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Refugees and those affected by emergencies are especially vulnerable to vitamin and mineral deficiencies

Vitamin and mineral deficiencies can easily develop during an emergency – or worsen if they are already present.

In times of war or natural disaster, livelihoods and food crops are lost, food supplies are interrupted, diarrhoeal diseases break out, and infectious diseases suppress the appetite while increasing the need for micronutrients to help fight illness.

Vitamin and mineral deficiencies have been reported for years in emergency settings, especially in refugee camps. For instance, a 2003 study among Burmese refugees in Thailand found a prevalence of iron-deficiency anaemia of 65% among children.

Due to a variety of factors, the delivery of essential micronutrient interventions is especially challenging in emergency settings. Although vitamin A supplements are already routinely included as part of an emergency response, other deficiencies are too often neglected.

However, during the past decade, multiple micronutrient fortification has been used increasingly in these situations. In 2003, mobile milling and fortification equipment was used at the Nangweshi refugee camp in Zambia to fortify maize meal with a number of micronutrients, including vitamin A, folic acid, iron and zinc. A 2007 study found that that the introduction of fortified maize meal led to a decrease in anaemia in children and a decrease in vitamin A deficiency in adolescents.

The UN Standing Committee on Nutrition has suggested that a combination of interventions may be appropriate, including increased access to fresh food, improved livelihoods and access to markets, enhanced fortification of food aid, distribution of supplements, and in-home fortification with multiple micronutrient powders or fortified condiments.