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Darfur Mortality Update: Nov 16, 2004


Current data for total mortality from violence, malnutrition, and disease

By Eric Reeves


Nov 16, 2004 — As the UN Security Council convenes in Nairobi for an unusual meeting outside New York, it has become clear that there has been an ominous shift in approach to the Darfur crisis. This shift in strategy is twofold. First, having seen that it cannot muster sufficient resolve to confront the Khartoum regime with serious consequences for ongoing genocide in Darfur, the Security Council, along with other international actors, has decided to substitute "carrots" for "sticks"; contrived inducements for Khartoum to improve its behavior have taken the place of any threat of sanctions or more robust consequences. Moreover, the language of "demands" has been abandoned, as has any consideration of near-term actions that might reverse the rapidly deteriorating security situation in Darfur, or increase humanitarian capacity for a conflict-affected population now in the range of 3 million human beings (see below).

Second, the larger international diplomatic effort, in the wake of the meager achievements reflected in the Abuja accord (November 9, 2004), is now to complete the agreement in Naivasha between the Khartoum regime and the southern opposition Sudan People’s Liberation Movement/Army (SPLM/A). But while there is certainly a compelling logic here if Khartoum were serious about signing a peace agreement that was essentially completed in May 2004, there are all too many signs that the regime is again stringing out the diplomatic process, and indeed re-opening previously negotiated issues (e.g., the fate of the southern militias aligned with the regime, the status of Abyei).

Moreover, the only person able to make the real political decisions for the regime---Khartoum’s negotiating principal and First Vice President, Ali Osman Taha---isn’t scheduled to return to the Naivasha talks until December 11, 2004, over three weeks after the Security Council meeting. The UN was unable and unwilling to work to ensure that the principal negotiators for Khartoum and the SPLM/A would be present during this historic session. In turn, conceived as a means of highlighting the urgent need for a peace agreement to be consummated, the Nairobi UN Security Council meeting is more likely to highlight UN and international impotence. The current draft of the Security Council resolution to be voted on this week is, almost inconceivably, weaker and more useless than the two previous resolutions (No. 1556, July 30, 2004 and No. 1564, September 18, 2004).

There are simply no meaningful provisions in this new document---nothing that will convince Khartoum that it must accelerate the time-table for peace in Naivasha, or respond to the earlier Security Council "demand" that it disarm the Janjaweed in Darfur and bring the leaders of these savage proxy forces to justice (Paragraph 6 under "Measures," UN Security Council Resolution 1556, July 30, 2004). This new resolution is essentially, and weakly, hortatory.

Indeed, it is not an overstatement to say that in the war of nerves between Khartoum and the international community, Khartoum has prevailed. Even as genocide continues in Darfur, with increasing mortality from disease and malnutrition, even as the Naivasha process shows no signs of being completed this year, there are no real consequences for the National Islamic Front regime. On the contrary, the US, Britain, and the UN have determined upon a course of absolving, indeed rewarding the genocidaires if they will only provide the diplomatic fig-leaf of a signature in Naivasha.

If we are in any doubt about the confidence that Khartoum is feeling, this should have been fully dissipated by last week’s actions immediately following the regime’s signing of the Abuja protocols on security and humanitarian access.

On November 9, 2004, the Khartoum regime agreed to:

"Take all steps required to prevent attacks, threats, intimidations and any other form of violence against civilians." ("Protocol on the Improvement of the Humanitarian Situation in Darfur," Abuja, November 9, 2004)

The day following its commitment to this agreement, Khartoum’s actions at the El Jeer (also El Jir and Al Geer) camp for displaced persons were reported by the BBC:

"Sudanese government forces stormed a refugee camp in Darfur, attacking men, women and children, within hours of Khartoum signing a security agreement with rebels that was supposed to bring peace to the region. BBC television footage showed Sudanese security forces entering the El Geer refugee camp near Nyala, bulldozing it, firing tear gas at women and children, beating some of the male inhabitants and moving others to a nearby camp. The violence came hours before Jan Pronk, the United Nations’ Sudan envoy, arrived to visit the camp, the BBC said. At one point during his visit a plastic bullet was fired at a cameraman standing next to a UN vehicle." (BBC, November 10, 2004)


Though there has been much celebration of the Abuja accord by Kofi Annan and others, including US special envoy for Sudan Charles Snyder, this is conspicuously disingenuous. For the two protocols (on security and humanitarian access) that make up the accord add almost nothing to the terms of the failing April 8, 2004 ceasefire agreement. The security protocol speaks of Khartoum’s "refraining from hostile military flights," but the constraining quality of this clause was almost immediately trimmed by Khartoum to the point of meaninglessness ("defensive" and re-supply military aerial missions are still permitted, Khartoum has argued).

The security protocol also endorses the very slightly expanded mandate of African Union (AU) forces operating in Darfur, per the terms of the October 20, 2004 African Union "Communiqué" on Darfur" (Peace and Security Council of the African Union, Addis Ababa, October 20, 2004). AU forces may now "protect civilians [including "humanitarian operations"] whom it encounters under imminent threat and in the immediate vicinity, [ ] it being understood that the protection of the civilian population is the responsibility of the Government of Sudan" (Communiqué, section 6). In other words, AU forces may respond only if civilians are being killed or attacked before their very eyes, and only if such action is "within resources and capability."

Though a UN daily press briefing reported Kofi Annan as "especially welcoming the broad [sic] mandate given to the AU Mission" (UN Daily Press Briefing, October 21, 2004), it is difficult to see this change in mandate as of anything other than minimal significance in how the AU forces will operate in Darfur. Nothing remotely approaching a peacekeeping mandate for the AU has been approved by Khartoum, and Annan’s disingenuously suggesting otherwise is yet another measure of his failure in responding to the human catastrophe in Darfur.

An all too telling image of the constraints upon the movements and actions of the AU is offered in today’s Washington Post account of Khartoum’s attack last week on the Al-Jeer camp for displaced persons, hours after the "expanded" mandate had been secured in Abuja:

"Last week, more than 100 Sudanese police officers with guns, sticks and teargas overran a refugee camp in an attempt to force occupants to move to another location. Some refused to leave and took refuge in a mosque, while the soldiers careered through the camp in trucks, swinging their batons. Two African Union officers arrived from a nearby base to investigate, but they were armed only with notebooks and cameras. Lt. Col. Henry Mejah, a Nigerian, said he tried to interview a Sudanese commander, but the man yelled at him and stormed away. Other police officers screamed at Capt. Rex Adzagba Kudjoe, a Ghanaian, when he tried to take photographs of the site. Shortly afterward, the two officers left."

"Two days later, another bulldozer rammed into the camp, crushing homes that had just been rebuilt." (Washington Post, November 16, 2004)

Abuja adds nothing of real significance to the mandate of the AU forces, or to the nominal military constraints of the April 8 cease-fire agreement. In turn, the security situation on the ground in Darfur continues its extremely rapid deterioration, with many observers fearing a wholesale collapse. In July 2004 Jan Egeland, UN Undersecretary for Humanitarian Affairs, worried that "Darfur was becoming too dangerous for aid workers"; and in a chilling moment of speculation, Egeland described, "’my worst scenario: that the security will deteriorate, that we will step back at a moment we have to actually step up [emergency relief]’" (BBC, July 14, 2004).

This is precisely what is now in evidence, and implications for mortality among the civilians in Darfur are terrifying.


The last mortality assessment by this writer (October 8, 2004; available upon request) concluded that approximately 300,000 people had died over the course of 20 months of brutally destructive conflict and genocidal counter-insurgency warfare in Darfur. The present estimate, based on both new data as well as underlying disease and malnutrition mortality, is 335,000 dead since February 2003.

Of these, 200,000 are estimated to have died from violence. Primary sources for this figure are the report from the Coalition for International Justice ("Documenting Atrocities in Darfur," September 2004, publication of the US State Department; available at: http://www.state.gov/g/drl/rls/36028.htm); an epidemiological study of violence in West Darfur by Doctors Without Borders and others (The Lancet, October 1, 2004, "Violence and mortality in West Darfur, Sudan (2003-04): epidemiological evidence from four surveys" (available online at: http://www.thelancet.com/journal [requires (free) registration]); and the UN’s "Darfur Humanitarian Profile," No. 6, September 16, 2004; http://www.who.int/disasters/repo/14756.pdf).

There have been no additional studies or releases of data since the previous mortality assessment that allow for any significant change in this estimate of violent deaths, though certainly these continue to be reported. (The section of the October 8, 2004 analysis treating mortality from violence is included here as Appendix 1.) Indeed, Khartoum’s continuing refusal to curtail violence or to permit meaningful AU peacekeeping has created what UN High Commissioner for Human Rights Louise Arbour recently described as a "climate of impunity." Violence in the camp environs and in the rural areas is very likely claiming many more lives than are being reported.


Mortality figures and reports continue to be very badly misrepresented in news accounts; this is true in particular of the assessment by the UN World Health Organization (WHO) study of health-related mortality in Darfur. This misrepresentation has had the extremely unfortunate effect of giving apparent UN authority to a putative total morality figure of "50,000" deaths (and more recently "70,000"). What the WHO study and accompanying public commentary represented---as explicitly confirmed to this writer by David Nabarro, chief of emergency operations for WHO---was a figure of more than 50,000 deaths from disease and malnutrition, from early April 2004 to mid-September 2004, in camps to which there has been humanitarian access.

The WHO figure did not include violent deaths; it did not represent morality in Chad; and it did not represent mortality in areas inaccessible to humanitarian operations. Most significantly, it did not include deaths from disease and malnutrition prior to April 2004 (again, the conflict began in February 2003). In short, the mid-September WHO figure was of highly limited relevance. Further, as Dr. Nabarro confirmed to this writer by telephone communication, the WHO figure for monthly mortality should be closer to 10,000 in the "6,000 to 10,000 deaths per month" range reported as coming from WHO. Only such a higher number begins to take adequate account of populations more difficult to assess.

In the two months since the WHO report was published (assuming with Dr. Nabarro the higher mortality rate), 20,000 people have died, suggesting that more than 70,000 people have died in accessible areas since April 2004.

Mortality in rural areas to which there is no access is best assessed on the basis of the US Agency for International Development projections ("Projected Mortality Rates in Darfur, 2004-2005" (http://www.usaid.gov/locations/sub-saharan_africa/sudan/cmr_darfur.pdf). We may use as a very conservative denominator for these projections the figure of 500,000 inaccessible persons in need of humanitarian assistance, promulgated by the UN in its September "Darfur Humanitarian Profile" No. 6 (troublingly, no updated figure was estimated in the October "Darfur Humanitarian Profile" No. 7). For the past five months, US AID projections indicate an average Crude Mortality Rate of almost 10 per day per 10,000 (for a population without humanitarian relief and experiencing severe food shortages). Over 150 days, assuming an average denominator of 500,000, total mortality is approximately 75,000. These deaths would be primarily among very young children, the elderly, and those made vulnerable from violent trauma.

Still, a figure of 75,000 may be too high for several reasons, primarily the highly developed foraging abilities of these people and the use (and likely exhaustion) of food reserves. On the other hand, insecurity produced by continuing Janjaweed predations would compromise both of these food sources. If we assume (very conservatively) that a figure of 75,000 overstates by 100%, this still leaves a figure of over 35,000 deaths from malnutrition and related disease over the past five months in inaccessible areas of Darfur. Together with the figure deriving from the September WHO report and data, this suggests a composite figure of 105,000 deaths from malnutrition and disease since April 2004.

Still excluded from this figure, however, is the number of deaths from disease and malnutrition during the period February 2003 to April 2004. During this period several humanitarian organizations reported high Crude Mortality Rates at various junctures. Many thousands died in the camps, especially children, though there is no systematic data that permits extrapolation of a total figure. If we assume a level of death from disease and malnutrition only one-fifth the current rate estimated by WHO (for a stronger camp population, and one that has only gradually grown to its present size), then another 30,000 have died from these causes.

Total mortality from disease and malnutrition is thus approximately 135,000.


Darfur’s ultimate insecurity is evident in the UN’s most recent "Darfur Humanitarian Profile" (No. 7) and an "Emergency Nutrition Assessment of Crisis Affected Populations, Darfur Region," prepared by WFP and the US Centers for Disease Control and Prevention. For food insecurity threatens the populations of Darfur and Chad in the most fundamental way. Darfur’s African tribal populations have been driven from the lands and livelihoods they know, have been deprived of virtually all resources, and are now forced into camps that are dramatically inadequate in providing for their basic human needs, including security.

"Darfur Humanitarian Profile" No. 7 indicates that 48% of the people targeted for humanitarian assistance have no shelter, 60% have no access to clean water, and 58% are without sanitary facilities. A third have no access to primary health care. (October "Darfur Humanitarian Profile" No. 7, page 15; based on data as of October 1, 2004). These percentages are essentially unchanged for the past few months.

Troublingly, the number of conflict-affected persons defining humanitarian need in the eyes of the UN continues to rise rapidly, as does the number of internally displaced persons. The number of conflicted-affected persons has risen, according to this most recent "Darfur Humanitarian Profile," from just over 1 million in June 2004 to over 2 million at the beginning of October 2004---an average monthly increase of 250,000 (page 9). The number of internally displaced persons has increased from approximately 1 million in June 2004 to 1.6 million at the beginning of October 2004---an average monthly increase of 150,000. The straight-line graphs representing these two increases, over four months, strongly argue that additional increases must be estimated as of November 16, 2004, producing an updated total of 2.4 million conflict-affected persons and 1.8 million internally displaced persons.

These figures do not include the more than 200,000 people who are refugees in Chad; nor do they represent the increasingly distressed rural populations that are beyond humanitarian access or even assessment, again a figure likely in excess of 500,000---perhaps well in excess. Together these figures suggest that the total conflict-affected population now exceeds 3 million in Darfur and Chad, and that well over 2 million people have been internally displaced or made refugees. Data in the October "Darfur Humanitarian Profile" suggest that the average Crude Mortality Rate (CMR) for this vast conflict-affected population is approximately 3.0 per day per 10,000, a figure very likely significantly higher for the rural populations without humanitarian assistance. In short, approximately 1,000 human beings are dying every day; 30,000 every month.


Data from the World Food Program/CDC study (collected between September 2 and September 20, 2004) strongly suggest that there is still a significant statistical understatement of the scale of Darfur’s humanitarian crisis. For example, 22% of the Internally Displaced Persons households "did not have a ration card" ("Emergency Nutrition Assessment of Crisis Affected Populations, Darfur Region," page 3), and thus were not entitled to food distributions. Since food registration by the World Food Program is the primary tool in assessing food need and actual distribution, such a high percentage of people without ration cards is deeply troubling.

Further, food needs are greatly exceeding humanitarian capacity. A telling example is offered in the WFP/CDC study:

"Of those households with a ration card [78%] that received a ration in September [2004], more than half did not receive oil or pulses [leguminous foods] (64.5% and 72.8% respectively). [ ] More than half of households (57%) only received a cereal in the general ration in September" (page 3).

This is the context in which to assess the meaning of the figure of 70% receiving food aid in September, claimed in the most recent "Darfur Humanitarian Profile" (page 15). People cannot live on cereal indefinitely. 21 months into an extraordinarily destructive and traumatic conflict, many of those receiving only cereal will suffer severe health consequences; a great many will die.

Even more troubling is the report from the UN’s World Food Program that it was able to reach 175,000 fewer people in October than in September (Agence France-Presse, November 9, 2004). At precisely the moment that huge numbers of people are becoming food dependent, WFP is actually being forced to reduce its reach because of insecurity. As Bettina Luscher, a public affairs officer with the World Food Program, recently declared:

"’We need a political solution quickly here. Things are getting far worse and more complicated by the day. We are really concerned about how we will feed these people by the end of the year.’" (Washington Post, November 16, 2004)

There are simply no adequate plans to address either the shortfall in humanitarian capacity, or the insecurity that cuts ever more deeply into presently deployed capacity. Indeed, insecurity is so central an issue for humanitarian operations in Darfur, and so clearly has the international community failed to address this critical issue, that six humanitarian organizations operating in Darfur have felt compelled to speak bluntly to the UN Security Council, condemning the meaningless actions taken to date:

"Six international aid agencies working in Sudan said Monday [November 15, 2004] the humanitarian situation in Darfur is deteriorating. The groups also called for the Security Council to take stronger action. ’Previous UN resolutions on Darfur have amounted to little more than empty threats, with minimal impact on the levels of violence,’ said Cynthia Gaigals, speaking for a group of organizations including CARE International and Oxfam International. ’The Security Council must now outline specific and time-bound compliance measures and agree to implement them if there is no clear and sustained progress.’" (Associated Press, November 15, 2004)

It is highly unusual for operational nongovernmental organizations (i.e., those with personnel on the ground) to speak so openly. But the utterly desperate situation in Darfur, and the growing threat to humanitarian workers, makes silence the riskier option.

Even Jan Pronk, Kofi Annan’s special representative for Sudan, finally seems aware that the UN performance has been thoroughly ineffectual. Pronk, who has so often in the past proved dismayingly accommodating of Khartoum’s duplicity and bad faith, and who has made so many serious miscalculations in responding to the crisis, recently declared to the UN Security Council that "’Darfur may easily enter a state of anarchy, a total collapse of law and order. The conflict is changing in character.’" (Washington File [New York], November 5, 2004)

The international humanitarian intervention that was so clearly required many months ago as a response to the catastrophe in Darfur may now be too late. Though the world community continues to pretend the slowly deploying African Union force is somehow adequate to the crisis, it is clearly not and cannot be even at full strength as presently contemplated. The AU is certainly unable, and without a mandate, to secure Khartoum’s compliance with the singular UN Security Council "demand" that the regime disarm the Janjaweed: instead of disarming these brutal militia forces, the Khartoum continues to arm them, and support them logistically and through direct military collaboration.

The larger effects of Janjaweed predations on the increasingly vulnerable civilian population have been made clear in numerous reports, including a superb new report from Human Rights Watch ("’If we Return, We Will Be Killed’: Consolidation of Ethnic Cleansing in Darfur," Human Rights Watch, November 2004 at: http://www.hrw.org/english/docs/2004/11/15/darfur9664.htm).

But one of the sharpest images of current insecurity is registered in an account offered by the distinguished Oxfam International:

"More than a hundred thousand people are essentially being held captive by armed militias in West Darfur, international aid agency Oxfam reports today [November 4, 2004]. ’It is clear that the security situation has deteriorated in many areas,’ says Adrian McIntyre, spokesperson for Oxfam in Darfur. ’The presence of militias and other armed groups around towns in West Darfur not only poses direct and daily threats to tens of thousands of displaced people who have sought shelter there. Local residents are also living in fear of violent attacks. In one particular town, villagers cannot venture even one kilometre beyond the edge of the settlement to tend their crops for fear of being brutalised or killed.’" (Oxfam International press release, November 4, 2004)

This ghastly situation now prevails in most of Darfur, with the most deadly consequences.


Romeo Dallaire, head of the UN peacekeeping mission in Rwanda during the genocide of 1994, has spoken out with growing authority on genocide in Darfur, and recently bluntly noted the lack of response from the US, despite an unambiguous finding of genocide announced by Colin Powell during Senate testimony of September 9, 2004:

"’The use of the word "genocide" was nothing more than the US playing politics with a term that should be sacrosanct.’" (Washington Post, November 16, 2004)

The searing truth of this assessment was only confirmed in a statement by the State Department’s senior representative on Sudan, Charles Snyder, in speaking of the US genocide determination:

"’The word "genocide" was not an action word; it was a responsibility word.’" (Washington Post, November 16, 2004)

This debased and misleading venture in semantic analysis by Mr. Snyder does far too much to explain why the US, the UN, the EU, and virtually the entire international community has allowed genocide to continue for so long, so destructively, so utterly inexcusably. Genocide must always be a word whose use implies both action and responsibility: to sever one from the other is a formula for impotence, precisely what is represented by the UN Security Council gathering in Nairobi.

Eric Reeves
Smith College
Northampton, MA 01063

Appendix 1: October 8, 2004 Retrospective Assessment of Violent Deaths

The previous mortality analysis by this writer (September 15, 2004; available upon request) highlighted several important new sources of mortality data. The most important of these was a very extensive study conducted by the distinguished Coalition for International Justice ("Documenting Atrocities in Darfur"). On the basis of 1,136 carefully randomized interviews, conducted among the Darfuri refugee population in Chad at a number of camp locations along the border, the Coalition for International Justice (CIJ) found that "sixty-one percent [of those interviewed] reported witnessing the killing of a family member."

The total number of refugees in Chad is now greater than 200,000. If we assume that this population of persons displaced from Darfur is representative of many hundreds of thousands of violently displaced persons within Darfur, then the total number people represented by the CIJ study is over 1.5 million, and may reach to 2 million.

How do we establish the approximate figure for those people violently displaced, either into camps, into towns, within inaccessible rural areas in Darfur---or into Chad?

In its most recent "Darfur Humanitarian Profile," the UN Office for the Coordination of Humanitarian Affairs (OCHA) estimated that 1.45 million people have been displaced into accessible camps within Darfur; this figure is based on food assistance registrations by UN and nongovernmental humanitarian organizations ("Darfur Humanitarian Profile," No. 6, September 16, 2004, page 5). The UN report also estimates that an "additional 500,000 conflict-affected persons are in need of assistance" (page 9), and it is reasonable to assume that most of these are displaced persons in inaccessible rural areas. (Even a figure of 500,000 almost certainly understates the number of displaced persons in rural areas.) Moreover, the UN report does not attempt to assess either the host communities or the size of displaced populations in the three state capitals (Nyala, el-Fasher, and el-Geneina) because there are still no systematic food registrations in these large urban areas.

Thus out of a total displaced population in Darfur of over 2 million, we require an estimate of the number of persons who experienced violent displacement of the sort that created refugees in Chad. Given the extremely high level of village destruction throughout Darfur, and the tenacity with which these people have sought to cling to their land and livelihoods, displacement per se is a very likely indicator of violent displacement.

Moreover, a recent epidemiological study published in The Lancet (Britain’s premier medical journal) offers clear evidence that displacement is overwhelmingly related to violent attacks. In two camps, Zalingei and Murnei, statistically rigorous assessments found that "direct attack on the village" accounted for displacement of 92.8% of the Zalingei population and 97.4% of the Murnei population (the combined camp populations is approximately 110,000) (The Lancet, October 1, 2004, "Violence and mortality in West Darfur, Sudan (2003-04): epidemiological evidence from four surveys").

If we conservatively assume that 80% of the total displaced populations that have remained in Darfur were driven to flee by "direct attack on villages," the number of violently displaced persons is 1.6 million.

This yields a total figure of violent displacement, for Chad and Darfur, of very approximately 1.8 million. The average family size in Darfur is slightly more than five, suggesting that a population of 1.8 million represents almost 360,000 families. If randomized interviews by the Coalition for International Justice (CIJ) find that "sixty-one percent [of those interviewed] reported witnessing the killing of a family member," then this yields a mortality figure for violent deaths of over 200,000 human beings.

Caveats and other considerations:

There is some chance that despite randomizing of interviews in Chad, and multiple camp locations at which interviews were conducted, overlaps exist in the "family members" identified as having been seen killed. This is a negligible number if "family" refers to nuclear family. Indeed, the chances of overlap even for members of extended families are quite small, given the diversity of interview locations.

More significant is the fact that those conducting interviews for the CIJ found that interviewees often reported more than one family member had been killed, often several more than one. Yet the statistical derivation offered here presumes that only one family member has been killed among the 61% who reported seeing (at least) one family member killed.

Secondly, the study cannot take account of the number of families in which all members were killed, and who thus had no reporting presence in the camps where interviews took place. The CIJ study does report that 28% of those interviewed "directly witnessed" persons dying from the consequences of displacement before reaching Chad. These deaths must be considered the direct consequence of violence, if not violent deaths per se, and would significantly increase violent mortality totals.

Moreover, the CIJ study indicates that 67% of those interviewed "directly witnessed" the killing of a non-family member." As the raw data from the CIJ study is soon scheduled for release, it may be possible to put this extraordinary figure in a statistical context that is yet more revealing of violent mortality. Given the number camp locations (19), and the randomizing techniques used within the camps---

"refugees were selected using a systematic, random sampling approach designed to meet the condition in Chad. Interviewers randomly selected a sector within a refugee camp and then, from a fixed point within the sector, chose every 10th dwelling unit for interviewing. [ ] One adult [from the dwelling unit] was randomly selected [for interviewing]" (CIJ study, page 5)---

— -the figure of 67% of refugees "directly witnessing" the death of a non-family member strongly suggests that assumptions made in this analysis may lead to significant underestimation.

In light of these various CIJ findings, and data reported in The Lancet, a figure of 200,00 violent deaths over the past 20 months of conflict seems a conservative estimate. The Lancet article, which concludes that West Darfur is the site of a "demographic catastrophe," has other important implications.

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