A sense of normalcy is developing in Kisangani with the appearance of traffic police patrolling around the town. It has been three weeks since the end of the war and life is considered much calmer. There was a national holiday on the 30th June to celebrate 40 years of independence but the real celebration for the people was to welcome the end of the war. However military forces from both sides of the recent conflict remain in areas of the town and there is still no sign of UN peace keeping forces. The demining teams have destroyed over 2,300 UXO, 63 grenades, 45 detonators and two anti-personnel mines. There have been eight victims and five deaths due to mines. The ICRC will send a defused anti-personnel mine to Uganda to follow up in the International Court of Law as they have signed and ratified the Anti-Personnel Mine treaty but have used anti-personnel mines in Kisangani.

IDPs

There are approximately 30,000 Internally Displaced Person (IDPs) currently living outside Kisangani and the general worry appears to be: inaccessibility to the market due to price or shortage of items and inaccessibility to health care as they do not have enough money to pay the five franc consultation fee. There also appears to be an insufficient supply of water for the increased population. A sensibilisation campaign by a joint NGO task force will be started to encourage the IDPs to return to Kisangani. Transport will be provided to assist the remaining approximately 20,000 people back to Kisangani. ICRC, UNOCHA and WFP will make a distribution of food and non-food items.

HEALTH & NUTRITION

Both inside and outside Kisangani Town, health and nutrition is a chronic problem that has been exacerbated due to the war. There are both inadequate and expensive items in the market due to the lack of commercial planes and trucks. Also the cost of living has increased due to security problems. Outside Kisangani, where the situation is also chronic, there has been a strain on the local resources due to the increased numbers in the villages because of the IDPs.

MSF PROGRAMME ACTIVITIES

MSF has been involved in the nutritional resuirements of the local population with five therapeutic feeding centres (TFC) and ten supplementary feeding centres (SFC). Both of these programmes are targetted at the child population, as they are the most severely affected by malnutrition. It has been a busy week with a large increase in the numbers of children, and some of the centres getting quite crowded. The nutritional team will make an assessment of the feeding centres next week and, if necessary, tents will be erected on some sites to prevent overcrowding and subsequent hygiene problems.

On average there are 8-9 new admissions/day in each TFC and the SFC are seeing approximately 15-20 new admissions per week in each centre. The numbers of new admissions to the five TFCs have nearly doubled, so now MSF is meeting the nutritional needs of almost 1,000 severely malnourished children, plus their care givers. In our 10 SFCs, the numbers have also risen after the war and we are now providing services to about 1,500 moderately malnourished children.

The MSF nutritional team is concerned that, despite two weeks of supplementary rations, some of the children in the SFC are not gaining weight. It is thought that due to the lack of food security for the general population, the children's rations are being divided amongst the family. To counteract this problem, the MSF team there has decided to distribute high-energy biscuits or increase rations at the supplementary level to ensure that the children benefit from the distribution. MSF will provide 1,420 kcal/day instead of 1,240 kcal/day to those children who are not gaining weight. The nutrition team is planning a nutrition survey in three to four weeks, after the departure of the IDPs, to assess the nutritional status of the population.

NGO CO-ORDINATION

MSF is currently taking part in an "Internally Displaced Population" co-ordination meeting. MSF's role is data collection, lobbying and co-ordination. It is hoped that through a sensibilisation campaign and distribution of food and non-food, the remaining displaced will return to their home communities and alleviate some pressure from the rural areas of Kisangani. In addition, by encouraging the local "coping" mechanisms, the Congolese will be less dependent on the humanitarian agencies for assistance. IRC and Oxfam have opened offices in Kisangani. IRC will focus on medical needs, while Oxfam will provide water and sanitation assistance. UNICEF is working on a vaccination campaign.