Link NCA Case Study 2

1. Case Study 2: Castleblack Refugee Camp, Westeros
Context
Westeros is situated in East Africa with a population approaching 12 million. Though a
stable democratic country, Westeros is bordered by several war-torn states. In the north
of the country, Westeros has been hosting refugees at Castleblack refugee camp from for
over 20 years. The camp itself is well established and heralded as a model of success by
UNHCR. It holds approximately 100,000 refugees who have been forcibly removed
from their homes due to conflict and persecution from the neighbouring country The
Land of Always Winter. The refugee population has remained relatively stable over the
past 10 years. The camp predominantly holds refugees from the Frozen ethnic group.
Together with UNHCR and partners, the organisation have been providing nutrition and
WASH programmes in the camp for the past 7 years. The nutrition programme has
focused on prevention of under-nutrition and facilitation of management of acute
malnutrition by strengthening awareness and knowledge of target groups on malnutrition
and its causes and consequences, as well as directly providing detection, referral and
follow up of acutely malnourished children.
Safety issues have been reported within the camp in the past 3 months, the situation
might remain instable for the several coming months.
Nutrition situation
Admission rates have remained stable over the past 5 years though high with 30% (15 –
45%, CI 95%) of children under five believed to be acutely malnourished (GAM). There
is no data available on levels of stunting in the camps, and the causes of malnutrition are
widely unknown, varied and complex within the camp.
Food security situation
Life in the semi-arid desert environment of the camp is rather challenging. The area has
always been full of problems: dust storms, high temperatures, poisonous spiders, snakes,
and scorpions, outbreaks of malaria, cholera, and other hardships. The average daytime
temperature is 40 degrees Celsius.
Due to their legal situation and local environmental conditions, the Frozen refugees are
largely unable to support themselves with income-generating activities. The semi-arid
climate of the camp is ill-suited to agriculture, while restrictions on employment deter
refugee job-seeking. Consequently, most refugees are dependent on food handouts.
Food is provided by the World Food Program (WFP) as a dry ration. Currently the
ration is provided to all residents but does not include fresh foods such as vegetables or
fruit and many residents have little access to food beyond that which is provided. The
Castleblack camp has a market where resident vendors sell a variety of items including
fresh foods. However, since residents are prohibited from employment, their ability to
obtain these foods is closely related to the limited level of external support they get from
remittances or through the sale of part of the general food ration. Consequently
household dietary diversity is low.
The main diet is typically a kind of maize paste mixed with water and served with beans.
Furthermore, according to their traditional culture intra-household food allocation
discriminates against women and girls.

2. Situation of women
The fertility rate is significantly higher than the host population at 6 children per woman
and the contraceptive prevalence rate is estimated at just 15%. Traditionally, women have
limited power in decision making in their families, on economic resources, access to
education, and limited movement. However, on the camps, women have been provided
with free literacy classes, with some reluctance from their husbands.
WASH situation
Access to safe drinking water is generally very high during the dry season, though
reportedly more difficult during the rainy season, when the roads connecting the camp
are muddy. Although sanitation access is reportedly good per capita, anecdotally, many
female refugees do not use them because of safety concerns. WASH teams have been
providing hygiene education, though traditional beliefs about the causes of diarrheal
diseases persist.
Health situation
The most commonly reported causes of morbidity and mortality include diarrheal
diseases, measles, acute respiratory infections, malaria, malnutrition and other infectious
diseases. Traditional beliefs dictate the illness is caused by evil spirits and treatment
seeking for childhood illness is far from not optimal.
IYCF practices
Care practices appear to be suboptimal. A study on the camp from 2005 found that 59%
of newborns do not received breast milk within first hour of birth, and 1 in 4 children
are not exclusively breastfed up to 6 months. Furthermore, complementary feeding
practices appear to be problematic with pre-lacteal feeding common and just one in three
children receiving timely introduction of complementary feeding.
Group exercise
After reviewing the case study information, identify if a Link NCA might be relevant in
the area and justify:
- Identify the potential information gap
- Why conduct (or not) a Link NCA? Is there any other method more suitable for
this context?
- Objectives?
- Set up of the study?
 What is the objective of the study? Which kind of response are you planning to
do (refer to the 3-triers approach)?