Some epidemiologic features of disasters in guatemala

Epidemiological procedures can be organised under disaster conditions by means of a simple surveillance system and with few personnel.
In the aftermath of the 4 February 1976 earthquake in Guatemala, an information system was organized by which the requisite information for decision-making was obtained with adequate speed and promptness.
The initial epidemiologic informution was based on reports collected during the early days on symptoms observed at hospitals and health centers and in localities and villages in the stricken area.
At a second, post-emergency stage a more elaborate surveillance system was instituted to provide guidance in the investigntwn of outbreaks, evaluate the health activities and establish basic criteria for preventive and control measures.     

Mortality and morbidity in refugee camps in eastern Sudan: 1985-90

Civil war has disrupted life in Ethiopia since the 1960s and many people have sought refuge in Eastern Sudan, particularly during the famine emergency of 1984–85. UNHCR has provided the main financial support for the refugee programme, but began scaling down operations in 1990. Nearly 300,000 refugees still live in camps and benefit from food and health programmes. Health services are co-ordinated by the Sudanese Refugee Health Unit which operates a centralised health and nutrition surveillance system with the co-operation of the NGOs responsible for health care in the camps. A revision of the monthly reporting system and the establishment of a computer database in 1990 provided an opportunity to review the situation in the camps over the five years since the emergency. Child death rates for example, appear to have been reduced to levels below those expected in rural Africa. Patterns of mortality, morbidity, and nutritional status are outlined here and point to the general effectiveness of the health care programme. The surveillance system can, however, be used to identify those camps which have persistent problems, while monthly comparisons with the situation in previous years can provide early warning of deteriorating conditions.     

Post-Emergency Epidemiological Surveillance in Iraqi-Kurdish Refugee Camps in Iran

In 1991 a computerized, comprehensive epidemiological surveillance system was developed to monitor health trends in approximately 25,000 acutely displaced Kurds in Nowsood and Saryas refugee camps, Bakhtaran region, Northwestern Iran. In addition, community-based surveys offered information unobtainable from health facilities. Weekly population movements, attack rates, point-prevalence estimates, and case fatality ratios were calculated, and the data were analysed and compared. The overall crude mortality rate (CMR) in the camps under study was still 9 times higher than the reported CMR for Iraq. Health problems with very low rates (less than 1.0/ 1,000 population/week) included the triad of measles, meningitis and tetanus. However, morbidity for the most common conditions (acute respiratory infections, diarrhoea, skin infections, eye diseases and, finally, typhoid fever) was shown to increase at the end of the intervention, highlighting that the pressure of repatriation on refugees made them progressively worse. This article concludes that epidemiological surveillance systems should be implemented during mass-migrations in developing countries also in post-emergency settings. Furthermore, surveillance appears to be indispensable in order for the international agencies to keep abreast of events and to safeguard human rights when international attention subsides.     

Evaluation of a population mobility,mortality, and birth surveillance system in South Kivu,Democratic Republic of the Congo

Prospective, community-based surveillance systems for measuring birth, death, and population movement rates may have advantages over the ‘gold-standard’ retrospective household survey in humanitarian contexts. A community-based, monthly surveillance system was established in South Kivu, Democratic Republic of the Congo, in partnership with a local implementing partner and the national ministry of health. Data were collected on the occurrence of births, deaths, arrivals, and departures over the course of one year, and a retrospective survey was conducted at the end of the period to validate the information. Discrepancies between the two approaches were resolved by a third visit to the households with discordant records. The study found that the surveillance system was superior in terms of its specificity and sensitivity in measuring crude mortality and birth rates as compared to the survey, demonstrating the method's potential to measure accurately important population-level health metrics in an insecure setting in a timely, community-acceptable manner.     

Disease Surveillance and Control After a Flood: Khartoum, Sudan, 1988

Following a flood in Khartoum, Sudan, emergency disease surveillance was implemented to monitor the health status of the population. Simple, symptom-oriented case definitions for diarrheal disease, measles, respiratory disease, malaria, and jaundice were included on the report form used to collect daily counts of outpatients in a sample of both temporary and permanent clinics located in areas of the city most affected by the flood. Data collected from major teaching hospitals allowed comparison of pre- and post-disaster levels of morbidity and mortality. In addition, special surveys collected information unobtainable from health facilities. Sentinel clinic surveillance data indicated that diarrheal disease accounted for the greatest number of clinic visits, while malaria was the second most common reason for seeking medical attention. Malaria blood smear surveys showed that the parasitemia prevalence ranged from 11% to 19% in the general population and from 21% to 46% among febrile clinic patients. Hospital admission data demonstrated an increase in morbidity from diarrhea and malaria in August 1988, when compared to previous months and August of the previous year, although it is uncertain whether this increase was due to the flood. Nutrition surveys demonstrated that 23% of young children were moderately or severely undernourished, with substantial variation by area of the city. No major outbreaks of communicable disease were detected in the 4 weeks after the flood. Disease surveillance provided data useful in identifying public health problems, setting priorities, targeting interventions and controlling rumors. Disease control measures taken by the Ministry of Health included provision of potable water, standardization of medical care, and distribution of immunizations, oral rehydration salts, and vitamin supplements to children.     

Health Assessment of the 1985 Flood Disaster in Puerto Rico

In Puerto Rico, during October 1985, tropical storm Isabel caused widespread flooding, landslides, and collapsing of bridges. A maximum of 180 persons died, including an estimated 127 at a landslide where the majority (78%) of deaths resulted from traumatic injury. Approximately 3,000 homes were damaged with 4,400 persons temporarily displaced into 44 shelters. A shelter surveillance system was established to monitor 19 acute and chronic conditions in 28 shelters during a 5-week period. Trend analysis trends of selected reportable communicable diseases in the general community revealed no changes attributable to the disaster in the 12 most severely affected municipalities. In these municipalities, the number of persons using the scheduled outpatient clinics after the disaster decreased significantly, but the mean daily number of emergency room visits did not show significant change. Analysis of surveillance data showed that no infectious disease outbreaks had occurred in the shelters. The post-impact health consequences resulting from this widespread flooding were minimal. Even so, disease surveillance remains essential for efficacious resource allocation and prevention strategies.     

A baseline assessment of emergency planning and preparedness in Italian universities

Besides offering teaching and research services, schools and universities also must provide for the safety and security of their employees, students, and visitors. This paper describes emergency preparedness in a sample of Italian universities. In particular it examines risk perception within a specific professional category (university safety and security officers) in a specific cultural context (Italy). In addition, it discusses the transposition and implementation in a European Union (EU) member state of EU Council Directive 89/391/EEC of 12 June 1989, on the introduction of measures to encourage improvements in the safety and health of workers. The findings highlight heterogeneous and fragmented emergency management models within the Italian university system, underlining the need for a stricter framework of standardised safety protocols and emergency management guidelines. The study also points out that enhancing emergency planning and preparedness in Italian universities entails increasing safety leadership, employee engagement and individual responsibility for safety and security; essentially, it necessitates improving the culture of risk prevention.     

Surveillance of the Health and Nutritional Status of Rohingya Refugees in Bangladesh

Early in 1992, Bangladesh experienced an influx of Burmese refugees, reaching a total of 263,000 by May. As the health and nutritional status of the refugee population was reportedly poor, a need was felt to collect dependable data through epidemiological surveillance, on which interventions could be based. The nutritional and health status of children was dramatically poor in all camps surveyed and a deterioration was expected in the coming monsoon. Several problem areas could be identified. Based on these findings it was possible to undertake appropriate action and to avert threatening calamities. Epidemiological surveillance is an important monitoring tool to provide reliable data on the health and nutritional status of refugee populations and to help the organizations involved to prioritize and evaluate their actions.     

The impact of refugees on the health status and health services of host communities: Compounding bad with worse?

Although there have been a number of recent developments in our understanding of refugee health problems that have influenced policies and action, the effects of refugees on the health status and services of host communities remain relatively neglected. This article sets out to explain why this is an important issue with implications for policy, planning surveillance and evaluation, training and research.
The first sections outline some of the problems facing host governments and communities in Africa and discuss the changing rhetoric between the first and second International Conferences for Assistance to Refugees in Africa. A number of possible ways in which refugees could affect the individual, agent and environmental causes of disease are considered, as are the characteristics of the refugees, the host communities and the response which may all modify this impact.
Policy implications of the impact of the refugees, both negative and positive, are discussed, and detailed consideration is given to the pros and cons of integrated and parallel approaches to health care provision. The need to monitor carefully the health status and services of host communities is emphasized and recommendations are made for this and other essential developments relating to training and research.     

救援人员的主要心理问题、相关因素与干预策略

救援人员泛指在各种紧急情况中提供救助的个体,其心理健康风险得到越来越多的关注.研究发现救援人员的心理问题主要是应激相关障碍,消极情绪以及倦怠感.不利的救援工作条件、创伤暴露与非适应性的情绪调节策略是救援人员心理健康主要的危险因素;救援工作中的有利条件、社会支持、心理弹性以及适应性情绪调节策略是心理健康的保护因素.对救援...     

强震记录中速度大脉冲模拟及其对反应谱的影响

在近断层地震中,具有速度大脉冲的强震动对建筑物的影响较大。为了描述速度大脉冲,Makris和Roussos提出了由简单连续函数构成的模型,该模型参数较少、形式简单,用来描述实际地震记录中的速度脉冲大多取得较好的效果,但还是有一些记录模拟的结果会出现"丢失"现象,存在一些缺陷。针对此问题,本文提出了2个改进的方法——组合法和镜像法,用来扩展Makris和Roussos模型的适用范围,使其具有更好的适应性。     

发电机定冷水系统微碱化加药处理装置的应用

针对发电机定冷水系统传统水质处理方法所出现的水质 pH 值较低、铜离子含量高、 换水量大等问题,通过分析论证,提出了微碱化加药处理方法。实施后,系统水质指标有了明显的好转,符合定冷水标准要求。应用结果表明:该方法操作简单、易于实施、水处理方式可人工控制、稳定有效,设备安装方便、占地面积小,适用于机组定冷水系统水质优化处理。     

Natural disasters and older US adults with disabilities: implications for evacuation

We analysed 2003 and 2004 Behavioral Risk Factor Surveillance System (BRFSS) data from New Orleans-Metairie-Kenner, LA to produce estimates of the number of community dwelling people aged 65 years or older with a disability and requiring special equipment.(4) Approximately, 47,840 (31.6 per cent) older adults with a disability and 24,938 (16.6 per cent) older adults requiring the use of special equipment were community dwelling and might require assistance to evacuate or a shelter that could accommodate special equipment. Older adults who need special equipment were likely to be female, unmarried and white, and to rate their health as fair or poor. Personnel who plan and prepare for evacuations and temporary shelter during disasters need baseline information on the number of older adults with a disability or who require special equipment. A surveillance system, such as the BRFSS, gathers information that planners can use to prepare for and to deliver services.     

基坑开挖地质灾害分析及智能监测系统研究

随着地下空间的广泛、深入利用，深基坑工程应运而生，它解决了许多技术难题，使得一幢幢高楼能拔地而起。但基坑工程的开挖也会带来很多危险，产生许多地质灾害，围绕这个问题进行了分析。研究认为，进行智能监测是防治有关灾害的良策。     

基于光纤光栅和小波包分析的结构损伤探测

以光纤光栅为传感元件、小波包分析为信号提取工具,获取了智能材料四边简支板损伤前、后的动态应变信号检测方法,并采用耦合神经网络方法对智能材料四边简支板结构进行了损伤识别分析。结果表明,光纤光栅可非常灵敏地检测出智能材料内部的动态应变信号,小波包信号处理方法可获得大量反映结构损伤特征的有效信号;随着损伤孔径的增大,耦合神经网络损伤识别的精度提高,可得到损伤的位置和大小的信息。研究结果在大型工程结构的健康监测中具有重要的潜在应用价值。     

Does nutritional surveillance have a role to play in early warning of food crisis and in the management of relief operations?*

A major area of investment in data collection in developing countries has been that of nutritional surveillance and monitoring. From recent debate it is clear that there is currently no consensus on the potential role of nutritional status as an early warning indicator. The author presents a synthesis of the broad spectrum of views on the role nutritional surveillance could or should have in early warning. Conceptual problems and technical difficulties are reviewed in the light of recent experiences in Africa and Asia. The author raises a number of issues for future discussion in this ongoing debate.     

Training refugees as primary health care workers: Past imperfect, future conditional

Many problems have been encountered in the planning and implementation of health care in refugee camps, and more specifically in the training of refugees as primary health care workers. A review of the published literature and a "survey" of the opinions and experiences of refugee, national and international health personnel regarding training has therefore been undertaken to provide an overview of what has been done and to make recommendations for future work.
The review highlights the need to reallocate resources away from high visibility emergency aid to development activities, such as training, that will create an infrastructure for primary health care and promote self-reliance.     

Post-disaster behavior of some communicable diseases

The surveillance of communicable diseases after a natural disaster reflects the permanent state of effectiveness of the health services and the adverse factors of the natural, physical and family environments. Diarrhoeal diseases may be the best indicator of a community's period of recovery. The return of these diseases to endemic levels means that the pre-disaster situation has been reestablished.     

The health sector gap in the southern Africa crisis in 2002/2003

The southern Africa crisis represents the first widespread emergency in a region with a mature HIV/AIDS epidemic. It provides a steep learning curve for the international humanitarian system in understanding and responding to the complex interactions between the epidemic and the causes and the effects of this crisis. It also provoked much debate about the severity and causes of this emergency, and the appropriateness of the response by the humanitarian community. The authors argue that the over-emphasis on food aid delivery occurred at the expense of other public health interventions, particularly preventative and curative health services. Health service needs were not sufficiently addressed despite the early recognition that ill-health related to HIV/AIDS was a major vulnerability factor. This neglect occurred because analytical frameworks were too narrowly focused on food security, and large-scale support to health service delivery was seen as a long-term developmental issue that could not easily be dealt with by short-term humanitarian action. Furthermore, there were insufficient countrywide data on acute malnutrition, mortality rates and performance of the public health system to make better-balanced evidence-based decisions. In this crisis, humanitarian organisations providing health services could not assume their traditional roles of short-term assistance in a limited geographical area until the governing authorities resume their responsibilities. However, relegating health service delivery as a long-term developmental issue is not acceptable. Improved multisectoral analytical frameworks that include a multidisciplinary team are needed to ensure all aspects of public health are dealt with in similar future emergencies. Humanitarian organisations must advocate for improved delivery and access to health services in this region. They can target limited geographical areas with high mortality and acute malnutrition rates to deliver their services. Finally, to address the underlying problem of the health sector gap, a long-term strategy to ensure improved and sustainable health sector performance can only be accomplished with truly adequate resources. This will require renewed efforts on part of governments, donors and the international community. Public health interventions, complementing those addressing food insecurity, were and are still needed to reduce the impact of the crisis, and to allow people to re-establish their livelihoods. These will increase the population's resilience to prevent or mitigate future disasters.     

A comparison of health provision and status in ban napho refugee cAMP and nakhon phanom province, northeastern Thailand

Health care provision and health status in Ban Napho Refugee Camp is compared with that of the surrounding Nakhon Phanom Province for the year 1988. Records for the period 1984–88 were also examined to compare trends in health status. Personal experience of health services in the Camp and visits made to local schools and health facilities were also used in the comparison. Although direct comparison was difficult (because of the mobile nature of the camp population and problems to do with the interpretation of statistics), it was found that health care for refugees was more comprehensive, at a primary level, than for the Thai population of the surrounding Province. Access to primary health care facilities in the Camp was, moreover, easier and free of charge. This may explain the higher use of health facilities in the Camp but, despite this, health and nutritional status appeared to be worse in the Camp than in the Province. Possible reasons for the difference in reported health status and the use of facilities are discussed.