodies, UN agencies and NGOs, with the objective to coordinate and take decisions on key food security issues in The Gambia. During the 2012 crop failure emergency the forum met on a bi-monthly basis, but without the representation of UNHCR. 5 In The Gambia, humanitarian coordination on behalf of the UN System is the responsibility of WFP given the absence of an OCHA representation. UNHCR has the mandate to coordinate refugee affairs but it has not been part of the joint UN appeal in 2012.
29 from January 2011 onwards, surpassing the 2008 crisis benchmark of 20 Dalasi per kilo already in August 2012.
Figure 12: Development of rice prices in The Gambia (2008 - 2012)
22.00 20.00 18.00 16.00 14.00 12.00
10.00
Jul Jul Jul Jul Jul
Jan Jan Jan Jan Jan
Sep Sep Sep Sep Sep
Nov Nov Nov Nov Nov
Mar Mar Mar Mar Mar
May May May May May 2008 2009 2010 2011 2012
Small-grained rice (imported) Paddy rice (local)
Food price inflation is currently the main driver of overall inflationary pressure in The Gambia. As of December 2012, year on year inflation of food products (6%) was more pronounced than for non-food products and services (4%), while it was recorded highest for bread and cereals (10.6%), oils and fats (6.6%), fruits and nuts (5.6%) and meat (5.4%).6 Rising food prices may negatively affect the food access and quality of diet of poorest and most vulnerable households and reduce their capacity to withstand other shocks (e.g. drought, floods or loss of primary bread winner in the family). Floods Flooding has been a re-current phenomenon in The Gambia as a result of heavy rainfall, blocked drainage and widespread settling in riverine urban areas. In 2009, 2010 and 2012 between 15,000 and 40,000 people have been negatively affected by floods and windstorms on an annual basis, with major damage recorded to private property, infrastructure and livelihoods. However, flooding has not been a significant shock for the refugee population with only minor damages and less than 100 households recorded in need of assistance during the entire period of 2008 – 2012.
6 Daa Nyeeno – Food Security and Market Information Bulletin for The Gambia (Issue 5, May 2013)
30 b) Food Availability, Food Access, Food Utilization and Coping
RECAP
Findings: Recommendations: “The initial response to the crisis is appropriate “The JAM mission recommends that the EMOP be and effective and greatly appreciated by the extended for a period of six months (October 2008 beneficiaries, government and various partners” through March 2009) and that the rations be
reduced as of January 2009 from 2,100 “The 2007/8 agricultural season is considered by farmers and all partners met to be below well kcal/person/day to 1,600 kcal/person/day, since average in all villages visited, and food stocks are this period corresponds with end of the harvest, low. Unfortunately, at the time of the mission and the height of food availability and food
official data to confirm this were not available.” access. If the harvest for 2008/2009 is below normal, and a detailed assessment reveals that a “[R]efugees and hosts are sharing their food full ration is required, this recommendation can be resources to cope with the lack of food from their revisited” (JAM 2008) own harvests.” (JAM 2008)
“[T]his JAM found that the expected harvest at “[T]he JAM duly notes that the shift from food household level is above average/ acceptable. support to livelihoods support has been
Better-off refugee households (seven out of a total appropriate and the focus on the latter should be of 33) indicated food stocks will last 4 months maintained. Given the increased degrees of food whereby poor and very poor refugee households security and self-reliance attained by refugees indicated a range of 1.5 – 2.5 months. By despite the reduction in food distribution over the comparison, host households indicated production last few years, the JAM recommends a complete will last up to 5 months.” phase out of food assistance by mid-2010 for the non-vulnerable refugee population contingent to “Due to lack of timely contributions the project the following conditions: experienced considerable pipeline breaks in 2009. A. Continue with the current food assistance […] [...] food commodities were only able to meet 26 for the initial period during which the refugee percent of the requirements for November and database should be updated December 2010. Consequently, rations for the C. Upon updating of refugee database, there General Food Distributions had to be reduced by will be two target groups: 50% and the FFW activities cancelled”. i. The non-vulnerable refugee population “There is no sign of deterioration in the food will be assisted through FFW/FFT schemes security situation of refugees since the last JAM. only during the remaining months until Production estimates for the upcoming harvest complete phase out by June 2010; and are well above last year and the 5 year average ii. The vulnerable refugee population will be and expected to cater for over 50% of domestic assisted with a full ration 2,100 Kcal at least food needs of rural farmers. At the household until the next harvest season […] and beyond level, expected harvest is above average and if necessary and given priority consideration CONTEXTUALbetter than lastBACKGROUND year with food stocks estimated for the aforementioned integration package to last up to 4 months for refugees and 5 months with regard to IGA and other self-reliance for hosts respectively. (JAM 2009) opportunities. (JAM 2009)
31 Throughout the emergency period food assistance has been the primary source of food for the majority of refugee households, with beneficiary coverage7 being nearly universal and the ration size adequate8 between 2007, 2008 and much of 2009. Reviews of refugees’ vulnerability situation repeatedly highlighted that refugees remained highly dependent on assistance to ensure that their basic food requirements were met, even though up to 90% of households were engaged in farming activities. Limited productive capacity, low output potential, endemic poverty and few alternative income sources meant that up until 2009 food from own agricultural production and income generation was seen as able only to complement the rations received from aid agencies and not serve as an adequate substitute.9
“At the time of the previous JAM (Dec-08), a high percentage of refugee households reported to depend almost entirely on food aid for their daily meals. Most refugees cultivated some land but harvest was found to be generally poor with grains barely lasting two months.” (JAM 2009)
“The refugees interviewed categorically highlight the lack of food for the family. In all the meetings, the refugees said they depend on 2 meals per day while others on 1 and a half meal [...]. None of them have breakfast in the morning; only left-over food from the dinner is given to the children. [...] Majority of them says [food from own produce] will serve them for 1-3 months. The reason for the cause is said to be on flooding of crop fields, poor soils, insufficient land and insufficient tools and inputs.”
(UNHCR/GAFNA Situational Assessment of Donkeys, 2012)
In order to foster the transition towards self-reliance full rations were provided to vulnerable households10 (UNHCR 2009) only and a ration cut of 30% was implemented for all other households, starting from the General Food Distributions (GFD) in January 2009. A full ration was reintroduced for all beneficiaries in July 2009, with the commencement of the Food-for-Work (FFW) project towards which 50% of the rations were devoted as food assistance conditional upon refugees’ participation in the planned activities. However, throughout 2009, WFP experienced considerable pipeline breaks due to the lack of timely food donations and had to borrow food from its development project to maintain the ration size and distribution schedule for the refugee project. Low food balances for the months of November and December 2009 (26% of requirement), lack of prospect for new funds, favorable agricultural predictions for the 2009/2010 harvest and the simultaneous development of the self-reliance strategy created an environment in which the phase out food assistance was considered necessary already in November 2009.11 The timing of the phase-out was critical in so far as the refugee households still remained in a highly fragile position with regard to food access and self-reliance. The self-reliance strategy was merely beginning to take shape,12 without alternative livelihood activities being put in place until 2010; the Food-
7 Nutrition and Health Survey of Casamance Refugees in The Gambia (2008, NaNA/WFP) 8 Each refugee received a daily ration of Rice (400g), Corn Soya Blend (60g), yellow split beans (60g), vegetable oil (25g) and iodized salt (5g) to meet the recommended 2,100 kilocalories per person per day 9 Ibid. 10 The most vulnerable households included amongst others the elderly, ill, physically disabled, widows with children, pregnant women and female headed households 11 Remaining stock balances were distributed on one more occasion (May and June 2010) to most vulnerable households and all other households at a ration cut of 50%, coinciding with the beginning of the ‘hungry season’. 12 UNHCR Livelihood assessment missions from October 2008, April 2009 and September 2009
32 for-Work activities were suspended in November 2009 since they were tied to the phase out of food assistance itself, while their true impact on household self-reliance was not encouraging; and the refugees’ groundnut harvest for 2009/2010 was predicted to be insufficient due to the poor quality of seeds supplied, with germination failure ranging between 40-60%. The only other period where food assistance13 was provided concerned the new refugee influx of 1,650 people in 2011 (January – April) and 2012 (January – May, July – October), leaving the majority of the refugee population (86%) to source food through own production, borrowing or reliance on the host communities throughout 2010 – 2012.
CURRENT SITUATION Food availability Overall food availability in The Gambia has been improving in the period of 2007 – 2010, based on favorable weather conditions and high investment in agriculture. In an optimistic scenario14 total cereal production in The Gambia reached nearly 250,000 metric tons, accounting for up to 88% of national cereal requirements in 2010, thereby providing a good basis for the resumption of agriculture based livelihood activities and the strengthening of self-reliance among the refugee population.15 However, as a result of the 2011 crop failure national crop production has significantly contracted and did not recover to its pre-crisis levels (See pp. 28-29 for more details). For 2012, the expectations are that national cereal requirements could be met by up to 69% through domestic production16, similar to the 2008 levels.
Figure 13: Proportion of annual domestic cereal requirements covered by national cereal production
100% 23% 12% 80% 30% 31% 54% 54% 60% 40% 88% 70% 77% 69% 20% 46% 46% 0% 2007 2008 2009 2010 2011 2012 Domestic food gap Domestic crop production (optimistic)
The emergency situation has also affected the farming activities of refugee households and undermined efforts to improve their self-reliance. Following the 2011 crop failure refugee households experienced very low food availability and seed scarcity, with 87% of households able to source food from own production for a duration of 1-3 months only, similar to output levels observed throughout the period of 2007 - 2009. The livelihood situation was further undermined by lack of seed and input support in 2011 and 2012 and could have further exacerbated refugee households’ food security in 2012/2013.
13 Food was donated by UNHCR and provided by GAFNA through local procurement, consisting of rice (400g/person/day), vegetable oil (25g), iodized salt (5g), local beans (100g). 14 The most optimistic assumption is that total crop production would be adjusted downwards by 15% to account for post-harvest losses and seeds. In the sub-Saharan context, however, post-harvest losses for major crops might reach even up to 40%. 15 The national cereal requirement is based on annual cereal consumption of 175 kilograms per capita. 16 WFP analysis, based on data from 2013 National Agriculture Sample Survey
33 Figure 14: Period of availability (in months) of self-grown cereal stocks for own consumption following harvest in 2011/12
Average 15% 72% 12% 0 Foni Kansala 19% 67% 11% 1 to 3 Foni Bintang 11% 75% 14% 4 to 6 Foni Berefet 11% 78% 9% 7 to 12 0% 20% 40% 60% 80% 100%
Low food availability stemming from domestic production is not the only determinant of household food insecurity throughout the country given good availability of imported food, in particular staples such as rice, vegetable/cooking oil or sugar. In June 2011, a WFP-led market assessment concluded that food is generally available and markets throughout the country are functioning while supply routes are well integrated, with short distances to major markets facilitating physical access to produce and customers.17 The refugee hosting districts are directly connected to the major national market of Brikama (Kombo Central District) and have at least two relevant markets at disposal for commercial activity and sale of farm produce in Sibanor (Foni Bintang) and Bwiam (Foni Kansala).
Food access In The Gambia, the key constraining factors in relation to food security Figure 15: Annual refugee evolve less around physical availability of foods or remoteness of markets household income but to other factors inhibiting their economic access, particularly in terms of affordability of food and the means of transportation to buy or sell produce. 6% 7% Household poverty among the refugees is high, endemic and reflective of 11% low asset ownership and limited productive capacity. Three out of four 49% refugee households (76%) estimate an annual income of no more than 27% 10,000 Dalasis, which translates into less than 1,000 Dalasis or roughly US$ 33 per month for the entire household.18 Nearly 50% of households reported annual earnings that are even half that amount while 6% report not to have any significant earnings at all. >20,000 10,001 - 20,000 Reliance on one income source only is reported by nearly 22% of 5,001 - 10,000 households, while that figure is at 47% and 22% for households with two <5,000 and three or more incomes sources respectively. The vast majority of No income households have no salaried employment (91%), while 5% and 4% of households have either one or two members as salaried employees respectively. Remittances, either seasonal or regular, do not seem to be a reliable income source for the majority of refugees. Most of them
17 The Gambia - Urban Market Assessment: A Feasibility Study on Cash and Vouchers (WFP, 2011) 18 As per official exchange rate of 30 Dalasi / US$ 1, as at July 1st 2013.
34 (89.7%) reported not to have any household or extended family members working away from the household, either within the West Coast Region, Senegal or elsewhere. High employment competition and scarce income opportunities have already been previously reported as common in the Foni Districts. In 2007, a self-reliance assessment by WFP revealed that most of refugee households were engaged in farming activities (91%) with the sale of firewood being the only other income source for the predominant part of the refugee households (80%). Production and sale of vegetables (20%) or skilled labor (10%) were available only to a minority of the households as an alternative income source. In 2012, the employment opportunities seem to be more diversified but refugees overall remain engaged in low income or vulnerable employment.
Figure 16: Proportion of refugee population engaged in income generation, as per primary economic activity
5.3% 4.9% Sale of food crops production (including garden produce) 1.9% 3.9% Sale of animals (livestock) / animal products 20.6% Self-employed / street vendors (fruits, dvds, mobile credits) 7.8% Agricultural wage labour (paid in kind) Self-employed / services (e.g. taxi, carpenter, crafts) 24.5% 31.1% Non agricultural wage labour (e.g. construction worker) Aid, gifts Other
Refugee livelihoods are primarily agriculture based, with sale of own Figure 17: Households devoting a food crops production (20.6% of households), sale of animals or animal share of expenditure on food products (31.1%) and agricultural wage labor (7.8%) representing the Gambia (2011) main economic activity for nearly 60% of refugee households. Over one quarter of households are engaged in some type of self-employment 18% related to either small-scale sales (24.5%) or provision of services 30% (3.9%). Nearly 5% of refugee households remain particularly vulnerable 19% as they primarily depend on some form of aid or gifts. 33% The household expenditure pattern, in particular the share of Refugees (2012) household expenditure devoted to food, is another good indicator of endemic poverty as well as poor dietary intake19 prevalent among the majority of refugee households. In The Gambia, nearly 58% of overall 38% 34% household expenditure is devoted to food. 20 Among the refugee population every second household (52%) has a proportion of 14% 14% expenditure devoted to food that is well above the national average (65% or above). Almost 38% of households devote 75% of their < 50% 50 to 65% expenditure to food only. This is reflective of the high state of moderate 65 to 75% >=75% or severe food insecurity and a poor diversity of diet.
19 See pp. 36-37 for more details on quality of diet 20 Comprehensive Food Security and Vulnerability Assessment (WFP, 2011)
35 The majority of the refugee households (57.4%) reported not to have access to credit / loans in times of need, highlighting limited coping opportunities and heightened vulnerability to food insecurity. From the remaining households, the majority (55.1%) relies primarily on help from family and friends in The Gambia, while shopkeepers / traders are the second most important source of credit. To the contrary, family / friends outside of The Gambia (5.3%) or micro finance / credit institutions (1%) remain negligible as a source of credit. Nearly half of the refugee households (46%) reported borrowing money in the 6 months preceding the survey, or the ‘hungry season’ (May – October 2012), of which the majority (88%) reported borrowing money to buy food.
Food utilization
Every second refugee household shows an adequate intake of food (well Figure 18: Classification according above 2,100 kcal pp/day) suggesting energy sufficient diets and regular to Food Consumption Groups eating habits. On the other side, nearly one out of four households has poor (22%) or borderline (27%) food consumption, suggesting an inadequate or minimally adequate intake of food in terms of quantity, 22% regularity and quality of diet. However, food consumption alone does not explain if the diet is adequate in terms of its diversity and nutritional value (including for households with ‘acceptable’ food consumption) and 51% might conceal the existence of macro- and micronutrient deficiencies. 27% Dietary diversity is classified as a household’s consumption of specific food groups over a designated period of time. The assessment looked at Poor Consumption the frequency at which households have consumed each of the following food groups over a 7-day recall period: cereals, pulses, vegetables, fruits, Borderline consumption meat, fresh milk, sugar and oil. Only about 1 out of 10 households (8%) Adequate consumption can demonstrate a good diversity of diet encompassing the consumption of energy, nutrient and vitamin-rich food groups on a Figure 19: Dietary Diversity regular basis, i.e. between 6 to all 8 food groups have been consumed during the week. The remainder of households is nearly equally split into those with a low (44%) or average (48%) diversity of diet. Households with a low dietary diversity have regularly consumed only up to 4 food 8% groups throughout the recall week. These might also account for 44% households with poor (22%) or borderline (27%) food consumption. Households with a poor consumption profile (22%) have predominantly 48% an energy based diet, consuming rice or another cereal almost every day of the week and sugar nearly every second day of the week. Animal protein (meat), oil, pulses and fruits are barely consumed (up to once per Low diversity week). Vegetables and milk are consumed at least every second day. In Average diversity general, high percentages of households or individuals not consuming nutrient dense food groups on a given period of time are indicative of a Good diversity serious risk to macro- micronutrient deficiency and can be a major cause of under-nutrition.
36 When comparing the diet of households with a poor food consumption and adequate consumption it can be easily established that households with poor food consumption consume less high nutritious food items and generally lack of micronutrient intake. Protein rich foods are consumed only by 10% of the households with poor food consumption while almost 85% of households with an acceptable score consume protein nearly every day. During the recall period, nearly one out of three households with poor consumption did not consume protein at all (31%).
While the consumption pattern of other nutrient dense and vitamin rich food groups is slightly in favor of the population with acceptable food consumption, the high level of nutrient and vitamin deficiency is prevalent across the entire refugee population, irrespective of food consumption score. Almost 80% of the households with a poor score and nearly 50% of the households with an acceptable score have not consumed any iron rich foods during the recall period, suggesting a high risk of iron deficiency and anemia. Oils and fats have not been consumed by 70% of the poor consumption group and 55% of the acceptable consumption group which suggests a serious consumption gap of essential fatty acids. This might have a negative consequence particularly for young children and recent mothers.
Figure 20: Dietary Intake by consumption frequency of food groups with particular nutritional values
100%
80%
60%
40%
20%
0%
Poor Poor Poor Poor Poor Poor
Acceptable Acceptable Acceptable Acceptable Acceptable Acceptable Staples Protein rich foods Fruits and Iron rich foods Vit A rich foods Oils and Fats Vegetables
6-7 days 1-5 days 0 days
If at all, vitamin-A rich foods are not regularly consumed by nearly 80% of the households with poor consumption and slightly over half of households with acceptable food consumption. The results suggest a heightened risk to under- and malnutrition and the gradual weakening of the immune system among a predominant part of the refugee population, putting at risk particularly young children, pregnant and breastfeeding women. It has also been observed that almost 40% of children and 75% of adults eat only up to 2 times per day, underlining their vulnerability to malnutrition due to insufficient food intake. Two thirds of the households report this condition as usual both at the period of recall and the time of the year. Cooking is conducted by most households in an outdoor kitchen (67.5%) with the remainder using either an indoor kitchen (19.5%) or report not to have a kitchen at all (11%). Almost all households (98.6%) use wood
37 as the main cooking fuel, the use of which continues to put pressure on the already decreasing forest cover. Details on cooking practices can be assessed in the section on health and nutrition (p.56). Coping strategies and perceptions of food insecurity
The serious state of food insecurity of the refugee population is also well Figure 21: Type of coping reflected in the type of strategies employed to cope with food deficits at strategies employed the household level. While only 5% of the households did not have to 5% resort to any kind of coping mechanisms to ensure a sufficient and 9% balanced diet, almost 70% of the households engaged in coping strategies 26% that actually undermined their livelihood base and future productive capacity, i.e. sale of productive assets, reduction of expenses on health and education (stress or crisis coping). 60%
Households have also directly perceived food insecurity in the family. The majority reported that at least 1 – 3 times a week there was no food to eat No coping of any kind in the household (73% of households), household members Consumption coping Stress coping went to bed hungry (65%) or household heads worried that there would be Crisis coping not enough food that day (60%).
CONCLUSION Food Security Classification and Vulnerability Context Only 16% of refugee households can be considered as food secure while 84% show some form of food insecurity and vulnerability. Nearly half of the households (45%) are able to meet only minimally adequate food consumption needs (2,100 kcal per person/day) without engaging in irreversible coping strategies that would undermine their livelihood base. The proportion of the refugee population experiencing moderate or severe food insecurity and/or engaging in damaging coping strategies is at alarming 39%. The high level of moderate and severe food insecurity among the refugee population can be explained by multiple factors, including constantly low food availability, highly constrained production capacity, endemic poverty and low asset ownership and the limited impact of food and livelihood interventions. External shocks that were experienced recently, such as a countrywide crop failure and rising food prices have played a pivotal role in exacerbating the refugee households’ level of vulnerability and undermining their food access and coping capacity. Food Availability Overall food availability in The Gambia has been steadily improving in the period of 2007 – 2010, based on favorable weather conditions and high national investment in agriculture. However, a severe crop failure nearly halved the national crop output in 2011, limited crop recovery in 2012 is not expected to meet more than two-thirds of the national cereal requirement (in the most optimistic scenario), similar to 2008 levels. Following the 2011 crop failure refugee households experienced very low food availability and seed scarcity, with 87% of households able to source food from own production for a duration of 1-3 months only, similar to output levels observed during the period of 2007 – 2009. Lack of food, seed and input support in 2011 and 2012 for the majority of households could have further exacerbated their current food security levels and put their future livelihood at continued risk.
38 Food Access Household poverty among the refugees is high, endemic and reflective of low asset ownership and limited productive capacity. Over 75% of households estimate an annual income of less than 10,000 Dalasis, which translates into under 1,000 Dalasis or roughly US$ 33 per month. Nearly 50% of households reported annual earnings that are even half that amount. Record high food prices in 2012 and 2013 will put an additional strain on refugee household’s limited income and food consumption. The vast majority of households have no salaried employment (91%) while 69% of households report to have no more than two incomes sources. Refugees remain engaged primarily in agriculture based, low income or vulnerable employment, with the majority of households (57%) not having access to credit / loans in times of need. Among the refugee population every second household (52%) devotes at least 65% of their expenditure to food. Almost 38% of households devote 75% of their expenditure to food only, well above the national average (58%), reflecting the high state of moderate or severe food insecurity and a poor diversity of diet. Food utilization Nearly half of refugee households have either poor (22%) or borderline (27%) food consumption, suggesting an inadequate or minimally adequate intake of food in terms of quantity, regularity and quality of diet. Few households (8%) can demonstrate a good dietary diversity encompassing the consumption of energy, nutrient and vitamin-rich food groups on a regular basis. The majority of households have either low (44%) or average (48%) diversity of diet. Households with a low dietary diversity have regularly consumed only up to 4 food groups throughout the recall week, most of which are energy rich but poor in nutrients and vitamins. The high level of nutrient and vitamin deficiency is prevalent across the entire refugee population, irrespective of overall food consumption.
Coping The serious state of food insecurity among the refugee population is well reflected in the type of strategies employed to cope with food deficits at the household level. Almost 70% of the households are engaged in coping strategies that actually undermine their livelihood base and future productive capacity. The direct perception of food security among refugee households is high, with 60-70% of households reporting to go to bed hungry or not to be able to provide sufficient food on a regular basis. RECOMMENDATIONS Provision of Food Assisstance • Ensure that administrative and logistical arrangements are in place to enable the rural refugee population to benefit from food, nutrition and livelihood assistance under the protracted relief and recovery project “PRRO 200557: Targeted Nutrition and Livelihood Support to vulnerable people impacted by floods and drought in Gambia”
• Provide emergency food aid and NFIs for any new influx below 5000 refugees
Monitoring • Include refugee population as specific population group to be assessed on a regular basis on food security and nutrition status in future food security surveys and monitoring exercises
39 c) Self-Reliance
RECAP
Findings: Recommendations: “The 2007/8 agricultural season is considered by “The Country Office should conduct an in-depth farmers and all partners met to be below well food security and self-reliance assessment in average in all villages visited, and food stocks are December 2008 to determine the level of self- low. Unfortunately, at the time of the mission reliance among all refugees […] to justify any
official data to confirm this were not available” future operations.”
“Dry season market gardening is prevalent “Once the assessment provides a clearer analysis throughout the Foni for both host and refugee of the refugees’ situation, phase out strategies
families, but marketing of vegetables is a problem. and activities can be designed either for a (JAM 2008) complete phase out in March 2009, or a more gradual withdrawal over a longer period of time”
“Refugees are more likely to be food insecure than
hosts due to the uncertainty of having guaranteed “For the remaining period of the current EMOP, access to land on a continuing basis, poor soil the JAM mission recommends that the CO and fertility and lack of farming tools and implements, partners put a greater emphasis on self-reliance all of which deny them the possibility of proper activities, in particular agricultural and investment and asset building” horticultural production” (JAM 2008)
“There are positive signs of refugees having “It is therefore recommended to strengthen the
achieved a certain degree of self-reliance since the current livelihoods and support strategy for last JAM. […] The range of additional income improved self-reliance of refugees. In particular, sources has widened, including soap-making, tie the provision of agricultural tools and and dye, petty business, sale of cash crops, wages implements, which was already recommended by and remittances. Efforts are underway to further the previous JAM but has not been realized yet, improve the coverage and reach out of micro should be given priority” finance services to rural areas. In the mean-time a “It is therefore recommended to strengthen the series of vocational trainings have been carried linkage between vocational training and income out but often did not directly result in income generating activities by means of developing a generating activities” proper integration package”
“It was not clear to determine the status of “Continue with ongoing roll-out of MFI services existing development [FFW] projects in different and expand to rural areas” villages. The mission team did not find any “Map out existing development projects to ensure ongoing projects in the [14] villages visited. At the efforts by different partners are complementary” same time there were accounts of duplication of assistance by different partners in the same “In lieu of strengthened livelihood support, village(s) without coordination in advance. […] It is engage with more development partners too early to gauge the true impact of these including World Bank, ILO, FAO, etc.”
development projects on the livelihoods of the “It is thus recommended to draw lessons learned refugees and hosts, however there are few best and exchange best practice for development practice examples […] that indicate potential” projects and FFW schemes and explore ways to (JAM 2009) replicate a ‘working model’. (JAM 2009) 40
CONTEXTUAL BACKGROUND Introducing self-reliance activities within existing interventions became an important subject already within the first year of the refugee influx and is the only element of support for most of the refugees today. In September 2007, WFP conducted the first food security assessment of refugees which covered aspects of self-reliance and already in March 2008 the second Joint Assessment Mission recommended a gradual shift away from food assistance to comprehensive livelihood support in view of strengthening refugees’ independence. The shift was inasmuch a reflection of WFP’s and UNHCR’s corporate approach to put equal emphasis on self-reliance activities as to general food distributions in a refugee context.21 The March 2008 JAM already considered a gradual phase out of food distributions until March 2009 but conditioned any transition on an in depth assessment in order to determine the level of self-reliance among all refugees and to justify any future operations. A fact-finding mission by UNHCR in October 2008 advocated for extension of food aid for at least one year (until October 2009) in order to enable the establishment of “strong programmes on livelihood projects for self-sustainability, in the absence [of which] the refugee families cannot be food secured”.22 Eventually, the phase out of food assistance did not happen until November 2009, primarily conditioned by recurrent food pipeline breaks and lack of prospect for new food donations as well as by delays and limited implementation of planned self-reliance activities. Ironically, the discontinuation of food distributions also resulted in the early suspension of Food for Work, one of the primary components of the self-reliance strategy before other activities even began taking shape (e.g. livelihood skills training, distribution of agriculture and horticulture inputs). Prior to its suspension, the November 2009 JAM already noted that “[i]t is too early to gauge the true impact of these development projects on the livelihoods of the refugees and hosts”, highlighting only single best practice examples that would indicate potential for emulation. It also drew attention that “food assistance activities lack good coordination, strategic mutual planning and organization, clear-cut division of labor and lack of commitment towards joint ownership of project’s objectives”. Both statements sent a strong signal that, despite their importance in the overall assistance framework, important elements of the self-reliance approach were far from being well thought through or not resting on strong and efficient partnerships and coordination mechanisms, at a time when the phase out of food assistance seemed unavoidable and the new livelihood strategy was yet to take shape.23 In that context much uncertainty remained over the effectiveness, sustainability and adequacy of complementary self- reliance activities in meeting refugee households’ livelihood and food security needs in the future.
21 WFP Programme Guidance Manual (PGMWiki) on refugees; Handbook for Self-Reliance (UNHCR, 2006); Among the two main objectives outlined in their 2002 Memorandum of Understanding (MoU), WFP and UNHCR put at par the “promotion of the highest possible level of self-reliance among the beneficiaries, through the implementation of appropriate programmes to develop food production or income-generation, which will facilitate a progressive shift from general relief food distribution towards more targeted assistance and sustainable development-oriented activities” with general food distributions aimed at the restoration and maintenance of a sound nutritional status among the refugee population. 22 Mission Report in Gambia (UNHCR, 2008) 23 An integrated approach to self-reliance began taking shape only in mid-2009 with two missions conducted by UNHCR in April and September 2009, to study the potentialities and opportunities for local integration and to develop a Local Integration and Livelihood Strategy, as a basis for the implementation of livelihood activities.
41 RESPONSE TO DATE
Food for Work Food for Work (FFW) has been the main intervention modality in the area of livelihood support aimed to assist refugee and host communities to build community assets, move towards self-reliance, prevent animosity between the refugees benefiting from food aid and their host families and reduce dependence on food aid. Originally, it has been designed to relieve host communities from the additional burden incurred through the refugee influx and the extensive sharing of resources with refugee families. It provided host families with food rations in exchange for labor through activities that would develop productive infrastructure and support their livelihood, particularly by improving water supply, irrigation and latrines. Food for Work was initially provided by UNHCR for host families during the period of May – September in 2007 and 2008. Based on the recommendations from the December 2008 JAM, refugee households were included for the first time in the activity in the period of April – December 2009 with WFP providing conditional food rations and the Gambia Red Cross Society being the main implementing partner, while the Department of Forestry, UNHCR and Concern Universal were meant to support certain aspects of the project. A total of 122 activities have been implemented in 37 communities, most of which consisted of communal farming (55%), reforestation (18%) and road rehabilitation (15.5%) and in single cases the construction of refugee houses, digging of pit-latrines and the rehabilitation of wells, depending on the needs of the refugees and host communities and the availability of resources. Refugee and host households participating in the project were entitled to food rations24 upon fulfillment of minimum work norms25 while their fulfillment, individual participation and entitlement was recorded by members from the respective Village Development Committees (VDC). The arrangement was also meant to allow participating households to concentrate on other livelihood activities outside the scope of this project. The November 2009 JAM concluded that for “almost all [villages visited] it is too early to gauge the impact of agricultural or income generating activities on lowering the refugee households’ dependence on food aid”. Despite single communities being observed earlier as success stories deserving emulation, the survey team did not find any ongoing development projects in the villages visited while it was generally unclear what the status of existing development projects was as of November 2009, one month prior to the official ending of the project and the overall phase-out of food assistance. Repeated monitoring conducted by WFP and GRCS towards the middle and the end of the project (August – October) revealed shortcomings in both design and implementation of the activities which undermined their potential to serve as a sustainable substitute for food assistance and hindered an evidence based evaluation on how far the activities actually enhanced self-reliance (See Box 1 for key shortcomings).
24 Refugees 50% of total ration, Hosts 100% of total ration 25 These consisted primarily of each participating household providing at least one participant per five household members who would work 3 days in a week for 8 hours a day and 11 days per month, accumulating a minimum 88 working hours per month to be eligible for assistance
42 Box 1: Summary of key shortcomings of 2009 FFW activities: . Communities excluded: From 47 communities that were supposed to benefit from FFW, it was not clear if 12 communities (25.5%) have not at all been included in the project or if they were merely not monitored in terms of fulfillment of working norms and activity performance
. Communities not monitored: From 37 communities monitored, data on FFW performance was not collected in 9 communities (24.3%)
. Participation bias: In 37 communities monitored, more members from host households (913) have participated in the project than refugees (478), resulting in a 2-1 participation ratio against what was the initial plan (1-1), causing a diversion of scarce resources away from refugee households
. Gaps in application of working norms: Poor record keeping and wrong interpretation of working norms was observed in several communities, with a possible negative effect on entitlements and the creation of sustainable assets
. No impact measurement: Output indicators and tracking tools were developed only towards the end of the project, eventually without being used due to its closure, thereby hindering an adequate evaluation on the contribution of the activities towards increased self-reliance and asset creation
. Loss of motivation: The expectation of monthly food distribution proved to be the only relevant incentive for refugee and host households to engage in communal livelihood activities, with a long term perspective of community ownership being observed only in individual villages. Whenever pipeline breaks occurred a disengagement from communal towards individual activities (e.g. farming) was common and the rate of overall participation declined, negatively affecting the potential of the activities to build self-reliance . Community based intervention: By definition, activities were not specifically designed to enhance self-reliance of individual households but to build assets of the community and enhance community ownership. With limited production being shared among numerous households, no significant improvement of food security status could be expected nor was the actual impact on individual food security in any way measured . Reforestation component: Despite several attempts to coordinate the activity, seedlings could eventually not be provided and refugee communities had to resort to individual seedling collection
Other livelihood interventions With the phase out of Food for Fork in January 2010, complementary livelihood interventions by UNHCR and GAFNA became the only mechanism to strengthen self-reliance of refugee households. They were implemented in different communities and beneficiaries according to specific needs and included the provision of seeds, draught animals, agricultural and horticultural implements; rehabilitation of water sources as well as the provision of training in non-agricultural livelihood activities. However, resource limitations, coupled with low household coverage, delays in the implementation of several activities and coordination issues between key partners meant that here too the potential towards creating sustainable livelihoods was limited and could hardly compensate for the phase out of food assistance or food based livelihood activities (See Box 2 for activity snapshots) In the period of 2010 – 2012, livelihood activities geared towards additional skill acquisition in areas such as tie and dye, bee keeping or bakery covered only 35% of the refugee households while the distribution of agricultural and horticultural inputs was far from universal, ranging mostly between 59 – 82% of recorded
43 refugee households. In addition, the level of assistance geared towards the enhancement of crop production in the form of seeds, tools and particularly draught animals seems to be inadequate given over usage and high mortality of donkeys, low overall farming potential per refugee household (1-2ha) and limited duration and quality of output (1-3 months of household consumption).26 Bad quality of groundnut seeds (2009), a countrywide drought emergency (2011) and delays in seed provision due to defaulting on contracts (2012), limited significantly the output of groundnut, the single most important cash crop and income source for refugee households, thereby exposing them to protracted vulnerability. In addition, coordination between agencies providing assistance and their implementing partners seems to have been at times insufficient and monitoring inadequate. This also resulted in coverage gaps, inconsistency and delays in reporting of beneficiary figures, insufficient follow-up and weak measurement of impact. Main concerns raised by refugees in the rural areas were the unavailability of water and poor soil quality, limited access to medium or long term skills training and lack of access to grants or micro-credit to facilitate the establishment of income generating activities as well as uncertainty over their long term status and integration opportunities.
Box 2: Snapshot of other livelihood interventions and type of support provided
Agriculture
Date Households Villages Type of support provided Households (Number, type) (Number) coverage 2010, May 400, old influx 56 One animal unit per 4 households 38% (seeder, sine hoe and donkey) 856, old influx 56 One bag (50kg) of decorticated 82% 256, hosts groundnut seeds per household 2010 20, old influx 12 Cockerels for poultry production 2% 2011, May 124, new influx 12 Set of tools per 4 households 76% (seeder and sine hoe) 2012, July 243, new influx 34 One animal unit per 3 households 115% (seeder, sine hoe and donkey) 124, new influx 7 One bag (50kg) of decorticated 59% groundnut seeds per household
Horticulture Date Households Villages Type of support provided Households (Number, type) (Number) coverage 2010, October 800, old influx 10 Inputs for community gardens (fencing materials, tools, seeds) 77% 200, old influx 1 Construction of bio-gas plant and provision of livestock 19% 2011, October 300, old influx 5 Inputs for community gardens (fencing materials, tools, seeds) 29% 2012, July 418, old influx 5 Construction of bio-gas plant and provision of livestock 40%
26 UNHCR/GAFNA Situational Assessment of Donkeys (2012)
44
Box 2 (continued): Snapshot of other livelihood interventions and type of support provided
Other Skills
Date Households Villages Type of support provided Households (Number, type) (Number) coverage 2010 80, old influx 2 Inputs for baking business (flour and construction materials) 8% 2010 45, old influx 3 Training of women in soap making and tie and dye 4% 2010 45, old influx 3 Training of men and women on bee keeping and honey processing 4% 2011 60, old influx 4 Training of men and women on bee keeping and honey processing 6% 2011 30, old influx 2 Training of women in soap making and tie and dye 3% 2012 30, old influx 2 Training of men and women on bee keeping and honey processing 3% 2012 15, old influx 1 Training of women in soap making and tie and dye 1% 2012 60, old influx 4 Training in food processing and vegetable preservation 6% Total 365 21 35%
SOME LIVELIHOOD SUCCESS STORIES Karunor tie and dye livelihood group This group composes of 14 women and one man. They were trained by GAFNA in April 2011 and since then the group has registered tremendous progress. They had 42,000 Dalasi (US$ 1,400) of initial savings with the Credit Union and cash withdrawn of GMD 16,000. The first 8,000 Dalasi was used to buy new parts and paid for the maintenance of the Community hand pump while the other balance was used as loan to group members who experienced food shortages, resulting in GMD 34,000 of total savings. Another success story is the bee-keeping group of Bwiam refugees with a membership of 15 individuals. At the initial stage of the activity in 2011 they were supported with 10 bee-hives, honey harvesting jeers and seed money to commence the businsess. The group has savings account with the Bwiam Credit Union with a deposit of 13,130 Dalasi (US$ 440). This group also gave out loans to members once in August 2012 to buy food during the lean season. In other single success stories that merit attention, such as the bakery projects in Bwiam or the Bio-Gas plant at Ndemban Jola vegetable garden, refugee groups managed to create significant savings and invest in community assets. However, despite their success at the level of single groups, with limited household coverage, only a limited impact on self- reliance of the overall population can be recorded through the implementation of these activities.
45 CURRENT SITUATION
Land access and ownership Uncertainty of having guaranteed access to land on a Figure 22: Access and ownership of land for continuing basis has been repeatedly identified as a key livelihoods activities factor denying refugee households the possibility of a 100% proper investment and asset building, in addition to poor 85.4% 80% soil fertility and lack of farming tools and implements. In 2012, access to land for farming is still not universal (85% 60% 37.7% of households benefit) while access to land for 40% 14.0% horticulture activities is limited to slightly more than a 20% 3.1% 3.1% third of refugee households (38%). Land ownership 0% 0.2% continues to be an exception, with respectively 14% and Farming Gardening Other 3% of households reporting to own the land on which Access Ownership they grow their crops or vegetables.
Adequacy of fields and plots On average, refugee households use nearly 1.5 fields for household farming activities and 0.65 plots for household gardening. While 11% of refugee households indicate not to have any field under cultivation, the predominant majority (78%) has only 1 to 2 fields available for farming, an indication of very low potential
Figure 23: Share of households engaged in horticulture and/or crop production per number of plots/fields under cultivation
100% 78% 80% 59% 59% 60% 34% 32% 32% 37% 40% 31% 20% 11% 11% 7% 1% 0% 9% 0% 0 fields 1 to 2 fields 3 to 5 fields 6 or more fields
Refugees (horticulture) Refugees (crops) WCR (crops) The Gambia (crops)
to attain food self-sufficiency. The proportion of farming households which are cultivating only 1 to 2 fields is significantly lower in the West Coast Region (59%) and for The Gambia (31%), in favour of those households cultivating more fields. Only 11% of refugee households cultivate three or more fields for crop production whereas this applies to nearly one third of households on the level of the West Coast Region and The Gambia. The main reason for households not cultivating any land at all for crops or vegetables is lack of access to adequate land. Type and purpose of crop grown On the land available for cultivation refugee households grow primarily cereals (62%), vegetables (21.5%) and cash crops (11%). About two thirds of households growing crops (67.5%) do so for subsistence (home consumption) and less than one-third (31.2%) grows crops for additional income.
46 Livestock ownership and use
In 2012, every second refugee households Figure 24: Ownership of livestock by district confirmed ownership of some type of livestock with the level of ownership being highest in Foni Total 49% 51% Bintang (61%) and lowest in Foni Kansala (41%). Foni Kansala 59% 41% In terms of animals owned, most households report ownership of poultry (43%) or sheep and Foni Bintang 39% 61% goat (31%). Less than a fifth of households Foni Berefet 47% 53% reports ownership of draught animals such as Horses, Mules and Donkeys (17%) or Cattle and 0% 20% 40% 60% 80% 100% Oxen (11%), commonly used for agriculture and No Yes other type of livelihood activities.
Figure 25: Ownership of livestock by type of animal
Poultry 57% 43% Goats / Sheep 69% 31% Horses/Mules/Donkeys 83% 17% No Cattle / Oxen 89% 11% Yes Pigs 96% 4% Others 98% 2%
0% 20% 40% 60% 80% 100%
Even in cases where livestock ownership is reported, the number of animals owned is very limited, in particular with regard to draught animals commonly used for livelihood activities. Of the households that report ownership of horses, mules or donkeys (n=82, 17%), most own only one animal (89%) while for households owning cattle or oxen (n=55, 11%) this proportion rises to 98.2%. Higher ownership of animals per household is more frequent with regards to poultry and small ruminants. Recent survey findings by UNHCR also indicate mortality rates (15%) of donkeys that were provided to refugee households to support livelihoods. This is considered mainly due to an inappropriate sharing ratio of animals, which was set at one donkey for four refugee households, thereby resulting in eventual exhaustion of the animal.
Figure 26: Proportion of households owning livestock, by type and number of animals owned
Poultry 19.2% 28.4% 26.9% 25.5% Goats / Sheep 30.2% 36.2% 23.5% 10.1% 1 animal Horses/Mules/Donkeys 89.0% 9.8% 2 to 3 animals Cattle / Oxen 98.2% 1.8% 4 to 6 animals Pigs 94.4% 5.6% 7 or more animals Others 83.3% 16.7%
0% 20% 40% 60% 80% 100%
47 Only 11 households (8% of those owning animals), have reported the sale of livestock in the last 6 months. Most of the households who sold their livestock mentioned as primary reason the need to purchase food (70% in the case of goats and sheep; 50% in the case of poultry, 40% in the case of cattle). In the case of the refugee households, the main reason behind the low level of livestock sale during the hungry season is the low level of actual livestock ownership and their high appreciation for ongoing livelihood activities. Ownership of productive assets and other household items Farming by refugee households relies on very limited and basic ownership of productive assets, if available at all. In 2012, more than three-quarters of the households (76%) have indicated that they own some basic manual farm tools such as hoe, axe or sickle. This still leaves one out of four households without any such tools to enable a minimum of farming activity. Only about 15% of households own animal drawn carts or ploughs and seeders that could somewhat intensify farming activity while the ownership of any sort of sophisticated machinery or fishing gear is nearly inexistent.
Figure 27: Ownership of productive assets and other household items
Hoe/Axe/Sickle 24% 76% Animal drawn carts (donkey, horse) 86% 14% Animal draft (ploughs, seeders) 85% 15% Fishing gear (net, boat) 100% 0% Motorized vehicle (car, motorbike) 98% 2% Machinery (Tractor, processing) 99% 1% Bicycle 65% 35% Wheelbarrow 95% 5% Cooker (Gas / Electric) 99% 1% Refrigerator / Freezer 99% 1% Electric Generator 100% 0% Sofa 93% 7% Mattress 99% 1% Bed 97% 3% Cabinet /Armoire 43% 58% Table /Chair 46% 55% Fan 89% 11% Air Conditioner 100% 0% Satellite Dish 100% 0% Iron 100% 1% Watch / Clock 99% 1% Telephone (mobile/landline) 98% 2% Radio 36% 64% Cassette/VCR/DVD player/HiFi 93% 7% Television 93% 7% Computer 100% 0% Photo/Video Camera 100% 0% 0% 20% 40% 60% 80% 100%
No Yes
48 Additional transportation modalities are available in the form of a bicycle for 35% of households while the ownership of a radio constitutes the main means of communication for 64% of the households. Slightly over a half of households own basic furniture such as a cabinet, armoire, table or chair while items such as a sofa, mattress and bed are nearly inexistent. The vast majority of the households do not possess any other productive assets or household items, reflecting a high degree of poverty and very low coping potential in the event of external shocks.
CONCLUSION Although ambitious in scope, asset creation and livelihood activities put in place between 2009 and 2012 had only a limited impact in enhancing refugee self-reliance and local integration. Chronic resource limitations, coupled with incomplete household coverage, delays in the implementation of several activities and insufficient coordination between key partners meant that the potential towards creating sustainable livelihoods was very limited and could hardly compensate for the phase out of food assistance or food based livelihood activities in 2009. The level of assistance geared towards the enhancement of crop production in the form of seeds, tools and particularly draught animals seems to be inadequate given over usage and high mortality of donkeys (15%), low overall farming potential per refugee household (1 -2 plots of less than a hectare) and limited quality and consumption availability of own produce (1-3 months). The self-reliance potential was further eroded by a crop failure and rising food prices in 2011-2012. Access to land for farming is still not universal (85%) while access to land for horticulture activities is limited to slightly more than a third of refugee households (38%). Land ownership continues to be an exception. The predominant majority of households (78%) have only 1 to 2 fields available for farming usually at a size of less than a hectare, an indication of very low potential to attain food self-sufficiency, with the proportion being lower in the West Coast Region (59%). Every second refugee household confirms ownership of some type of livestock, most of which are chicken or small ruminants, while less than a fifth of households report ownership of draught animals. Even in cases where livestock ownership is reported, the number of animals owned is mostly limited to one, in particular with regard to draught animals commonly used for livelihood activities. As a result, the sale livestock is hardly used as a coping strategy in the event of food insecurity. Refugees experience a very limited and basic ownership of productive equipment with one out of four households being even without any basic tools that would enable a minimum of farming activity. Only about 15% of households own animal drawn carts or ploughs and seeders that could somewhat intensify farming activity while the ownership of any sort of sophisticated machinery or fishing gear is nearly inexistent. The vast majority of the households do not possess any other productive assets or household items, reflecting a high degree of poverty and very low coping potential in the event of external shocks. Main concerns raised by refugees in the rural areas are the unavailability of water and poor soil quality, limited access to medium or long term skills training and lack of access to grants or micro-credit to facilitate the establishment of income generating activities. Uncertainty over their long term status and integration opportunities remains a common concern.
49 RECOMMENDATIONS Provision of Livelihood Assistance • Provide agricultural tools and implements, with an emphasis on households not covered in the previous distributions
• Increase the number of animal units provided and reduce the ratio of households sharing one animal unit
• Include fertiliser as part of the assistance package to address the low soil fertility and enhance production potential
Vocational Training and Functional Linkages • Intensify the implementation of the self-reliance strategy by increasing the coverage of the refugee population through vocational training and support the kick start of more alternative livelihood activities
• Improve access to credit facilities for rural refugees to enable the pursuit of sustainable livelihood opportunities and link livelihood skills training with loan schemes
Advocacy • Advocate actively for availability of residential and agricultural land for the refugees, access to other income-generating activities and effective participation in the labor market
50
Section 1: Demography
Section 2: Food Security
a) Vulnerability Background and External Shocks
b) Food Availability, Food Access, Food Utilization and Coping Strategies
c) Self-Reliance
Section 3: Health and Nutrition
Section 4: Water and Sanitation
Section 5: Shelter
Section 6: Education
Section 7: Protection
51
RECAP
Findings: Recommendations: “Overall, the nutritional status for the refugees is “Continue to promote refugees’ understanding of adequate and no alarming trends have been their rights to healthcare at the designated detected through either of the two [nutrition] centers - Bwiam Hospital and Sibanor Clinic” surveys [in January and November 2007]” (JAM 2008)
(JAM 2008) “Conduct the fourth Health and Nutrition Survey
“This JAM noted that overall nutritional and by NaNA should take place the soonest in order to health situation for the refugees was adequate confirm and complement the qualitative findings
and no alarming trends of deterioration have been of this JAM. […]UNHCR to organize (as planned) a detected through over the time period of the three comprehensive Public/Reproductive Health and surveys [January and November 2007, November HIV/AIDS assessment among refugees and host 2008]” (JAM 2009) communities and make clear and practical recommendations” (JAM 2009)
CONTEXTUAL BACKGROUND According to the last health and nutrition survey conducted on refugee households (November 2008): “food aid and other interventions for the refugee population appear to have contributed positively to the well-being of the refugees. Therefore, the food aid and other interventions such as vaccinations, vitamin-A supplementation and de-worming should be continued”. Indeed, in the first two years under examination (2007 – 2008), acute malnutrition rates among the refugee population have been stable, with the prevalence of wasting27 among children aged 6 – 59 months recorded between 4.3 – 6.6%, throughout the period which was below the national average of 7% at the time.28 Adequate food assistance,29 above average rates of breastfeeding and good health care practices were attributed as primary reasons for good nutrition outcomes. Food relief has been nearly universal with 98 – 99.8% of respondents receiving full family rations a month prior to the nutrition surveys. At the same time, 99.7% of children of less than two years of age were breastfed while the rate of exclusive breastfeeding for infants less than 6 months stood at 82.9% in November 2008, up from 59.5% in November 2007. However, in the period from 2007 to 2012 the overall nutrition situation in The Gambia as a whole gradually worsened. Bi-annual monitoring through the Gambia National Nutrition Surveillance Programme (GNNSP) revealed a continuous deterioration of nutrition outcomes among children aged 6 - 59 months.30 Similarly, the prevalence of acute malnutrition increased at national level from 8.9% in February/March 2007 to 10.6% in August/September 2012. In the West Coast Region, the change in prevalence revealed a more elevated trend from 9.9% to 11.3%. The most recent SMART Nutrition Survey, conducted in
27 too low weight for height 28 Multi Indicator Cluster Survey (GBOS/UNICEF, 2005) 29 See pp. 32-33 for details on ration and food pipeline situation 30 Data is collected in February/March when food availability and access are considered highest (dry season) and in August/September when they are considered lowest (rainy and so called ‘hungry season’)
52 September 2012, revealed a prevalence of Global Acute Malnutrition (GAM) at 9.9% at the national level while rates were below the national average in the West Coast Region, at 7.5%.
Figure 28: Trends of acute Malnutrition in The Gambia, 2007 - 2012
15.0% Gambia (GAM)
10.0% West Coast Region (GAM) 9.9% 7.5% Gambia (WfH) 5.0%
West Coast Region (WfH)
0.0%
WfH / GAM
Aug/Sep Aug/Sep Aug/Sep Aug/Sep Aug/Sep
Aug/Sep
Feb/Mar Feb/Mar Feb/Mar Feb/Mar Feb/Mar Feb/Mar 2007 2008 2009 2010 2011 2012
CURRENT SITUATION Since the last comprehensive nutrition and health survey31 on the refugee population was conducted in November 2008 and given the deteriorating nutrition trends in The Gambia ever since, it was decided to include within the 2012 JAM a cross-sectional household food security survey with a specific nutrition and health component. All children in households selected for the interview were assessed for anthropometry while data was also collected on nutrition, health and care practices of women of reproductive age (15 - 49 years). This section presents information on the nutritional status of children aged 6-59 months and explores factors contributing to poor food utilisation in the refugee population. The WHO 2006 growth reference was used to analyse the nutritional status of children aged 6 – 59 months with regard to acute malnutrition, stunting and underweight. Global Acute Malnutrition (GAM) Figure 2 presents the prevalence of global acute malnutrition rates based on the weight for height z-scores (WHZ).32 In November 2012, the prevalence of GAM was 18.1% while severe acute malnutrition stood at 5.3% for the children included in the assessment (n=414). The prevalence is nearly three times higher than during the last nutrition survey of the refugee population in November 2008 and more than double the overall prevalence for the West Coast Region measured two months prior to this survey, indicating a significant deterioration of the nutrition situation among the refugee population in the last four years. There are more acutely malnourished males (20.2%) than females (16%) in this population. Global acute malnutrition among the refugee population is above the WHO emergency threshold of 15%.
31 Nutrition and Health Status Survey of Casamance Refugees in The Gambia (NaNA/WFP, 2008) 32 See Annex A, p.8 for complete overview and breakdown of global acute malnutrition rates by gender, based on weight for height z-scores.
53 Figure 29: Prevalence of Global Acute Malnutrition (GAM), wasting among children aged 6-59 months
20.0% 18.1% Global Acute Malnutrition (GAM) 15.0% WHO Classification 'Critical' 9.9% 10.0% WHO Classification 'Serious' 6.7% 6.6% 7.5% 4.3% 5.0% WHO Classification 'Poor'
0.0% 0.0% 2007 2007 2008 2012 2012 2012 Prevalence (Jan) (Nov) (Nov) (Nov) (Sep) (Sep) Refugee Population WCR Gambia
Stunting The prevalence of stunting33 is serious in the refugee population (above 30% WHO threshold). Based on the height-for-age index, 32.3% of children assessed were stunted (n=400), with 12.0% being severely stunted. There is no difference in prevalence of stunting between boys and girls.34 This outcome represents a serious setback for food and nutrition based interventions conducted during the first two years of the refugee operation. From January 2007 to November 2008 the prevalence of stunting gradually decreased from 28.4% to 18.2%. In 2012, the prevalence of stunting in the West Coast Region was 17.8% and even lower than the national average of 21.2%.35
Figure 30: Prevalence of Stunting, children aged 6 - 59 months (for WCR and Gambia aged 0 – 59 months)
50.0% Prevalence of Stunting 40.0% WHO Classification 'Critical' 28.4% 32.3% WHO Classification 'Serious' 30.0% 22.2% 21.2% 18.2% 17.8% 20.0% WHO Classification 'Poor' 10.0% 0.0% 0.0% 2007 2007 2008 2012 2012 2012 Prevalence (Jan) (Nov) (Nov) (Nov) (Sep) (Sep) Refugee Population WCR Gambia
Underweight Underweight is a composite measure of stunting and wasting and is used globally to track progress on the Millennium Development Goals (MDGs). Among the refugee children between the ages of 6 – 59 months almost every third child was underweight (30.1%) while one out of ten children (10.4%) suffers from severe underweight. This assessment shows that the prevalence of underweight among refugee children is double the overall rate in the West Coast Region while on the national level it has been recorded at 18% in
33 Stunting – too short for age, a sign of long term i.e. chronic malnutrition 34 See Annex A, p. 8 for complete overview and breakdown of stunting rates based on height for age z-scores. 35 On the national and regional level the 2012 stunting rates, as measured by the SMART survey, apply for children aged 0-59 months
54 September 2012. Underweight among the refugee population is slightly above the WHO critical threshold of 30%. This is a serious situation in that almost all underweight children are also stunted.
Figure 31: Prevalence of underweight, children aged 6 - 59 months (for WCR and Gambia aged 0 – 59 months)
40.0% Prevalence of Underweight 30.1% 30.0% 25.9% WHO Classification 'Critical' 23.6% 22.2% 18.0% 20.0% 15.5% WHO Classification 'Serious' 10.0% WHO Classification 'Poor'
0.0% 0.0% 2007 2007 2008 2012 2012 2012 Prevalence (Jan) (Nov) (Nov) (Nov) (Sep) (Sep) Refugee Population WCR Gambia
Micronutrient deficiency Although the survey did not gather information on the severity of micronutrient deficiencies among children, indications of the existence of micronutrient deficiency can be deduced from data collected on overall food consumption patterns and dietary intake of refugee households during the 7 days preceding the survey. Results show that among most households with both ‘poor’ and ‘acceptable’ food consumption scores, there is very low consumption frequency of iron-rich foods, Vitamin A-rich food and oils and fats. In particular, between 90 – 100% of refugee households with ‘poor’ consumption scores did not consume any or only on few single occasions protein- or iron-rich foods while almost 40% of children reportedly ate only two times per day (for more details see Section 2, pages 36-37). Low overall food consumption and low consumption frequency of nutrient dense foods among refugee households point towards significant micronutrient deficiency among children aged 6-59 and may be a key explanatory factor of alarmingly high levels of malnutrition.
Figure 32: Rate of coverage of major preventive health interventions, 2007 - 2008
100% 85% 71% 70% 74% Jan-07 80% 68% 71% 59% 62% 54% 62% 60% Nov-07 60% 43% 34% Nov-08 40% 28% 20% 4% Nov-12 0% Measles Vitamin A De-worming Mosquito Nets
Micronutrient supplementation and preventive health interventions for children and mothers play an important role in promoting health and nutrition among infants and young children. The coverage rate of preventive health interventions has steadily improved since 2007, despite a slight setback in 2008. Apart from measles vaccinations, which reached 70% in November 2012 and recorded almost no changes in coverage rate since 2007/8, significant improvements have been recorded in 2012 in the level of coverage of vitamin-A supplementation (74%) and the provision of de-worming tablets (62%). The positive
55 achievements were fueled by the institutionalization of Vitamin-A supplementation into the routine Expanded Programme on Immunisation while the provision of de-worming tablets has been part of annual de-worming and vaccination campaigns. Provision of de-worming medicines is also an Figure 33: Women access to disease preventive services, integral part of WFP’s school feeding programme 2012 in which refugee children are also take part. The current assessment also collected data on the rate 100% 33% 25% 26% 25% of micronutrient supplementation for refugee 80% mothers. Of the women interviewed (n=415), 60% more than half had access to disease preventive 40% 67% 75% 75% 75% measures. Nearly 75% had taken Iron-folate 20% tablets whereas the same proportion received a 0% tetanus shot and slept under a mosquito net the Vitamin A Iron Folic Tetanus Mosquito previous night. Only 67% of women received Acid Nets Vitamin A after giving birth. No Yes
Pregnancy status and infant feeding
The current assessment revealed that among the Figure 34: Pregnancy status of women in reproductive age women of reproductive age (15-49 years), 40% of those interviewed (n=729) have just become 8.1% 0.8% Pregnant mothers or are short from giving birth and nearly 0.3% Pregnant & breastfeeding every third woman interviewed is currently 17.1% Breastfeeding only breastfeeding (31.9%). One out of three women 31.1% Pregnant in the past (34.2%) has not attended any antenatal 41.2% Don’t know consultation during the current or last pregnancy, with 26.2% attending only once and the Never pregnant remainder attending at least twice or more times. Previous assessments rated the rate of breastfeeding, exclusive breastfeeding and complementary feeding among women from refugee households as impressive and above the national average.36 In 2008, the rate of breastfeeding for children aged 0 – 23 months has been nearly universal, while 83% of women practiced exclusive breastfeeding for infants below 6 months of age and 74.2% of women practiced complementary feeding for those aged 6-9 months. Although fluctuating, the breastfeeding rate of infants aged 12-15 months and 20-23 months remained high with 92.3% and 80% respectively. In addition to breast milk, complementary feeding included food and drinks such as: water, tea, juice, powdered milk, infant formula, porridge, semi-solid and solid foods. Specific ingredients used in food preparations included sugar, soybeans, beans, millet, fish, eggs, corn soy blend (CSB), milk (powdered, fresh, condensed) and water (both treated and untreated). It was noted with great concern that the majority of mothers did not add fats and oils such as oil, butter, groundnut paste/flour in the preparation of porridge and that mothers tended to add more water than necessary when cooking, thereby reducing the nutrient density of the porridge. The current rate of breastfeeding,
36 Nutrition and Health Status Survey of Casamance Refugees in The Gambia (NaNA/WFP, 2008)
56 exclusive feeding and complementary feeding practices in women from refugee households has not been subject of this assessment and could not verify data collected from surveys conducted in 2007 and 2008.
Figure 35: Proportion of infants and children undergoing breast and complementary feeding, 2007 - 2008
99.7% 1 82.9% 77.1% 74.2% 0.8 69.2% 59.5% 64.7% Jan-07 0.6 Nov-07 0.4 0.2 Nov-08 0 Breastfeeding Exclusive Breastfeeding Complementary feeding (0 - 23 months) ( < 6 months) (6 - 9 months)
Hygiene The importance of personal hygiene and sanitation cannot be overemphasized. The hygiene practices such as hand washing of women can greatly impact on the health and nutrition status of members of her household, particularly that of children. The levels of hand washing seen among women in refugee households are far from desirable. From the mothers interviewed for hand washing after the use of the toilet and after cleaning child stools respectively (N = 803, N=744), just over half of women washed their hands with washing soap and water (54% and 56%), almost 16% percent with homemade soap and water and in both cases nearly 30% percent washed their hands with water only.
Figure 36: Hand washing practices of refugee women in reproductive age, 2012
100.0% 80.0% 54.0% 56.0% After use of toilet 60.0% 29.9% 28.2% 40.0% 15.8% 15.6% After cleaning of 20.0% 0.2% 0.1% child stools 0.0% water only homemade soap/ash washing soap & other & water water
This is more so a cause of concern when 28% of households reported using water for drinking and basic hygiene from unprotected water sources (see Section 5, pages 61-62 for more details). Unprotected sources of potable water and exclusively water based hand-washing may be a potential source of contamination leading to diarrhea and other water-borne diseases, thereby negatively affecting food utilization. Infections and care seeking behavior Nearly half (44.5%) of children surveyed (n=465) and more than one out of three (35.1%) mothers interviewed (n=803) reported to have suffered from an illness in the two weeks prior to the survey. Every third child (33%) had a fever while nearly one out of ten children suffered from either diarrhea (9%) or cough with respiratory difficulties (7%). However, the disease incidence in 2012 has been lower than in the 2007 – 2008 reporting period. The type of care that was provided and the level of care seeking behavior among mothers and care taking women was not part of this assessment.
57 Figure 37: Incidence of infections and disease among refugee children aged 6-59, 2007 – 2008 and 2012
100%
80% Jan-07 53% 60% 48% 46% Nov-07 40% 33% 25% Nov-08 12% 10% 11% 20% 9% 6% 7% 9% Nov-12 0% Acute Respiratori Infection (ARI) Diarrhea Fever
Access to basic health care services
Of the refugee households covered by this Figure 38: Access to basic health services assessment, the predominant majority had access to basic health care services (81.9%). Nearly 12% of 3.5% 1.4% 0.8% 0.4% Yes households gave distance to health centers and 3.5% 11.9% No = Distance cost as main reasons for not accessing health care. No = Costs The remaining 2.6% of the households could not No = Security access health care services due to protection related No = Status matters, giving ‘security’ (1.4%), ‘status’ (0.8%) or 81.9% No = Identification ‘identification’ (0.4%) as the main prohibiting factors. Literacy and level of education of mothers
Nearly two out of three mothers assessed (64.7%) Figure 39: Level of education of refugee mothers, 2012 could not read or write simple messages. In terms of level of education, over half of mothers (57.3%) 2.4% indicated not to have attended any school while 1.3% No school nearly 17% have only pre-school or primary school Pre-school education. One out of five mothers (22.3%) have 22.3% achieved some form of secondary school education Primary school 57.3% (junior or senior secondary) while the proportion of 12.3% Secondary school mothers with higher education or other type of 4.4% education (e.g. vocational training) remains Higher / Tertiary negligible. Type of employment and the amount of Other daily workload of mothers has not been part of the present survey. CONCLUSION The above findings indicate that health and nutrition situation in the refugee population has significantly deteriorated and calls for an urgent intervention. In particular, the prevalence of global acute malnutrition among children aged 6-59 months surpassed the WHO emergency threshold of 15% and stands at 18.1%, more than double the rates measured by the SMART 2012 in the West Coast Region (7.5%). The level of stunting is ‘serious’ at 32.3% and the proportion of underweight children ‘critical’ at 30.1%.
58 The level of morbidity among children and women of reproductive age is high at 44.5% and 35.1% respectively, despite declining trends in incidence levels of single diseases, good overall access to health care facilities and steady progress in the provision of preventive health care services. The quality of hygiene among women (30% report hand washing with water only) coupled with a high proportion of households sourcing drinking water from unprotected wells (28%) are a serious cause for concern. Unprotected sources of drinking water and exclusively water based hand-washing after the use of the toilet and cleaning of child stools may be a potential source of contamination leading to diarrhea and other water-borne diseases, with a negative effect on individual food utilization. Although the level of breast- and complementary feeding has been impressive in 2007/8, at rates between 80% to universal among mothers from refugee households this assessment could not verify the current level of infant feeding practices. Overall low food intake among half of the refugee households, poor dietary diversity in a majority of refugee households and generally inappropriate food preparation practices for infants point towards significant food and micronutrient deficiency among the refugee population and are key explanatory factors behind high malnutrition rates of children under five years of age. Food pipeline breaks in 2009, lack of food assistance throughout the 3-year period (2010 – 2012) for 86% of the refugee population (2006 – 2010 arrivals) and limited effectiveness of the self-reliance strategy after the phase-out of food assistance in 2010, coupled with high rates of poverty and poor asset ownership among refugee households, are key explanatory factors behind low food intake and poor dietary diversity of refugee households. RECOMMENDATIONS Assessment and Vulnerability Identification • Conduct a rapid assessment on the rates of exclusive breastfeeding and breastfeeding practices, health and care practices, and workload of mothers and determine responses accordingly • Put in place strategies for early identification, referral and management of acute malnutrition, particularly among children 6-59 months, pregnant and nursing women
Awareness Raising and Training • Sensitize refugee families on their rights to healthcare service • Sensitize refugee families, particularly women with children of 6-23 months and people living with HIV, on good hygienic and hand washing practices, appropriate infant and young child feeding practices and diet diversification • Sensitize refugee families on HIV prevention • Conduct refresher trainings for community health nurses, MDFTs, village support groups on IYCF, screening for malnourished children and adults
Advocacy • Advocate for the implementation of the Government’s policy of equal access to the health care services at equal fees for both Gambians and refugees •Promote micronutrient interventions, consumption of iodised salt, Vitamin A supplementation, provision of iron folate and use of micronutrient powders
59
Section 1: Demography
Section 2: Food Security
a) Vulnerability Background and External Shocks b) Food Availability, Food Access, Food Utilization and Coping Strategies c) Self-Reliance
Section 3: Health and Nutrition
Section 4: Water and Sanitation
Section 5: Shelter
Section 6: Education
Section 7: Protection
60
RECAP
Findings Recommendations “Despite efforts by partners to address the “Repair broken wells, deepen those that are problem, pressure on existing water and insufficient; Build additional latrines; and sanitation sources is increasing; the number of lobby/research funding for new borehole wells” latrines remains insufficient to meet the needs of (JAM 2008) the population” (JAM 2008)
With a few exceptions, drinking water is available “After mapping of water sources in each village,
in refugee hosting communities. However, [...] install additional pumps in communities with water for other types of domestic and non- larger number of population to meet domestic use is insufficient. Further, the poor recommended standards (500 persons per hand maintenance of hand pumps is a common factor pump) and ensure communities have enough that aggravates water availability and access water for kitchen gardening during the dry
problems” (JAM 2009) season” (JAM 2009)
CONTEXT Inadequate supply of water for both domestic and productive use (e.g. vegetable gardening) and growing pressure on existing water and sanitation facilities has been a recurring issue, while little if any progress has been reported in fully meeting the needs of the refugee and host population between 2007 and 2009. It was a common sight to see one hand pump or water point servicing a whole community including people from farther distances who find it difficult to meet their daily water needs. The issue of sustaining these facilities, their durability and repair cost were a challenge in most of the communities interviewed earlier. The 2009 JAM also highlighted that “when it comes to water used for other purposes, all communities mentioned having serious problems; in particular, water for kitchen gardening was reported to be insufficient. This affects crop production and therefore food security for community members”. Installing additional water pumps, drilling new boreholes and training Village Development Committees on the maintenance and repair of water pumps was seen as a top priority to ease the water pressure on refugee and host communities and provide an enabling environment for a successful implementation of the self- reliance and livelihood strategy. CURRENT SITUATION Water availability and adequacy In 2012, one out of four refugee households (24.9%) reported unmet basic household needs for water (cooking, drinking and washing). The proportion of households is highest in Foni Kansala where nearly every third household (31.5%) reports unmet basic water needs against nearly every fifth household in Foni Bintang (20.1%) and Foni Berefet (19.2%). In six communities, five of which are in Foni Kansala, at least every second household has unmet basic water needs: Karunorr (54%), Janack (50%), Kambong (57.1%), Monon (71.4%), Karor (50%) and Mandina (57.1). See Annex A, page 9 for complete village breakdown.
61 The vast majority of households who report unmet basic water needs (n=121) name distance (41%) as the main prohibiting factor while another 28% report overall insufficiency of water as the main reason. For nearly one quarter of households (23%) congestion and overcrowding is a major concern. Distance and congestion were constraints predominantly encountered in Foni Kansala with 57% and 64% of households respectively while water insufficiency is a problem encountered equally in all three districts. Breakdowns and maintenance of the water sources does not seem to be a major problem any longer as 97.3% of households report their water source as fully functional (n=486). Of the remaining 13 households 84.6% report duration of non-functionality to be less than 3 months. Water access is free for almost all households (97.5%) while the remainder pays on average 50 Dalasi per month for access.
Figure 40: Does the water source meet your daily household needs for water? Figure 41: Main reasons why unmet (Cooking, drinking and washing) 28% 3% 41% Average 24.9% 75.1%
Foni Kansala 31.5% 68.5% 5% 23% Foni Bintang 20.1% 79.9% Distance Foni Berefet 19.2% 80.8% Congestion Breakdowns 0% 20% 40% 60% 80% 100% Insufficient water No Yes Other
Water quality and treatment More than every fourth refugee household (28.2%) uses open (unprotected) wells as main source of drinking water in 2012 whereas 54% uses wells with pumps. Despite continuous efforts by development partners in the past five years to increase the number of protected wells through the provision and repair of pumps and complementary training of Village Development Committees in their maintenance, access to safe water sources has slightly but gradually deteriorated. The proportion of households using open wells to access water is up from 20.5% in January 2007 and from 27.8% in November 2008. It is also significantly above the proportion encountered throughout rural Gambia in 2010 (17%).37
Figure 42: Proportion of households with unprotected water sources, 2007-12 Figure 43: Type of water sources used
100% 3% 14% 80% 28% 60% 1% 40% 20% 27.8% 54% 20.5% 21.6% 28.2% 17% 0% Public / Communal tap (piped) Jan-07 Nov-07 Nov-08 Nov-12 2010 Private tap (piped) Refugee Households Gambia (rural) Hand-pump well Other water source (protected) Open well (unprotected) Borehole with pump Open well
37 Integrated Household Survey (GBOS/UNDP, 2010)
62
Three out of four refugee households do not treat water in any way before consumption (76%), while the majority of those who treat water (85%) use the filtering method and only 11.4% treat water through chlorination. Sanitation and waste disposal Figure 44: Type of toilet facility used by refugee households The majority of refugee households (79%) use traditional pit-latrine as primary toilet facility 5% Traditional pit latrine while the proportion of households with an 15% improved ventilated pit latrine is negligible Ventilated improved pit (VIP) latrine (1%). The remaining households (20%) show Open pit (no walls) 79% signs of heightened sanitary vulnerability 1% None / bush, stream, ‘flying toilet’ through use of open pits or unavailability of any toilet within the compound. Solid waste is mostly disposed of on a rubbish heap, pit or cesspool (42.8%), while 38.5% of households practice open burning, the latter being an even more common practice in the Foni (57%) as well as in The Gambia (46%).38 About 18% of households throw their solid waste in the bush or roads and less than one percent dispose of their solid waste in some other way. Source of lightning Almost half of the households (49.8%) use battery powered lamps as the main source of lightning, above the proportion in the Fonis (44%) and The Gambia (25%) while almost 35% of households use candles. Access to the public electricity grid have only 8.6% of the households, a significantly smaller proportion of the population than in the Fonis (14%) or nationally (25%).
Figure 45: Main source of lightning for households
Electricity (NAWEC) Gambia 25.0% 25.0% 42.0% Generator Battery powered lamps Foni 14.0% 44.0% 35.0% Paraffin Refugee Candle 8.6% 49.8% 34.6% Households Solar panel 0% 20% 40% 60% 80% 100% Other
CONCLUSION Overall water availability among the refugee population still remains a challenge, with nearly a quarter of households (24.9%) reporting unmet basic water needs for cooking, drinking and washing. The proportion of households with insufficient water access is highest in Foni Kansala (31.5%) in which communities were even found where over 50% of the households have unmet basic water needs. Limited water availability
38 Integrated Household Survey (GBOS/UNDP, 2010)
63 was a challenge mentioned frequently by refugee focus groups in relation to their productive activities (e.g. vegetable gardening). It appears that interventions aiming to enhance water availability and access had a only a very limited impact, if any, in enhancing refugee’s overall productive capacity and self-reliance, with the exception of a few women gardens, whereas a significant proportion of the population does not even have basic water needs met. In terms of enhancing access to safe drinking water a slight deterioration has been actually observed compared to the previous years, with over 28% of households reported sourcing water from open (unprotected) wells. This is worrisome in so far as 76% of households do not treat water in any way before consumption, thereby increasing their exposure to water borne diseases and, eventually, ineffective food utilization. RECOMMENDATIONS Water Access and Capacity Building • Drill new boreholes and provide training to village development committees (VDC) on the maintenance and repair of water pumps to ensure that communities have enough water for both domestic and productive purposes (i.e. gardening)
• Explore new ways of irrigation e.g. piped drop system, for more efficient use of scarce water resources during productive activities, e.g. gardening
Monitoring and Evaluation (M&E) • Increase the share of protected water sources in refugee communities to meet the basic water needs of the population, in line with UNHCR and WHO guidelines
• Increase the share of latrines in refugee communities to meet the basic sanitary needs of the population, in line with UNHCR and WHO guidelines
64
Section 1: Demography
Section 2: Food Security
a) Vulnerability Background and External Shocks b) Food Availability, Food Access, Food Utilization and Coping Strategies c) Self-Reliance
Section 3: Health and Nutrition
Section 4: Water and Sanitation
Section 5: Shelter
Section 6: Education
Section 7: Protection
65
RECAP
Findings Recommendations “There is clear evidence of overcrowding and “Select refugee families should be assisted with inadequate accommodation; entire families building materials, in particular roofing; criteria typically share one room, without beds and host for selection should be based on community families obliged to now share a smaller living identification of need and inability to procure
space” (JAM 2008) materials” (JAM 2008)
“The housing situation of the refugees has “Carry out a verification exercise to better improved with most refugees now living in their understand the dynamics of refugee households own houses as compared to the situation assessed not having their own houses; Implement the
by the last JAM when 80% of refugee families lived recommendation from the previous JAM under one roof with host families. There is also no regarding the provision of building materials clear evidence that the general living conditions according to need” (JAM 2009) are significantly different from those of hosts” (JAM 2009)
CONTEXT The housing status and overall living conditions have been an ongoing challenge for the refugees in the first two years of their presence in The Gambia. Up until the end of 2008, 80% of the refugee population was still living with host families while overcrowding was putting high pressure on the few available sanitary facilities. Despite overall openness of the communities to provide land for housing, construction and furnishing (e.g. bedding) of housing facilities remained limited due to the lack of financial means among refugee households. Sporadic and unrecorded migration of refugee households to the urban areas or to Senegal made it the more difficult to determine the extent to which vulnerability played a role in the housing status of the households and how further assistance for housing should be targeted. In the meantime, environmental shocks (e.g. floods) in 2011 and 2012 became an additional factor undermining the housing conditions of a limited number of refugee households and requiring the provision of additional assistance. CURRENT SITUATION Tenure status From 2008 to 2012 a significant improvement is observable with regard to the housing situation of the refugee households. While the previous assessment (JAM 2009) reported that over half of the refugee population has already settled or was planning to settle in their own houses in the near future, compared to only 20% a year earlier, this proportion has grown to near 60% in 2012. While the proportion of households that is still living under one roof with the host population has decreased to 19.8%, another 21% of refugee households still live in houses belonging to the host community. This makes the total population that remains in some form of dependency on the provision of shelter fall only slightly, from 44% to around 40% compared to 2009/10 estimates. The overall improvement of the housing status of households is probably less attributable to the provision of official shelter assistance, than the self-help of refugees within
66 the hosting communities and their steady migration to other communities or back to Senegal, which automatically eased the overall housing pressure and increased the proportion of those with some form of independence in terms housing status. In 2010 – 2012 official shelter assistance has been provided mainly to new refugee arrivals of 2011 and 2012 (17% of total refugee households) and to a handful of households which were affected by floods and windstorms. Overall, 96.5% of households reported not to pay anything for living in their dwelling.
Figure 46: Trend in tenure status of refugee households, 2008 - 2012 Figure 47: Tenure status in 2012
100% 0.2% 0.6% 19.80% 7.6% 80% 44.3% 23.0% 21% 21.0% 60% 80% 27.8% 40% 19.8% 55.7% 59.2% 20% 20.0% 0% Owner – with title deed JAM 2008 JAM 2009 JAM 2012 Owner – without title deed Rent free (living with host family) Rent free (living with host family) Rent free (not living with host family) Rent free (not living with host family) Tied – employment related tenancy Family owned house Independent (own housing) Land access and ownership Other
Overall access to land for housing is good but almost Figure 48: Proportion of households with access to and a third of households (30.5%) still does not have ownership of land for housing the opportunity to build own houses due to the 100% limited access to land. In addition, only one out of 80% 30.5% four households (25.3%) reported to own land for 60% 74.7% housing, which is an indicator of limited progress in 40% terms of long-term local integration. Continuing 69.5% 20% uncertainty regarding access to and ownership of 25.3% land can further undermine efforts to increase 0% refugees’ self-reliance and food security (See Section Access Ownership No Yes 7, page 75 for more detail). Housing conditions The overall housing conditions of refugee households remain very basic and are a relevant indicator of the poverty level and vulnerability to environmental hazards prevailing among the refugee community, but also Gambian households in the hosting region. Among the refugee households, the use of mud and earth for the construction of the house structure (i.e. walls and floor) and the use of corrugated iron for roofing is nearly universal, with about 95 - 98% of refugee households using these materials. Identical conditions prevail throughout the Fonis with the sole exception of concrete being used for flooring by nearly one third of Gambian households against 4% of refugee households.
67 Figure 49: Major material of the wall
Gambia 34% 41% 25% Concrete Foni 9% 85% 6% Mud / earth Other (e.g. brick, wood) Refugees 1.6% 97.7% 0.6%
0% 20% 40% 60% 80% 100%
Figure 50: Major material of the floor
Gambia 56.0% 32.0% 12.0% Concrete Foni 31.0% 64.0% 5.0% Mud / earth Refugees 4.1% 94.9% 1.0% Other (e.g. corrugated iron, tiles) 0% 20% 40% 60% 80% 100%
Figure 51: Major material of the roof
Gambia 17% 80% Cement / concrete
Foni 5% 95% Straw / Thatch Refugees 1.0% 97.5% Corrugated iron 0% 20% 40% 60% 80% 100%
CONCLUSION The overall housing situation of refugees has slightly improved against the 2009 findings but much remains to be done to enhance their housing conditions. Almost 40% of households are still dependent on external assistance for shelter, of which nearly half still lives under one roof with host families. Although land availability for housing is good and communities generally welcoming, 30% of households still cannot access land to construct own houses and only 25% of households own land for housing, with much uncertainty remaining concerning the potential for local integration and the establishment of long-term livelihood opportunities. The average occupancy rate in a refugee household is high with 4.3 household members sharing a room, compared to 2.1 in the West Coast Region and 1.9 for the national average, as established during the 2003 population census. Among 42% of refugee households the occupancy rate is above the national average. Very basic housing structures, limited ownership of furnishing and household assets and poor sanitation facilities are further indicators of endemic poverty, limited coping opportunities and heightened vulnerability of refugee households to disease outbreak, all of which may exacerbate their food insecurity situation, particularly in the event of unexpected shocks.
68 RECOMMENDATIONS Dialogue • Intensify the dialogue on the issue of refugees’ access to land, particularly on the question of dwelling, with the government authorities at both local and central levels
Assessment and Vulnerability Identification • Conduct a mapping exercise of acute shelter needs, in particular for households without own or inadequate shelter
Capacity Building • Conduct training of refugees and hosts on appropriate techniques for construction of durable shelter
69
Section 1: Demography
Section 2: Food Security
a) Vulnerability Background and External Shocks b) Food Availability, Food Access, Food Utilization and Coping Strategies c) Self-Reliance
Section 3: Health and Nutrition
Section 4: Water and Sanitation
Section 5: Shelter
Section 6: Education
Section 7: Protection
70
RECAP
Findings Recommendations “Refugee primary school enrolment rates seem “Conduct a more detailed analysis of this and good, with the majority of refugee families met promote higher enrolment where necessary” reporting that their children attend the local (JAM 2008) school” (JAM 2008)
“Proactively engage in discussions with UNICEF “Access to education, particularly primary and the Ministry of Education on sustainable schooling is acceptable for both refugees and access mechanisms to education for refugees for hosts. [...] Reasons for children not attending the coming school years; [...] UNHCR should school include distance, lack of nursery and lack of update the list of refugee households who are money (especially for secondary schools which eligible for educational support especially for require fees for entrance exams)” (JAM 2009) secondary and tertiary schooling, taking into account language issues for refugee children”
(JAM 2009)
CONTEXT The education of the children has always been a particular concern for the refugee families and the host communities, and key challenges consisted in the difficulty of paying for the overall cost of education and growing pressure on sanitary and teaching facilities in schools with a sizeable proportion of refugee children. However, school access of refugee children has been generally good with major assistance being provided in the period of 2006-2009 and again in 2012 to facilitate school attendance and provide for the expansion of necessary facilities in schools. School fees have been provided by UNHCR on an annual basis. CURRENT SITUATION In June 2012 the Ministry of Basic and Secondary Education with support from UNICEF conducted a rapid assessment of school access and educational needs of the refugee children in the host communities. The assessment established the total number of refugee children, how many attend school and at what educational level. Out of 1,170 refugee children identified 1,052 were registered within 10 Early Childhood Development Centres, 15 Lower Basic Schools, 9 Upper Basic Schools and 3 Senior Secondary Schools, with refugee children usually making up between 3-16% of the total student population.
Figure 52: Breakdown of refugee children in- and out of school, per district (June 2012)
Foni Berefet 193 0 Foni Bintang 578 18 In School Foni Kansala 252 97 Out of School Other 29 3
0% 20% 40% 60% 80% 100%
71 The remaining 118 children (10% of total) were not registered in any school, majority of which are from the communities of Dobong (66 children) and Kanilai (26) in the Foni Kansala District. The current assessment could confirm that the high proportion of school-children not attending school in Foni Kansala is a problem that still persists, mostly affecting the newly arrived refugee populations. Of the 117 children not attending any school 61% are boys. However, it could not be verified if non-attendance is also linked to any specific level of schooling. A major factor identified as barring children from attending school is that either their families or the host families could not afford the overall cost of education. This includes the cost of educational supplies such as exercise books and pencils; the cost of school uniforms and foot wares and in individual cases even the contributions to school meals. The rapid assessment also covered the availability of water sources and latrines in schools. It was established that in 14 out of 37 schools (38%) the water and sanitary facilities were not adequate. Latrines and pumps were either in need of rehabilitation or were insufficient to cover the needs of the enrolled student population.
RECOMMENDATIONS Water and Sanitary Access • Improve and maintain water and sanitary facilities in the schools of refugee communities, particularly in schools with an acute water and sanitary situation and constant overcrowding
Universal Education • Ensure that all refugee children identified out of school attend again the school programme
Vocational Training • As part of long term self-reliance planning in the rural areas, introduce gradually long term formal skills training and after-training packages on non-agriculture based livelihood skills for refugee children which are about to graduate from middle/secondary/tertiary schools
72
Section 1: Demography
Section 2: Food Security
a) Vulnerability Background and External Shocks b) Food Availability, Food Access, Food Utilization and Coping Strategies c) Self-Reliance
Section 3: Health and Nutrition
Section 4: Water and Sanitation
Section 5: Shelter
Section 6: Education
Section 7: Protection
73
RECAP
Findings Recommendations “Refugees move freely throughout the country” “Ensure that all refugees are registered, have their ID cards, or at least understand the registration
“Refugees and host families seem ready to accept process”
local integration. Land for settlement and farming “The option of local integration should be is available in the majority of the villages visited. discussed urgently with the [Government] and [...] The question of local integration is crucial to recommendations made as soon as possible to determining the type of assistance refugees and allow families to make decisions on settlement host communities would need in the future and and plan for their future” (JAM 2008) inform future operations” (JAM 2008)
“The Refugee Bill [establishing the Gambia “During this JAM’s key informant meetings, an
Commission of Refugees] and granting the official from The Government of The Gambia refugees the same rights as the local Gambians in stated refugees ‘could stay’. It is necessary to terms of access to different services (but confirm the government’s official position on necessarily nullifying their refugee status) was refugee settlement and/or integration option” passed by the Assembly and has been enacted by (JAM 2009) the President of the National Assembly on October 23rd, 2008.” (JAM 2009)
CONTEXT The provision of identity cards since January 2007 and the passing of the Refugee Act in October 2008, which also established the Commission for Refugees, were milestone achievements that enhanced the level of protection, mobility and access to basic services and fundamental human rights for refugee households. Ever since, The Gambia commission of refugees has a functional board with a chairman appointed and adequate provisions are in place for refugee children to be issued birth certificates. With 97% of the refugee households belonging to the Jola tribe39 and their close ethnic, religious and family ties with the host communities the overall level of acceptance of refugees in the Fonis is very high, providing a solid basis for a conducive environment for their further integration within the local communities. A key challenge at the time of the last assessment was uncertainty on the government’s official position on refugee settlement and their integration option. As a consequence, “lack of assurance/guarantee for continuous land usage in the following seasons”, including the question of land ownership, was a concern identified by refugee households, reportedly impeding local integration and the successful implementation of self-reliance opportunities. It was also reported that most of the refugees intended to stay and settle in The Gambia in light of continuing fighting and insecurity in Senegal.
39 Nutrition and Health Status Survey of Refugee households in The Gambia (NaNA/WFP, 2008)
74 CURRENT SITUATION Identification
Of the 486 interviewed households over 96% have Figure 53: Share of ID Coverage / arrival year indicated that they have been registered as refugee households and almost 94% are in a possession of a 100% 3% 7% 22% refugee identification card, highlighting almost universal 80% coverage with identification documents. However, this 60% does not reflect equal ID coverage of refugee populations 40% arriving to The Gambia in different periods. Of the 20% refugee population who arrived between 2006 and 2010, 0% almost 3% still has no ID while this share lies at 7% for 2006-2010 2011 2012 those who arrived in 2011 and at 22% for the most ID Coverage No ID Coverage Yes recent arrivals in 2012. Land access and ownership Access to land for housing and livelihood activities is the Figure 54: Land access and ownership basis for a successful integration of refugee households in 100% 85.4% local communities, which have been very generous in 69.5% allocating land for use by refugees. However, despite a 6- 75% 50% year presence of most refugees in the Fonis almost one 29.3% 37.7% third of the households (31.5%) still do not have land 25% 14.0% 3.1% 3.1% allocated for housing while 15% remain without access 0% 0.2% to land for agriculture. Only 38% of the households have Housing Farming Gardening Other land available for horticulture use. Access Ownership The previous JAM noted that “[p]oor soil quality and lack of assurance/guarantee for continuous land usage in the following seasons [...] are major limiting factors for expansion of cultivated areas”. To what extent refugee concerns related to land access are justified and what the impending factors are is unclear since land can be accessed for farming and shelter purpose through Government involvement, in consultation with the village chiefs (‘alkalos’) and village development committees (VDC). While this has been an ongoing process, still much work remains to be done to ensure universal access to land for housing and agriculture based activities and to enable the pursuit of sustainable livelihoods and long-term integration options. A minority of refugee households reported actual ownership of land for housing (29.3%), farming (14%) or gardening activities (3.1%). However, the question of how land ownership rights are handled is less clear and will require a separate dialogue, given the sensitivity over the issue of land availability and natural limits to agricultural cultivation in The Gambia. Sexual and Gender-based violence The issue of sexual and gender based violence (SGBV) is a newly occurring subject which has a bearing on the protection of Casamance refugees, particularly young females. Although several cases of violence have been reported since 2010 it remains unclear to which extent this is prevalent and how it is affecting the welfare and vulnerability status of the refugee population. This aspect of vulnerability has not figured clearly in the determination of targeting criteria for food based assistance applied in the past.
75 CONCLUSION Over the last four years the protection status of refugees has considerably improved with the introduction of the Refugee Act, the establishment the Commission for Refugees and the near universal coverage with identification documents, thereby enhancing their overall mobility and access to basic services. However, local integration and the pursuit of sustainable livelihood activities remains hampered by incomplete access to and very limited ownership of land for housing, farming and gardening activities. Uncertainty over the continuation of land usage in the future seems to be a barrier to agriculture based self-reliance activities and the improvement of refugees’ food security status, despite the fact that land for shelter and livelihoods can be accessed through government involvement in consultation with village authorities. Clarification of the question of land ownership, as distinct from land access, and proper sensitization of refugee families on both questions seems required to ensure more certainty among the refugee population with regard to their long-term integration options.
RECOMMENDATIONS Advocacy • Intensify promotion of local integration as a durable solution for Senegalese refugees in the Gambia and ascertain Gambia Government’s official position on the question of naturalisation of refugees in the Gambia
• Advocate for inclusion of refugees in National development plans
Protection and Access to Services • Ensure universal coverage of refugees with identification documents, including birth registration and certification of refugee children born in the Gambia
• Assess the magnitude and characteristics of SGBV violence within the refugee community
• Sensitize refugees on the family reunification process for lost family members
Long-term Strategy • Identify and implement durable solutions for refugees, i.e. local integration, voluntary repatriation and resettlement where feasible
• Identify self-reliance and development opportunities for those refugees who opt to integrate locally
76 5.References
Food Security Government of The Gambia (Department of Agriculture), 2008 – 2013. – National Agriculture Sample Survey Government of The Gambia, UN System, GRCS, TANGO, May 2013. – Daa Nyeeno - Food Security and Market Information Bulletin for The Gambia, Issue 5 Government of The Gambia, UN System, GRCS, TANGO, May 2012. – Multi-Sectoral Emergency Needs Assessment Government of The Gambia, UN System, GRCS, TANGO, January 2012. – Detailed Post Harvest Assessment WFP, September 2011. – The Gambia - Urban Market Assessment: A Feasibility Study on Cash and Vouchers WFP, May 2011. – Comprehensive Food Security and Vulnerability Assessment
Self Reliance and Livelihoods UNHCR/GAFNA, 2012. – Situational Assessment of Donkeys and Livelihoods of Senegalese Refugees in The Gambia UNHCR, December 2012. – Update on Local Integration in West Africa UNHCR, June 2012. – Update on Local Integration in West Africa UNHCR, March 2012. – Update on Local Integration in West Africa UNHCR, December 2011. – Update on Local Integration in West Africa UNHCR, June 2011. – Update on Local Integration in West Africa UNHCR, August 2010. – Update of LI situation for west africa UNHCR/Ilunga, S; Dicko, S. September, 2009. – Monitoring of local integration and livelihood activities, Activities Report n°11 UNHCR/Ilunga, S. April, 2009. – Support to Livelihoods Strategy for Senegalese Refugees, Activities Report n°8 UNHCR/Ilunga, S. April, 2009. – Stratégie régionale d’intégration locale et moyens de subsistance UNHCR/Ilunga, S. November, 2008. – Mission Report in Gambia UNHCR, July 2006. – UNHCR Handbook for Self-Reliance, Handbook GRCS, December 2009. – FFW Monitoring Report WFP, November 2009. – Food for Work (FFW) Progress Report WFP, October 2009. – Field Findings on Food for Work activities from recent Monitoring Missions and Follow-up, WFP letter to GRCS dated 14 October 2009
77 Nutrition NaNA/UNICEF, January 2013. – National Nutrition Survey in The Gambia Using Standardized Monitoring and Assessment of Relief Transition (SMART) Methods NaNA, August/September 2012. – The Gambia National Nutrition Surveillance Programme Report (GNNSP), 54th Edition NaNA/WFP, December 2008. – Nutrition and Health Survey of Casamance Refugees in The Gambia GBOS/UNICEF, 2005. – Multiple Indicator Cluster Survey
Education MoBSE/UNICEF, June 2012. – A Report on the Rapid Assessment of Refugee Children in Schools in Foni Conducted by RED2
Joint Assessment Missions UNHCR/WFP, December 2009. – UNHCR/WFP Joint Assessment Mission with the Department of State for the Interior and NGOs in The Gambia UNHCR/WFP, December 2008. – Joint Rapid Assessment Mission, Senegalese Refugees in The Gambia UNHCR/WFP, September 2008. – UNHCR/WFP Joint Assessment Misison (JAM), Guidelines UNHCR/WFP, March 2008. – Joint Assessment Mission UNHCR/WFP with the Department of State for the interior and Concern Universal
Other GBOS/UNDP, 2010. – Integrated Household Survey UNHCR/WFP, July 2002. – Memorandum of Understanding between the United Nations High Commissioner for Refugees (UNHCR) and the World Food Programme (WFP) WFP, 2013. – WFP Programme Guidance Manual (PGMWiki), section on refugees WFP/UNHCR, December 2012. – Synthesis of Mixed Method Impact Evaluations of the Contribution of Food Assistance to Durable Solutions in Protracted Refugee Situations, Synthesis Report
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