A team of Oxfam staff in Kenya has just returned from an assessment mission in the Rift Valley Province. This western province has been hardest hit by the post election violence. Up to 120,000 people in this area have been forced from their homes.

Oxfam Public Health Promoter, Zedek Maithya shares his thoughts on what he saw.

Where did you go and what is the situation ?
We visited several camps - in Eldoret, Burnt Forest, Cherangany, Turbo and Kitale - these are the areas with the largest number of displaced people in Rift Valley. In Eldoret, we went to the camps located at the show ground and the Catholic cathedral - the situation is desperate as most people have very few belongings. Most of the people in the camps are women and children and since they had no time to pack and leave, they are surviving on very little - mostly basics provided by well wishers and humanitarian who have managed to reach the displaced and provide food, water, medical supplies and materials to put up shelters. So far, they have been given supplies to last a week, but as numbers soar, its hard to tell how long these supplies will last in some of the camps.

What are some of the challenges in responding to the humanitarian situation?
There are challenges already with the water and sanitation facilities in most camps being inadequate to accommodate the number of people. At the Eldoret show ground, the facilities are outside the fence, a bit of a distance from the shelters (maybe 100 metres), which means that they are not very safe for women and children to access in the night and in the early hours of the morning for their own security. There is definitely need for proper water and sanitation facilities to be put in place as well as hygiene promotion to prevent the outbreak of cholera, diarrhoea. Most of the children and women are sleeping in the cold and some have started presenting with respiratory infections at the mobile health clinics.

In some camps like those in primary schools and at police stations, the need for more water and sanitation facilities cannot be overemphasised. The existing structures cannot cope with the numbers - MSF (Medecins Sans Frontieres) is trucking water in some places, while bladder tanks have been placed at strategic points to distribute water in the camps. In other places, long lines of people are waiting to get water. There is definitely an urgent need for more water and sanitation facilities if we are to avert a disease outbreak in any of these camps.

In some parts of the camps - especially those in more rural areas like Burnt Forest, the conditions are worse - water and sanitation facilities are lacking and the people are sleeping in the open - no tents or canvas materials to make shelter. If nothing is done, it is highly likely that diseases such as diarrhoea, cholera will break out, and respiratory infections as a result of sleeping in the cold - making these communities even more vulnerable.

Are people willing to go back home ?
People are scared to go back home because the same people who sent them away are still there; one of them even asked me - how do I go back when its my neighbour who attacked me, and he is still living there? There I need for serious mediation and reconciliation for many to agree to return. In fact, most people in the camps are talking of moving to safer towns instead of going back home.

How is Oxfam planning to respond?
Oxfam is now planning to start some emergency public health promotion work in some of the worst affected areas where large numbers of people have congregated. We're looking to help around 30,000 displaced people to avoid diseases. This will be done by training up local health promoters who will work with the commuties to make sure drinking water is kept clean, and faeces safely disposed of. They will launch awareness campaigns about the importance of hand washing. Our public health experts will also work alongside other organisations giving technical advice on the best siting of water and sanitation facilities.