With the April cease fire, more territories in Angola have opened up, allowing MSF to expand their efforts deeper into the country. In the southern province of Cuando Cubango, MSF has been stationed in the town of Menogue for two years and have now been able to reach out to Mavinga Town, some 300kms away to the east. Accessing the region has been the first difficulty. The roads between Menogue and Mavinga were heavily mined during the conflict and are difficult to travel and so the best way to reach the town is to fly.

MSF entered, by plane, on June 17 - the first aid organisation to set up a project in the town. It was the sole organisation active there until this week. There are ten MSF expats and between 150 and 200 national staff members now working in Mavinga and the surrounding region. Teams there have discovered a region with almost no aid supplies, massive malnutrition levels and living conditions that are miserable. There is no electricity, so teams are limited to working during daylight hours.

The lack of water in the region is also presenting sanitation issues. Some 7,000 people live in Mavinga and nearby. Another 40,000 people are gathered in Quartering and Family Areas (QFAs) around the town. The local infrastructures are almost entirely destroyed. Mavinga Town is scarcely a town at all. More a collection of dilapidated buildings alongside an airstrip. The local population is spread throughout the region, living alongside the dry river bed, or in the savannah, further complicating any aid programme.

MSF has been able to use the landing strip during the past month to bring in urgently needed supplies and humanitarian personnel. However the facilities at the strip are minimal and refuelling of planes is not possible.

This places limitations to the number of planes capable of making the journey, round-trip, without refuelling. If the transport situation makes it difficult to enter, living conditions there are presenting challenges for the staff members, as well as those who have been surviving there. In the first week, MSF had to 'med-evac' two staff members. MSF now regularly rotates staff to avoid excess exhaustion and consequent medical problems.

First actions

Within two days of arrival, MSF had established a Therapeutic Feeding Centre (TFC). As of June 28, there were over 200 patients at the facility. Conditions there are considered catastrophic with global malnutrition levels at 25% and severe malnutrition at 10% (figures from a rapid assessment conducted by MSF staff). The population is in a severe state and are in need of food, basic living supplies and necessary medication. "They often have no food for ten days from UNITA or FAA", said Fred Meylan,the MSF Head of Mission). MSF staff have distributed blankets (one per child) throughout the local population.

Quartering and Family Areas

The people in the QFAs surrounding Mavinga are only in a slightly better condition. At the Campembe QFA, MSF found 100 severely malnourished people during the first exploration and ten people had already died since the QFA opened in April. In the Matungo QFA, MINSA (Ministry of Health of Angola) did a polio vaccination in May this year and there is a functioning health post. However the health post is ill-equipped to treat the severely malnourished children. Since MSF's first visit, the most severe cases have been transferred to the TFC in Mavinga, but the question of transport has yet to be resolved because the Matungo to Mavinga road is rough and takes at least two hours each way.

Measles vaccinations

With the weakened condition of the local population and the large concentration of people in one locale, a measles vaccination campaign has been done by MSF. By June 28, staff had vaccinated 17,868 children aged from six months to 15 years. In addition, MSF has taken on a blanket feeding programme using stocks provided by the World Food Programme. The blanket feeding programme targets families with children under-five and the total beneficiaries are 982.