The unseen face of humanitarian crisis in Eastern Democratic Republic of Congo: was nutritional relief properly targeted?

Study objective-Comparison of children's nutritional status in refugee popu lations with that of local host populations, one year after outbreak refuge e crisis in the North Kivu region of Democratic Republic of Congo. Design-Cross sectional surveys. Setting-Temporary and other settlements, in the town of Goma and surroundin g rural areas. Subjects-Anthropometric indicators of nutritional status and presence or ab sence of oedema were measured among 5121 children aged 6 to 59 months recru ited by cluster sampling with probability proportional to size, between Jun e and August 1995. Results-Children in all locations demonstrated a typical pattern of growth deficit relative to international reference. Prevalence of acute malnutriti on (wt/ht < -2 Z score) was higher among children in the rural non-refugee populations (3.8 and 5.8%) than among those in the urban non-refugee popula tions (1.4%) or in the refugee population living in temporary settlements ( 1.7%). Presence of oedema was scarcely noticed in camps (0.4%) while it was a common observation at least in the most remote rural areas (10.1%). As c ompared with baseline data collected in 1989, there is evidence that nutrit ional status was worsening in rural non-refugee populations. Conclusions-Children living in the main town or in the refugee camps benefi ted the most from nutritional relief while those in the rural non-refugee a reas were ignored. This is a worrying case of inequity in nutritional relie f.