Report of a visit to Bluewaters Refugee Camp
22 November 2008
Dr Philip Ginsberg, Professors Walter Loening, Heinz Rode, Ass Professor Louis Reynolds
Following reports of poor health conditions at Bluewaters Refugee Camp we visited the camp on 22 November 2008 to assess the situation of children and to find out whether their health rights were being violated or not.
We were informed that access to the camp had been restricted by the authorities, but were assured that health professionals would be allowed in after an intervention by advocate William Kerfoot from the LRC.
When we arrived at the camp gate at 07:30 we were refused access by a man known as Nico, the camp coordinator. There was no explanation for this, except that ‘the camp is closed’. Law enforcement officers at the gate, clearly upset about the conditions they were expected to enforce, told us that there were to be no more deliveries of food.
A small group of women from inside the camp approached us at the road-side. They also repeated that food deliveries had stopped. The portable toilets in the camp were no longer being cleaned. The clinic near the entrance to the camp had been closed. Their children were hungry and some of them had had not been fed yet as there was no food.
We agreed to assess as many of the children as possible outside the gates of the camp.
Main findings
1 Basic conditions
Sanitation has been brought to a dangerous level in that the toilets are not being emptied and apparently in an unacceptable condition. Water is not readily available. There is potential for an outbreak of serious enteric disease, possibly even cholera.
Food is no longer supplied which has resulted in a crisis on top of a chronic highly inadequate and inappropriate food supply. For several months the food that was supplied comprised dry bread with a bottle of juice at midday and rice with some yellow vegetable and rarely a little meat in the evening. Camp occupants have no easy access to other food outlets or shops.
2 The general health of children
We saw 93 children aged 1 week to 13 years of whom 46 were 5 years or younger. There was evidence of weight loss in a few cases but the majority of children did not present with overt malnutrition. However, there were at least 16 of the under-5’s that had clinical signs of anaemia.
It is alleged that a doctor visits the camp on a daily basis but that the advice and medicines provided did not go beyond Sugar/salt solution for diarrhoea, and Panado. The local clinic some 200 m. from the camp, had been open twice a week for some hours previously but has recently been closed with no alternative services offered.
3 Rapid screening of 10 children
- Julis, aged 15 months. Brought to the gate by her grandmother as her mother is not well. Breast fed with 1 or 2 supplemental feeds of baby cereal. Road To Health (RTH) card shows full immunisation and good clinic attendance and that she had been thriving, but no recent entry or recorded weight; records stopped a few months ago. Her mother is losing weight; has attended False Bay hospital but missed her follow-up appointment because she had no transport. Breast feeding her baby unlikely to be sustainable.
- Nathan, aged 10 months. Excellent and detailed information available on RTH card showing good primary care until a few months ago, but no up to date notes. Had been thriving. Now coughing and chesty.
- Thesi, aged 5 years. Has been in Cape Town since 2006. Well grown but clinically anaemic. Dental caries and gum disease.
- Karene, aged 2 years and 5 months [Thesi's sister]. Clinically well, growing well as reflected on RTH card. Had 2 meals the previous day, none available today.
- Ramla, aged 14 months. RTH card shows good nutritional status until last weight a few months ago. Fully immunised. Chesty and coughing for a few days. Dry bread yesterday, no food today.
- Faiza, aged 3 and a half years. No RTH card. Dental caries. Weight 17.5 kg.
- Clotilde, aged 19 months. Clinically well. RTH card shows good nutritional status. Fully immunised. Had rice and chicken yesterday, now food insecure.
- Blessing, aged 17 months. RTH card shows growth faltering when last weighed at clinic at about 9 months old.
- Amidu, aged 5. No apparent medical problems.
- Alex, aged 3 years and 11 months. Has chronic health problems and has appointments at Red Cross Childrens Hospital with the Renal Clinic and the Haematology/oncology department. He is to be admitted to a surgical ward in January 2009. His mother could not explain exactly what his problems were.
While we did not see acutely ill children in the camp it is clear that (unless there is a change in the situation) it is only a matter of time before serious illness emerges. Already several children have medical problems. With deteriorating sanitation, a lack of food and no food security, the health of all children in the camp is seriously threatened.
Moreover, the constitutional rights to nutrition, a safe environment and health care are being undermined by the withdrawal of food deliveries and sanitation services, and their right to shelter by the looming camp closure. Finally, it is clear that any move to discontinue basic services and/or force vulnerable families out of the camp are a violation of the principle of the “best interests of the child” enshrined in our constitution which states: “In all matters concerning the child their best interests must be a prime consideration”.