(EST PUB DATE) GLOBAL HUMANITARIAN EMERGENCIES, 1993-94

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00580607
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December 28, 2022
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September 7, 2017
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F-2015-02015
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October 1, 1993
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Approved for Release: 2017/08/31 C00580607 Director or Central Intelligence National Intelligence Estimate Global Humanitarian Emergencies, 1993-94 This National Intelligence Estimate represents the views of the Director of Central Intelligence with the advice and assistance of the US Intelligence Community. Sec MN-NO('ON IRA( 1. et NIL )3-36 Oa( ther 1QQ3 ( 0 r Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607 Director of Central Intelligence NIE 93-36 Global Humanitarian Emergencies, 1993-94 ( Prepared by Charles E. Allen, National Intelligence Officer for Warning! Secret NOF RN-NOCONTRACT Approved for Release: 2017/08/31 C00580607 October I (NJ Approved for Release: 2017/08/31 C00580607 Secret NOR. RN- CONTRACT Figure 1 Most Likely Critical Humanitarian Emergencies Estimated number of persons ii need (millions) Present situation compared to last year: � More critical 1992-93 Cause 1993-94 Present Potential Conditions Assumed Present Potential "., l./111.11i11161.A.1 0 i A:titi critical Sub-Saharan Africa 2.0-3.0 2.0 � Conflict; poor security. Angola Drought, conflict 3.0 No cease-fire; renewed attacks on food convoyslflights. Liberia 1.0 10 0 Unsteady cease-fire. Conflict 1.7 Conflict sups; refugees retunt.� Mozambique 4.0 1.8 � Peace accords hold; some security problems. Conflict. drought 3.0 Refugees return, or conflict resumes. Rwanda 1.0 1.0 6 Peace accords hold. Conflict 1.5 Refugees return, or renewed fighting. Somalia 2.0 1.3 � Sporadic violence, food security good. Conflict, drought 2.0 Renewed clan warfare. Sudan 3.0-5.0 2.0 � Intensified war in south. Drought, conflict 3.4+ Conflict worsens: local food supplies targeted. Former Yugoslavia 1.3 2.8 � Continued conflict. Bosnia-Herzegovina Conflict 2.0 Conflict stops: refugees return. Central Eurasia 0.35 0.5 0 Supply routes cut off. Armenia Blockade 0.3 Situation improves if conflicts end in Georgia and/or Azerbaijan. Azerbaijan 0.5 0.9 . Secessionist movements and leadership crisis persist. Conflict 1.4 Government pandysi% deepens, greater Annenian intwlventent in war. Georgia 0.1 0.5 � Secessionist wars persist. Conflict 1.0 Full-blown civil war. Tajikistan IA) 0.3 � Low-level clan/regional fighting continues. Conflict 1.0 Clan, regional warfare intensifies. Middle East/North Africa 0.75 1.2 � Baghdad sustains blockade. Iraq (Kurds) Blockade by Baghdad 1.2 Electricity cut off harsh winter. South Asia 4.5 5.0 � Fighting does not subside. Afghanistan Conflict 5.5 More Tajiks crass border, or some Afghans repatriate if conflict lessens. Sudan: Southern rebels-as well as the government-often impede the flow of supplies. a If conflict stops, the number of people in need of aid would increase as refugees return, but the situation would be less critical because relief probably would flow more freely. Bosnia: Relief convoys headed for opposing sides frequently are blocked and turned back ConfidenMelORN 341342 10,93 II Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607 Seer Key Judgments RN-NOCONTRACT Ethnic conflict and civil strife have increased humanitarian needs around the world. The international relief system is under severe strain and faces burgeoning demands in the future. Bureaucratic tangles and competi- tion will remain the most common problems; the UN often has trouble coordinating relief efforts even among its own agencies. "Donor fatigue" will lead to more selective responses to disaster situations. Other donor countries and UN agencies will look to the United States for leadership Hostile environments are impeding relief efforts. In some areas of conflict, only forceful�and costly�intervention will ensure that aid reaches those in need International operations are becoming more dangerous. Relief workers, including those under the UN flag, increasingly will become targets of violence Africa will continue to generate the most severe humanitarian crises despite the end of the drought in the southern part of the continent. More than 6 million refugees and three to four times that many internally displaced persons will be at risk of hunger and disease. Fighting in Angola and Sudan is creating conditions as severe as those in Somalia last year. In Somalia itself, the recovery is precarious. If fighting continues in Bosnia as we expect, the population in need will be double that of last winter, or reach some 2.8 million. Bosnians will need about 390,000 metric tons of supplies to survive�the equivalent of 19,500 C-130H flights�over the next six months. Even if fighting stopped, the region would require about 270,000 metric tons. Conflicts within the countries of the former Soviet Union have intensified over the last year and will result in greater numbers of people needing emergency aid. The most severe needs this winter will be in Georgia, Armenia, Azerbaijan, and Tajikistan. (b)(3) (b)(3) (b)(3) (b)(3) (b)(3) (b)(3) (b)(3) pproved for Release: 2017/08/31 C00580607 sr NI E 93-36 October I 003 � Approved for Release: 2017/08/31 C00580607 Ethnic warfare in Afghanistan and, to a lesser extent, in Sri Lanka will cause millions to be displaced. The number of Kurds requiring relief in northern Iraq has grown from 750,000 to 1.2 million over the past year. The 100,000 to 150,000 Shias in the southern marshes of Iraq could be at risk of severe food shortages over the next few months. Emergency humanitarian needs in the East Asia�Pacific region are declining for the second consecutive year. The political situation in Cambodia remains tenuous, however, and intensified conflict would produce additional humanitarian needs. iv Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607 Secr N;ir Scope Note RN-NOCON TRACT This Estimate identifies the ongoing and potential humanitarian crises stemming from conflict worldwide for which the United States may be asked to provide assistance over the next year. In addition, it addresses the following questions: � What will be the magnitude and scope of the crises? How many people will be affected and what are their needs? � What are the complications for delivery of aid? Is "donor fatigue" a factor? � Can the international infrastructure cope with burgeoning demands? Included with this Estimate is a wall chart (in pocket at back) containing specific environmental and operational data for each crisis and a foldout locater map indicating the need, degree Of severity, and cause of potential or actual emergencies. Are4Alost often affected by natural disasters are identified in figure I OL, V Approved for Release: 2017/08/31 C00580607 et NIE 93-36 ocwher I Q93 Approved for Release: 2017/08/31 C00580607 maareram......kpfmr.,*neexayow _s Discussion' Secr NO RN-NOCONTRACT Unrelenting civil strife and ethnic warfare around the world continue to place millions of noncombatants at risk of death from starvation and disease. Since last year's Esti- mate, critical humanitarian needs stemming from conflict have increased.' Efforts to respond to humanitarian crises have had mixed success. International inter- vention in Somalia relieved the mass starva- tion, and resourceful and determined efforts in Iraq sustain the Kurds. In Bosnia, howev- er, attempts to meet critical needs�while saving thousands of lives�have fallen short. Can the Relief System Cope? The demands placed on the international infrastructure for delivering emergency relief over the past two years have uncovered ominous faultlines. Lives continue to be saved, but breakdowns in the system have occurred. Even where food supplies are ade- quate, bureaucratic tangles and coordination problems, especially among UN agencies, as well as local political and economic barriers, impede the delivery of aid to people in critical need. If not addressed, the effect of these weaknesses, particularly those involv- ing UN agencies, will erode donor confi- dence and make donor countries more reluc- tant to participate. ' We define "critical humanitarian needs" as those arising from acute emergency conditions�wars, conflict, natural or techno- logical disasters�that are not met by routine relief programs and mechanisms. We use the term "populations at risk" to mean those in need of or dependent on international aid to avoid deprivation leading to serious malnutrition or death.ie< Sources of Information The information used in this Estimate comes from a variety of sources includ- ing diplomatic, military, and press reporting; data from UN agencies and nongovernmental organizations; and interviews with relief workers on the scene. These reports frequently provide con- flicting information: each organization reports on situations as seen through the filter of its own program, and crises developing in isolated or denied areas often have few observers. We believe some reporters�political opponents, rebel groups, governments, and relief providers�at times exaggerate the gravity of a situation. For example, at one point last year, estimates on the number of people at risk of starvation in Sudan ranged from 200,000 to 10 mil- lion. Any specific numbers cited in this Esti- mate, therefore, represent our best assessment based on a review of all available information, and we are confi- dent that they accurately portray the magnitude of the problem�if not the absolutely precise numbers of the popu- lation in need (b)(3) (b)(3) (b)(3) Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607,.. The International Relief Network A multitude of organizations�UN agen- cies, international and national nongov- ernmental organizations (NGOs), and regional organizations�as well as donor countries comprise the humanitarian relief system. The UN bodies include the UN Department of Humanitarian Assis- tance (UNDlif A), the UN High Commis- sioner for Refugees (UNHCR), the World Food Program (WFP), the International Children's Fund (UNICEF), the UN Development Program (UNDP), the World Health Organization (WHO), and the Food and Agriculture Organization (FAO). Among the largest and most active of the more than 16,000 NGOs are the International Committee of the Red Cross, various national Red Cross Societ- ies, the International Rescue Committee, Medecins Sans Front ieres, Equilibre, OXFAM, and the International Save the Children Alliance. Formal interaction between humanitarian aid providers takes place in organizations established for that purpose. The 86- member International Council of Volun- tary Agencies (IC VA) meets regularly with UN relief agencies; its task forces provide a focal point for NGO activities in disas- ter-stricken countries. The LicrossIVolags Steering Committee, founded by the League of Red Cross and Red Crescent Societies (LORCS) and several other NGOs, submits humanitarian relief policy to the UN and meets monthly to review current disaster situations. The EC/NGO Liaison Committee provides a dialogue between about 600 European NGOs and the EC. In addition, the Conference of NGOs (CONGO) provides for NGO partic- ipation in UN meetings and committees. When disasters occur, UN agencies, NGOs, and representatives of donor coun- tries meet to plan relief efforts. They often carry out needs assessments in combined missions, although they also may do so independent of each other. Likewise, they may issue appeals as a consolidated group or on an individual basis. International conferences are held to elicit contributions as well as to coordinate relief efforts. In addition, a Special Representative of the Secretary General and a UNDHA Special Coordinator are sent to disaster areas; in theory at least, the UNDHA Special Coordinator organizes the relief opera- tions. NGOs, the EC, and donor countries also send coordinators. While all of these representatives�as well as those from aid-receiving countries�meet to discuss their individual operations and to coordi- nate their efforts, the number of meetings and the level of successful coordination appear to be specific to the country receiv- ing aid and the organizations operating there. cret 2 Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607 Showing Its Warts... The international relief system comprises myriad independent or semi-independent organizations that often work together but sometimes do not. The UN's agencies and officials frequently compete for primacy, to the detriment of aid delivery. In Angola, for example, the personal representative of the UN Secretary General, working with little data, has tried to make crucial decisions that run counter to the plans of the UN agencies charged with delivering emergency aid. Duplication of activities, bureaucratic bun- gling, tensions between organizations, and lack of coordination are commonplace. The creation last year of the UN Department of Humanitarian Affairs (UNDHA) was sup- posed to alleviate these problems but instead has compounded them. UNDHA often has difficulty coordinating between its New York office responsible for policy and its operations headquarters in Geneva. ... And Coming Under Fire Hostile environments around the world impede, and sometimes prevent, organiza- tions from delivering sufficient assistance in a timely fashion. Attacks on relief convoys, theft of supplies, and murders of relief work- ers all contribute to the impression that the organizations cannot get the job done. Pri- vate volunteers have long faced such dan- gers, but attacks on UN forces and officials during the past year have struck a blow against the UN's moral authority. The UN's experiences in Bosnia and Somalia will encourage belligerents elsewhere to regard relief workers under the UN flag as legiti- mate targets of violence. (s Figure 2. Swedish UN troops secure relief supplies at Sarajevo airport. (u) More Challenges Ahead As humanitarian needs grow, the task of delivering emergency assistance is becoming more dangerous and complex: � In areas of conflict, forceful and costly intervention�requiring a range of logistic, security, and combat forces�often is required to ensure that food, shelter, and medicines reach the populations at risk. � International forces will face additional problems from infectious diseases and envi- ronmental health risks, which represent a greater threat than battle injuries to the effectiveness of units conducting the relief operations Potential exposure to the AIDS virus pre- sents another complexity. The militaries of some countries with which US forces may be working have H IV-infection rates in excess of 50 percent. Special planning will be required in operations involving those forces, especially in areas of conflict and in places (b)(3) 3 Approved for Release: 2017/08/31 C00580607 S ret Approved for Release: 2017/08/31 C00580607-- � Acquired Immune Deficiency Syndrome (AIDS) and Humanitarian Emergencies (b)(3) (b)(3) AIDS is the final stage of a viral infection of the human immunodeficiency virus (HIV), which destroys the body's natural immunity to fight infections. All HIV infections are fatal. Refugees, peacekeeping or monitoring forces, demobilizing militaries, and labor migrants contribute to the spread of AIDS beyond specific countries. Humanitarian aid missions involving militaries with high HIV-infection rates could spread viruses to countries where it is not now a problem. For example, Liberia's relatively low infection rate could be threatened by all three countries�Uganda, Tanzania, and Zimbabwe�considering joining an expanded monitoring force there UN regulations now require governments to certify that their personnel are HIV- negative before deploying them on UN- sponsored missions. However, AIDS screening is expensive, and some militar- ies will shirk this costly procedure. Some countries are already having difficulty finding sufficient HIV-negative personnel to meet multinational force commit- ments�another disincentive to testing. In addition, UN officials are not enforcing their HIV regulation. Thus, the Ugandan contingent soon to arrive in Somalia has at least a 50-percent injection rate. The commander of the UN force in Mozam- bique has asked that the Zambian contin- gent�many of whom he says have AIDS and are causing operational and morale problems�be replaced at the end of its tour by troops from another country; how- ever, he is skeptical that the UN will honor his request. The United States and other donor coun- tries will have to take measures�includ- ing leading and funding the international oversight of HIV testing�to ensure the safest possible environment for relief personnel where medic ner nations tions, US forces medical services directly to !o that have high infection rates "Donor Fatigue" Sets In... The extent of critical humanitarian needs and the problems of addressing them are ties are shared with part- n some reliel opera- e expected to provide affecting the international response. Over the past year, donors generally have become slower to respond, and contributions often have fallen short. For example: � Aid for Afghanistan lagged badly this year; the UN Secretary General's Special Representative reported in late June that only about $36 million of a $138 million appeal for the January to September period had been pledged. 4 Approved for Release: 2017/08/31 C00580607 111116111.1"7-71pprove .or Release: 2017/08/31 COO Who Are the Donors? � The European Community provides sig- nificant humanitarian aid in addition to the aid provided by its members on an individual basis. Other West European and North American countries plus Japan contribute most of the personnel, supplies, and funds for humanitarian assistance, either unilaterally or through UN organi- zations and nongovernmental organiza- tions. The share offunding varies with the situation: developed nations had contrib- wed over $950 million in disaster relief to the former Yugoslavia as of June 1993; the United States contributed some $354 million of the total. On the other hand, the United States has contributed about three-fourths of the funds for relief efforts in Liberia. What Do They Provide? In addition to food, medicine, and funds, donors provide mobile hospital units, shelter supplies, blankets, trucks, and communications equipment. Russia and Ukraine have specialized in supplying mil- itary and civil transport and helicopters on a contract basis at advantageous rates. Russian aircraft have supported opera- tions in Somalia and Cambodia; the Ukrainians have flown hundreds of mis- sions into Armenia. Stockpiles of emergency items are main- tained by various governments and private relief organizations around the world. For example, Japan's International Relief Organization has storehouses in Japan, Singapore, Mexico, and Italy for rapid deployment to disaster sites. The UN Department of Humanitarian Assistance is promoting the worldwid register of such disaster stocks. � As of early August this year, the Interna- tional Committee of the Red Cross's appeal for the former Soviet Union had yielded less than half of the amount requested. � The UN so far this year has received commitments of only $89 million of the $226 million requested for Angola. ...With Tough Choices in Store The international relief system, already under severe strain, faces burgeoning demands in the future. The resources of the United States and other donors will be spread more thinly, and donors will have to be more selective about which crises to address The decision of the international community to respond to a specific humanitarian crisis will depend on the accessibility of the popu- lation in need, the risks to relief personnel, and severity of the crisis, as well as the level of effort already being expended for other critical needs. As in the past, some dire situations in remote locations will be over- looked by donors. Other crises will receive widespread media attention that will (b)(3) (b)(3) (b)(3) 5 pproved for Release: 2017/08/31 C00580607 et Approved for Release: 2017/08/31 C00580607 (b)(3) (b)(3) (b)(3) World Grain Supply Few countries have suffered serious crop failures from droughts, floods, or other natural disasters in 1993. In most coun- tries requiring food relief shortages have resulted from political or economic tur- moil that has disrupted imports or distri- bution within the country, particularly distribution of food to persons displaced by conflict. Although global production of grains, which provide human as well as animal sustenance, will probably decrease slight- ly from the record levels of 1992, grain production will still be above the average for the past five years. Production of wheat and rice�the main components of the human diet in most countries�will likely be higher than that of 1992 and almost 3 percent above the recent average. Most countries with large increases in grain production had good rainfall this year, and their governments have raised crop prices and promoted irrigation to boost production. For example, wheat crops in most of the countries in a band from Kazakhstan through the Middle East to parts of North Africa benefited from above-normal rainfall during 1993. Moreover, several of these countries� including Iran, Iraq, and Turkmenistan� have vigorously promoted wheat produc- tion to decrease their dependency on im- ports. Despite their production increases, several of these countries will still have large deficits and will require imports or food aid. Agricultural experts expect the largest proportional declines in food production to occur in a diverse group of countries: Morocco, hit by a drought this year; Venezuela, whose economic disruption has curbed production; Somalia, where conflict has prevented planting of much cropland; and East European countries, subject to both drought and economic disruption. Most of the countries in which 1993 production is likely to be 10 percent or snore below average will not experience food problems, however, because they can afford to increase imports or, in some cases, will still have surpluses for export. enhance our ability to estimate the scope of the crisis while increasing international pres- sure to act. Still, some crises�especially in areas that are less accessible or where con- flict is intense�may be considered too costly or complex to undertake large-scale relief efforts The United States will be expected to take the lead in identifying and responding to (b)(3) humanitarian crises. Sub-Saharan Africa Africa will continue to generate humanitar- ian emergencies on an unparalleled scale. Despite progress toward peace in some coun- tries and the end of the drought in the southern part of the continent. Africa still has most of the world's refugees�about 6 million�and three to four times that many (b)(3) (b)(3) 6 Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607' displaced persons. Moreover, African gov- ernments on the whole are the world's needi- est and least able to cope with their emergencies: � More than half of the world's poorest countries are found in Sub-Saharan Africa. � Africa has 12 ongoing insurgencies, includ- ing those in Rwanda and Mozambique where cease-fires are in force but rebels have not been disarmed. � The AIDS epidemic is spreading through all of Africa and straining its already feeble health care systems; of the 13 mil- lion people worldwide infected with the HIV virus, 8 million are in Africa. During the coming year, international aid and intervention will be necessary to stave off human catastrophes in parts of Africa. In addition to emergency shipments of food and medicine, the transition from war to peace in some areas will require assistance in refugee resettlement, infrastructure repair, landmine removal, and support for demobilized mili- tary forces. The Horn: More Turmoil in Store Somalia. The massive international relief effort has ended the starvation, and some local councils are beginning to function again. Nevertheless, instability in Mogadi- shu and random violence in the countryside make the recovery precarious. Most of the 1.3 million refugees and displaced persons in camps remain dependent on international assistance, and the majority of international relief workers�forced to leave by the earlier violence--have not returned. The security of food supplies and delivery is problematic. Without a continued international effort, widespread hunger and disease could reap- pear quickly. Sudan. The civil war in the south is creating humanitarian conditions as severe as those in Somalia last year. The intensified govern- ment offensive against the rebels makes the task of reaching the 1.5 million southerners in need of humanitarian assistance-800,000 of whom are already at risk of starvation� even more difficult. An additional 1 million people elsewhere in Sudan�including 600,000 displaced in the transition zone between north and south�now need humanitarian assistance. Another 200,000 are in danger of being caught in the fighting and may join the 350,000 Sudanese refugees who already have fled to neighboring coun- tries�primarily Zaire and Uganda. Sudan has enough food to meet most of its needs but has provided only about half of the grain promised for relief in the south. The government suspects that relief efforts are aiding the rebels; all sides have impeded the flow of aid. Khartoum would oppose a US- or UN-led relief intervention in the south and would likely stage guerrilla attacks Qn foreign military forces and aircraft. Meanwhile, locust infestations in both Somalia and Sudan have become serious and are likely to aggravate the food crises in both countries. The political situation in northern Somalia precludes international eradication efforts there; in Sudan, UN sources say the locust infestation will worsen if current weather conditions persist. (b)(3) (b)(3) (b)(3) 7 Approved for Release: 2017/08/31 C00580607 SiEiet Approved for Release: 2017/08/31 C00580607 Figure 3 Africa and the Middle East North Atlantic - �coati - Morocco Western Sahara Mauritania CV� Verde Thu Gambia. SmOri Guinaa.Bissett Guir ea Feeetown SIERRA LEONE Monrovia* UBERIA Cote d'Ivolre South Atlantw- Ocean Unclassified Tunisia Algeria Benin Nigeria Equatonai Gulneac --PGabon C�I1 San Tame and Principe, -Central African Republic *NOMA iCabinifol IGnshasa *Luanda ANGOLA Namibia S. Afr. Bar � Turkey Swia Lebanon Israel SUDAN RWANi A ZAIRE Burundi Botswana Baghdad IFIA�Q\ Kuwait Saudi Arabia Eritrea r Yemen Ethiopia Kenya Tanzania �. Iran ,/SOMAUA *Mogadishu //Id/ Ocoim Comoros Sureties MOZAMBIQUE Madagascar NLivnliil*. Swaziland I Maputo South ae�tho Africa Reunion irruncel itharr ()cr_vro Bounds, nierraintrienn nno rinceamni, ARAIWILIIM 7:RW1211111004751 10 113 8 Approved for Release: 2017/08/31 C00580607 (b)(3) (b)(3) (b)(3) Approved for Release: 2017/08/31 C00580607' Southern Africa: Drought Ends, But Peace Elusive About 4 million people in this region are in danger of starvation Angola. Some 2 million are at risk as a result of a more destructive phase of the 16-year civil war. Relief organizations have substan- tial supplies in-country, but logistic con- straints and attacks on food convoys and relief flights will contribute to even greater starvation; deaths per day may now exceed several hundred. The UN and other relief organizations, however, have little reliable data on the location and numbers of people in need Mozambique. The signing of peace accords has facilitated relief deliveries to the 1.8 million persons who depend on aid, al- though food deliveries are still subject to interdiction by armed bands. Ample rains this year have helped improve the local har- vest; but, by yearend, surplus stocks of maize�both donated and locally pro- duced�will be expended, and additional shipments will be needed. Moreover, uncer- tain security conditions and a ruined infra- structure will hamper resettlement efforts that are slated to begin late this year for 1.5 million refugees, several million dis- placed persons, and at least 60,000 demobi- lized soldiers. Until the former combatants are disarmed, a breakdown in security still could lead to an acute humanitarian crisis. Peace Possible Elsewhere, But Conflict More Likely Rwanda and Liberia. Recent peace accords are allowing supplies to flow to populations dependent on international relief in Liberia and Rwanda. If the accords hold, the inter- national community will be called upon to help resettle about 700,000 refugees and more than 185,000 displaced persons in Liberia and nearly 1 million displaced per- sons and 2(4000 to 500,000 refugees in Rwanda. Chances of renewed conflict in both countries remain high, however Sierra Leone. More than 20 percent of the population has been displaced or has left the country as a result of fighting in the south- east. Some 240,000 already arc dependent on feeding programs, another 300,000, most of whom are in Liberia, are expected to return from neighboring countries, and up to 300,000 more are internally displaced but not currently receiving aid. The government seems to have the upper hand against the rebels, but the end gf the insurgency is far from certain. Zaire. Three years of political impasse between the President and his opposition has led to a breakdown in central control. The collapse of basic services, ethnic strife, and looting and violence by unpaid soldiers have reduced the availability of food. Malnutri- tion and disease are at high levels in the capital, and low food reserves in all provinces make localized famine in urban areas likely over the next three to six months. The vio- lence so far has displaced over 500,000. If substantial portions of Zaire's 40 million population begin to flee across borders, as some already have, neighboring Angola, Zambia, Rwanda, Uganda, and Sudan could not cope with the influx Europe After Africa, the world's most acute humanitarian crises are concentrated in the former Yugoslavia. Some 4.3 million people, (b)(3) (b)(3) (b)(3) 9 Approved for Release: 2017/08/31 C00580607 ,;_Sepedt Approved for Release: 2017/08/31 C00580607 acording to the United Nations High Com- missionerfor Refugees (UNHCR), are in need of aid�two-thirds of them in Bosnia. Long-term subsistence on minimal food sup- plies, limited medical care, severe shortages of water and sanitation supplies, and damage to housing have left the Muslim population in Bosnia weakened, more susceptible to disease, and progressively less capable of surviving bouts of hunger and cold. The infrastructure in central and eastern Bosnia is severely damaged, and many towns there are dependent on the humanitarian relief effort. Relief deliveries fall short of demand and are hampered by insufficient resources, fighting and denial of access, poor road conditions, bureaucratic hurdles, and bad weather If War Continues... The impact of continued conflict will be more devastating this winter than anything we have seen thus far. Tens of thousands could perish from disease, hunger, and cold. If fighting continues as we expect, the Bosnian population in need will be double that of last winter�or about 2.8 million people. Total relief requirements during the next six months will be an estimated 390,000 metric tons�equal to about 19,500 C-130H flights at maximum payload�about 80 percent of which will be food.' Food reserves in Bosnia have been largely consumed. A harsh winter this year�unlike last year's unusually mild one�will make I By comparison, the UN HCR sent 120,000 metric tons of relief supplies into Bosnia during the first six months of this year: in March 1993. UNF1CR delivered 25,000 metric tons-- the largest single monthly shipment to date. Figure 4. Residents of Sarajevo line up to get / their water from a unoff pipe flowing into a suburban river. i Figure 5 Former Yugoslavia Time 0 Austria Italy 100 Kilometers too %ties Rulg. *Skopje MACitX)NIA Greece Unclassified 75)?, 14141 *veil It) 4.4 relief deliveries throughout much of Bosnia more difficult at the same time that humani- tarian needs are highest. ... And If the Fighting Stops The humanitarian outlook would improve, but needs would dictate a substantial relief 10 Approved for Release: 2017/08/31 C00580607 (b)(3) Approved for Release: 2017/08/31 C00580607' operation. Requirements could total as high as 270,000 MT of aid over the next six months. Planning figures by the UNHCR suggest that such an operation�through normal relief agency channels�would cost about $200 million. The amount of aid would reach this level as significant population displacements occur, including the move- ment within Bosnia of as many as 200,000 Muslims from Croat- and Serb-controlled areas to the central Muslim core; of about 60,000 Croats to western Bosnia; and 20,000 to 50,000 Serbs to other parts of Bosnia. In addition, about 200,000 Muslim refugees probably would return from Croatia to Bosnia, as would about the same number of Serb refugees from Serbia itself. Croatia. The UNHCR lists about 530,000 persons-250,000 displaced Croatians and more than 280,000 refugees from Bosnia�in need of assistance. (u) Kosovo. If ethnic fighting expanded into Kosovo, we would expect that over 300,000 Albanian refugees initially will flow into Albania and Macedonia, and many more (b)(3) would flee as the fighting spread. (b)(3) Central Eurasia Conflicts along the southern flank of the former Soviet Union will generate acute needs for humanitarian assistance. Most regimes are less stable than they were a year ago. Virtually the entire Caucasus region, for example, is embattled or under blockade, and disputes among Tajikistan's clans and regional factions continue to impede efforts to provide relief and resettle refugees. Conditions in Azerbaijan, Armenia, and Georgia are worse than last year. Azerbaijan's war with its ethnic Armenian-dominated enclave, Nagorno-Karabakh, has escalated since June with a Karabakh-Armenian offensive, sending some 300,000 Azeris toward the Iranian border. Tehran�already burdened by 2 million Afghan refugees�is delivering relief supplies and establishing displaced person camps on the Azerbaijan side of the border in an effort to prevent the Azeris from crossing into Iran; Turkey is providing funds for other camps. Baku can- not provide for its nearly 1 million refugees and displaced persons while it wages a losing war, struggles to resolve a leadership crisis, and tries to cope with regional secessionist movements in the north and south. We esti- mate the fighting this year alone has dis- placed more than 400,000 people. Living conditions can be expected to worsen as ts in and food supplies dwindle. rmenia is all but cut off from the outside world by civil strife in Georgia and an Azerbaijani blockade. During what is expected to be its second consecutive harsh winter, Armenia will face shortages of food, oil, water, and electricity. Turkey will restrict use of its territory for delivery of relief supplies to Armenia as long as the Nagorno-Karabakh conflict continues, and airlifts will be necessary to sustain the population. The ethnic and civil conflicts in Abkhazia and western Georgia will continue, with full- blown civil war a possibility. T'bilisi's access routes north to Russia and west to Black Sea (b)(3) (b)(3) 11 Approved for Release: 2017/08/31 C00580607 IMIMIMMIMIIIIIIIIMIIIIIIIIIII.MIMgk3proved for Release: 2017/08/31 C00580607 ?74 Figure 6 Caucasus Region (b)(3) � �Boundary between Chad:ante and ti Inoushetia has not been established RUSSIA Abkhazia 'As Sukhumi Black Sea Turkey Syria Uncl Kabardino- Balkaria North Ossetia Ingushetiad GEORGIA Iraq Chechenie Tbilisi Caspian Sea AZERBAIJAN * . �� Baku ' < rr t,Nagorno. \Karabakti 141011) ports are tenuous and subject to frequent disruption. Emergency deliveries of food and medicine�in addition to current aid in the pipeline�will be needed during the winter. Iran O 10014Ianelers I.. O 100 Macs 730013 190033.0 10 93 Territorial and ethnic conflicts are also brewing in the North Caucasus region of Russia�particularly the republics of Ingushetia, Chechenia, and North Ossetia. Limited local warfare in those areas over the ret 12 Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607 (b)(3) (b)(3) (b)(3) next several months is likely and will produce refugees who will need support. Conflict in the North Caucasus will hinder supply routes into the entire Caucasus region. More than 30,000 Tajik refugees have been repatriated from Afghanistan to southern Tajikistan, but efforts to reintegrate them are failing and the humanitarian situation there probably will worsen. The population of the Pamirs�swollen by more than 30,000 displaced persons and refugees returning from Afghanistan�faces a winter of famine if relief routes are not kept open. By October, snows will cut off much of the region. Mean- while, the impoverished Gorno-Badakhshan and wealthier Leninabad regions are both operating independently from Dushanbe. The lack of central government control hinder relief and resettlement efforts South Asia Ethnic warfare�particularly in Afghanistan and, on a smaller scale, in Sri Lanka�will continue to generate humanitarian needs in South Asia. Conflicts will keep about 6 million people dislocated and dependent on humanitarian assistance. Pakistan will re- main dependent on international support as long as it hosts significa t numbers of Afghan refugees In Afghanistan, fighting in Kabul and along the Afghan-Tajik border, as well as guerrilla attacks throughout the country, has wors- ened over the past year and will displace more Afghans, hinder refugee repatriation, and impede the delivery of international aid. Without emergency relief, about 5 million people�either refugees or internally dis- placed persons�would suffer from food and fuel shortages, inadequate water and elec- tricity, and epidemics. About 1.5 million Afghans are internally displaced, 1.5 million more are refugees in Pakistan, and another 2 million are in Iran. In addition, at least some 60,000 Tajiks fled to northern Afghan- istan after civil war erupted in Tajikistan last year. The job of delivering emergency aid in Afghanistan has become more treacherous. Factional fighting and lack of central gov- ernment control have heightened the threat to aid workers. Relief operations staged in Afghanistan rely heavily on air transport, which is vulnerable to Afghan guerrillas armed with antiaircraft weapons. Overland transport to isolated populations requires the cooperation of local warlords. Elsewhere in the region, the civil war in Sri Lanka that pits the Sinhalese majority against Tamil separatists will continue to inflict hardships on the populations in the north and east of the island. Some 600,000 people have been dislocated by the conflict, and about 80,000 refugees remain in India. Middle East�North Africa Iraq will be the only country in this region likely to generate substantial emergency humanitarian needs unrelated to natural disasters during the next year. The Kurdish population will face harsh conditions this winter; the number of Kurds requiring assis- tance has grown from 750,000 to 1.2 million over the past year, and the Kurds have become even more dependent on international (b)(3) (b)(3) (b)(3) 13 Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607 Figure 7 Afghanistan and Tajikistan Turkmenistan Iran Uzbekistan AFGHANISTAN Boundary representation Is not necessarly autnontatirm. 0 200 Kilometers 0 200 Miles Tashkent Dushanbe , e.TAJI I,K.ISTAN Gomo-Badakhshan Autonomous P .1 Oblast Kabul Kyrgyzstan Pakistan China /1 India r s /30034 0700915) 10 93 ,stieet 14 Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607 )p Figure 8. Thanks to Baghdad's continuing blockade, the Kurds of northern Iraq will spend their third winter as dependents al the inter- national relief system.1 help. In addition, a health crisis is developing in parts of the North where the lack of electricity�which was cut off by B is curtailing access to safe water As a result of Baghdad's ongoing em of the north, the UN estimates that over 90 percent of Kurdish food, fuel, and medical needs must come from territory that is not controlled by Baghdad. Shortfalls in the funding of relief agencies, harassment by the Iraqi Government, harsh weather that would close convoy routes, and a possible end to cooperation from Turkey�through which the aid flows�will co eaten relief efforts this wint The 100,000 to 150,000 Shias in the south- ern marshes of Iraq�site of a low-level insurgency�are likely to be at risk of severe food shortages over the next few months. Baghdad continues to dry out a substantial part of the hlands where the Shia live, dcstroI dr t ditional means of subsis- tence. We cannot verify the extent of acute needs in southern Iraq. Baghdad denies the UN and other relief organizations access to the area. The only route for delivering relief would be through Iran and would pcq.vire smuggling supplies past Iraqi troop East Asia�Pacific The region is expected to have its usual share of emergencies stemming from natural disas- ters, but the number of people dependent on emergency aid for survival�displaced per- sons and refugees�will continue to decline as noted in last year's Estimate. Cambodian refugees have returned home from Thailand as a result of a UN-brokered peace agree- ment. In addition, improved conditions in Vietnam are encouraging many Vietnamese refugees to repatriate from asylum in I-long Kong, Indonesia, Malaysia, and elsewhere. 15 Approved for Release: 2017/08/31 C00580607 SC et Approved for Release: 2017/08/31 C00580607 Figure 9. Extreme poverty and - political violence in Haiti are a boon to the boat-building business but could again spark massive miuration to the United States. Cambodia will need food assistance during the next year as more than 360,000 recently returned refugees run out of UN rations and Cambodians try to produce a crop without adequate irrigation or fertilizers. Low-level fighting and banditry will pose hazards for donors distributing assistance outside the capital. Moreover, the Khmer Rouge could return to more intense warfare that would once again displace large numbers of people, send refugees fleeing across borders, and dramatically increase the need for humani- tarian assistance. 16 Widcworld 0 Latin America�Caribbean Most humanitarian needs at present can be handled through routine aid programs. Des- perate economic conditions and political repression in Haiti and Cuba, however, could bring calls for emergency relief and stimulate sudden and massive migration that would necessitate direct US assistance. Approved for Release: 2017/08/31 C00580607 Approved for Release: 2017/08/31 C00580607 � Figure 10 Countries Willi Significant Populations Vulnerable to Major Natural Disasters Earthquake Volcano /181 ,Tropical Cyclone' Flooding (.'ountry Armenia Aierbaijan Bangladesh Burma Caribbean islands Chile China Costa Rica 'itha Ecuador F.I Salvador (;recce India Indonesia Iran Italy Jaran Kyrgyistan Mexico NicaraQua Pacific islands Pakistan PaII:1111a Peru Philippines South Korea liiaII Tajikistan Turkey Ceophysical Disaster Meteorological Disaster it V "1 lurricanes and typhoons, which are limited to the May�November period in the Northern I lemisphere. tJuef5ssIicd +I:4�14 10,11 l?e�erse 7 Sret Approved for Release: 2017/08/31 C00580607 C00580607 Figure 11 Emergency/Critical Humanitarian Relief Needs Through 1994 Secre OFORN ,. Equator \ South $. Pacific Ocean � ist / � 4\:1 � /N.-,- ,zt- - --%� 1 - / -r. . _ ,,, -, , _1,r :�... ...----,- ;IL---...., ..:.-z..- 1-4-4 I )".� ', :i,: . Atlantic Ocean r it) CEN i "'Pak ),D3co GUAC � EL SALV PMAAM4'- 1_64/ ����/"/ COSTA � 1 c m RERUifs . COLOMBIA � I � . .� N I ECUADOR I � Former YUGOSLAVIA BOSNIA AND MEL CROATIA MACEDONIA SERMA AND MONT. South Adantic Ocean Severity of need Moderate Hii Likelihood of need Low Moderate Hipp Severity of need Low Moderate Hies Low Likelihood of need Cause C conflict � Drought E Economic restructuring a N Natural disaster T Technological disaster Moderate High a In the forrner Soviet Union. every country is error undergoing economic restructuring or feeling the effects of snarler country's taxon* restneduring. Currently necessitating some kind of emergency humanitarian relief T Potentially necessitating some kind of emergency humanitarian relief ret 7799671.�01St, IOU 8 cD CD � Potential Humanitarian Eme Generated by Conflict, 1993- Country Persons in Need, Most Likely Number Estimated Food Political Environment Physical Environment Airfields Ports Rail Highway Inland Needs for Next Six Months a (metric tons) Waterway igI I _) ..e) )-5 D -- N a) Afghanistan 5 million 446,000 Unreliable Little government control Landmines , Deserts; scrub-covered mountains Extreme temperatures Snow; summer dust storms; earthquakes; avalanches Albania 150,000 13,400 Reliable Forested mountains 0 � cn RI (1) Coastal plains T..) Earthquakes' Y � 0 0 a) > ' - � . . . . � : 2 o_ o_ Angola 2 million 178,400 Unreliable Coastal lowlands Civil war Interior highlands - Landmines Winter rain � Armenia . 500,000 44,600 Government support limited Mountainous Little foiestland � 0 � 0 Hot, dry climate Winter snow Earthquakes --- Droughts - Azerbaijan 900,000 80,300 Limited government control in ivest Large lowlands Mountains in north and west %.". Semiarid . _ Winter snow . 2017/08/31 C00580607 ergencies -94 Inland Fuel Medical N � Waterway cD co oo Civil strife strife and ethnic warfare around the world are putting civilian populations at risk of death from starvation and disease. The 24 countries or areas below have either ongoing humanitarian crises that are expected to persist through next year or have strong prospects of such emergencies occurring over the next year. ) ) ) ) ) � � System in poor condition Marginal facilities in Kabul; others substandard Shortage of professional personnel Physicians to population ratio: 1:4,797 J Bed to population ratio: 1:2,054 ) ') ...., r 1 Below Western standards Physicians to population 3 ) Numerous and well-spread ratio: 1:640 � facilities Bed to population ratio: 1:180 Universal access Old equipment Personnel poorly trained 3 ) - . . Critical shortage of drugs ) , 5_ D_ 0 111 Below Western standards Shortages of personnel and supplies ,T ... 57 hospitals 20,000 beds (1:445 population) . 1,000 physicians (1:9,891 population) Relies on aid and imports � 0 System taxed by conflict Critical shortages of supplies Equ ipment outdated .. , Latest data 1989: , 14,200 physicians (1:232 population) 30,000 beds (1:110 population) 0 II System taxed by conflict Critical shortages of supplies Equipment outdated � 4,4," Latest data 1989: 28,000 physicians (1:250 population) 21..111:111-1- .1 LI Cm - t .� 1 Country Persons in Need, Most Likely Number Estimated Food Political Environment Needs for Next Six Months' (metric tons) Macedonia 150,000 13,300 Government likely to cooperate , Mozambique 3 million 267,500 Fragile security Bandits Landmines Returning refugees Demobilizing military Devastated economy Government welcomes aid Russia (Northern Caucasus) NA NA Government would support relief Some armed opposition Rwanda 1.5 million 133,800 Fragile security situation Serbia and Montenegro Montenegro NA NA Government supports relief r�-� CD Co CD 00 Physical Environment Airtie)ds Ports Rail Highway Inland Fuel Medical Waterway For Official Use Only Transportation infrastructure � Supports relief effort O Supports limited effort � Support severely constrained or no support Double dots indicate quality varies by region in country Fuel infrastructure II Extensive Cl Limited Very limited NA Not available D likely to .) �.)- D _ N Mountainous Sparse forests Hot and dry Winter snow Earthquakes Droughts 0 � 0 � 0 CI Substandard Critical shortages of supplies and equipment Bed to population ratio: 1:170 Physicians to population ratio: 1:415 3.i 33 3.) 1) - o . 0 a) > � '�I fugees military conomy. . welcomes aid Plains Forested plateaus Subtropical south Tropical center and north October November rains . - .., 0 , . . . . � . :�-� . :1 �� � 0 � � 0 .. ,. � � - . ,. IN Substandard 143 hospitals 24,300 beds (1:614 population) Physicians to population ratio: 1:48,375 Severe shortages of supplies 0_ a-fr would ef opposition Very high forested mountains Winter snow � 0 � � 0 III NA .� ,s . , *ty situation Highlands Scattered plains Tropical climate ' Winter rain- Short, dry summer � - ' � 7 � � ' lb. 0 - - la Substandard , 25 hospitals 2,500 beds (1:3,400 population) 250 physicians (1:32,825 population) . All supplies imported _ , , supports Mountainous Sparse forests Moderate climate, little snow Earthquakes 4111meseambe�ms. 0 0 0 � 0 0 Facilities are old, poorly malt tained, overcrowded, and lack Wcstern capabilities Many qualified physicians in Serbia Support services poor � .. .. . . C00580607 C00580607 - - � . r.. - . - Azerbaijan 900,000 80,300 Limited government control in west Large lowlands Mountains in north and west Semiarid Winter snow Drought � o 0 0 Bosnia-Herzegovina 2.8 million 315,000 Unreliable Little government control Landmines At times, all factions oppose relief . to other parties Forested mountains Extreme temperatures - ; . i 1/4., � � 1/4_, � _ . Cambodia 360,000 32,100 . Factional strife Landmines Government supports rel:ef Theft, corruption Flatlands Rolling hills Dense forest Low wetlands Monsoons Typhoons Flooding ' ' o o c o o r--- C a7 C: co Ls) C C C cr. oc C r-- 1/4�-� C a 0 71 0 7 c s s Croatia 530,000 t 47,300 Government supports relief Potential ethnic strife Interior plains: hot summer, win ter snow Coastal highlands: dry summer, mild winter 1 , . ; 1 1 " 0 � C 0 Georgia 500 Roo 44,600 Government supports relief Control of countryside doubtful Mountains: cold, snowy winters Lowlands near Black Sea: mild winter, dry summer C � � � � � Ic Haiti 900,000 80,300 Minimal government support for relief Mountainous Summer rain Warm, humid year-round Hurricanes Earthquakes � (:.:' r � � � 0 � Iraq 13 million 115,900 Government can deliver support throughout country Government hinders relief to Kurds and Shias Mostly flat Northern mountains Desert Freezing temperatures, north and desert Dust/sand storms Heat/dehydration � o � � � _ Liberia - . _ 1 million 89,200 Limited government _ Flat, some forestland - ' 0 . � � ___ control Hot and humid COO Cr) aD CD CD C (/) Cil a) a) Ct 0 a) 2 c_ c_ System taxed by conflict Critical shortages of supplies Equipment outdated Latest data 1989: 28,000 physicians (1:250 population) 71,000 beds (1:98 population) Infrastructure damaged or destroyed Serious shortages of personnel and supplies Much equipment nonfunctional Physicians to population ratio: 1580 Bed to population ratio: 1:220 Rudimentary 150 facilities: damaged, lack piped water and electricity 7,500 beds (1:1,100 population) 700 physicians (1:12,200 population) Shortages of all supplies Best system in former Yugoslavia Many large hospitals in Zagreb provide Western standard of services Sufficient, qualified physicians Shortages of other personnel System taxed by conflict Critical shortages of supplies Equipment outdated 32,000 physicians (1:171 population) 60,000 beds (1:92 population) Substandard Little service in rural areas Critical shortages of - personnel, supplies, and equipment � 964 physicians (1:6,673 population) 60 poorly equipped hospitals (22 in capital) System operating at half capacity Supplies scarce Personnel mostly in cities 250 hospitals Bed to population ratio: 1:600 7,000 physicians (1:2,600 population) 10,000 nurses (1:1,800 population) 36 hospitals before current N- CD (N1 Pharmaceutical industry lacks money to buy raw, Materials Bed to population ratio: 1:130 Physicians to population ratio: 1:390 1,000 dentists (1:18,000 population 8,000 support personnel (1:2,200 population) Serbia and Montenegro Montenegro Kosovo Sierra Leone Somalia Sudan Tajikistan 13 million � 3.4 million 26,800 Government supports relief Government supports relief for Serb refugees Government opposes relief for ethnic Albania and Bosnian Muslim refugees No government assistance or opposition to reli*f Insurgents along Liberia border No local authority can assist relief Opposition from clans, bandits, religious radicals Civil war Government and rebels. � obstruct relief to south Landmines . Government cannot assist relief in south or east Armed opposition _ upports Mountainous Sparse forests Moderate climate, little snow Earthquakes Droughts C 0 0 0 Facilities are old, poorly maintained, overcrowded, and lack Western capabilities Many qualified physicians in Serbia Support services poor Supplies available Bed to population ratio: 1:170 Physicians to population ratio: 1:415 ., upports b Northern plains Southern mountains Cold, snowy winter Hot, humid summer 0 0 .... 0 0 0 co Lo cs CD 0 x� Cr) co cs ----- r-- sng c) r\I cn cu cu PPoses nic Albanians Muslim Lowlands divided by mountains Summer, hot and dry Winter snow Droughts Earthquakes C C System taxed by poor economy, political tensions Some hospitals closed Bed to population ratio: 1:320 Physicians to population ratio: 1:890 at assistance n to relief er Swamps; beaches Low plains Highlands Tropical climate Seasonal changes Constant heat and �as humidity S 0 .. � 0 Substandard � Some qualified physicians Facilities and equipment poor Shortages of supplies 1:t 0 4-� -0 cu > 2 sp_ sp_ nty can om clans, ous radicals Large plateau Coastal plain Mountains in north Sparse rain Severe heat Drought S S�S S U Substandard 90 hospitals prewar, now damaged No supplies available on open market UNISOM II medical support meets US standards Assessment of personnel or beds not possible nd rebels f to south Desert, extreme heat in north Swamp, forest, flooding in south C 5 C Below Western standards 164 hospitals: old, overcrowded, unsanitary Critical shortages of personnel and supplies 2,170 physicians (1:11,153 population) 90 percent of medicine and all equipment imported , , -�Equipment annot n south . non Mountainous Very cold in Pamir Mountains Semiarid lower areas C 0 S o 5 U Basic services unavailable to most of population Facilities deteriorating Critical shortages of supplies 15,000 physicians (1:3,401 population) 55,000 hospital beds (1:92 population) outdated annot Swamps in north Plateaus in south C 0 C C � C 0 C NA Substandard 4 fru, fqrilitine 1,3,���� nwa-lorn� Georgia 500,000 44,600 Government supports relief Control of countryside doubtful Mountains: cold, snowy winters Lowlands near Black Sea: mild winter, dry summer C � � � ,. � � i Haiti 900,000 80,300 Minimal government support for relief , Mountainous - Summer rain Warm, humid year-round ' Hurricanes Earthquakes 1 0 C C � � � r:', Iraq 1.3 million 115,900 Government can deliver support throughout country Government hinders relief to Kurds and Shias _ Mostly flat Northern mountains Desert Freezing temperatures, north and desert Dust/sand storms Heat/dehydration � 0 � � � _ Liberia . - . 1 millio n . 89,200 . Limited government. control Insurgents BanditsIi Flat, some forestland Hot and humid Rainy and dry seasons . � rs ...,. � c� . � - Attacks on UN forces and officiah responding ro humanitarian emergencies hare increased ores the past year. � Estimates of food needs for the nest six months are based on UNICEF's standard of the minimum necessary for surshal: 490 yams of Inod'person.'day. except Bosnia hc re UNI ICR's standard of %inter food needs-6I4 grams'personiday�s as used. Loral transport for milef supplies is often inadequate for the task. This vehicle in Somalia has seen some rough roads. In areas of logist: combat required shelter, popufau 11111111110111111111111E21111111111110111111111111E21111111111110111111111111E211111111111110111111111111101111111111110111111111111 8 :P. System taxed by conflict Critical shortages of supplies Equipment outdated 32,000 physicians ' (1:171 population) 60,000 beds (1:92 population) Substandard 5,830 beds (1:1,103 population) Little service in rural areas . Critical shortages of personnel, supplies, and equipment 964 physicians (1:6,673 population) 60 poorly equipped hospitals (22 in capital) 0 to o co Lc) o o O System operating at half capacity 1,000 dentists (1:18,000 population) Supplies scarce 8,000 support personnel Personnel mostly in cities (1:2,200 population) 250 hospitals Bed to population ratio: 1:600 7,000 physicians (1:2,600 population) 10,000 nurses (1:1;800 population) )lease: 2017/08/31 36 hospitals before current No ability to produce drugs of conflict; many-now damaged, other supplies - destroyed 1,800 beds (1:1,359 population) Physicians to population ratio: 1:8,000 Personnel poorly trained 2 In ar..%s of conflict. a range of logistic, security, and comba: forces could be required to ensure that food, shelter, and medicines reach populations at risk. Landmines can be major impediments to the delivery of aid Here in Cambodia. a UN vehicle is destroyed Somalia 1.3 million 115,900 No local authority can assist relief Opposition from clans, bandits, religious radicals Sudan 3.4 million 302,200 Civil war Government and rebels obstruct relief to south Landmines - Tajikistan � 300,000 26,800 Government cannot assist relief in south or east Armed opposition -.. Zaire �assist 500,000 44,600 =-- Government cannot- - relief - Little or no civil authority Crime and extortion : Hostile environments sometimes prevent the timely delivery of aid to people in need. Sarajevo airport has frequently come under attack. Even as global nceds grow. the task of more dangerous. here in Somalia, for at each stage of dclhrry. 1.1111111.11:0111111111.111.101111M111111E11111.111110011111.11111.111EEI111111111-1101111.111111110:111111.1.111.11101111.111111.15111111.11111 C00580607 -a a) 2 CD Co CD 00 " CD CD Cr) 00 CD CD a) a) ct 8 a) 2 cp_ cp_ hority can rom clans, igious radicals Large plateau S S U Substandard Coastal plain 90 hospitals prewar, now damaged Mountains in north No supplies available on Sparse rain open market Severe heat UN1SOM 11 medical support Drought meets US standards Assessment of personnel or beds not possible Desert, extreme heat C� Below Western standards t and rebels in north 164 hospitals: old, overcrowded, lief to south cvamp, forest, flooding unsanitary in south Critical shortages of personnel and supplies 2,170 physicians (1:11,153 population) 90 percent of medicine and all equipment imported t cannot Mountainous in south Very cold in Pamir Mountains sition Semiarid lower areas t cannot civil authority xtortion Swamps in north Plateaus in south Mountains in east Humid, tropical climate Heavy rains in east Dense vegetation over half the country cds gen.,. the task of re ponding &Tonics here in Somalia, food rutst be guarded Cl�. I-Ires negotiate their entry into a tillage controlled by Khmer Rouge guerrillas in Cambodia. 11111111111 Basic services unavailable to most of population Facilities deteriorating Critical shortages of supplies 15,000 physicians (1:3,401 population) 55,000 hospital beds (1:92 population) Equipment outdated Substandard A few faciiities have modern equipment and well-trained physicians 300-bed clinic in capital Shortages of personnel and supplies Securing the for humanitarian rdief: weapons captured by UN troops in Somalia. 1111111111110111111111111101=11M11111111111101.111111111M1111111 IL...12411101