Aid workers are concerned that the people of Kuando Kubango, a vast province in the southeast of Angola, are edging towards a humanitarian disaster, with hunger just one of a raft of issues waiting to confront them.
Landmines, food shortages, ruined roads, scant basic services and political intolerance give Kuando Kubango the dubious honour of being one of the worst places to live in Angola - a country with some of the lowest human development indicators in the world.
"People talk about pockets of emergency, but in Kuando Kubango it's more like big black holes," said Mike Pillinger, Angola representative of the International Organisation for Migration (IOM), which operates a Community Revitalisation Programme (CRP) in the province.
"Basic services are pretty abysmal outside the provincial capital, and certainly worse than anywhere else in Angola," Pillinger added. IOM assists the reintegration of returning refugees, helping them to generate an income by providing agricultural training, equipment and support.
Kuando Kubango's problems stem from the 27-year civil war in Angola: the region was a stronghold of the UNITA rebel group - now an opposition party - and the scene of intense, protracted fighting.
The end of the war in April 2002 brought little relief, as tens of thousands of returning internally displaced persons and refugees tried to reintegrate into communities in remote, often arid areas.
"I'm very worried about food security in Kuando Kubango," said Matthew Olins, acting head of the UN's Transition Coordination Unit (TCU).
Fewer people are at risk in Kuando Kubango than in the centrally situated Planalto region, where the World Food Programme (WFP) has been providing assistance, but Kuando Kubango's estimated 400,000 people are scattered across a huge area where destroyed roads and landmines thwart access.
The provincial capital, Menongue, around 800 km from Luanda, is physically cut off from the national capital, and some suspect that Menongue and even more remote areas of the province, like Mavinga and Rivungo, are also politically isolated because of the region's affiliation with UNITA.
"Kuando Kubango is an area which gets almost no attention," alleged an aid worker who requested anonymity. "It is still very much a UNITA stronghold; it is far away from Luanda and in the run-up to elections the ruling MPLA is not bothered about registering people to vote, and is certainly not interested in improving the situation in order to win support."
There is also concern that the area could be sinking to the bottom of the humanitarian community's list of priorities because of the complexity and cost of providing assistance.
"Kuando Kubango is being ignored - not because of malicious intent, but because of practical issues," Olins said. "There is a low presence of NGOs and a very limited UN presence because it is so inaccessible and has few densely populated areas. It is more practical for humanitarian organisations not to work there, and to work elsewhere where they can have a greater impact. With these constraints, the most vulnerable people cannot be reached."
A WFP assessment earlier this year revealed that food security in the province had worsened after poor rains in December to February destroyed the cereal crop. An appeal by the WFP for US $3.2 million to keep its Mavinga office open, and be able to provide basic foodstuffs to 50,000 vulnerable people for a period of six months, has fallen on deaf ears.
Tens of thousands of people - estimates range from 20,000 to 60,000 but no-one really knows - have effectively been displaced from their villages because they do not have enough to eat and lack the basic tools to sustain themselves.
During a visit by the Norwegian Refugee Council (NRC) and the WFP to the community of Luengue, Lars Andersson, Angolan representative of the NRC, found barely-clothed children and adults living in extremely difficult conditions: their homes were built of the most basic materials, and several of them had swollen bellies and pale hair - telltale signs of poor nutrition.
The visit in August 2004 prompted action, but the situation does not appear to have improved in other parts of the region. "It is our belief that you will still find pockets where people live like this, where people need food, clothing, blankets and also the most basic of infrastructure," Andersson said.
NRC and WFP have made efforts to increase food security in what he describes as "the Luengue, Rivungo, Mavinga triangle". In conjunction with WFP's food-for-work programme, the NRC has provided ploughs, draught oxen, goats and chickens, as well as implementing a seeds multiplication programme.
But a recent report by the international medical NGO, Medicins Sans Frontieres (MSF), showed that between January and September the hospital in Mavinga received 60 cases of severe malnutrition.
"That in itself is an indication of a still vulnerable food production situation in the region," Andersson said.
Antonio Girona Vidal, head of mission at the Swiss branch of MSF, whose 100-plus national and international staff run the hospital, fears those 60 cases are just the tip of the iceberg. He is worried that many more are stuck in the countryside, cut off by landmines and impassable roads, and is anxious about how the rickety health system will cope once MSF hands the hospital over to the health ministry at the end of 2006.
"Everything in Mavinga is a problem: malaria is a problem, food security is a problem, mines are a problem, the low government presence is a problem, water is a problem," he said.
MSF has set up the only water system in the area, providing the hospital with 120,000 litres per day if the pump is fully functioning. Most of the people - 95 percent - rely on rivers for their water.
Landmines - another deadly legacy of war - are also seriously curbing aid work, despite the efforts of the Halo Trust, a demining NGO, to make key roads safer.
"Both Mavinga and Rivungo are ringed with landmines. Just to get to their fields or to water points, people have to cross known mined areas," said Olins of the UN's TCU.
Landmines have prevented WFP from properly researching the situation beyond the municipal centre of Mavinga, but anecdotal evidence indicates that less than half of the local population are food secure.
"People are not dying, but they are eating very badly and they are on the move looking for food," said WFP's Country Director Rick Corsino. "A general physical weakening can be expected which could, in turn, lead to much more serious health risks."
Without financial support, WFP's Mavinga field office will close its doors at the end of 2005, putting at risk some 27,000 people currently relying on WFP assistance and shattering the hopes of the potentially thousands more who do not.
But Kuando Kubango's problems do not end there. Augmented by short-term food aid, a more long-term approach ensuring that all returnees have access to land, seed and equipment to carry out basic farming and build houses, is desperately needed.
"While people certainly need food assistance, a concerted effort is required to improve the macro-situation of the area," Corsino noted, "otherwise people will need food aid forever".
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