Iron and Vitamin A Deficiency in Long-Term African Refugees

Imagine living in refugee camp where all you had to eat were beans, corn, sugar, oil and salt once every day for about decade of your life. This was my life growing up in Kakuma refugee camp in Kenya and that is why I deeply care about this topic.

Although food aid rations may vary between refugee camps in East and North Africa, they typically include legumes, cereal, oil, and salt. It has been assumed practices of Vitamin A capsule distribution, iron and folate tablet for pregnant women, the supply of a balanced food aid ration with fortified blended foods and iodized salt, are enough to prevent micronutrient deficiencies in the refugee camps. Researcher Andrew Seal and his colleagues investigated this assumption in refugee camps for over two years. This research was done in five different refugee camps in North and East Africa: Kakuma, Acholpii, Fugnido, Kebribeyah, and Tindouf.  

The researchers collected blood samples from refugees to assess micronutrient deficiencies. They found acute malnutrition was present at worrisome level at the time of the survey especially in children between 6 months and 5 years old in all the refugee camps. Anemia is caused by the lack of enough healthy red blood cells or hemoglobin in the body. The researchers found the prevalence of anemia in children was generally high. For example about 61% of the refugees randomly selected in Kakuma had anemia. Anemia was even higher in Acholpii (73%) and Fugnido (63%) refugee camps.

Serum transferrin receptor (sTfR) was used as measure of iron deficiency because it is unaffected by inflammation and infection that may be present such as malaria. This was important so that malaria which is very common in these regions was not a confounding factor in the assessment. The prevalence of iron deficiency was high ranging from 22.6% up to 75.0% from the five refugees camps. Refugees in Kakuma, Acholpii and Fugnido refugee camps had the highest levels of iron deficiency.

Serum retinol levels in the blood samples were used to measure Vitamin A deficiency. Vitamin A deficiency was present at high levels ranging from 20.5% to 61.7% in the four refugee camps that were assessed. Only four out of the five refugee camps were assessed for Vitamin A deficiency. Refugees in Tindouf camp did not receive Vitamin A capsules at the time of study and were not assessed for Vitamin A deficiency.

These deficiencies affect children the most. For example Vitamin A deficiency may cause irreversible damage such as blindness.

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 Refugees in refugee camps are heavily dependent on international food aid and other forms of assistance for many years. The results of this research show that enhancing intake through diet or supplementation in refugee camps is a serious and urgent matter. It demonstrates food aid and practices for dealing with micronutrient malnutrition are inadequate and improvement is necessary for the health of refugees. There needs to be more awareness and advocacy for refugees. The international community needs to ensure foods refugees receive contain necessary nutrients adequate for good health and work towards improvement.  Read More Here