The last foreign worker in the north, a Frenchman with Action Contre La Faim (Action Against Hunger), reached the capital, Freetown, last night. There was concern for a team from Medecins Sans Frontieres (MSF) which remains in the east.
Jules Albers of MSF said in Freetown yesterday: "It has been a very hard decision because stopping the humanitarian pipeline sends a terrible signal to the people and for confidence in the peace process." The joint decision by non- government organisations (NGOs) yesterday morning followed a rebel attack on Saturday against a helicopter carrying medical supplies, which Mr Albers had taken to the central city of Makeni.
British workers from Oxfam, who are establishing refugee camps for 50,000 displaced people in the Bo and Kenema areas in the east, have remained there. Bo and Kenema are controlled by Ecomog, the Nigerian-led intervention force, though the towns are near Liberia, sponsor of the rebels.
Mr Albers said yesterday that the humanitarian situation inland was dire. Sierra Leone has been devastated by eight years of fighting between the rebel Revolutionary United Front (RUF), other rebel groups and pro-government forces who want to control the diamond-rich country.
He said: "There is every kind of illness you can imagine, including malaria, respiratory tract infections, bloody diarrhoea and elephantiasis.
"We have not yet found widespread epidemics, of say, cholera, though we have seen yaws." Yaws is a highly contagious illness that causes large ulcers and was a problem in West Africa during colonial times.
Mr Albers added: "There are areas where we are seeing starving adults and that is a very bad sign because it means the children have already died.
"In Makeni, people are existing on a very poor diet made up of cassava leaves and cassava roots. The roots they are eating are very small. They have started eating toads and rats. You hardly see any chickens and the goats and other animals are long gone.
"We established a clinic in Makeni on Friday after eight months out of the country and there is a huge amount of work to do if the thousands of people coming to Makeni from rural areas are to be saved."
Action Contre La Faim, which was the first aid agency last month to travel deep into the interior, said the problem was the result of warfare disrupting sowing and harvests plus the danger facing anyone travelling by road from gangs of rebels themselves hungry.
The French agency's chief of mission, Nathalie Ernoux, said: "To travel inside Sierra Leone, you need permission from the rebel commanders. The situation is uncertain but we have never had a problem with our convoys.
"When we pulled out last time, during the fighting in December last year, there was already a high level of malnu- trition in Makeni and the north. About 1.5 million people in the north are cut off from us. When we finally get there, we fully expect to find no children under the age of two alive."
Despite a ceasefire on 27 May, followed by the signature of a peace deal between the government, Ecomog and the rebels on 7 July, there are still reports of troop movements in rebel areas.
The rebels, mainly the RUF and the Armed Forces Revolutionary Council, which is holding the foreign hostages near Freetown, have been accused of widespread humanitarian crimes. These include gang rapes, burning people alive in their huts and amputations by knives, machetes and axes of ears, lips, hands, arms and legs.
The aid agencies fear that their departure, after only a short time back in rebel- held areas, will prompt a new upsurge in the barbaric attacks because the guerrillas are becoming more desperate as their hunger increases.