Rwanda Relief Groups to Help Fittest Survive

MUKINGO, Rwanda —  Monique Nagelkerke, a Dutch nurse, wasn’t surprised when one of the first Rwandan refugees to stumble into her new field clinic here Saturday simply collapsed and died.

After all, the old woman had walked for three days after fleeing the hunger and disease of the refugee camps in eastern Zaire. The road was long and hard, a cold climb through rugged mountains. No food was distributed along the way.

“She got here and just dropped dead,” Nagelkerke said, as workers carried the corpse by in a blanket.

The only real surprise was that the woman was a casualty of a deliberate new policy by the Office of the U.N. High Commissioner for Refugees, the World Food Program and several non-governmental humanitarian groups.

In an unusual attempt to stop the refugees’ now-ebbing cholera epidemic from spreading into Rwanda, the agencies agreed Saturday not to transport any of the tens of thousands of refugees now trying to return home--even the old, the lame and the ill--until they have walked nearly 50 miles to the city of Ruhengeri. The effect, officials said, is to weed out the sick and weak.

“No one will be picked up,” explained Nagelkerke, a coordinator with the Dutch chapter of Doctors Without Borders. “However cruel it might sound, you’ll get some sort of natural selection.”

Mercedes Sayagues, the World Food Program spokeswoman, said the agencies met Saturday in Kigali, the capital of Rwanda, and agreed to a request by the new government not to begin assisting refugees until they have reached Ruhengeri.

“This is the request of the (government),” she said. “They are very much afraid of bringing cholera into Kigali.

“It makes sense,” she added. “We think the people who have walked all that way are healthy and strong.”

She said 11 empty World Food Program trucks heading back to Uganda will begin transporting refugees today from Ruhengeri to Kigali.

The new, Darwinian-style repatriation policy reflects the painful moral dilemmas the overwhelmed relief groups have faced since an estimated 1.2 million refugees flooded into Zaire two weeks ago in fear of the advancing rebel army of the Rwandan Patriotic Front.

Many refugees unquestionably died, for example, when relief officials consciously decided not to distribute food or water to tens of thousands of sick and hungry refugees in the city of Goma and at the nearby Munigi camp, the center of the cholera epidemic. The goal was to force the refugees to move miles down the road to other sites.

Similarly, relief workers recognize that the international aid effort sustains others besides the innocent. After all, among the refugees are many of the government soldiers and members of paramilitary militias who carried out what human rights groups have called a genocidal campaign of massacres against ethnic Tutsis that left up to half a million dead.

The relief effort also reflects the reality of the ethnic landscape here. Aid officials say privately that the Rwandan government fears that its former enemies, now in the refugee camps, could infiltrate back into the country if trucks are used from the border. The walkers pass innumerable roadblocks.

Still, the new repatriation policy means that tens of thousands of refugees--some strong, but many weak--are walking down a mountain road as empty trucks roar by, adding yet another chapter to this country’s epic tragedy.

On Saturday, at least one boy hobbled slowly on crutches. Four men carried a woman in a litter. Most simply trudged along, carrying sleeping mats and cooking pots on their heads. Many, including children, had babies swaddled on their backs.

The clinic was erected here Saturday, outside Ruhengeri, to screen the refugees for cholera. But even as the white canvas tents went up, dozens of passing refugees stumbled in and fell to the ground in exhaustion.

“People are in very weak condition,” said Nagelkerke, who spoke as she stocked a storeroom with supplies of medicine, bandages and soap. “They’ve been walking for days. And they don’t have enough food. They’re tired, weak, hungry and sick.”

Outside, a woman was shaking with fever and carrying a baby who whimpered weakly as flies crawled on his face. “I’ve got three sick children,” Francoise Nzacharinya, 28, said as she shivered. “And I’m sick.”

Nearby, Colonelle Nsenguyumva lay on the ground with his crutches. Shot in the ankle in June, the 15-year-old had large metal pins poking from the heel and shin of his withered leg. Passing military vehicles and other drivers had given him rides this far, he said.

Agnes Musigiyaha sat silently as her 2-year-old tried to suck milk from her withered breasts. “I have no milk,” she said. “I did not eat for three days.”

A white Toyota suddenly pulled up. Johanna MacLeod jumped out and gently helped about a dozen women and children out of the back and into the medical tents. Most were dazed, near collapse, walking like zombies.

“They’re very malnourished,” she said. “And dehydrated.”

She had found them at a military checkpoint a mile or so down the road. “Today’s the first day we could pick them up even from there,” she said.

The World Food Program last dropped food along the road Wednesday. The International Committee of the Red Cross has promised to provide food today. Ultimately, a truck belonging to Doctors Without Borders will be sent down the road to pick up the dead, and two will be assigned to offer rides to the sick.

But for now, there are too few trucks, too little water, too few high-protein biscuits and too many problems.

“It’s not acceptable,” said Rex Hendriksen, a sanitation engineer with Doctors Without Borders. “But what’s our choice? What can we do?”