Many Malians and Nigeriens fled the fighting and violence that occurred mainly in the Ménaka and Anderamboukane areas of northeastern Mali. The total number of people who crossed the border was estimated at 57,618, including 54,546 Malians and 3,072 Nigeriens as of September 3, 2012. Most of the people who fled the attacks and reprisals had crossed the border into Mali on foot, in carts, or on donkeys, in difficult conditions, with no supplies and no access to clean water and food. This crisis situation created enormous humanitarian needs and increased the vulnerabilities of the refugee populations. These needs include protection, education, shelter, food and non-food items, health, nutrition and access to water, hygiene and sanitation. In response, humanitarian organizations have provided assistance in various areas, including water, hygiene and sanitation. The crisis is also an aggravating factor in the food and nutrition crisis.