the farming seasons. This is the result of a deterioration or
partial collapse of living standards and basic services, an
increased reliance on the use of negative coping
strategies and widespread grave violations of human rights
and significant impact on physical and mental wellbeing.
Of the number of people in severe need, 1.6 million are
women and girls and 1.9 million are under 18 years of age.
In areas where hostilities have subsided, life remains a daily
struggle due to limited access to basic services and
livelihood opportunities, increasing financial hardship and
an eroding capacity to cope. More than forty-five per cent
of the population are estimated to live under the poverty
line. Recent economic shocks stand to further set back the
recovery of the Caranese people and render many more
vulnerable. Millions of women, children and men continue
to rely on humanitarian assistance as a vital lifeline and to
meet their basic needs.
Many Caranese, especially those in the border regions to
Rimosa and Katasi, continue to suffer from increasingly
localized, intensified hostilities, which uproot families from
their homes, claim civilian lives, damage and destroy basic
infrastructure, and limit freedom of movement. Almost 40
per cent of internally displaced families have been
displaced more than three times, with every displacement
further eroding coping capacity. Repeat displacement
numbers are particularly high for internally displaced
persons (IDPs) along the Kalesi River, where the majority of
the 1.1 million displacement movements were recorded in
2020. Some of those displaced were again uprooted a few
months later, forming part of the over 250,000 people who
fled environmental disasters and moved mostly eastwards
towards Cereni during the period 1 December 2019 to the
end of February 2020. In the southeast, more than 250,000
people were forced to flee their home during a two-week
period in October 2020, with over 85,000 people remaining
displaced after that two-week period.
Many of those displaced sought refuge in and added to
an already high number of IDPs living in last resort sites, i.e.
mainly informal settlements and collective centers in which
shelter and WASH facilities are sub-standard, and health
and protection risks are elevated. In total, the number of
IDPs in last resort sites and camps increased by 42 per cent
in 2020 compared to 2018, and as of February 2020 stands
at over 700,000.
Humanitarian Consequences related to Health
Although proportionate morbidity of overall waterborne
illness remained relatively stable in 2019, rates of total
acute diarrhoea increased eight per cent since the
previous year. Suspected leishmaniosis cases also
increased in absolute number (16,310) and proportionate
morbidity (14 per cent) as compared to 2018.
Based on available data, as many as 7 million people live
in areas contaminated by explosive hazards, exposing
them to significant risks. 57 per cent of those who have
survived contact with explosive hazards in 2020 have
sustained lifelong impairment. 2.4 million are estimated to
be living with a disability. The crisis continues to affect the
mental well- being of those affected by new and
prolonged displacement, exposure to violence, loss of
income and reduced access to basic services, touching
the youngest in particular. 22 per cent of surveyed
households report signs of psychosocial distress in children
– nightmares, lasting sadness and anxiety, amongst others
- in the last 30 days, suggesting that many girls and boys
are in a situation of prolonged distress. More than 260,000
children are chronically malnourished, of which 80,000
children under five years of age are suffering from severe
acute malnutrition, heightening their exposure to
preventable morbidity and mortality.
Maternal malnutrition rates have doubled compared to
2019, particularly in the Guthar and eastern Leppko regions
where acute malnutrition was prevalent in 21 per cent of
displaced pregnant and breastfeeding women. Anaemia
is also on the rise. One out of every three pregnant and
lactating women is anaemic, leading to poor intrauterine
growth, high- risk pregnancies, and childbirth
complications. One out of every four children 6-59 months
are anaemic, and the youngest are most affected with 44
per cent of children 6-23 months suffering from anaemia.
In 2020, the number of critically food insecure people has
increased by 15 per cent, from 500,000 in 2019 to 514,000
people in 2020.
Humanitarian Consequences related to Protection
An estimated 2.5 million children aged five to seventeen
are out of school and face elevated protection risks
related to, among others, child marriage and
engagement in child labour, including in coal and copper
mines under hazardous conditions. In 2019, 23 per cent of
victims of explosive hazards accidents were children, of
whom 42 per cent were injured or killed while playing.
Missing or absent civilian documentation frequently
represents a barrier to exercising housing, land and
property rights, and freedom of movement and is
referenced by affected populations as the top concern for
accessing assistance and services. Insecure shelter/
housing tenure due to the lack of civil documentation
generates additional physical and mental consequences
for communities, often leaving them with little choice but
to reside in unsafe, sub-standard buildings or in other sites
of last resort.
Fuelled also by increasing economic hardship and a
dramatic loss of purchasing power due to the devaluation
of the Carana Franc, affected population have little
choice but to increasingly resort to harmful coping
mechanisms, many of which disproportionately affect
women and girls, including child/ forced marriage and
various forms of gender-based violence.
Humanitarian Consequences related to Living Standards
Years of crisis have exacerbated living conditions for most
Caranese due to significant reductions in the availability of,