6 'Putting the last first' In the absence of community organisations among refugees which are empowered to identify and look after those most in need, agencies have relied on conventional definitions of the vulnerable, that is, the physically handicapped, the elderly, widows, and orphans. Statistical studies, just like programmes designed for 'the masses', cannot identify all those individuals and classes of people who are in serious need of special assistance. The best that this survey can do is to present data which demonstrates to policy makers and refugee communities the extent and range of unmet needs. In addition, many case studies were collected.[2] One of the underlying assumptions of refugee policy for Africa is that the basic unit of production is the normally constituted peasant family. (e.g. Land 1981.) At the same time, there is an appreciation among policy-makers that in the process of mass migration under conditions of extreme coercion, family structure has been adversely affected. The statement that the majority of refugees are women and children has become almost a cliche. Statistically this is true of nearly all populations, and the special significance of this fact for refugees is insufficiently understood. Given the emphasis on pushing refugees towards economic independence, it is essential to discover just how refugee communities re-constitute themselves and what economic strategies they are capable of employing to survive without relief aid. The essential disabilities suffered by refugees could be grouped under three categories:
To be effective, an assistance programme must not only take account of how best to indemnify the victims for such loss of control over their lives, it must also be flexible enough to take account of the almost infinite variation in personal resources which individuals bring to their experience in exile. Policies which ignore individual differences, and which aim to give equal treatment to all, actually increase economic disparities, to the detriment of the most vulnerable. The argument that assistance should be targeted to the poorest is unlikely to be controversial. The major question is: how can aid be differentially distributed to make sure that those most in need are given priority ? However, not all refugees arrive in their country of asylum without assets. Wherever possible, refugees used the capital investments they brought with them to maintain their independence. The lack of support in maintaining the assets with which they arrived has meant that from the beginning refugees were started on a downward economic spiral until many were finally forced to accept relief. Scattered throughout the district one may see tractors, generators, grinding machines, lorries and other vehicles which are not functioning for the want of a battery, tyres, or some other spare part. Even modest loans would have enabled some of these 'rich' refugees to maintain economic independence, not to mention the contribution to the local economy where such equipment is in short supply. Assistance programmes are aimed at 'bringing the refugees to the level of the nationals'. It might be time to question what is meant by 'the level of the nationals'. In practice, it means bringing refugees to the level of the poorest in the society of the host. Humanitarians are extremely sensitive to the possibility of being criticized by the host government for creating islands of relative privilege in the sea of poverty which is characteristic of areas in which most refugees are found in Africa. Refugee communities in southern Sudan include a wide array of expensively educated, experienced skilled workers and professionals. Yet all who accept aid are expected to make their living through agriculture. The failure of policy to support entrepreneurial activity among refugees is a great loss to the economy of the host. While it has been well-established that economists' dream that the benefits from creating pockets of wealth would finally 'trickle down' to the poorest in society is an illusion, case studies of Ugandan households suggest that at least some of the refugees who have attained relative economic stability are supporting very large numbers of people. (Wilson et al. 1985.) Perhaps the perils of life in exile can also have the positive effect of increasing social responsibility as well as undermining it.[4]
Defining and identifying the vulnerable As the programme aimed to help refugees become economically self-sufficient in the shortest possible time through agricultural production, a first measure of vulnerability is the capacity of households to undertake farming as their means of livelihood. 'How many individuals know how to cultivate land?' might have been a first question. As noted earlier, although 80.1 per cent of the assisted refugees came from rural areas only 20.1 per cent had previously earned their living through agriculture; among the unassisted refugees, 57.7 per cent said that in Uganda they had been cultivators or herdsmen. On the face of it, agriculture as a means of livelihood was inappropriate for the majority of those in settlements and for slightly under half of the self-settled. This, in turn, may partly explain the failure of the settlements to achieve self- sufficiency and the greater agricultural productivity of the self-settled areas. It may also explain why so few hand tools remain in the settlements: over half the households (excluding the population of the three transit camps where tools were normally not issued) had only one hoe, 6 per cent had no hoe, and 15.3 per cent no panga. There is as yet no data to measure the extent to which lack of experience or interest in farming has affected production. But one might conclude that the imposition of such an inappropriate programme rendered the majority of refugees vulnerable. There are other factors, however, which make the situation slightly less grim than these facts suggest. There is a strong tradition of food self-sufficiency in Uganda, and agriculture is included in the curricula of some secondary schools. Whatever the occupation of a father, a family having access to land will cultivate some of its own food. Children from around 10 years old are expected to do some cultivating when they are not occupied with school work. Traditional practices, combined with economic changes since colonialism, have conspired to place most of the responsibility for food production on women. Among most West Nilers, with the exception perhaps of the Madi, those men who do farm concentrate most on producing cash crops such as tobacco and cotton. As noted, in some West Nile communities, the men are traders, others are employed as labourers, and many make their living through fishing. Many others joined the army. As women are the major producers of food crops, their greater numbers among the self-settled may also contribute to the apparently greater productivity of this community of refugees. Certainly one can conclude that the presence of more men in the settlements does not guarantee more agricultural production. Men are likely to prefer to concentrate their energies on other economic activities.[5] Formerly in Uganda the earnings of men and women were largely kept separate, each spouse having distinct financial obligations to the household. Women controlled the food they had produced, which was stored in their own granaries. In settlements, rations are issued to the head of the household and at least some men take these as their own personal expendable income, permitting the family to rely on what women can earn through piecework for locals, or leja-leja, to the great detriment of the family as a whole. Formerly the West Nile was fairly self-sufficient in food production, with crops from different areas (and fish) circulating through trade from one part of the region to another. In the late 1970s people began selling produce to cities as far away as Kampala. In addition to cash crops such as coffee, tobacco, and cotton, some civil servants and others (forced to leave their jobs because of insecurity), returned to their rural homes and took up commercial farming. A few began to rear large herds of cattle.[6] In fairness to men now living in settlements, it should be noted that one never heard a Ugandan, whatever his previous occupation, indicate that he was unwilling to try to grow his own food. About the strongest complaint I received was a note from one refugee, formerly a flight instructor, who first survived as a self-settled refugee with his wife and two children, and later moved to Otogo settlement.
To name only a few, these careers included engineers, radar operators, a flight engineer, foresters, accountants (even an auditor for the former East African Community), railway engineers, expertise from all levels of the tobacco industry from growers to leaf managers, in addition to teachers, medical workers, and businessmen. The data from the oldest settlements, together with observations, suggest that those who find the opportunity to escape the settlements do so - and at the earliest opportunity. As these are usually the able-bodied, their departure leaves behind those who are the more vulnerable and decreases the chances of the settlements becoming viable agricultural economies. The tendency, so often observed, of putting personal survival before social responsibility, means that any gainful employment is unlikely to benefit those who are left behind. The very presence of an assistance programme probably salves the consciences of those who desert their relatives in settlements. Although no attempt was made to collect systematic data on the extent to which refugees employed outside settlements share earnings with settled relatives, I heard of only one case where this occurred. An elderly Nubi widow, living in Limbe, had a son who was a driver. As he plied the Juba/Yei road, it was convenient for him to stop en route to give his mother money from time to time. With the best of intentions, others would have had difficulty in getting transport to see relatives, as many of the settlements are so remote. Another empirical basis for assessing the capacity of a family to make its living through agriculture is to count the numbers potentially able to cultivate, that is the people old enough and physically strong enough. The average size of households in settlements was 5.29; the overall average number per household who were able to cultivate was 2.75. The shortage of labour to farm interferes with education; 13.9 per cent of those giving reasons for children not attending school, said that it was because they were needed either to till the soil or to care for younger children while the mother went to the field. It is likely that the actual number is much higher. Parents were embarrassed to admit their children were not enrolled in school, and teachers reported that absenteeism, a constant problem, was always much higher when food supplies had run out in the settlements. This suggests that children are also involved in leja-leja or looking after the household in the absence of adults. As noted, households range in size from one person to a family which had 26 members living on one plot. The smaller households (from one to three) had the highest percentages able to cultivate. Once the size of the family had reached six, the number of those able to cultivate dropped to an average of 50 per cent. Households having between seven and twelve members did not include any greater percentages of cultivators and in those households with thirteen and fourteen persons, the average dropped to 44 and 30 per cent. These data contradict the usual assumption that the larger the household, the more viable it is as a productive unit. In fact, once a household is larger than three persons, it was found that the ratio of people dependent on others to support them increased. The vulnerability of all refugees in settlements is most starkly demonstrated by the lack of land upon which to farm. While the programme aimed to give each Ugandan household 10 acres of land for farming and this amount was expected to support five persons (Land 1981), the survey found - excluding the transit camps where land was not allocated - that 21 per cent of the population in settlements had no land. Taking only the 78.5 per cent which had land, the average amount per household was 1.1 acre; only 0.2 per cent had as much as 5 acres; 80.2 per cent of the male-headed households and 85.7 per cent of those headed by women had 1 acre or less; 5.8 per cent of the male-headed and 2.9 per cent of the women-headed households had between 2 and 3 acres. Table III.4 (Appendix III), shows the percentages of households having no land by settlement. One would have expected that these landless households would have been found in the newest settlements where there had been no time to allocate land, but in Kala settlement, 11.8 per cent had no land. In Limbe, another of the (older) settlements, 21 per cent could not farm for this reason, and by 1984, the Oxford team found that 37 per cent of the households in Limbe said they were not farming! (Wilson et al. 1985.) The situation for the self-settled refugees was quite different. Data from 3,648 households shows that only 7.1 per cent had no land, 46.7 per cent had up to I acre, 43.6 per cent had between 1 and 5 acres, and the others all had more, ranging up to 7 of the households which had more than 15 acres under cultivation. One self-settled refugee family, not included in the interviews, had already cleared and cultivated 22 acres of forest. Another, Nasuru Okuti, reputedly a millionaire in Uganda, living near Morobo, is said to have a much larger farm. When these self-settled refugees were asked what was their main problem, only 4 per cent mentioned land, but 15 per cent cited the lack of tools and 0.19 per cent said that obtaining seeds was their main problem. There was more than one way for assisted refugees to acquire land. In settlements the agricultural advisers were responsible for surveying and dividing the area which the local community, in theory, had agreed to hand over to the refugees. Earlier I alluded to the varying response of local communities to being asked to follow the central government's agreement to make such land available. The conflicts which arose were almost always settled to the disadvantage of the refugee. Often refugees cleared a piece of land and harvested a crop, only to be told that the owner was resuming control. Settlement land was often located too far from the settlement to permit women both to cultivate and to supervise the daily running of the household. Wild animals were a constant threat in many areas if crops were unsupervised. This is why, when rabies struck at Kala, it was so difficult to persuade the refugees to kill all dogs. Baboons were a particular problem in many settlements, and in Wunduruba, even wild buffalo roamed.[7] Some settlements were actually located within a game reserve and in other cases when the UNHCR office was surprised at the generosity of some chiefs in allocating sufficient land, it was discovered that it was infested by tsetse fly. Many refugees in settlements, like the unassisted, acquired farm land through personal negotiation for each piece. The negotiation process and its political implications will be discussed later in this book, but suffice it to say here, from the point of view of those refugees with no assets, the process was extremely expensive. It often required the exchange of food rations or other material assistance. For example, one refugee in Mopoko gave his hoe for the use of one acre. By selling a bed he brought from Uganda, he paid others to dig for him, and used the rest of his money to start trading in cigarettes, salt, paraffin, and sugar. Of the women-headed households who had land, 84.5 per cent had obtained theirs through allocations made by the settlement's agriculture adviser, 10.2 per cent through personal negotiations with locals, and 5.3 per cent had used both methods to acquire the land they were using. More of the men who were heads of households negotiated directly with locals for the land they used: 10.6 per cent reported they were only using land acquired in this way; 81 per cent got their land through the agriculture advisor; and 8.4 per cent used both methods to acquire land. All self-settled refugees relied on personal negotiations to acquire land. They, too, reported the problem of some locals reclaiming lands after one harvest. However, as each piece had been individually agreed upon, there was less likelihood that a local could later use the argument that the refugee was farming on his ancestor's burial place. Moreover, in some cases at least, refugees could appeal to a local chief against a blatantly unfair local farmer. It may be, of course, that those least successful at personal negotiations with locals had already moved to settlements.
No one to cultivate But a more serious problem is households having no one able to cultivate: 3.4 per cent were found to be in this situation. The size of these varied from 7 one- person households to one which had 14 members. Altogether these households represented 299 individuals. Assuming a representative sample, this means that there are nearly 3,000 people who live in family units where no one is able to cultivate at all. These households appear in our sample scattered over twenty different settlements. In 41.2 per cent of the cases, both spouses were present; women were heads of 30.9 per cent (over half of these, or 71 per cent, were widows); and the remaining households were headed by men with 11.8 per cent being under 21 years of age and 16.2 per cent adult men. At the time of the interview 15 per cent of the members of the households where no one could cultivate were suffering from an acute illness. When asked why they had come to the settlement, 54.4 per cent cited illness, malnutrition, or 'death' as the reason; 23.5 per cent said they had been harrassed or pushed; and others came because they had no one to help them, their money had run out, or, as in 2.9 per cent of the cases, they had heard the settlements were 'better'. The situation of these households supports the general observation that refugees used the settlements as places to send some of the most vulnerable. Although 58.8 per cent reported having relatives living outside settlements and 79.4 per cent had relatives in other settlements, the distances and lack of transport mitigate against their receiving help from them. The largest concentrations of the extremely vulnerable households were in Koya (14) and Otogo transit camps (6) and these were soon to be moved to settlements far beyond the reach of their relatives who were at the border or in other settlements. Four families who could not cultivate had already arrived at a newly-opened settlement - Morsak. At least in newer settlements people were still entitled to receive full rations: but two of the older settlements - Kala and Limbe - which WFP had already deemed to be self-sufficient, each had 4 such families, and the others were all in settlements where the rations had already been officially reduced. As these numbers appeared in the 10 per cent sample, the total numbers might even be greater. Agencies had no method of identifying families unable to cultivate, and even had they been able to, there was no programme for regularly supplying them with food.
The physically handicapped As noted above, the more standard way of assessing the extent of vulnerability and of identifying those who qualify for special assistance is to count the numbers of orphans, lepers, and otherwise physically handicapped. Our survey did this. Based on the 10 per cent sample, 5,320 were physically handicapped or suffering from long-term (probably terminal) illness at the time of the interview, and 31.2 per cent of the households included one or more such persons. In 5.8 per cent of the households, one or more members of the family had leprosy; at least I .3 per cent of the population had this disease. The same percentage of the population were crippled - I .3 and 6.5 per cent of the households included at least one crippled person. Deafness affected 0.52 per cent of the population, with about half of these also unable to speak. And, according to the sample, there were 340 blind persons, or 0.32 per cent of the population. Information collected from unassisted refugee households was less detailed. At the time of the interview, an average of 0.39 persons per household were judged to be ill or physically disabled. But these were found in 1,027 of the 3,814 households, in other words, just under one-third of the unassisted refugees had one or more members who were ill or disabled. Among those affected, the average number was 1.4 persons per household.
Gathering an accurate count of the number of orphans is complicated. In most African societies a child is regarded as an orphan if either parent dies. However, we defined an orphan as being a child of 15 years or younger, both of whose parents were dead. According to the responses given in the interviews (and considerable effort was made to emphasise our definition of an orphan), 10.9 per cent of the population in settlements are orphans, or 19.1 per cent of all children 15 years and under. Presuming the responses are accurate, there are 11,630 orphans living in settlements. To check further on the validity of these findings, the relationship of all children in this age group to the head of the household in which they were living was also analysed. It was found that only 60.7 per cent of the girls and 54.6 per cent of the boys 15 years and younger were living in households where the head of the family was either their mother or father. Even if all those children described as orphans had a parent living elsewhere, these data give yet a further indication of the extent to which families in settlements represent only segments of 'normal' families; they also indicate the great vulnerability of settlement populations. In 1984 Alula Pankhurst (1985) undertook a study of orphans in Gumbari settlement. He interviewed 135 children under the age of 16 who had lost one or both parents. They lived in 53 households; about one-third had lost both parents. The parents of 41 per cent of these orphans had been killed since 1979; 9 children did not know what had happened to their parents as they had fled with other relatives; and 20 per cent of them had lost a parent in the Sudan after crossing the border. The main cause of these deaths was illness coupled with malnutrition as a result of inadequate diets during flight and after arrival. Other parents had been shot while returning to Uganda for food or being forcibly returned from Zaire, some had died in accidents while escaping, and one father was drowned by soldiers. One mother had died giving birth and another at a feeding centre. Nine other parents had died since arriving in Gumbari. According to Pankhurst (1985):
In the few cases where there were no close relatives around, friends or neighbours brought up the orphans. In a couple of cases, salaried members of the settlement, such as the driver and the settlement chairman, were looking after several orphans. Only a handful of orphans lived alone. In these cases there was usually an older sibling who assumed the parental role. It was often the death of a parent which triggered the movement to the settlement and this is why a number of orphans had come to Gumbari. Children are sent to settlements because of the availability of health care, education, and, according to Pankhurst's informants, especially because of food. When, as happened during the time of his interviews, there was no food in the settlement, some of the orphans normally resident there had been sent to live with relatives at the border. As he puts it, 'Population flows between settlement and border zones can be seen to respond to changes in the survival conditions. This could have considerable implications in terms of the decision to phase out relief.' (ibid.) The Oxford team's nutritional survey revealed that about one-quarter of the malnourished were orphans.
Without a more extensive study (such as differences in school attendance) which compared these children with those who have not been orphaned, it is not possible to know if they were in any way discriminated against within the household, but Pankhurst (1985) found many had 'devised resourceful ways to help their foster family.' These included trading either in agricultural produce or cigarettes, making and selling charcoal making ropes, knives, hoe handles skull caps, knitting, and mat-making in addition to helping in the house, on the farm, and doing leja-leja alongside the other members of the family.
The elderly Given the degree to which family responsibility has been abandoned, life was also hazardous for the elderly in settlements. If one defines the elderly as those who were 45 years and older, there were 244 men and 276 women in this age group living in settlements. Given the important role which old people assume in family life in Uganda, it is not surprising to find it is difficult for them to adjust to the enormous social dislocation associated with life in exile. Not only do the elderly have to adjust to normal processes of aging in an alien social environment, they have, for the most part, been stripped of the status associated with old age. Some do serve on the settlement dispute committees, but the other leaders are elected and refugee communities have not, for the most part, opted to reinstate traditional figures of authority. The idea of being buried away from their homeland has an even more profound significance and at least some of the elderly have opted to repatriate (even when their families have refused) in order to make sure they die in Uganda. Many refugees reported that their elderly parents had refused to flee; others had got as far as inside the Sudan border and refused to move to a settlement, even when the rest of the family believed they had no option if they were to survive. Pankhurst (1985) interviewed an old and disabled man who had no relatives in the Sudan. He was totally dependent on WFP rations and would be reduced to begging when they were phased out. This was not unusual. Another, 'whose daughter died during their flight, virtually lost his sight and speech overnight. He resented living surrounded by strangers ... and refused to venture outside his hut despite his grandchildren's pleas.' (ibid.)
Assisting the vulnerable When UNHCR awarded the contract to SCC to implement a programme of aid for the vulnerable, the budget for staff was based on the assumption that only 10 per cent of the population would require special assistance. SCC had already begun to distribute some material aid to lepers, cripples, orphans, and the elderly and in some settlements they paid social workers; in others there were volunteers. These workers were asked to identify the vulnerable and to distribute such aid as used clothing or bars of soap. Deciding which individuals require special assistance is difficult and unsatisfactory. First of all, there is the matter of limited resources. When in one settlement the social worker drew up a list of nearly 100 orphans, he was told that he must be 'more strict' - SCC did not have the resources to help that many orphans. On what basis was the social worker to decide which orphan was more in need than another? Giving assistance to one member of a family introduces other problems when all are as poor as the individual officially defined as vulnerable. Sometimes the heads of such households understandably insisted that the extra assistance be shared equally among all. Moreover, a cripple or someone with leprosy living in a household where there were enough people able to cultivate was less likely to go hungry than those members of a family where no one could cultivate, or where the head of the family alone was responsible for a number of young children. Certainly the physically handicapped needed a special programme of assistance, but their long-term problems would not be solved by the irregular distribution of bars of soap, used clothing, or food. Income-generating activities introduced into settlements largely excluded the vulnerable. The policy of the agency responsible for implementing the budget for such activities was only to support co-operatives. Settlers were urged to include the handicapped in their co-operatives, but funds were usually appropriated by the strong. In the survey, informants who were physically handicapped were asked in what ways they might be able to earn a living on the basis of previous experience or training in Uganda. A few had skills which could have produced an income: these included handicrafts, tailoring, cobbling, beer- brewing, petty trade, and carpentry. Should assistance programmes for African refugees mount special schemes for assisting the physically handicapped and orphans? In Gumbari settlement, the handicapped started a tea shop and earned enough profit to allow them to give free cups of tea to other vulnerable members of the community. On the other hand, elsewhere, the Oxford team found a social worker who was reluctant to encourage such activities, who repeated such stereotypes about the handicapped as that they are 'dirty' and incompetent. In many African societies such people are ostracised or, as in the case of orphans living with unrelated families, exploited. (One's position in society is always bound up with the presence of relatives who protect each other's interests, which is why family disruption is so serious.) Under normal circumstances, the mentally ill and physically handicapped will be fed by members of a community, but as they are unfit to contribute to the family economy, it would not be surprising if, under conditions of exile, this responsibility were neglected. During our interviews, no information was collected concerning traditional beliefs about the handicapped, but Orley (1970) found that, among the Baganda, leprosy and epilepsy were considered contagious. Mogiri was established for the first few leprosy sufferers that arrived. Later, however, most were sent to other settlements and there were many complaints that they were not given proper treatment by the medical staff, who either were not trained to deal with the disease or shunned such patients. In 1983, it appeared that funds might become available for building a vocational school. Discussions were held with Ugandans, Sudanese, and agency officials to consider what were the appropriate subjects to be taught. Given the limited opportunity for employment in the district, would it not have been wise to use the limited funds for training the physically handicapped and to include Sudanese in such a programme from the outset? Had funds been available for individuals, certain of the handicapped could have been helped to earn a living simply by providing the tools of their trade. In Otogo settlement, for example, I bought stools from a carpenter who was a polio victim. When war struck his area in Uganda, he had insisted his wife flee with the children, leaving him to face the soldiers in his own compound. But, as he said (with a smile) when the sound of gunfire came nearer, he decided he would prefer to be shot while escaping. He crawled the forty miles to the Sudan. Only once did he meet another human being, a woman who gave him some cassava. In Otogo, with only a panga, a hammer, and a saw, this man managed to make boards from logs he cut himself. With his wife's help, he had built their house and dug a latrine. Given his talent and energy, even a few more tools might have allowed him to support his family as he had done in Uganda. Another man in Limbe, an amputee, was head of a family of 6 children; the eldest child was 15 and mentally retarded, the youngest was 2 months. Before the sudden death of his wife in mid-July 1982, she had supported the family through farming and leja-leja. It was said that she had simply worked herself to death. For some unexplained reason, associated (so the social worker vaguely claimed) with 'traditional beliefs', people in Limbe were unwilling to give this family any assistance. The man had been trained as a tailor and he asked me to buy a sewing machine so that he could support his household. ACROSS was the agency responsible for implementing the income generation programme, but it was against their policy to support individual projects. It was not until a year later that the UNHCR programme officer finally found money to buy a machine for him. The Oxford team found that he had stopped tailoring by 1985. He had been given some cloth and had sold the garments he made. He was unable to save enough to purchase more cloth. His main occupation in Uganda was as a blacksmith and in Limbe he had borrowed tools from a local Sudanese. The team actually purchased some of his products (arrows). But he was not interested in pursuing this occupation, pointing out how seasonal were the demands for his products. He wanted to return to tailoring.
Agricultural production and the more vulnerable Observations in 1982 led us to the conclusion that the present methods of defining and assisting the vulnerable were inadequate. My team and I therefore decided that, in addition to counting the numbers classically defined as vulnerable, the survey would record those who were most vulnerable in relation to the demands of the assistance programme. We had observed that many people in settlements were unlikely ever to be able to grow enough food to support themselves. Interviewers counted those people whose family circumstances and physical condition suggested that they would never be able to support themselves through farming and had no one else to help them. Each evening these cases were discussed and the interviewers were asked to explain both their subjective assessments and their objective criteria. Two examples will help to clarify our method. For example, a half-Asian orphan who lived with an unrelated family was classified as vulnerable. The head of his household rejected the boy, beat him regularly, and refused him food. He had to beg from other households. On the other hand, when the head of a household was an aged widow, living with one or more young, healthy and apparently responsible sons, neither she nor her family were classified as vulnerable. Using this method of defining vulnerability, we concluded that 21.3 per cent of the settlement population would never be able to support themselves through agriculture. In other words, a total of 22,700 people are at serious risk and become more so as food rations are reduced, in line with UNHCR policy, and finally stopped altogether. To further check on the validity of the criteria used to define the vulnerable, those cases where the household size equalled the number assessed as vulnerable were separately analysed. There were a total of 289 such families in this sub- sample, representing 14.3 per cent of all households. They account for 1,071 individuals, or 10 per cent of the total population of settlements. The analysis suggests my interviewers were remarkably objective in assessing vulnerability in these terms and lends credence to our conclusion that more than 20 per cent of the refugee population in settlements were totally dependent on aid. TABLE 6.1: Type of family head of vulnerable households compared with all households (assisted)
Table 6.1 shows the composition of these households according to the type of family head and compares them with the overall distribution of family heads. In only 8 per cent of the cases were both spouses present; 53 per cent of families were headed by women; and in 35.3 per cent of cases the head of the family, whether male or female, was under 21 years of age. Compared with the population as a whole, the households which interviewers assessed as totally vulnerable suffered a greater number of other disadvantages. Against an overall average household size of 5.29, they had an average of 3.71 persons per household. They ranged in size from I person to 16, but 47.4 per cent had more than 3 members. As demonstrated earlier, in a family of more than 3 members, the overall ratio of those able to cultivate begins to drop, making the larger households among this group also more vulnerable: 10 per cent had no one able to cultivate. The 289 families, where all members were identified as vulnerable suffered greater disabilities as compared with the overall average of assisted refugees. They had fewer than average relatives in other settlements or in the unassisted areas, and thus few people to call on for help. The distribution of ages of this population also differed radically from that of the overall population. (Figure 3 :1 shows the overall age distribution.) Comparing these 289 families with the total population, there were 4.6 per cent more women, and twice as many women over 45 years of age. There were more children between 5 and 14 years and fewer under 5. The population as a whole had 4 times as many men between 20 and 44 years than did these 289 households. There were more than twice the number of physically handicapped. And there were 157 orphans and 120 individuals who were ill at the time of the interview. (This was slightly more than average for the whole population.) A greater number (60 per cent compared with 55.1 per cent) had had no previous employment in Uganda, but had been dependents. When asked about their hopes of returning to Uganda, more than twice as many responded, 'All our relatives have been killed.' We found those who responded to the question in this way were also the ones who expressed the greatest sense of despair and hopelessness concerning the future. Such people often expressed their total resignation to the conditions in which they found themselves, and most of them believed that they would never be able, or live to see the day, when they could leave the Sudan. We took a lot of trouble to find ways of defining and identifying such vulnerable households. Another of our methods for determining vulnerability was to draw up a list of 34 factors which - singly or together - would be likely to prevent people from being able to support themselves through farming. The factors included lack of tools or land, no other relatives in the Sudan, debts, a physically handicapped or ill person living in the household, etc. Since it was not possible to weigh the importance of each variable in determining vulnerability, the presence of each characteristic was given a score of 1. Using this method, all households proved to be to some extent vulnerable. Those having the highest score (the highest was 23), were households headed by widows, followed by adult females, and normal families. Those having the lowest scores were households headed by men under 21. Separate examination of some of these cases did not, however, confirm the validity of the method. Statistical methods will never be an adequate means for finding the truly vulnerable people who require special assistance. They can only be known by the members of their own community.
The vulnerable one year later In 1984 the Oxford team followed up on households which had been interviewed in Roronyo settlement in 1983. Altogether 82 households were included in the survey and in 61 cases there were individuals who were either physically or socially handicapped, i.e. the elderly, widows, 'separated' wives, orphans, the blind, deaf, crippled, leprosy sufferers, or the household head was below the age of 21 years. In 1984, 54 of the 61 vulnerable households were still living at the same address. Of the seven 'missing' cases, two had repatriated, one had returned to the border, two were temporarily absent (at school or doing leja-leja), one had died, and one had exchanged plots to be nearer kinsmen. (Pankhurst 1985.) It was found that
The Oxford team also found that Vulnerability is a process in which a number of factors combine, it cannot be reduced to a single aspect or indeed to a prescribed set of limited factors.' (ibid.) There are, however, several characteristics which clearly distinguish the vulnerable. These include low physical mobility which affects agricultural production and ability to work for others, and the lack of even basic economic assets. The condition of the vulnerable is exacerbated by 'distress sales' of blankets, hoes, and cooking equipment to buy food when rations do not arrive, as well as by the absence of relatives near enough to offer support. One medical worker from Moyo hospital who had lost his left arm in a car accident was living alone at Limbe settlement. He had literally nothing but a burlap bag in his hut. To get food he had been forced to sell everything received from the assistance programme. Among the 21 other households interviewed in the 1983 survey which did not include vulnerable individuals, 6 were not living at the same address in 1984. 'Although the reasons for changes in population could not be established, and the figures are small, this may indicate the greater mobility of those who were not classified as vulnerable.. . i.e.6 out of 21 compared with 7 out of 61 households had moved somewhere else.' (ibid.) The Oxford team discovered that two of the households in the survey sample had become vulnerable during the year. In one case the house had burned down and in another, a woman died, leaving a 9-year-old orphan. In 1983 only 3.7 per cent of the household said they had no land but in 1984 10 per cent of the sample said they were not farming. Consideration for the most vulnerable families is now not even a part of the assistance programme. The need for food rations is determined on the basis of overall numbers and the decision to cut them is based simply on the number of months a settlement has been occupied. At the same time, enormous amounts of money are spent on such facilities as school buildings in settlements which refugees are clearly capable of organising and building for themselves. Near Kaya in an area of about 18 by 20 kilometres, on the Zaire/Uganda border, we found 12 self-help primary schools which, together with local Sudanese, the unassisted refugees had built out of local materials. In this area there were also many chapels and mosques which had been built on the community's own initiative. Would it not be more practical to redirect monies now spent on buildings to a welfare programme which first ensured that the most vulnerable families are supported?
Women: another vulnerable group? Male domination is a feature of most societies, but given the general powerlessness of refugees, are women likely to be even more vulnerable? The question of whether or not women should be singled out as a vulnerable class must be answered in the light of both recent historical changes and the nature of the aid programme itself. Some western observers believe the status of African women is even more inferior to men than in their own society. However, a number of studies have demonstrated that in the past the division of labour, the allocation of economic obligations within the household unit, and the elaborate protections built into the marriage system, gave African women more rights and protection than western feminists assume. (Hafkin and Bay 1976.) It has also been shown how the economic changes which occurred during the colonial period (and which have continued since independence) profoundly eroded women's position in society. (Smock 1975.) But despite the general deterioration of women's position, in most African societies women have retained certain rights and spheres of authority. An assistance programme could take account of these and actually encourage their maintenance. In the West Nile, for example, and as in many African societies, womens' economic obligations to the household were supported by certain rights and privileges. While she was responsible for producing much of the food which the family eats each day, she also had access to her own land and her granaries were strictly under her own control. Men who farmed concentrated on cash crops. The food crops a man produced were usually kept in his own granary and he might use it for gifts to his family, particularly his sisters.[8] While a wife is expected to prepare food for the husband's guests, if the guests are his relatives, he should not count on her being willing to draw from her own stock of food. A good-natured woman usually does so, but if there are tensions in the marriage, he can be sure that she will demand he provide the ingredients to feed his relatives. Among the self-settled refugees, such customary domestic arrangements could at least partially be maintained, but in the settlements, dependent as refugees were on rations and leja-leja and where there was not enough land, it is difficult for households to organise themselves along familiar lines. The failure to recognise their pivotal position in the household economy, and the special needs and particular vulnerability of women in the refugee situation, has led not just to women being disadvantaged, although this is obviously the case, but to whole programmes going awry. Unfortunately, through ignorance and sometimes through personal prejudices, both policy-makers and fieldworkers often unknowingly contribute to the further weakening of women's position. The male bias built into refugee programmes at the planning stage, conspires with the fact that African women do not normally expect to take on public roles. Ingrid Palmer (1982) observed that even where both spouses are present it would appear that the 'refugee women assume a lower social profile than usual, while patriarchy in the family intensifies... This is partly due to the new alien environment where men assume greater mobility and social visibility relative to women...' But, she continues, this is also due 'to the fact that the dependent family is given attention by relied agencies through male representatives...' That is to say, that the relief programme acts to bolster male status. In this regard the programme in Yei River District was no exception.[9] Although few men in the settlement had formerly earned their livelihood through agriculture, the entire agricultural programme focused on men. Agricultural advisers were men; the 'productivity' committees in each settlement were composed entirely of men. Women who were not heads of households were not allocated their own land. The main cash crop introduced into a few settlements was tobacco and very few women participated even though some of them had extensive experience in handling this crop. Apparently the agency staff was unaware that when men grow cash crops, it cannot be assumed that the family will directly benefit; men have responsibility to their sisters and to other kin. If women want access to food or to cash crops, they must grow their own; it is not necessarily a male responsibility. Perhaps for this reason, we found as many women as men growing cash crops. Excluding the transit populations, when asked if the household grew cash crops (in addition to tobacco, vegetables are also sold), 21.5 per cent of those headed by men, and 20.9 per cent of the women-headed households, said 'yes'. The responsibility for the time-consuming work of collecting water and preparing food for the family each day falls on women and children. One of the easiest ways to assist women is to ensure access to water near to the compound. It was the aim of the programme to provide settlements with a sufficient number of bore-holes, but the type of pumps provided required constant maintenance. Moreover, many of the wells were too shallow to supply water throughout the dry season. (It has already been noted that few households had adequate containers for collecting the day's supply.) Another time- consuming task is grinding grains to make them edible. The Sudan Council of Churches placed diesel-run grinders in Tore and Mogiri, but women were charged for the service. When hand grinders were placed in each block at Limuru settlement, this was done to help men generate income, yet grinding for the household had never been a male occupation. Tables 6.2 and 6.3 compare some of the characteristics of households headed by men and women. According to these data women-headed households are in most cases slightly worse off than their male counterparts, although 7.1 per cent more of them were living in a completed house and 5.2 per cent more of these households had at least one hoe. But note in Table 6.3 the large difference in numbers judged by the interviewer on other criteria to be vulnerable. There were insufficient data to make a similar comparison for the unassisted refugee households. TABLE 6.2: Some characteristics of male- and female-headed households (assisted)
The practice of issuing rations to the head of the family might also put the family at risk if the head were a man: 74.3 per cent of all families are headed by men. Among the 'normal' families (excluding those headed by a woman whose husband lived with her co-wife in the same settlement), 2.5 per cent of the registered heads of the household were women. Some women arrived first in the settlement and were registered as the head of the household. Later, when their spouse joined them, 27 of these women, perhaps wisely, declined to surrender their designation as head of the family and were so able to retain control of the rations. TABLE 6.3: Some (further) characteristics of male- and female-headed households (assisted)
That rations were issued on the basis of numbers of individuals gave a few women some sense of independence. Men complained that this policy was eroding marriages, as some women were said to taunt their husbands, reminding them that they now had other sources of income. According to the men, marriages are now considerably less stable than they were in Uganda. Following a dispute, women often abandon their husbands, taking refuge in another household, carrying with them their 'share' of such items as buckets or cooking pots issued by UNHCR. The resulting disputes usually involve wife-beating. It would be understandable to find conditions of life in exile had indeed eroded marriage relationships, but given the lack of comparative information (to say nothing of the complications of any study of marriage stability), we did not look for such empirical evidence. Had rations been supplied to women only, marriages might have been further eroded, but there might have been a better chance that the rations would be used to feed the family. Ugandan refugee women (as is doubtless the case elsewhere) arrived with some distinct disadvantages. Table 6.4 shows the amount of education of both men and women 15 years of age and over. TABLE 6.4: The number of years of schooling of men and women over 14 years of age (assisted)
Communication was a great problem in the settlements. Women were the last to receive information which affected them. For instance, I found few women who knew of the Red Cross Tracing Service, which was responsible for trying to find lost relatives. Lists of names were simply posted in Yei and occasionally workers visited and posted them in settlements. Women (and many men) were even unaware of what the food ration was meant to include. The inability to speak English was a major disadvantage. According to the sample, 37.2 per cent of the settlement population could speak at least some, but only about one-third of these were women. Nevertheless, in 1982, settlements were asked to elect only English- speakers as block leaders, obviously for the convenience of agency staff. However, the unfairness of this policy finally dawned on officials when, in Goli, the non-English speakers nearly staged a rebellion against the 'educated' class. After that, at every meeting which I attended, the proceedings were translated into the major language of the settlement. The organization of settlements with elections of officers as devised by the UNHCR programme officer, aimed to encourage the widest possible participation of the community in directing its own affairs. Within each group of 24 households, making up a block, officers were elected. These included a block leader, an assistant, a secretary, and representatives to serve on the settlement's health, education, and agricultural committees. (In practice, only the latter were active.) The settlement chairman and other officers were elected from among the block leaders. Rules for running an election were circulated and refugees were reminded that women were eligible to stand for any office. But Ugandan women are unaccustomed to taking public roles. Unless called upon to do so, most women do not even speak at meetings where men are present. A total of 5.9 per cent held positions of responsibility in settlements of which only 14.8 per cent were women. Eligible voters included everyone 16 years or older and those younger boys and girls who were heads of families. Voting demonstrates at least a minimum of interest in public matters. Excluding the transit camps (where proper elections were impossible) 51.5 per cent of the population over 15 voted and of those women who were eligible to vote, just less than half took part. There were other opportunities for playing a part in community life. Each settlement had a dispute committee and some also had them in each block. There were religious organizations, co-operatives, Scout associations, branches of the Red Cross, and other ad hoc groups set up for particular projects. In all,7.9 per cent of the population said that they belonged to one or other of such groups; of these 41.3 per cent were women. There were some salaried positions in each settlement. According to the sample, 1.1 per cent of the population is paid as a social worker, teacher, medical worker, etc. Of these only 21.1 per cent were women. Most of those employed to head women's organisations in the settlements were men. All expatriate agency personnel except the medical staff were men.[10] One reason that agricultural programmes are unsuccessful is because they are not directed at women. Even when there was a special programme for women's cultivation, it was organized by men. While the sectoral policy, described in Chapter Two, was still operating, two competing agencies were involved in organizing women's groups. At that time, GMT, having failed to get the contract for implementing agriculture, started nutrition clubs for women and appointed an agricultural adviser to organize them. Thus each settlement had, potentially, two (male) agricultural advisers; one for the settlement and one for the women's nutrition club. For women the attraction of the nutrition club was that tools and seed were provided. After it was discovered that women tended to drop out of the club (to work in their own fields) once they had a hoe, it became the policy to lock up the club's hoes after each meeting. All members were supposed to work on the communal plot at the same time. This approach to assisting women had a very mixed success. Women quarrelled over which of them had worked more and thus had a right to more of the harvest. Aside from such problems (and the question of whether settlements really needed two trained agriculturalists), the nutrition clubs probably brought more tangible benefit than did the income-generating projects organized for women by ACROSS. Again, the failures of these projects resulted from a combination of agency bias and the tendency for men to seize opportunity to the disadvantage of women. SCC had placed sewing machines in some settlements, but I found they had all been taken over by men, and women did not even get a chance to use them. Tailoring co-operatives organized by ACROSS also ran into similar difficulties. Men did not allow women access to the machines. Selling cooked food and tea was a popular way of earning cash. But again, funds were not provided to individuals and co-operatives always tended to be taken over by males. Women often asked for personal loans, as did many men, to establish some income-generating project, but apparently they were not regarded as good credit risks. There are many reasons why refugees find themselves in debt. The need to employ someone to build a house, as mentioned earlier, is a common reason why women and the handicapped fall into debt. Among the sample, 31.4 per cent of the households reported having borrowed money since arrival and not yet having repaid it. Of these, 21.3 per cent were headed by women. That fewer women were still in debt may have been less a function of need than of the difficulty of getting credit. The budget for women's projects was always far below that allocated for men's. Some had as little as £S30 start-up money, while a project like a butchery co-operative could receive several hundred pounds. Projects for women tended to be limited to handicrafts and embroidery, the profits on an item (equivalent to about 25 pence) did not justify the many hours required to complete it. Moreover, there was a limited market since refugees could not usually afford to buy table-cloths or crochet work. Raw materials for most mats and baskets had to be purchased elsewhere and there were never sufficient funds to supply all who could have made them. Such shortages led to friction. GMT had programmes for Sudanese women and had opened a handicraft shop in Yei. But the limited and poor quality of materials used to produce handicrafts and the lack of a clientele to buy, quickly discouraged the women trying to earn income in this way. There was apparently no tradition in the West Nile of women organizing themselves outside the family unit, unlike the situation in West Africa where women have a long history of powerful societies. The solidarity of these groups has played an important role in lessening the effects of men's tendency to oppress them. (Ardener, S. 1975: 29-51.) Efforts to organize women's groups to generate income ran into a host of problems. Female solidarity is a rare commodity in any society and it may be even more difficult to get women to work towards common goals in a community which has suffered the experiences of refugees and in which extreme scarcity of resources encourages competition. In addition, the demands of domestic work under the conditions of life in the settlements make it difficult for the very women who most need to generate income to participate. The lack of solidarity among women was exacerbated by agency competition and conflict. Where more than one agency was involved in organising women, those under one agency's umbrella were often unwilling to co-operate with those under another. The more educated women were sometimes reluctant to join in with their illiterate sisters. The result was that more of the non-literate women were in the nutrition clubs, while the income-generating organisations usually included those women of the educated class who were members of 'normal' families. Women who had spouses, especially those who were employed as teachers, medical workers, and the like were notably unsympathetic to the plight of those who were surviving on their own with young children. The most important institutional protection of women against unfair treatment, the wider family, was sadly disrupted by the death and displacement of relatives in the course of their flight. The case of Florence is not untypical. Florence, married with two children, had worked as a secretary in Kampala. Her husband was killed in 1981. On arrival in the settlement, a single woman with young children to support, she had agreed to marry again. The new husband did not regularize the marriage because Florence had no family to whom he had to answer. Subsequently, he took another wife and paid the dowry her parents demanded. This put Florence and her children at a disadvantage in the household in which they lived together with his parents. Respect for a woman's position is very much bound up with the presence of relatives and a 'proper' marriage. In addition to farming, of which she had no previous experience, she brewed beer to earn cash. Florence was selected for a two-week leadership training course in Yei. Having been appointed as the nutrition club's treasurer, she was responsible for its £S50. As no provision had been made in Yei for food or accommodation, and Florence had to send food to her children left behind in the settlement, she spent the money, hoping to be able to replace it from beer sales. On her return she confessed her debt to the other women. To make enough beer required endless days of leja-leja to acquire the cassava. Florence did not have the strength. She tried to join the sewing co-operative to earn cash, but the other women refused. She was already under one 'umbrella'. Even when I paid Florence's debt (which was the second excuse the women gave for excluding her), they would not allow her to join. The chairman of this co-operative was married to the man employed by ACROSS to organise women's groups. He appeared unconcerned over the unforgiving attitude of his wife. Apparently almost everyone in the community looked down on Florence. In Otogo, however, and without any help from an agency, women began making baskets and other household items from sorghum straw. Since most women made their own, at first these generated no income. I was able to put them in touch with a tourist shop in Khartoum. The latest report is that they had earned enough to buy three sewing machines. However, they still depend on the willingness of UNHCR staff to carry the baskets from Yei to Khartoum when travelling by charter plane. Where it exists, an assistance programme for refugees ought to take account of male resistance to women's organisations Many Ugandan men objected to their wives participating in women's organizations. In all the settlements (except those under SSRAP) the women's income-generating projects were led by men. When I met the women in settlements without their male 'leader' present, I was accused of inciting women to rebellion. In one settlement, Wondurubu, where the group actually had a woman as their leader, this problem was frankly discussed. They reported that some husbands beat their wives, on principle, if they attended one of the meetings. Their tea co-operative had failed because some husbands refused to allow their wives to take their turn running the shop. Only those women with more 'progressive' husbands had continued to participate.[11] In the absence of a sufficient number of enlightened Ugandans who could devote themselves to this entrenched social problem, agencies would be better advised to help individual women with projects which they could carry out in their own compounds. There were ways in which women could have used their 'non- controversial' agricultural skills to generate cash. Growing onions is highly lucrative and the crop can be stored for long periods. Yei River District is laced with rivers and it would have been possible to develop irrigated perimeters for women to grow onions and other vegetable crops. A number of simple technologies have been developed for lifting water. Although some women had the highly specialised skills required for growing tobacco, this labour intensive crop also requires the labour of men and they are unlikely to encourage women's participation. Bee-keeping, using improved hives, could also have been promoted. An indigenous Kenyan company offered to supply the technical and administrative services and the industry would have given work to tailors and carpenters. The company sent a proposal to the Commissioner in Khartoum, but for whatever reason the idea was not picked up by the agencies which are in charge of income-generation. The most common income-generating activity among women was brewing beer from cassava or sorghum, and for this product there seemed to be an unlimited market.
Responsibility without authority The failure of the assistance programme to meet those most in need who remained outside the settlements, placed an inordinate burden on many women which forced many of them to take decisions which were disruptive to their family life. In case after case we found that it was a woman who was finally the one who took the decision to go to a settlement, acting against her husband's wishes. One of my team describes such a case.
The penalties of acting against a husband's wishes can be severe. Certainly he will feel relieved of all responsibility for his wife and children and such actions normally lead to divorce. With no relatives of her own to fall back on, such separated women are extremely vulnerable. Another such woman, also married to a polygamous husband, in 1983 found they had nothing on which to subsist. Her husband refused to agree to come to a settlement, and 'She tolerated the situation for a bit until it was aggravated by the death of her child who died due to improper feeding. This compelled her to disobey her husband and she made her way to the camp. ...She now remains with her one child and her sisters.' Women's lack of experience in taking independent decisions often led them into great difficulty when they found themselves alone and responsible for children. One day in Limuru a woman and three children appeared, having walked several miles from their compound in the bush. The visit of a sister with a message from her father had prompted her to venture to the settlement to get medical treatment for the children. I asked one of my assistants to interview her. This is her story as he recorded it:
Question: 'Why didn't you move earlier?
Atima, my assistant, concluded his report with a description of the three children who had accompanied Zaida.
Women and malnourished children Feeding programmes were usually organized when a settlement first opened and when the health of the population was at its most critical stage. It has already been noted that the aid programme did not consistently provide adequate feeding programmes for the malnourished children in settlements, but even when these services were available there was still the perennial problem of a low initial response rate and a high number of drop-outs. I often observed a marasmus child sucking at a dry breast, the mother seemingly unaware that her child was dying through lack of food. Most expatriate observers as well as the Ugandan medical staff viewed such behaviour as irrational or as an indication of the ignorance of women. The behaviour of women at Mopoko did little to encourage anyone to look further for reasons why mothers were failing to co-operate with efforts to save the lives of their children. There, it was reported, women were demanding to be paid, not only for cutting the firewood to cook the special meals, but for feeding their own children. I began looking for an explanation for such behaviour which appeared so irrational to observers. (See my own report of this situation in Chapter Two, and page 283.) I found a number of reasons for the high rate of noncompliance with feeding programmes for malnourished children. For one thing, treating a severely malnourished child is a full-time occupation since the child must be fed several times a day. The location of the feeding centres usually meant that a mother (or other caretaker) had to spend the entire day away from the household. In itself, this fact alone is sufficient to account for many of the women's demands. But in addition, women have other lives dependent on them. Most of them needed time to spend on other pressing household duties including cooking and carrying water, not to mention the fact that when settlements opened people were occupied in building and mudding houses, digging latrines, planting seeds when they had them, etc. When WFP supplies failed, women were forced to do leja-leja to feed the other members of the family. In retrospect, it would seem quite reasonable to compensate women for their time in the feeding centre so they could supply the household with food. But there were other reasons which encouraged women to stop coming to the feeding centres. While aware that it was the lack of food which caused their child's illness, the food children were given was totally unfamiliar. Mixing oil with milk is completely foreign, and women say that the gruel tastes 'disgusting'. No sugar was added and there was no attempt to offer a variety of food to stimulate a child's appetite as a mother would normally have done at home. Children are normally fed on demand. The idea of force-feeding an infant, on schedule, is unheard of and the experience of trying to impose such a regime is highly unpleasant for the mother. Mothers would comply so long as a nurse was watching, but when unobserved would usually respond to the protests (usually screams) of the infant. The medical staff often behave as though the mother is personally to blame for the child's illness and many are often roundly scolded for not co-operating. It is likely that Ugandan women, as in most African societies, are held responsible for the well-being of their children. In Sierra Leone, for example, a child's illness is taken as evidence that the mother has broken some taboo. (Harrell-Bond 1975;1975b.) Efforts to rehydrate a malnourished child tend to increase diarrhoeal symptoms. Many women are aware that their youngster is suffering from other illnesses which require treatment and the feeding programmes did not include medical examination or any other treatment. Women often told me it was useless to go to the feeding centre if medical treatment was not also given. This is not an irrational view, and given the circumstances in the settlements, a women may well be forced not to accept the aid offered. The Oxford team collected 97 case histories of malnourished children in settlements, among both refugees and Sudanese living near Panyume. In their analysis they attempted to distinguish a 'main' cause of malnourishment. In about half the cases, the 'main' cause was extreme vulnerability. Extreme vulnerability was defined as including some debilitating factor together with a set of social circumstances which led the child to receive inadequate support. About one-third of the children came from female-headed households and in many of these cases the woman was herself ill or incapacitated. About one-quarter of the children were orphans and again, many of these had joined already vulnerable families. In other cases one or both parents were either mentally or physically disabled or incapacitated by illness or torture. In two cases the child was disabled; one had been beaten over the head and body by the rifle butts of Ugandan soldiers and showed signs of complete mental/physical retardation, and the other was incapable of standing and appeared to have some kind of cretinism. The mother of this latter child appeared mentally retarded and the father was described by the interviewer as psychotic. Child disablement is not necessarily a cause of neglect leading to malnourishment, as other disabled children were observed who were not suffering malnutrition. TABLE 6.5: Mental health and malnourishment
Poor mental health may be an additional complicating factor leading to the neglect of children. The Oxford team administered an adapted form of a mental health instrument designed to diagnose clinical levels of anxiety and depression. The numbers tested were extremely small, and the results must be regarded as both preliminary and experimental. However, the correlation between the psychological states elicited by this scale and the incidence of malnourishment is too striking not to suggest that the problem requires more serious attention if assistance programmes are to deal adequately with the problem of malnutrition. The Sahrawi refugees, who manage their own health programme, have established centres for such sick children and their mothers. (Harrell-Bond 1981.) A neighbourhood committee in the settlement takes care of her household during the mother's absence. These 'protection centres', as they are called, are small camps located away from the main community. A very strict regime has been instituted which includes the daily examination of each child and its mother, and training in how to care for the child. As one responsible noted, by daily weighing of the child, the mother learns that it is food, not medicine which will cure her child. Apparently also aware of the psychological needs of these mothers, there is not only a strict regime, but regular social and musical evenings are organized in these protection centres.
Family planning services and the problems of women The UNHCR Handbook notes that contraceptives should always be made available to refugees, but this instruction was ignored. Family planning was not part of the health programme for Yei River District. While in Khartoum, I had been informed that refugee women in eastern Sudan were practising 'back-street' abortions and that there was a high rate of mortality. I was asked to include a question in the survey about the acceptability of contraceptives among Ugandans in order to provide data which would encourage GMT to provide these services. On the basis of my previous experience in Africa, I did not believe there would be interest in contraceptives and did not follow this advice. It was not until we had been interviewing for over a month that I realized how very wrong were my initial assumptions. In Limbe settlement, a group of men presented me with a petition demanding that these services be incorporated into the health programme. Family planning had been a part of the health programme in Uganda. They pointed out that many women were dying in childbirth as a result of the lack of medical facilities and the other problems they were facing in exile. (Hepatitis during pregnancy had already resulted in a large number of deaths in this and other settlements.) As these men pointed out, as refugees, they had to limit the number of children to support. While many suffered low fertility, others found the threat of pregnancy disruptive to conjugal relations. Later, I was presented with a memorandum from a group of women; the demand for family planning was top of the list. Further discussions suggest that this need was quite widely felt. A few individuals had received 'the pill' from the GMT doctor when they had personally requested it. One Ugandan declared he absolutely never wanted any more children and - perhaps because his request was so unusual - underwent a vasectomy operation in Juba. As there was more than one registered nurse with extensive experience in family planning, it would have been possible for the Ugandans to have organised their own services - at least for the settlements. Contraceptives are freely available in Khartoum and those who promote the extension of such programmes throughout Africa will immediately see the value of such an example for the Sudanese in the south.
Gender blindness On the face of it it might be concluded that women do not suffer any greater disabilities in exile than do men. Moreover, one might argue, they are unlikely to suffer as severely from being uprooted since they may resume their normal domestic life once they have settled in their country of asylum. Even though many formerly had careers outside the household or were students, it might be easier for them to adapt to domestic roles. But the very nature of customary female roles in this cultural setting means that ultimately women have to take the major responsibility for managing the home. (Christensen 1982.) It is the women who must ultimately find the food to feed the children, carry the water, cut the firewood, and nurse the ill. The insecurity of poverty ultimately falls most heavily on her. The assistance programme did not aim to discriminate against women. Rather it was the ignorance or indifference of those who ran the assistance programme combined with the undue emphasis upon equality. As with GMT's health programme, this could only lead to failure simply because the recipient population was so variegated. Women may be poor or illiterate, but they do have a good grasp of their needs. However in relation to the men who determined aid policy they were indeed a 'muted' group (Ardener, E. in Ardener, S. 1975) and aid policy tended to reinforce their 'muting' within settlement society. Women were thus at a double disadvantage. Even though I was a woman, it still required special attention to inspire women with sufficient confidence to discuss their particular problems with me. It was almost impossible to meet with the women alone - men were always hanging about to listen. One tactic to get rid of them was to raise a topic which is taboo for men to discuss.[12] I must admit that at times I did attempt to incite women to rebellion. I related stories from West Africa of mass demonstrations by women which I had witnessed. In Tore, where a man kept the womens' sewing machine buzzing from early morning until dark, l recommended the women take over the community centre where he worked. In Kala, where no rations were distributed as the settlement was deemed by WFP to be self-sufficient, I suggested one woman take her three starving children to Yei and hand them over to agency staff. In the same settlement, where a woman was still bleeding heavily months after having given birth to premature twins, and where, refugees complained, the doctor only delivered drugs late in the afternoon, refusing to see the critically ill, l recommended refugees surround the car with all such patients. But few Ugandan refugees, much less the women, were aware they had any rights. The fundamental reality - that no one gives power, and that it must be taken - was not part of the thinking of these desperate and starving people. Certainly Ugandan women must decide for themselves if their interests will be better served through collective action. Until they do, it is unlikely that the present agency programmes (organised and implemented by men) will benefit women who are indeed a specially vulnerable category. Nor will aid officials be able to identify and serve the needs of those vulnerable women who are now least able to care for themselves. Women may be 'muted', but this should not be interpreted to mean that they are either ignorant of their needs or unable to express them if the situation is right for them. In Limbe, one of several settlements where women put their complaints on paper, I was given the following petition. It gives poignant expression to just some of the burdens women bear.
Do women refugees suffer more or less than men?[15] While the results of the psychological test administered by the Oxford team cannot be regarded as conclusive, it found as many men suffered psychiatric morbidity. (de Waal in Wilson et al. 1985.)[16] Loss of status may be a more severe problem for men since so few of them are able to resume former occupations, while women's roles remained the same. Superficial observations and case histories suggest, however, that men are more likely than are women to express their frustration in ways which are socially disruptive. For example, excessive drinking has already been mentioned, but marital problems (including wife-beating) are also quite common. Such behaviours place even greater burdens on women. This, together with bearing the major responsibility for providing for the household under these conditions, would seem overwhelming. Problems for women worsen and programmes of assistance fail, precisely because policy-makers and field officers are gender blind. But gender blindness does not, as we have seen, lead to gender neutrality. ____________________ [1] I borrowed this title from Chambers (1983) who also borrowed it! [2] In 1984 the Oxford team followed up on the survey and collected further in depth material. This discussion relies heavily on their work, especially on that of Alex de Waal, Alula Pankhurst and Ken Wilson. [3] That refugees in Africa may also need such basics as training in language or information concerning soil conditions, rainfall patterns, or crop suitability has been overlooked. [4] Mustafa Idrissi, the ex-vice president under Amin, who came to the Sudan with five Mercedes Benz cars, was supporting 30 people in his house near Yei. By 1983, however. poverty had forced him to send some of his dependents to a settlement. I visited the home of an Eritrean who had established a number of successful enterprises in Khartoum. There were, by count, 50 people living in his small compound in a very poor part of the city. [5] But opportunities are limited. The frustration this causes may partly account for why many men indulge in excessive drinking. Women often complained that their men will sell anything and everything, even the food rations, to purchase (locally-brewed) alcohol. Admittedly, women also drank, and one cannot be absolutely sure their drinking did not also lead them to sell essential items. However no man ever complained to me that women were guilty of such behaviour. [6] One of these, Amin s administer of finance, Moses Ah, retired to his home village to rear a large herd of cattle when he was dismissed from office According to him, he had financed this venture from bank loons In 1 979 he was able to move all these cattle to Sudan by lorry Although he moved to Pakistan, the herd has been used to support relatives he lets behind. [7] In 1982 when Goli was first opened one young man escaped from an attack by a buffalo which then calved beneath the tree he climbed. He was stranded there - according to the reports [8] This is a highly over-simplified comment on what is an elaborate and highly complex system of division of economic and social roles between men and women. [9] But in 1985 UNHCR sent a woman to fill the post of head of the Juba office. [10] Apart from myself and an Oxford undergraduate who temporarily joined the research project, my team was also composed entirely of men though this was not for want of trying to employ women. Most women with the required educational standard had either married, or produced a child out of wedlock, or were in Juba. The problems of single women received altogether too little attention in this research. [11] I did not recommend militancy as a Wily of overcoming this problem. In fact I suggested that after each meeting, wives should take more trouble over the preparation of a meal to encourage their husbands to believe that the women's meeting could contribute to the welfare of the family rather than to its breakdown. But my words tasted sour in my own mouth, when I remembered that, at best, the ingredients available for crooking were limited to cereal, oil. milk and beans. [12] Given the problems of lack of soap, private bathing facilities, and even cloth, I could not imagine how refugee women dealt with menstrual flow. Once this was the topic of our discussion; to the amusement of the women, the men fled. [13] The agency responsible for health had organised these leadership training courses. Such training had been available in a women's centre in Juba tor years. and many capable Sudanese graduates of the course were unemployed. Before coming to the Sudan. a consultant for women's development programmes in Khartoum had lived for many years in Uganda. When her contract was completed. she had travelled to Juba to offer to work in the refugee programme. It was not taken up. She is now working in Kenya. If expatriates are required to administer programmes for women, would it not be wiser to employ women who have such relevant experience in Africa? [14] Herein lies a tale. I could not believe these women could seriously be asking for cement for grave markers when the programme was not even providing them with soap or salt. hut apparently it was a matter of 'keeping up with the Jones' and of social responsibilities to the dead. I visited the Limbe cemetery, and the mystery of an earlier disappearance of building materials was solved There I found several graves neatly covered with squares of smooth cement, carefully marked with the names of and appropriate farewells to the deceased Obviously someone on the building site had capitalized on some refugees need to give such respect to the dead. [15] Spring (1982) found that among the refugees living in Zambia. the women, through marriage, were able to more easily 'assimilate' than the men. [16] But, it should be noted, Orley and Wing (1979) also reported a mulch smaller sex difference in Uganda.
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