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During 2003 and 2004, the people of Darfur were in extreme danger. The mortality rates were much higher than the emergency benchmark. While mortality rates dropped once the survivors reached IDP camps, the rates remained above the emergency level. This was particularly true for very young children in the camps.
 

Of course the black Africans in Darfur are in extreme danger when their villages are attacked or they are trying to flee the violence. But what about the survivors who reach camps for internally displaced persons (IDP camps)? What kinds of dangers do they face?

A study of four IDP camps in Darfur reveals that while the mortality rates drop once the survivors reach the IDP camps, they are still in great danger.

What Is a Mortality Rate?

Mortality rate is calculated as the number of deaths per 10,000 people per day. So, for instance, if the mortality rate of a group is 6.0 then we would expect to see 6 people die for every 10,000 people in the group every day. In a camp with 20,000 people we would expect 12 people to die every day.

How many people dying per day is too much? The benchmark for mortality rate is 1.0, or one person dying every day for every 10,000 people. A mortality rate greater than 1.0 indicates an emergency of “very serious” situation.

How do the Darfur refugees in the different camps measure up against this benchmark? Not well.

Mortality by Period

A number of studies try to estimate the number of people who die in attacks on their villages of while they are trying to escape. But, this is only part of the over all mortality of the people of Darfur. IDP camps, which may be safer than a village under attack, are still dangerous. The danger in IDP camps comes not just from violence, but from lack of basic necessities: food, clean water and basic healthcare.

How do the mortality rates in IDP camps compare to the mortality rates during attacks or while fleeing? Figure 1 compares the mortality rates of these two periods experienced by survivors in four different IDP camps.

Figure 1: Overall Mortality Rate by Period and Camp

Note: Information on mortality rates during the village/flight period was not available for the IDP camp at El Geneina.

As Figure 1 shows, the mortality rates during the village/flight period are between five and ten times the emergency situation benchmark.

While the mortality rates drop once the survivors reach the IDP camps, the mortality rates are still above the emergency benchmark. In short, survivors who make it to the camps are still in grave danger.

The camp that sticks out in Figure 1 is El Geneina. The authors had data only for the camp period for this IDP camp, so we can't compare this to the village/flight period. However, what is most striking is that the mortality rate in the camp is dramatically higher than that in other camps—fourteen times the emergency level. But why? Who is in danger in the El Geneina camp?

The Weakest Are Most at Risk, Especially at El Geneina

Typically, the youngest children are most at risk because of disease or malnutrition. In all camps we see that the mortality rate for children under five years is higher than the mortality rate for the general population, though the rate is not dramatically higher for children in the Zalingei, Murnei and Niertiti camps.

The story is much different in the El Geneina camp. While the mortality rates for young children are below 3.0 in the Zalingei, Murnei and Niertiti camps (still well over the emergency situation benchmark!), the mortality rate for young children in the El Geneina camp is over fourteen times the emergency situation benchmark! (See Figure 2).

Figure 2: Camp Mortality Rates by Age

This tells us that the health situation at El Geneina was at extreme crisis levels during the period of the study. While humanitarian aid was critical in all camps, the need in El Geneina was desperate.

Mortality by Cause of Death

To what degree do people die from violence rather than other causes? It depends on the period. See Figure 3.

Figure 3: Violence Mortality Rates by Camp

As Figure 3 shows, people in Darfur are much more likely to die during attacks on villages or when they are trying to escape.

Who Is More Likely to Die by Violence?

Figure 2 shows that the mortality rates in camps is higher for younger children than the total population, but who is at most risk of dying by violence? Figure 4 compares the relative risk of dying a violent death.

Figure 4: Risk of Violent Death

The authors were able to calculate the relative risk of a violent death only for two camps: Zalingei and Murnei. The pattern is striking. While women in the Zalingei camp were nine times more likely to die by violence than children under 15 years, men were over 117 times more likely to die a violent death. The same pattern held for the Murnei camp though the numbers were not as extreme.

What this tells us is that the men were much more likely to be killed than women. Violence ending in death was only part of the story, however. Torture and rape were also rampant. Other research shows that women were much more likely to be raped and sexually tortured than men,[insert reference] though they were less likely to die.

The reader should also keep in mind that these risk estimates are relative to children under 15 years old. What this means is that the risk of a violent death for children under 15 could still be very high, but compared to children, the risks for adults are even higher (drastically higher in the case of men).

Bottom Line

During 2003 and 2004, the people of Darfur were in extreme danger. The mortality rates were much higher than the emergency benchmark. While mortality rates dropped once the survivors reached IDP camps, the rates remained above the emergency level. This was particularly true for very young children in the camps.

 
Data and Methods:

Data Source:

Data was gathered from four IDP camps in Darfur: Zalingei, Murnei, Niertiti and El Geneina in 2003 and 2004.

The authors used a two stage cluster sampling method to identify households within the camp. They interviewed the head of the household to gather the following information:

  • Deaths that had occurred during the recall period,
  • The age of the person who died,
  • The month (Islamic calendar) in which the person died,
  • The location of the death,
  • The cause of death,
  • People who had left the household more than two weeks (only for the Zalingei and Murnei camps),
  • The month of arrival at the camp,
  • The reason for leaving their village,
  • The age and sex of household members.

Using this sampling strategy, the authors interviewed the following number of subjects from each camp:

  • Zalingei: 460 households (representing 2386 people),
  • Murnei: 912 households (representing 4754 people),
  • Niertiti: 903 households (representing 5188 people),
  • El Geneina: 900 households (representing 5191 people).

Methods of Analysis:

The authors carried out two types of analysis:

  1. Mortality rate: the number of deaths per day per 10,000 people,
  2. Relative risk of violent death of adult men and women relative to children under 15 years of age.

Funding Source:

Mèdecins Sans Frontières.

 
Full Text Availability:
Not available.
 
Reference

Evelyn Depoortere, Francesco Checchi, France Broillet, Sibylle Gerstl, Andrea Minetti, Olivia Gayraud, Virginie Briet, Jennifer Pahl, Isabelle Defourny,Mercedes Tatay, and Vincent Brown. 2004. "Violence and Mortality in West Darfur, Sudan: Epidemiological Evidence from Four Surveys." Lancet 364: 1315-20.

 
 
 
 
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