(EST PUB DATE) GLOBAL HUMANITARIAN EMERGENCIES, 1993-94
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Director or
Central
Intelligence
National Intelligence Estimate
Global Humanitarian
Emergencies, 1993-94
This National Intelligence Estimate represents
the views of the Director of Central Intelligence
with the advice and assistance of the
US Intelligence Community.
Sec
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Director of
Central
Intelligence
NIE 93-36
Global Humanitarian
Emergencies, 1993-94 (
Prepared by Charles E. Allen, National Intelligence
Officer for Warning!
Secret
NOF RN-NOCONTRACT
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October I (NJ
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Secret
NOR. RN- CONTRACT
Figure 1
Most Likely Critical Humanitarian Emergencies
Estimated number of persons ii need (millions)
Present situation
compared to last year:
� More critical
1992-93
Cause
1993-94
Present
Potential
Conditions Assumed
Present
Potential
"., l./111.11i11161.A.1
0 i A:titi critical
Sub-Saharan Africa
2.0-3.0
2.0
�
Conflict; poor security.
Angola
Drought, conflict
3.0
No cease-fire; renewed attacks on food convoyslflights.
Liberia
1.0
10
0
Unsteady cease-fire.
Conflict
1.7
Conflict sups; refugees retunt.�
Mozambique
4.0
1.8
�
Peace accords hold; some security problems.
Conflict. drought
3.0
Refugees return, or conflict resumes.
Rwanda
1.0
1.0
6
Peace accords hold.
Conflict
1.5
Refugees return, or renewed fighting.
Somalia
2.0
1.3
�
Sporadic violence, food security good.
Conflict, drought
2.0
Renewed clan warfare.
Sudan
3.0-5.0
2.0
�
Intensified war in south.
Drought, conflict
3.4+
Conflict worsens: local food supplies targeted.
Former Yugoslavia
1.3
2.8
�
Continued conflict.
Bosnia-Herzegovina
Conflict
2.0
Conflict stops: refugees return.
Central Eurasia
0.35
0.5
0
Supply routes cut off.
Armenia
Blockade
0.3
Situation improves if conflicts end in Georgia and/or Azerbaijan.
Azerbaijan
0.5
0.9
.
Secessionist movements and leadership crisis persist.
Conflict
1.4
Government pandysi% deepens, greater Annenian
intwlventent in war.
Georgia
0.1
0.5
�
Secessionist wars persist.
Conflict
1.0
Full-blown civil war.
Tajikistan
IA)
0.3
�
Low-level clan/regional fighting continues.
Conflict
1.0
Clan, regional warfare intensifies.
Middle East/North Africa
0.75
1.2
�
Baghdad sustains blockade.
Iraq (Kurds)
Blockade by Baghdad
1.2
Electricity cut off harsh winter.
South Asia
4.5
5.0
�
Fighting does not subside.
Afghanistan
Conflict
5.5
More Tajiks crass border, or some Afghans repatriate if conflict lessens.
Sudan: Southern rebels-as well as the government-often
impede the flow of supplies.
a If conflict stops, the number of people in need of aid would
increase as refugees return, but the situation would be less
critical because relief probably would flow more freely.
Bosnia: Relief convoys headed for opposing sides frequently
are blocked and turned back
ConfidenMelORN
341342 10,93
II
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Seer
Key Judgments
RN-NOCONTRACT
Ethnic conflict and civil strife have increased humanitarian needs
around the world.
The international relief system is under severe strain and faces
burgeoning demands in the future. Bureaucratic tangles and competi-
tion will remain the most common problems; the UN often has trouble
coordinating relief efforts even among its own agencies. "Donor
fatigue" will lead to more selective responses to disaster situations.
Other donor countries and UN agencies will look to the United States
for leadership
Hostile environments are impeding relief efforts. In some areas of
conflict, only forceful�and costly�intervention will ensure that aid
reaches those in need
International operations are becoming more dangerous. Relief workers,
including those under the UN flag, increasingly will become targets of
violence
Africa will continue to generate the most severe humanitarian crises
despite the end of the drought in the southern part of the continent.
More than 6 million refugees and three to four times that many
internally displaced persons will be at risk of hunger and disease.
Fighting in Angola and Sudan is creating conditions as severe as those
in Somalia last year. In Somalia itself, the recovery is precarious.
If fighting continues in Bosnia as we expect, the population in need will
be double that of last winter, or reach some 2.8 million. Bosnians will
need about 390,000 metric tons of supplies to survive�the equivalent
of 19,500 C-130H flights�over the next six months. Even if fighting
stopped, the region would require about 270,000 metric tons.
Conflicts within the countries of the former Soviet Union have
intensified over the last year and will result in greater numbers of
people needing emergency aid. The most severe needs this winter will
be in Georgia, Armenia, Azerbaijan, and Tajikistan.
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Ethnic warfare in Afghanistan and, to a lesser extent, in Sri Lanka will
cause millions to be displaced. The number of Kurds requiring relief in
northern Iraq has grown from 750,000 to 1.2 million over the past year.
The 100,000 to 150,000 Shias in the southern marshes of Iraq could be
at risk of severe food shortages over the next few months.
Emergency humanitarian needs in the East Asia�Pacific region are
declining for the second consecutive year. The political situation in
Cambodia remains tenuous, however, and intensified conflict would
produce additional humanitarian needs.
iv
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Secr
N;ir
Scope Note
RN-NOCON TRACT
This Estimate identifies the ongoing and potential humanitarian crises
stemming from conflict worldwide for which the United States may be
asked to provide assistance over the next year. In addition, it addresses
the following questions:
� What will be the magnitude and scope of the crises? How many
people will be affected and what are their needs?
� What are the complications for delivery of aid? Is "donor fatigue" a
factor?
� Can the international infrastructure cope with burgeoning demands?
Included with this Estimate is a wall chart (in pocket at back)
containing specific environmental and operational data for each crisis
and a foldout locater map indicating the need, degree Of severity, and
cause of potential or actual emergencies. Are4Alost often affected by
natural disasters are identified in figure I OL,
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maareram......kpfmr.,*neexayow _s
Discussion'
Secr
NO RN-NOCONTRACT
Unrelenting civil strife and ethnic warfare
around the world continue to place millions
of noncombatants at risk of death from
starvation and disease. Since last year's Esti-
mate, critical humanitarian needs stemming
from conflict have increased.'
Efforts to respond to humanitarian crises
have had mixed success. International inter-
vention in Somalia relieved the mass starva-
tion, and resourceful and determined efforts
in Iraq sustain the Kurds. In Bosnia, howev-
er, attempts to meet critical needs�while
saving thousands of lives�have fallen short.
Can the Relief System Cope?
The demands placed on the international
infrastructure for delivering emergency relief
over the past two years have uncovered
ominous faultlines. Lives continue to be
saved, but breakdowns in the system have
occurred. Even where food supplies are ade-
quate, bureaucratic tangles and coordination
problems, especially among UN agencies, as
well as local political and economic barriers,
impede the delivery of aid to people in
critical need. If not addressed, the effect of
these weaknesses, particularly those involv-
ing UN agencies, will erode donor confi-
dence and make donor countries more reluc-
tant to participate.
' We define "critical humanitarian needs" as those arising from
acute emergency conditions�wars, conflict, natural or techno-
logical disasters�that are not met by routine relief programs
and mechanisms. We use the term "populations at risk" to
mean those in need of or dependent on international aid to
avoid deprivation leading to serious malnutrition or death.ie<
Sources of Information
The information used in this Estimate
comes from a variety of sources includ-
ing diplomatic, military, and press
reporting; data from UN agencies and
nongovernmental organizations; and
interviews with relief workers on the
scene.
These reports frequently provide con-
flicting information: each organization
reports on situations as seen through
the filter of its own program, and crises
developing in isolated or denied areas
often have few observers. We believe
some reporters�political opponents,
rebel groups, governments, and relief
providers�at times exaggerate the
gravity of a situation. For example, at
one point last year, estimates on the
number of people at risk of starvation in
Sudan ranged from 200,000 to 10 mil-
lion.
Any specific numbers cited in this Esti-
mate, therefore, represent our best
assessment based on a review of all
available information, and we are confi-
dent that they accurately portray the
magnitude of the problem�if not the
absolutely precise numbers of the popu-
lation in need
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The International Relief Network
A multitude of organizations�UN agen-
cies, international and national nongov-
ernmental organizations (NGOs), and
regional organizations�as well as donor
countries comprise the humanitarian
relief system. The UN bodies include the
UN Department of Humanitarian Assis-
tance (UNDlif A), the UN High Commis-
sioner for Refugees (UNHCR), the World
Food Program (WFP), the International
Children's Fund (UNICEF), the UN
Development Program (UNDP), the World
Health Organization (WHO), and the
Food and Agriculture Organization
(FAO). Among the largest and most active
of the more than 16,000 NGOs are the
International Committee of the Red
Cross, various national Red Cross Societ-
ies, the International Rescue Committee,
Medecins Sans Front ieres, Equilibre,
OXFAM, and the International Save the
Children Alliance.
Formal interaction between humanitarian
aid providers takes place in organizations
established for that purpose. The 86-
member International Council of Volun-
tary Agencies (IC VA) meets regularly with
UN relief agencies; its task forces provide
a focal point for NGO activities in disas-
ter-stricken countries. The LicrossIVolags
Steering Committee, founded by the
League of Red Cross and Red Crescent
Societies (LORCS) and several other
NGOs, submits humanitarian relief policy
to the UN and meets monthly to review
current disaster situations. The EC/NGO
Liaison Committee provides a dialogue
between about 600 European NGOs and
the EC. In addition, the Conference of
NGOs (CONGO) provides for NGO partic-
ipation in UN meetings and committees.
When disasters occur, UN agencies,
NGOs, and representatives of donor coun-
tries meet to plan relief efforts. They often
carry out needs assessments in combined
missions, although they also may do so
independent of each other. Likewise, they
may issue appeals as a consolidated group
or on an individual basis. International
conferences are held to elicit contributions
as well as to coordinate relief efforts. In
addition, a Special Representative of the
Secretary General and a UNDHA Special
Coordinator are sent to disaster areas; in
theory at least, the UNDHA Special
Coordinator organizes the relief opera-
tions. NGOs, the EC, and donor countries
also send coordinators. While all of these
representatives�as well as those from
aid-receiving countries�meet to discuss
their individual operations and to coordi-
nate their efforts, the number of meetings
and the level of successful coordination
appear to be specific to the country receiv-
ing aid and the organizations operating
there.
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Showing Its Warts...
The international relief system comprises
myriad independent or semi-independent
organizations that often work together but
sometimes do not. The UN's agencies and
officials frequently compete for primacy, to
the detriment of aid delivery. In Angola, for
example, the personal representative of the
UN Secretary General, working with little
data, has tried to make crucial decisions that
run counter to the plans of the UN agencies
charged with delivering emergency aid.
Duplication of activities, bureaucratic bun-
gling, tensions between organizations, and
lack of coordination are commonplace. The
creation last year of the UN Department of
Humanitarian Affairs (UNDHA) was sup-
posed to alleviate these problems but instead
has compounded them. UNDHA often has
difficulty coordinating between its New
York office responsible for policy and its
operations headquarters in Geneva.
... And Coming Under Fire
Hostile environments around the world
impede, and sometimes prevent, organiza-
tions from delivering sufficient assistance in
a timely fashion. Attacks on relief convoys,
theft of supplies, and murders of relief work-
ers all contribute to the impression that the
organizations cannot get the job done. Pri-
vate volunteers have long faced such dan-
gers, but attacks on UN forces and officials
during the past year have struck a blow
against the UN's moral authority. The UN's
experiences in Bosnia and Somalia will
encourage belligerents elsewhere to regard
relief workers under the UN flag as legiti-
mate targets of violence. (s
Figure 2. Swedish UN troops secure relief
supplies at Sarajevo airport. (u)
More Challenges Ahead
As humanitarian needs grow, the task of
delivering emergency assistance is becoming
more dangerous and complex:
� In areas of conflict, forceful and costly
intervention�requiring a range of logistic,
security, and combat forces�often is
required to ensure that food, shelter, and
medicines reach the populations at risk.
� International forces will face additional
problems from infectious diseases and envi-
ronmental health risks, which represent a
greater threat than battle injuries to the
effectiveness of units conducting the relief
operations
Potential exposure to the AIDS virus pre-
sents another complexity. The militaries of
some countries with which US forces may be
working have H IV-infection rates in excess
of 50 percent. Special planning will be
required in operations involving those forces,
especially in areas of conflict and in places
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Acquired Immune Deficiency Syndrome
(AIDS) and Humanitarian Emergencies
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AIDS is the final stage of a viral infection
of the human immunodeficiency virus
(HIV), which destroys the body's natural
immunity to fight infections. All HIV
infections are fatal.
Refugees, peacekeeping or monitoring
forces, demobilizing militaries, and labor
migrants contribute to the spread of AIDS
beyond specific countries. Humanitarian
aid missions involving militaries with high
HIV-infection rates could spread viruses
to countries where it is not now a problem.
For example, Liberia's relatively low
infection rate could be threatened by all
three countries�Uganda, Tanzania, and
Zimbabwe�considering joining an
expanded monitoring force there
UN regulations now require governments
to certify that their personnel are HIV-
negative before deploying them on UN-
sponsored missions. However, AIDS
screening is expensive, and some militar-
ies will shirk this costly procedure. Some
countries are already having difficulty
finding sufficient HIV-negative personnel
to meet multinational force commit-
ments�another disincentive to testing.
In addition, UN officials are not enforcing
their HIV regulation. Thus, the Ugandan
contingent soon to arrive in Somalia has
at least a 50-percent injection rate. The
commander of the UN force in Mozam-
bique has asked that the Zambian contin-
gent�many of whom he says have AIDS
and are causing operational and morale
problems�be replaced at the end of its
tour by troops from another country; how-
ever, he is skeptical that the UN will
honor his request.
The United States and other donor coun-
tries will have to take measures�includ-
ing leading and funding the international
oversight of HIV testing�to ensure the
safest possible environment for relief
personnel
where medic
ner nations
tions, US forces
medical services directly to !o
that have high infection rates
"Donor Fatigue" Sets In...
The extent of critical humanitarian needs
and the problems of addressing them are
ties are shared with part-
n some reliel opera-
e expected to provide
affecting the international response. Over the
past year, donors generally have become
slower to respond, and contributions often
have fallen short. For example:
� Aid for Afghanistan lagged badly this
year; the UN Secretary General's Special
Representative reported in late June that
only about $36 million of a $138 million
appeal for the January to September period
had been pledged.
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Who Are the Donors?
�
The European Community provides sig-
nificant humanitarian aid in addition to
the aid provided by its members on an
individual basis. Other West European
and North American countries plus Japan
contribute most of the personnel, supplies,
and funds for humanitarian assistance,
either unilaterally or through UN organi-
zations and nongovernmental organiza-
tions. The share offunding varies with the
situation: developed nations had contrib-
wed over $950 million in disaster relief to
the former Yugoslavia as of June 1993;
the United States contributed some $354
million of the total. On the other hand,
the United States has contributed about
three-fourths of the funds for relief efforts
in Liberia.
What Do They Provide?
In addition to food, medicine, and funds,
donors provide mobile hospital units,
shelter supplies, blankets, trucks, and
communications equipment. Russia and
Ukraine have specialized in supplying mil-
itary and civil transport and helicopters
on a contract basis at advantageous rates.
Russian aircraft have supported opera-
tions in Somalia and Cambodia; the
Ukrainians have flown hundreds of mis-
sions into Armenia.
Stockpiles of emergency items are main-
tained by various governments and private
relief organizations around the world. For
example, Japan's International Relief
Organization has storehouses in Japan,
Singapore, Mexico, and Italy for rapid
deployment to disaster sites. The UN
Department of Humanitarian Assistance
is promoting the worldwid register of
such disaster stocks.
� As of early August this year, the Interna-
tional Committee of the Red Cross's
appeal for the former Soviet Union had
yielded less than half of the amount
requested.
� The UN so far this year has received
commitments of only $89 million of the
$226 million requested for Angola.
...With Tough Choices in Store
The international relief system, already
under severe strain, faces burgeoning
demands in the future. The resources of the
United States and other donors will be
spread more thinly, and donors will have to
be more selective about which crises to
address
The decision of the international community
to respond to a specific humanitarian crisis
will depend on the accessibility of the popu-
lation in need, the risks to relief personnel,
and severity of the crisis, as well as the level
of effort already being expended for other
critical needs. As in the past, some dire
situations in remote locations will be over-
looked by donors. Other crises will receive
widespread media attention that will
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World Grain Supply
Few countries have suffered serious crop
failures from droughts, floods, or other
natural disasters in 1993. In most coun-
tries requiring food relief shortages have
resulted from political or economic tur-
moil that has disrupted imports or distri-
bution within the country, particularly
distribution of food to persons displaced
by conflict.
Although global production of grains,
which provide human as well as animal
sustenance, will probably decrease slight-
ly from the record levels of 1992, grain
production will still be above the average
for the past five years. Production of
wheat and rice�the main components of
the human diet in most countries�will
likely be higher than that of 1992 and
almost 3 percent above the recent average.
Most countries with large increases in
grain production had good rainfall this
year, and their governments have raised
crop prices and promoted irrigation to
boost production. For example, wheat
crops in most of the countries in a band
from Kazakhstan through the Middle
East to parts of North Africa benefited
from above-normal rainfall during 1993.
Moreover, several of these countries�
including Iran, Iraq, and Turkmenistan�
have vigorously promoted wheat produc-
tion to decrease their dependency on im-
ports. Despite their production increases,
several of these countries will still have
large deficits and will require imports or
food aid.
Agricultural experts expect the largest
proportional declines in food production
to occur in a diverse group of countries:
Morocco, hit by a drought this year;
Venezuela, whose economic disruption
has curbed production; Somalia, where
conflict has prevented planting of much
cropland; and East European countries,
subject to both drought and economic
disruption. Most of the countries in which
1993 production is likely to be 10 percent
or snore below average will not experience
food problems, however, because they can
afford to increase imports or, in some
cases, will still have surpluses for export.
enhance our ability to estimate the scope of
the crisis while increasing international pres-
sure to act. Still, some crises�especially in
areas that are less accessible or where con-
flict is intense�may be considered too costly
or complex to undertake large-scale relief
efforts
The United States will be expected to take
the lead in identifying and responding to
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Sub-Saharan Africa
Africa will continue to generate humanitar-
ian emergencies on an unparalleled scale.
Despite progress toward peace in some coun-
tries and the end of the drought in the
southern part of the continent. Africa still
has most of the world's refugees�about
6 million�and three to four times that many
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displaced persons. Moreover, African gov-
ernments on the whole are the world's needi-
est and least able to cope with their
emergencies:
� More than half of the world's poorest
countries are found in Sub-Saharan
Africa.
� Africa has 12 ongoing insurgencies, includ-
ing those in Rwanda and Mozambique
where cease-fires are in force but rebels
have not been disarmed.
� The AIDS epidemic is spreading through
all of Africa and straining its already
feeble health care systems; of the 13 mil-
lion people worldwide infected with the
HIV virus, 8 million are in Africa.
During the coming year, international aid
and intervention will be necessary to stave
off human catastrophes in parts of Africa. In
addition to emergency shipments of food and
medicine, the transition from war to peace in
some areas will require assistance in refugee
resettlement, infrastructure repair, landmine
removal, and support for demobilized mili-
tary forces.
The Horn: More Turmoil in Store
Somalia. The massive international relief
effort has ended the starvation, and some
local councils are beginning to function
again. Nevertheless, instability in Mogadi-
shu and random violence in the countryside
make the recovery precarious. Most of the
1.3 million refugees and displaced persons in
camps remain dependent on international
assistance, and the majority of international
relief workers�forced to leave by the earlier
violence--have not returned. The security of
food supplies and delivery is problematic.
Without a continued international effort,
widespread hunger and disease could reap-
pear quickly.
Sudan. The civil war in the south is creating
humanitarian conditions as severe as those in
Somalia last year. The intensified govern-
ment offensive against the rebels makes the
task of reaching the 1.5 million southerners
in need of humanitarian assistance-800,000
of whom are already at risk of starvation�
even more difficult. An additional 1 million
people elsewhere in Sudan�including
600,000 displaced in the transition zone
between north and south�now need
humanitarian assistance. Another 200,000
are in danger of being caught in the fighting
and may join the 350,000 Sudanese refugees
who already have fled to neighboring coun-
tries�primarily Zaire and Uganda.
Sudan has enough food to meet most of its
needs but has provided only about half of the
grain promised for relief in the south. The
government suspects that relief efforts are
aiding the rebels; all sides have impeded the
flow of aid. Khartoum would oppose a US-
or UN-led relief intervention in the south
and would likely stage guerrilla attacks Qn
foreign military forces and aircraft.
Meanwhile, locust infestations in both
Somalia and Sudan have become serious and
are likely to aggravate the food crises in both
countries. The political situation in northern
Somalia precludes international eradication
efforts there; in Sudan, UN sources say the
locust infestation will worsen if current
weather conditions persist.
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Figure 3
Africa and the Middle East
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Southern Africa: Drought Ends,
But Peace Elusive
About 4 million people in this region are in
danger of starvation
Angola. Some 2 million are at risk as a result
of a more destructive phase of the 16-year
civil war. Relief organizations have substan-
tial supplies in-country, but logistic con-
straints and attacks on food convoys and
relief flights will contribute to even greater
starvation; deaths per day may now exceed
several hundred. The UN and other relief
organizations, however, have little reliable
data on the location and numbers of people
in need
Mozambique. The signing of peace accords
has facilitated relief deliveries to the
1.8 million persons who depend on aid, al-
though food deliveries are still subject to
interdiction by armed bands. Ample rains
this year have helped improve the local har-
vest; but, by yearend, surplus stocks of
maize�both donated and locally pro-
duced�will be expended, and additional
shipments will be needed. Moreover, uncer-
tain security conditions and a ruined infra-
structure will hamper resettlement efforts
that are slated to begin late this year for
1.5 million refugees, several million dis-
placed persons, and at least 60,000 demobi-
lized soldiers. Until the former combatants
are disarmed, a breakdown in security still
could lead to an acute humanitarian crisis.
Peace Possible Elsewhere,
But Conflict More Likely
Rwanda and Liberia. Recent peace accords
are allowing supplies to flow to populations
dependent on international relief in Liberia
and Rwanda. If the accords hold, the inter-
national community will be called upon to
help resettle about 700,000 refugees and
more than 185,000 displaced persons in
Liberia and nearly 1 million displaced per-
sons and 2(4000 to 500,000 refugees in
Rwanda. Chances of renewed conflict in
both countries remain high, however
Sierra Leone. More than 20 percent of the
population has been displaced or has left the
country as a result of fighting in the south-
east. Some 240,000 already arc dependent on
feeding programs, another 300,000, most of
whom are in Liberia, are expected to return
from neighboring countries, and up to
300,000 more are internally displaced but
not currently receiving aid. The government
seems to have the upper hand against the
rebels, but the end gf the insurgency is far
from certain.
Zaire. Three years of political impasse
between the President and his opposition has
led to a breakdown in central control. The
collapse of basic services, ethnic strife, and
looting and violence by unpaid soldiers have
reduced the availability of food. Malnutri-
tion and disease are at high levels in the
capital, and low food reserves in all provinces
make localized famine in urban areas likely
over the next three to six months. The vio-
lence so far has displaced over 500,000. If
substantial portions of Zaire's 40 million
population begin to flee across borders, as
some already have, neighboring Angola,
Zambia, Rwanda, Uganda, and Sudan could
not cope with the influx
Europe
After Africa, the world's most acute
humanitarian crises are concentrated in the
former Yugoslavia. Some 4.3 million people,
(b)(3)
(b)(3)
(b)(3)
9
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acording to the United Nations High Com-
missionerfor Refugees (UNHCR), are in
need of aid�two-thirds of them in Bosnia.
Long-term subsistence on minimal food sup-
plies, limited medical care, severe shortages
of water and sanitation supplies, and damage
to housing have left the Muslim population
in Bosnia weakened, more susceptible to
disease, and progressively less capable of
surviving bouts of hunger and cold. The
infrastructure in central and eastern Bosnia
is severely damaged, and many towns there
are dependent on the humanitarian relief
effort. Relief deliveries fall short of demand
and are hampered by insufficient resources,
fighting and denial of access, poor road
conditions, bureaucratic hurdles, and bad
weather
If War Continues...
The impact of continued conflict will be
more devastating this winter than anything
we have seen thus far. Tens of thousands
could perish from disease, hunger, and cold.
If fighting continues as we expect, the Bosnian
population in need will be double that of last
winter�or about 2.8 million people. Total
relief requirements during the next six
months will be an estimated 390,000 metric
tons�equal to about 19,500 C-130H flights
at maximum payload�about 80 percent of
which will be food.'
Food reserves in Bosnia have been largely
consumed. A harsh winter this year�unlike
last year's unusually mild one�will make
I By comparison, the UN HCR sent 120,000 metric tons of
relief supplies into Bosnia during the first six months of this
year: in March 1993. UNF1CR delivered 25,000 metric tons--
the largest single monthly shipment to date.
Figure 4. Residents of Sarajevo line up to get
/ their water from a unoff pipe flowing into a
suburban river. i
Figure 5
Former Yugoslavia
Time 0
Austria
Italy
100 Kilometers
too %ties
Rulg.
*Skopje
MACitX)NIA
Greece
Unclassified
75)?, 14141 *veil It) 4.4
relief deliveries throughout much of Bosnia
more difficult at the same time that humani-
tarian needs are highest.
... And If the Fighting Stops
The humanitarian outlook would improve,
but needs would dictate a substantial relief
10
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operation. Requirements could total as high
as 270,000 MT of aid over the next six
months. Planning figures by the UNHCR
suggest that such an operation�through
normal relief agency channels�would cost
about $200 million. The amount of aid would
reach this level as significant population
displacements occur, including the move-
ment within Bosnia of as many as 200,000
Muslims from Croat- and Serb-controlled
areas to the central Muslim core; of about
60,000 Croats to western Bosnia; and 20,000
to 50,000 Serbs to other parts of Bosnia. In
addition, about 200,000 Muslim refugees
probably would return from Croatia to
Bosnia, as would about the same number of
Serb refugees from Serbia itself.
Croatia. The UNHCR lists about 530,000
persons-250,000 displaced Croatians and
more than 280,000 refugees from Bosnia�in
need of assistance. (u)
Kosovo. If ethnic fighting expanded into
Kosovo, we would expect that over 300,000
Albanian refugees initially will flow into
Albania and Macedonia, and many more
(b)(3) would flee as the fighting spread.
(b)(3)
Central Eurasia
Conflicts along the southern flank of the
former Soviet Union will generate acute
needs for humanitarian assistance. Most
regimes are less stable than they were a year
ago. Virtually the entire Caucasus region, for
example, is embattled or under blockade,
and disputes among Tajikistan's clans and
regional factions continue to impede efforts
to provide relief and resettle refugees.
Conditions in Azerbaijan, Armenia, and
Georgia are worse than last year. Azerbaijan's
war with its ethnic Armenian-dominated
enclave, Nagorno-Karabakh, has escalated
since June with a Karabakh-Armenian
offensive, sending some 300,000 Azeris
toward the Iranian border. Tehran�already
burdened by 2 million Afghan refugees�is
delivering relief supplies and establishing
displaced person camps on the Azerbaijan
side of the border in an effort to prevent the
Azeris from crossing into Iran; Turkey is
providing funds for other camps. Baku can-
not provide for its nearly 1 million refugees
and displaced persons while it wages a losing
war, struggles to resolve a leadership crisis,
and tries to cope with regional secessionist
movements in the north and south. We esti-
mate the fighting this year alone has dis-
placed more than 400,000 people. Living
conditions can be expected to worsen as
ts in and food supplies dwindle.
rmenia is all but cut off from the outside
world by civil strife in Georgia and an
Azerbaijani blockade. During what is
expected to be its second consecutive harsh
winter, Armenia will face shortages of food,
oil, water, and electricity. Turkey will
restrict use of its territory for delivery of
relief supplies to Armenia as long as the
Nagorno-Karabakh conflict continues, and
airlifts will be necessary to sustain the
population.
The ethnic and civil conflicts in Abkhazia
and western Georgia will continue, with full-
blown civil war a possibility. T'bilisi's access
routes north to Russia and west to Black Sea
(b)(3)
(b)(3)
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?74
Figure 6
Caucasus Region
(b)(3)
� �Boundary between Chad:ante and
ti Inoushetia has not been established
RUSSIA
Abkhazia
'As
Sukhumi
Black
Sea
Turkey
Syria
Uncl
Kabardino-
Balkaria
North
Ossetia
Ingushetiad
GEORGIA
Iraq
Chechenie
Tbilisi
Caspian
Sea
AZERBAIJAN
* .
�� Baku '
< rr
t,Nagorno.
\Karabakti
141011)
ports are tenuous and subject to frequent
disruption. Emergency deliveries of food and
medicine�in addition to current aid in the
pipeline�will be needed during the winter.
Iran
O 10014Ianelers
I..
O 100 Macs
730013 190033.0 10 93
Territorial and ethnic conflicts are also
brewing in the North Caucasus region of
Russia�particularly the republics of
Ingushetia, Chechenia, and North Ossetia.
Limited local warfare in those areas over the
ret
12
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(b)(3)
(b)(3)
(b)(3)
next several months is likely and will produce
refugees who will need support. Conflict in
the North Caucasus will hinder supply
routes into the entire Caucasus region.
More than 30,000 Tajik refugees have been
repatriated from Afghanistan to southern
Tajikistan, but efforts to reintegrate them
are failing and the humanitarian situation
there probably will worsen. The population
of the Pamirs�swollen by more than 30,000
displaced persons and refugees returning
from Afghanistan�faces a winter of famine
if relief routes are not kept open. By October,
snows will cut off much of the region. Mean-
while, the impoverished Gorno-Badakhshan
and wealthier Leninabad regions are both
operating independently from Dushanbe.
The lack of central government control
hinder relief and resettlement efforts
South Asia
Ethnic warfare�particularly in Afghanistan
and, on a smaller scale, in Sri Lanka�will
continue to generate humanitarian needs in
South Asia. Conflicts will keep about
6 million people dislocated and dependent on
humanitarian assistance. Pakistan will re-
main dependent on international support as
long as it hosts significa t numbers of
Afghan refugees
In Afghanistan, fighting in Kabul and along
the Afghan-Tajik border, as well as guerrilla
attacks throughout the country, has wors-
ened over the past year and will displace
more Afghans, hinder refugee repatriation,
and impede the delivery of international aid.
Without emergency relief, about 5 million
people�either refugees or internally dis-
placed persons�would suffer from food and
fuel shortages, inadequate water and elec-
tricity, and epidemics. About 1.5 million
Afghans are internally displaced, 1.5 million
more are refugees in Pakistan, and another
2 million are in Iran. In addition, at least
some 60,000 Tajiks fled to northern Afghan-
istan after civil war erupted in Tajikistan last
year.
The job of delivering emergency aid in
Afghanistan has become more treacherous.
Factional fighting and lack of central gov-
ernment control have heightened the threat
to aid workers. Relief operations staged in
Afghanistan rely heavily on air transport,
which is vulnerable to Afghan guerrillas
armed with antiaircraft weapons. Overland
transport to isolated populations requires the
cooperation of local warlords.
Elsewhere in the region, the civil war in Sri
Lanka that pits the Sinhalese majority
against Tamil separatists will continue to
inflict hardships on the populations in the
north and east of the island. Some 600,000
people have been dislocated by the conflict,
and about 80,000 refugees remain in India.
Middle East�North Africa
Iraq will be the only country in this region
likely to generate substantial emergency
humanitarian needs unrelated to natural
disasters during the next year. The Kurdish
population will face harsh conditions this
winter; the number of Kurds requiring assis-
tance has grown from 750,000 to 1.2 million
over the past year, and the Kurds have
become even more dependent on international
(b)(3)
(b)(3)
(b)(3)
13
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Figure 7
Afghanistan and Tajikistan
Turkmenistan
Iran
Uzbekistan
AFGHANISTAN
Boundary representation Is
not necessarly autnontatirm.
0
200 Kilometers
0
200 Miles
Tashkent
Dushanbe ,
e.TAJI I,K.ISTAN
Gomo-Badakhshan
Autonomous P .1
Oblast
Kabul
Kyrgyzstan
Pakistan
China
/1
India
r s
/30034 0700915) 10 93
,stieet
14
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)p
Figure 8. Thanks to Baghdad's
continuing blockade, the Kurds of
northern Iraq will spend their third
winter as dependents al the inter-
national relief system.1
help. In addition, a health crisis is developing
in parts of the North where the lack of
electricity�which was cut off by B
is curtailing access to safe water
As a result of Baghdad's ongoing em
of the north, the UN estimates that over
90 percent of Kurdish food, fuel, and
medical needs must come from territory that
is not controlled by Baghdad. Shortfalls in
the funding of relief agencies, harassment by
the Iraqi Government, harsh weather that
would close convoy routes, and a possible end
to cooperation from Turkey�through which
the aid flows�will co eaten
relief efforts this wint
The 100,000 to 150,000 Shias in the south-
ern marshes of Iraq�site of a low-level
insurgency�are likely to be at risk of severe
food shortages over the next few months.
Baghdad continues to dry out a substantial
part of the hlands where the Shia live,
dcstroI dr t ditional means of subsis-
tence.
We cannot verify the extent of acute needs in
southern Iraq. Baghdad denies the UN and
other relief organizations access to the area.
The only route for delivering relief would be
through Iran and would pcq.vire smuggling
supplies past Iraqi troop
East Asia�Pacific
The region is expected to have its usual share
of emergencies stemming from natural disas-
ters, but the number of people dependent on
emergency aid for survival�displaced per-
sons and refugees�will continue to decline
as noted in last year's Estimate. Cambodian
refugees have returned home from Thailand
as a result of a UN-brokered peace agree-
ment. In addition, improved conditions in
Vietnam are encouraging many Vietnamese
refugees to repatriate from asylum in I-long
Kong, Indonesia, Malaysia, and elsewhere.
15
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Figure 9. Extreme poverty and -
political violence in Haiti are a
boon to the boat-building business
but could again spark massive
miuration to the United States.
Cambodia will need food assistance during
the next year as more than 360,000 recently
returned refugees run out of UN rations and
Cambodians try to produce a crop without
adequate irrigation or fertilizers. Low-level
fighting and banditry will pose hazards for
donors distributing assistance outside the
capital. Moreover, the Khmer Rouge could
return to more intense warfare that would
once again displace large numbers of people,
send refugees fleeing across borders, and
dramatically increase the need for humani-
tarian assistance.
16
Widcworld 0
Latin America�Caribbean
Most humanitarian needs at present can be
handled through routine aid programs. Des-
perate economic conditions and political
repression in Haiti and Cuba, however,
could bring calls for emergency relief and
stimulate sudden and massive migration that
would necessitate direct US assistance.
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� Figure 10
Countries Willi Significant Populations
Vulnerable to Major Natural Disasters
Earthquake
Volcano
/181
,Tropical Cyclone'
Flooding
(.'ountry
Armenia
Aierbaijan
Bangladesh
Burma
Caribbean islands
Chile
China
Costa Rica
'itha
Ecuador
F.I Salvador
(;recce
India
Indonesia
Iran
Italy
Jaran
Kyrgyistan
Mexico
NicaraQua
Pacific islands
Pakistan
PaII:1111a
Peru
Philippines
South Korea
liiaII
Tajikistan
Turkey
Ceophysical Disaster Meteorological Disaster
it V
"1 lurricanes and typhoons, which are limited to the
May�November period in the Northern I lemisphere.
tJuef5ssIicd
+I:4�14 10,11
l?e�erse
7 Sret
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C00580607
Figure 11
Emergency/Critical Humanitarian Relief Needs Through 1994
Secre OFORN
,. Equator
\ South
$. Pacific
Ocean
� ist
/ � 4\:1
� /N.-,- ,zt- - --%� 1 -
/
-r.
. _
,,, -,
, _1,r :�...
...----,- ;IL---....,
..:.-z..-
1-4-4 I
)".� ', :i,: .
Atlantic
Ocean
r it)
CEN
i "'Pak
),D3co
GUAC
�
EL SALV PMAAM4'-
1_64/ ����/"/
COSTA � 1 c m
RERUifs
. COLOMBIA
� I
� . .� N
I ECUADOR
I �
Former YUGOSLAVIA
BOSNIA AND MEL
CROATIA
MACEDONIA
SERMA AND MONT.
South
Adantic
Ocean
Severity
of
need
Moderate
Hii
Likelihood of need
Low Moderate
Hipp
Severity
of
need
Low
Moderate
Hies
Low
Likelihood of need Cause
C conflict
� Drought
E Economic restructuring a
N Natural disaster
T Technological disaster
Moderate
High
a In the forrner Soviet Union. every country is error
undergoing economic restructuring or feeling the
effects of snarler country's taxon* restneduring.
Currently necessitating
some kind of emergency
humanitarian relief
T Potentially necessitating
some kind of emergency
humanitarian relief
ret
7799671.�01St, IOU
8
cD
CD
�
Potential Humanitarian Eme
Generated by Conflict, 1993-
Country
Persons
in Need,
Most Likely
Number
Estimated Food Political Environment Physical Environment Airfields Ports Rail Highway Inland
Needs for Next
Six Months a
(metric tons)
Waterway
igI I
_)
..e)
)-5
D
--
N
a)
Afghanistan
5 million
446,000
Unreliable
Little government
control
Landmines
,
Deserts; scrub-covered
mountains
Extreme temperatures
Snow; summer dust
storms; earthquakes;
avalanches
Albania
150,000
13,400
Reliable
Forested mountains
0
�
cn
RI
(1)
Coastal plains
T..)
Earthquakes'
Y
�
0
0
a)
>
' - � .
.
.
.
�
:
2
o_
o_
Angola
2 million
178,400
Unreliable
Coastal lowlands
Civil war
Interior highlands
-
Landmines
Winter rain
�
Armenia
.
500,000
44,600
Government support
limited
Mountainous
Little foiestland
� 0
� 0
Hot, dry climate
Winter snow
Earthquakes
---
Droughts
-
Azerbaijan
900,000
80,300
Limited government
control in ivest
Large lowlands
Mountains in north
and west
%.".
Semiarid
. _
Winter snow
.
2017/08/31 C00580607
ergencies
-94
Inland Fuel Medical
N � Waterway
cD
co
oo
Civil strife strife and ethnic warfare around the world are putting civilian
populations at risk of death from starvation and disease. The 24
countries or areas below have either ongoing humanitarian crises
that are expected to persist through next year or have strong
prospects of such emergencies occurring over the next year.
)
)
)
)
)
�
�
System in poor condition
Marginal facilities in Kabul;
others substandard
Shortage of professional
personnel
Physicians to population
ratio: 1:4,797
J
Bed to population ratio: 1:2,054
)
')
....,
r 1
Below Western standards Physicians to population
3
)
Numerous and well-spread ratio: 1:640
�
facilities Bed to population ratio: 1:180
Universal access
Old equipment
Personnel poorly trained
3
) -
. .
Critical shortage of drugs
)
,
5_
D_
0
111
Below Western standards
Shortages of personnel
and supplies
,T
...
57 hospitals
20,000 beds (1:445 population)
.
1,000 physicians
(1:9,891 population)
Relies on aid and imports
�
0
System taxed by conflict
Critical shortages of supplies
Equ ipment outdated
.. ,
Latest data 1989: ,
14,200 physicians (1:232 population)
30,000 beds (1:110 population)
0
II
System taxed by conflict
Critical shortages of supplies
Equipment outdated
�
4,4,"
Latest data 1989:
28,000 physicians (1:250 population)
21..111:111-1- .1 LI Cm - t .� 1
Country
Persons
in Need,
Most Likely
Number
Estimated Food Political Environment
Needs for Next
Six Months'
(metric tons)
Macedonia
150,000
13,300
Government likely to
cooperate
,
Mozambique
3 million
267,500
Fragile security
Bandits
Landmines
Returning refugees
Demobilizing military
Devastated economy
Government welcomes aid
Russia
(Northern Caucasus)
NA
NA
Government would
support relief
Some armed opposition
Rwanda
1.5 million
133,800
Fragile security situation
Serbia and
Montenegro
Montenegro
NA
NA
Government supports
relief
r�-�
CD
Co
CD
00
Physical Environment Airtie)ds Ports Rail Highway Inland Fuel Medical
Waterway
For Official Use Only
Transportation infrastructure
� Supports relief effort
O Supports limited effort
� Support severely constrained
or no support
Double dots indicate quality
varies by region in country
Fuel infrastructure
II Extensive
Cl Limited
Very limited
NA Not available
D likely to
.)
�.)-
D
_
N
Mountainous
Sparse forests
Hot and dry
Winter snow
Earthquakes
Droughts
0
�
0
�
0
CI
Substandard
Critical shortages of supplies
and equipment
Bed to population ratio: 1:170
Physicians to population ratio:
1:415
3.i
33
3.)
1)
-
o
.
0
a)
>
�
'�I
fugees
military
conomy. .
welcomes aid
Plains
Forested plateaus
Subtropical south
Tropical center and north
October November rains
.
- ..,
0
,
.
.
.
.
�
.
:�-� .
:1 ��
�
0
�
�
0
.. ,.
�
� -
. ,.
IN
Substandard
143 hospitals
24,300 beds (1:614 population)
Physicians to population ratio:
1:48,375
Severe shortages of supplies
0_
a-fr
would
ef
opposition
Very high forested
mountains
Winter snow
�
0
�
�
0
III
NA
.�
,s
. ,
*ty situation
Highlands
Scattered plains
Tropical climate '
Winter rain-
Short, dry summer
�
-
'
�
7
�
�
' lb.
0
- -
la
Substandard ,
25 hospitals
2,500 beds (1:3,400 population)
250 physicians (1:32,825 population) .
All supplies imported
_
,
,
supports
Mountainous
Sparse forests
Moderate climate,
little snow
Earthquakes
4111meseambe�ms.
0
0
0
�
0
0
Facilities are old,
poorly malt tained, overcrowded,
and lack Wcstern capabilities
Many qualified physicians in Serbia
Support services poor
� .. .. . .
C00580607
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.
-
Azerbaijan
900,000
80,300
Limited government
control in west
Large lowlands
Mountains in north
and west
Semiarid
Winter snow
Drought
�
o
0
0
Bosnia-Herzegovina
2.8 million
315,000
Unreliable
Little government control
Landmines
At times, all factions
oppose relief .
to other parties
Forested mountains
Extreme temperatures
-
;
.
i
1/4.,
�
�
1/4_,
�
_
.
Cambodia
360,000
32,100
.
Factional strife
Landmines
Government supports
rel:ef
Theft, corruption
Flatlands
Rolling hills
Dense forest
Low wetlands
Monsoons
Typhoons
Flooding
'
'
o
o
c
o
o
r---
C
a7
C:
co
Ls)
C
C
C
cr.
oc
C
r--
1/4�-�
C
a
0
71
0
7
c
s
s
Croatia
530,000
t
47,300
Government supports
relief
Potential ethnic strife
Interior plains:
hot summer,
win ter snow
Coastal highlands:
dry summer,
mild winter
1
,
.
;
1
1
"
0
�
C
0
Georgia
500 Roo
44,600
Government supports relief
Control of countryside
doubtful
Mountains: cold,
snowy winters
Lowlands near Black Sea:
mild winter, dry summer
C �
�
�
�
�
Ic
Haiti
900,000
80,300
Minimal government
support for relief
Mountainous
Summer rain
Warm, humid year-round
Hurricanes
Earthquakes
� (:.:'
r �
�
� 0
�
Iraq
13 million
115,900
Government can deliver
support throughout
country
Government hinders
relief to Kurds and Shias
Mostly flat
Northern mountains
Desert
Freezing temperatures,
north and desert
Dust/sand storms
Heat/dehydration
�
o
�
�
�
_
Liberia -
. _
1 million
89,200
Limited government
_
Flat, some forestland -
'
0
.
�
� ___
control
Hot and humid
COO
Cr)
aD
CD
CD
C
(/)
Cil
a)
a)
Ct
0
a)
2
c_
c_
System taxed by conflict
Critical shortages of supplies
Equipment outdated
Latest data 1989:
28,000 physicians (1:250 population)
71,000 beds (1:98 population)
Infrastructure damaged or
destroyed
Serious shortages of
personnel and supplies
Much equipment nonfunctional
Physicians to population
ratio: 1580
Bed to population ratio: 1:220
Rudimentary
150 facilities: damaged,
lack piped water and electricity
7,500 beds (1:1,100 population)
700 physicians (1:12,200 population)
Shortages of all supplies
Best system in former Yugoslavia
Many large hospitals in
Zagreb provide Western
standard of services
Sufficient, qualified physicians
Shortages of other personnel
System taxed by conflict
Critical shortages of supplies
Equipment outdated
32,000 physicians
(1:171 population)
60,000 beds
(1:92 population)
Substandard
Little service in rural areas
Critical shortages of
- personnel, supplies,
and equipment �
964 physicians (1:6,673 population)
60 poorly equipped hospitals
(22 in capital)
System operating at half capacity
Supplies scarce
Personnel mostly in cities
250 hospitals
Bed to population ratio: 1:600
7,000 physicians
(1:2,600 population)
10,000 nurses (1:1,800 population)
36 hospitals before current
N-
CD
(N1
Pharmaceutical industry lacks
money to buy raw, Materials
Bed to population ratio: 1:130
Physicians to population ratio:
1:390
1,000 dentists (1:18,000 population
8,000 support personnel
(1:2,200 population)
Serbia and
Montenegro
Montenegro
Kosovo
Sierra Leone
Somalia
Sudan
Tajikistan
13 million
� 3.4 million
26,800
Government supports
relief
Government supports
relief for Serb
refugees
Government opposes
relief for ethnic Albania
and Bosnian Muslim
refugees
No government assistance
or opposition to reli*f
Insurgents along
Liberia border
No local authority can
assist relief
Opposition from clans,
bandits, religious radicals
Civil war
Government and rebels.
� obstruct relief to south
Landmines .
Government cannot
assist relief in south
or east
Armed opposition
_
upports
Mountainous
Sparse forests
Moderate climate,
little snow
Earthquakes
Droughts
C
0
0
0
Facilities are old,
poorly maintained, overcrowded,
and lack Western capabilities
Many qualified physicians in Serbia
Support services poor
Supplies available
Bed to population ratio: 1:170
Physicians to population ratio:
1:415
.,
upports
b
Northern plains
Southern mountains
Cold, snowy winter
Hot, humid summer
0
0
....
0
0
0
co
Lo
cs
CD
0
x�
Cr)
co
cs
-----
r--
sng
c)
r\I
cn
cu
cu
PPoses
nic Albanians
Muslim
Lowlands divided
by mountains
Summer, hot and dry
Winter snow
Droughts
Earthquakes
C
C
System taxed by poor economy,
political tensions
Some hospitals closed
Bed to population ratio: 1:320
Physicians to population ratio:
1:890
at assistance
n to relief
er
Swamps; beaches
Low plains
Highlands
Tropical climate
Seasonal changes
Constant heat and
�as humidity
S
0
..
�
0
Substandard �
Some qualified physicians
Facilities and equipment poor
Shortages of supplies
1:t
0
4-�
-0
cu
>
2
sp_
sp_
nty can
om clans,
ous radicals
Large plateau
Coastal plain
Mountains in north
Sparse rain
Severe heat
Drought
S
S�S
S
U
Substandard
90 hospitals prewar, now damaged
No supplies available on
open market
UNISOM II medical support
meets US standards
Assessment of personnel
or beds not possible
nd rebels
f to south
Desert, extreme heat
in north
Swamp, forest, flooding
in south
C
5
C
Below Western standards
164 hospitals: old, overcrowded,
unsanitary
Critical shortages of personnel
and supplies
2,170 physicians (1:11,153 population)
90 percent of medicine and all
equipment imported
,
,
-�Equipment
annot
n south
.
non
Mountainous
Very cold in Pamir
Mountains
Semiarid lower areas
C 0
S
o
5
U
Basic services unavailable
to most of population
Facilities deteriorating
Critical shortages of supplies
15,000 physicians (1:3,401 population)
55,000 hospital beds
(1:92 population)
outdated
annot
Swamps in north
Plateaus in south
C 0
C
C �
C 0
C
NA
Substandard
4 fru, fqrilitine 1,3,���� nwa-lorn�
Georgia
500,000
44,600
Government supports relief
Control of countryside
doubtful
Mountains: cold,
snowy winters
Lowlands near Black Sea:
mild winter, dry summer
C �
�
�
,.
�
�
i
Haiti
900,000
80,300
Minimal government
support for relief
,
Mountainous -
Summer rain
Warm, humid year-round '
Hurricanes
Earthquakes 1
0 C
C �
�
� r:',
Iraq
1.3 million
115,900
Government can deliver
support throughout
country
Government hinders
relief to Kurds and Shias
_
Mostly flat
Northern mountains
Desert
Freezing temperatures,
north and desert
Dust/sand storms
Heat/dehydration
�
0
�
�
�
_
Liberia
. - .
1 millio n
.
89,200
.
Limited government.
control
Insurgents
BanditsIi
Flat, some forestland
Hot and humid
Rainy and dry seasons
.
�
rs ...,.
�
c�
.
� -
Attacks on UN forces and officiah responding ro humanitarian
emergencies hare increased ores the past year.
� Estimates of food needs for the nest six months are based on UNICEF's standard of
the minimum necessary for surshal: 490 yams of Inod'person.'day. except Bosnia
hc re UNI ICR's standard of %inter food needs-6I4 grams'personiday�s as used.
Loral transport for milef supplies is often inadequate for the task.
This vehicle in Somalia has seen some rough roads.
In areas
of logist:
combat
required
shelter,
popufau
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8
:P.
System taxed by conflict
Critical shortages of supplies
Equipment outdated
32,000 physicians '
(1:171 population)
60,000 beds
(1:92 population)
Substandard 5,830 beds (1:1,103 population)
Little service in rural areas .
Critical shortages of
personnel, supplies,
and equipment
964 physicians (1:6,673 population)
60 poorly equipped hospitals
(22 in capital)
0
to
o
co
Lc)
o
o
O
System operating at half capacity 1,000 dentists (1:18,000 population)
Supplies scarce 8,000 support personnel
Personnel mostly in cities (1:2,200 population)
250 hospitals
Bed to population ratio: 1:600
7,000 physicians
(1:2,600 population)
10,000 nurses (1:1;800 population)
)lease: 2017/08/31
36 hospitals before current No ability to produce drugs of
conflict; many-now damaged, other supplies -
destroyed
1,800 beds (1:1,359 population)
Physicians to population ratio:
1:8,000
Personnel poorly trained
2
In ar..%s of conflict. a range
of logistic, security, and
comba: forces could be
required to ensure that food,
shelter, and medicines reach
populations at risk.
Landmines can be major impediments to the delivery of aid
Here in Cambodia. a UN vehicle is destroyed
Somalia
1.3 million
115,900
No local authority can
assist relief
Opposition from clans,
bandits, religious radicals
Sudan
3.4 million
302,200
Civil war
Government and rebels
obstruct relief to south
Landmines
-
Tajikistan
�
300,000
26,800
Government cannot
assist relief in south
or east
Armed opposition -..
Zaire
�assist
500,000
44,600
=-- Government cannot- -
relief -
Little or no civil authority
Crime and extortion
:
Hostile environments sometimes prevent the timely
delivery of aid to people in need. Sarajevo airport has
frequently come under attack.
Even as global nceds grow. the task of
more dangerous. here in Somalia, for
at each stage of dclhrry.
1.1111111.11:0111111111.111.101111M111111E11111.111110011111.11111.111EEI111111111-1101111.111111110:111111.1.111.11101111.111111.15111111.11111
C00580607
-a
a)
2
CD
Co
CD
00 "
CD
CD
Cr)
00
CD
CD
a)
a)
ct
8
a)
2
cp_
cp_
hority can
rom clans,
igious radicals
Large plateau S S U Substandard
Coastal plain 90 hospitals prewar, now damaged
Mountains in north No supplies available on
Sparse rain open market
Severe heat UN1SOM 11 medical support
Drought meets US standards
Assessment of personnel
or beds not possible
Desert, extreme heat C� Below Western standards
t and rebels in north 164 hospitals: old, overcrowded,
lief to south cvamp, forest, flooding unsanitary
in south Critical shortages of personnel
and supplies
2,170 physicians (1:11,153 population)
90 percent of medicine and all
equipment imported
t cannot Mountainous
in south Very cold in Pamir
Mountains
sition Semiarid lower areas
t cannot
civil authority
xtortion
Swamps in north
Plateaus in south
Mountains in east
Humid, tropical climate
Heavy rains in east
Dense vegetation over
half the country
cds gen.,. the task of re ponding &Tonics
here in Somalia, food rutst be guarded
Cl�.
I-Ires negotiate their entry into a tillage controlled
by Khmer Rouge guerrillas in Cambodia.
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Basic services unavailable
to most of population
Facilities deteriorating
Critical shortages of supplies
15,000 physicians (1:3,401 population)
55,000 hospital beds
(1:92 population)
Equipment outdated
Substandard
A few faciiities have modern
equipment and well-trained
physicians
300-bed clinic
in capital
Shortages of personnel
and supplies
Securing the for humanitarian rdief:
weapons captured by UN troops in Somalia.
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