Intensified unrest in the townships caused greater humanitarian needs in 1990, as the disturbances in Natal worsened and spread to other regions as well, first extending down the Indian Ocean coast, and then reaching the townships around Johannesburg. Thousands died, thousands more were wounded, and there was widespread destruction of homes and property. The ICRC, in cooperation with the National Society, acted to relieve the suffering of the victims of this strife by implementing a family relief programme and a relief programme for displaced people in areas affected by the violence.

The fighting in Angola's 15-year-old internal conflict worsened in 1990, making it a particularly bleak year for the civilian population. Among the most affected people were those on the Planalto, or central highland, and in the south-east, where droughts and irregular rainfall disturbed food production for the third consecutive year.

The ICRC continued activities in a variety of fields in Mozambique in 1990. The delegation extended the scope of its visits to prisons, helped set up a specialized course for local orthopaedists, and opened a sub-delegation in Xai-Xai and an office in Chimoio. In addition to the local work of the Maputo delegation and the ICRC's four sub-delegations, delegates assessed the situation in governmentcontrolled areas of Tete, Niassa, Cabo Delgado and Inhambane provinces, where the ICRC had no permanent presence. However, many of the ICRC's relief and medical activities in the field, and especially those in areas under the control of the opposition and in contested regions, were suspended or reduced for months at a time because of security constraints or owing to lack of authorization from RENAMO. Despite these constraints, the ICRC continued year-round to provide relief and medical assistance to conflict victims in the field.

The main area of ICRC activity in Namibia remained the northern border region, where the institution assisted people affected by the conflict in neighbouring Angola. Late in the year, the delegation also set up the logistic base necessary to carry out cross-border operations into south-eastern and southern Angola.

The conflict that broke out in Nimba county, in the north, late in December 1989 slowly spread to the capital during the first half of 1990, leading a growing number of refugees to flee the country. In January, the ICRC set up a delegation in Monrovia to provide assistance within Liberia. The institution also quickly established tracing offices for Liberian refugees in neighbouring Cȏte d'Ivoire and Guinea, and later set up another tracing office in Sierra Leone. The ICRC's regional delegations also provided assistance to the National Societies of the neighbouring countries as they dealt with the influx of refugees.

In October, when the conflict broke out in northern Rwanda, an ICRC team reached that country within a day of the first reports of incidents, and provided about ten tonnes of supplies (mainly food) to hospitals and displaced people through the Rwandan Red Cross. Delegates began a series of visits to people arrested in connection with the events on 13 October. By the end of the year, they had visited 5,341 prisoners in 27 places of detention (18 Ministry of Justice facilities, eight gendarmerie installations and one military camp). During these visits, delegates provided about three tonnes of food, cleaning equipment, jerrycans, clothing and educational material to the prisoners. The ICRC also processed 3,550 Red Cross messages in Rwanda in 1990.

In Chad, the ICRC delegation continued efforts to gain access to Libyan prisoners of war held by the Hissène Habré government, and also carried out orthopaedic and dissemination work.

Once again in 1990, northern Ethiopia was the scene of heavy fighting and much human suffering. The armed conflict continued and tension increased during the year. In February, the port of Massawa changed hands after a major battle, leaving Asmara, the capital of Eritrea, dependent on air transport for communications with the rest of the country. Further south, major clashes were reported within 150 kilometres of the capital. Heavy fighting took place near Dessie (Wollo province) and Bahr Dar (a town in northern Gojjam province, near Lake Tana).

The ICRC extended the scope of its protection activities, set up an emergency first-aid medical post with surgical facilities for one month to care for people wounded in the Sudan conflict, and implemented a major relief programme for 85,000 displaced people in camps near Kumi. The delegation also assisted victims of the Rwandan conflict by participating in the repatriation of 214 Ugandans, including 52 children, from Kigali and by temporarily supporting refugees in the border region.

In 1990, the ICRC was the only humanitarian organization with a regular presence in northern Somalia, where the conflict between government forces and the SNM continued unabated. The fighting compounded ethnic tensions, leading to an extremely complicated situation where the various Somali tribes in the area found themselves aligned with the combatant groups; the circumstances of the conflict were rendered still more complex by the presence of thousands of Ethiopian refugees in the area.

From the beginning of 1990, the institution's activities grew steadily in southern Sudan. Delegates used road transport to reach Bor, and later descended the Nile to Shambe and Adok, the port towns for Yirol and Leer.

The ICRC regional delegations in Dakar, Lomé, Lagos, Kinshasa, Harare and Nairobi were instrumental in responding to a number of emergencies in 1990.

The ICRC carried out its protection and assistance work in El Salvador in 1990, in accordance with the provisions of Article 3 common to the Geneva Conventions and with Additional Protocol II. After the major offensive launched by the FMLN in November 1989, plans for the coming year had to be postponed, as immediate needs for emergency medical care, evacuation of the wounded and protection and registration of security detainees took priority. This emergency period continued into 1990, until the curfew was lifted on 1 February. Despite the obvious extra workload resulting from this violent period, projects originally planned for 1990 picked up again after this date, alongside efforts to deal with the aftermath of the fighting.

Cooperation with the Guatemalan Red Cross was a priority in 1990 and many facets of National Society work were touched upon, the ICRC offering assistance in the following ways: training staff; setting up a dissemination department within the National Society, which would eventually take over the training of their own staff; determining the needs of civilian victims of the conflict by conducting thorough surveys with the National Society to evaluate those needs and the best ways of meeting them.

Following the elections in March, the cease-fire agreement of April 1990 and the subsequent end of the conflict in Nicaragua, the situation in the country no longer came under the ICRC's mandate. For this reason, the network of ICRC sub-delegations and offices, which was set up over the years to offer protection and assistance to the direct and indirect victims of the conflict, was dismantled in the course of the year and the delegation's expatriate staff was reduced from 20 to 8 by December.

Visits were made to security detainees in 29 prisons run by the Gendarmeria national (Ministry of Justice), and to detainees under interrogation at the Policía de Investigaciones and the Carabiñeros. Negotiations with the new government which came into power in March resulted in permission to continue these visits.

Over the year ICRC delegates made 66 visits to 34 places of detention in Colombia, all of which were under the jurisdiction of the Ministry of Justice. During these visits 810 security detainees were seen and 217 new detainees were registered. In spite of repeated attempts, ICRC delegates were not granted access to detainees being interrogated by the armed forces and the police. Nonetheless, in December 1990 the Departamento Administrativo de Seguridad (DAS), which comes under the direct control of the Presidency, gave formal authorization for ICRC delegates to visit its detainees.