Not far from the longest river in the world, tens of thousands of Ugandans face the prospect of famine in the next few months because of drought and war along the Nile.
"If there is no external aid, dozens will die daily within a few months," said Melissa Wells, chief U.N. representative in Uganda, after a five-day, 900-mile tour of West Nile Province in northwestern Uganda.
Wells, a former U.S. diplomat at the United Nations, has appealed to the world organization for about $3 million to help the area surmount the immediate crisis and to prevent a major refugee problem. About 250,000 people fled across the Zaire and Sudan borders in October after a war between the Ugandan Army and guerrillas formerly loyal to ousted dictator Idi Amin. Most have come back but have little food because their crops rotted or were stolen in their absence.
In addition, in areas along the steamy Nile where there has been prolonged drought, many crops failed altogether. The basic technology to use the river for irrigation has never been developed. In Arua district, with a population of about 200,000, local officials told U.N. representatives that the harvest was only 30 to 40 percent of normal because of the war and the drought.
The immediate critical period starts next month, when meager supplies are expected to run out, and continues until June, the time of the next harvest -- if the rains come on schedule. If the food does not come from outside, there is likely to be a new outpouring of refugees, this time due to hunger rather than violence.
Over the long term, the area faces a crisis shared with much of the rest of Uganda -- a shortage of agricultural supplies, such as seeds, fertilizer and tools. It is estimated that Uganda, where fields are traditionally tilled by hand because of a lack of oxen, needs to import at least 5 million hoes if farmers are to work their fields normally. As a result of a decade of chaos under Amin and since, the country has not produced any hoes for years. Most still being used are worn down to less than half the original blade.
The country has no foreign exchange to buy hoes. It is relying on foreign aid, mainly from the United States and the European Common Market, for agricultural implements.
One U.N. official was given long lists of agricultural needs in each area. The shopping list at Moyo, near the Sudan border, was typical: 5 tons of fertilizer, 10 tons of groundnut seeds, 5 tons of sorghum seed, 2,500 packets of vegetable seeds and 10,000 containers of pesticides.
Wells estimates that it will be necessary to bring in 1,000 tons of food a month -- mainly corn, sorghum and milk -- to supplement the staple diet of cassava, a starchy root that is low in nutritional value.
Francesco Stripolli head of the U.N. world food program office in Kampala, noted sadly that in normal times there should be no reason for Uganda to import food. "Nature has blessed this country so much with abundant rainfall and good soil that Uganda should be an exporter of food," he said.
So luch is most of Uganda that people often say a stick shoved in the ground will grow. Two crops a year are common in many areas in West Nile. The famine caused by war and drought has been aggravated by lack of transport and commerce and waterborne diseases, particularly schistosomiasis.Only vehicles from the military or relief organizations were encountered during five days of driving through the province, which occupies Uganda's northwestern corner along the borders with Zaire and Sudan.
There are no buses. Even if there were, there is no fuel. Nor is it possible to phone or send a letter to Kampala, the capital.
Few people have returned to Rhino Camp -- a name now inappropriate since the white rhinos were illegally killed during Amin's rule. The few who did return often have to walk 24 miles to go to market. Because of the distance and fear of moving in the dark, the trip takes two days.
The Nile is both a provider and killer for the inhabitants of its banks. The river has two distinct personalities as it crisscrosses Uganda before entering Sudan, where it is called the White Nile and joins with the Blue Nile at Kartoum.
From its source at Lake Victoria, the White Nile flows rapidly to the northwest over a series of waterfalls to Lake Albert. It then slows considerably as it leaves the lake and meanders sluggishly toward Sudan. This is the part that borders West Nile.
The slow pace of the river makes it easier to net fish, the main source of protein, but it also encourages the growth of reeds. Snails, carrying the parasite that causes schistosomiasis, live on the reeds. The constant use of the river by the people means that contact with the parasite is inevitable.
The parasite causes dysentery, destroys the intestine and eventually lodges in the liver, leading to fatal cirrhosis. A cure exists, but medical aid is far away for most West Nile residents.
Dr. Carlo Spagnolli, who treats hundereds of victims at Angal mission near the river, said the disease, also known as bilharzia, cause "the intestine to become like a pipe. You put food in the body and it comes right out."
Driven by hunger, people also eat water lily seeds, causing further digestive difficulties.
In the highlands, the problem is different. The was was more intense there and with the border close by, most of the people became refugees. The nearness of the border increases the chance that the donated food will fall into the hands of smugglers eager to sell it across the frontier.
A lack of protein is causing illness in the border area where the diet consists of little but cassava.
The German Emergency Doctors Organization set up an outpatient clinic at Oluva mission, about two miles from the Zairan border, last month. By the third day of operation they were treating 300 patients, mainly children. The clinic is just around the corner from the inappropriately named Vitamin Hotel.
Dr. Reinhard Bunjes said the main health problem is kwashiorkor, caused by protein deficiency. It results in the bloated-looking stomach so common among starving children.
Looking at a small girl suffering from kwashiorkor, Bunjes said: "What can I do? She needs protein. Her mother can't buy it. I give her a few vitamins and feel guilty."
He points to Erika, an eight-month-old baby suffering from severe dehydration. She weighs less than 10 pounds and is not expected to live. Had she been brought in one day earlier, she might have survived, the doctor said.
He estimated that 15 percent of the children in the area already suffer from protein deficiency. Milk is the main source of protein in the supplemental program for the children, an inexpensive operation. All that is needed are powdered milk, sugar, oil, pots and bowls.