In background information, the authors write mass violence against civilians in the west of Sudan started in 2003 and has continued. "More than 1.5 million people (25 percent of the population of the region) are now scattered in 127 encampments in Darfur and 15 in neighboring Chad," the authors note. "Mdecins Sans Frontires (MSF) began work in West Darfur in December 2003, and operations in South Darfur, including feeding centers and primary care clinics, opened n May 2004 and have been centered on 3 sites." The three sites are Kass, Kalma, and Muhajiria, South Darfur.

Francesco Grandesso, M.Sc., and colleagues from Mdecins Sans Frontires, analyzed the results of surveys conducted in August and September 2004 in the three sites among 137,000 internally displaced persons to assess health and nutritional status for the relief efforts in those area. At each site, general household status, number of deaths among adults and children, and nutritional and vaccination status of children aged 6 months to almost 5 years were assessed. A questionnaire detailing access to food and basic services was administered to a subset of households (n= 210 in each site).

"Two hundred seventeen deaths were reported over the previous 121 days in Kass; and in Kalma and Muhajiria, there were 30 and 36 deaths over the 30 days prior to the survey," the authors found. "The crude mortality (death) rates at all 3 sites were considerably higher than the 1 per 10,000 per day that is recognized internationally as defining an emergency situation and 4 to 6 times the expected rate in sub-Saharan populations. In Kass and Kalma, the under 5-year mortality rates exceeded the 2 per 10,000 per day used as the emergency benchmark." Deaths from medical causes predominated in Kass
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Contact: Frances Sanderson, M.D., Ph.D.
frances.sanderson@imperial.ac.uk
JAMA and Archives Journals
22-Mar-2005