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.     

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.     

Health response to a large and rapid influx of Albanian refugees in southern Italy, 1991

Over a two-day period in March 1991, more than 23,000 Albanian refugees arrived without warning in the southern Italian port of Brindisi. A simple surveillance system was established within days of their arrival to monitor health problems that were expected to have a high frequency, were of concern to the Italian health care system because of potential spread to the local population, and were susceptible to therapeutic or preventive measures. The most commonly encountered health problems were pediculosis and scabies. Despite poor sanitary conditions, only one outbreak of gastrointestinal disease was reported. Obstetric events were common, and many resulted in adverse outcomes. Hospitalization rates were high, although in the early weeks of the emergency, many were unwarranted. This experience demonstrates the value of a simple, rapid surveillance system in prioritizing health problems and preventing rumors. In future, greater emphasis should be placed on outpatient management of simple medical problems.     

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.     

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.     

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.     

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.     

Interviews with Key Informants and Household Surveys: Central Ethiopia

Nutrition surveillance as part of, or complement to, the famine early warning system in Ethiopia has been used to collect reports on local food security from community leaders using structured interviews. As this information is crucial in the interpretation of other quantitative data, it is important to assess the extent to which leaders' information reflects the food related behaviour of the community. Information on various socio-economic variables related to nutrition were collected at the household level and at the community level through structured interviews with householders and community leaders. The information given by householders and by community leaders was compared. In general the correspondence between the two was good and the continued collection of local information from local leaders justified. There were a few topics on which information might be missed using only the local leader and ways to improve collecting this information are discussed.     

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.     

Control or rescue at sea? Aims and limits of border surveillance technologies in the Mediterranean Sea

The matter of boat migrants crossing the Mediterranean Sea, seeking to reach Europe, is interchangeably defined as a ‘security issue', requiring stricter border controls, and as a humanitarian issue with corresponding rescue and protection requirements. This paper seeks to understand what role various surveillance technologies, such as radar, satellites, and unmanned aerial vehicles, can play in this respect (legally and technically), in comparison to the role that they are assigned (that is, political expectations). To unravel what surveillance technologies can and cannot do vis‐à‐vis the aims of control and rescue, there is a need to comprehend what information can be collected and what information is needed to fulfil these objectives. The paper contends that there is a mismatch between the information sought to ‘control’ borders, but which cannot be gathered effectively by or processed using surveillance technologies, and the valuable information needed to perform rescue operations, which these surveillance technologies can supply.     

Decentralized Data Management in Nutritional Surveillance for Timely Warning and Intervention

In this paper we describe a theoretical approach for decentralized data management in sentinel community nutritional surveillance systems for timely warning and intervention, by using customized computer programs. By making the data available at lower levels first, the decentralized data management system builds the institutional capacity at regional, level and allows rapid and appropriate action by decision-makers. In addition, it facilitates the flow of information and strengthens the involvement of field staff. Reports from field experiences should further demonstrate the feasibility, efficacy, costs and benefits of customized data management computer programs.     

上海大雾气候特征及风险区划研究

大雾作为一种比较常见的灾害性天气,对交通运输和人体健康等都会造成严重的影响。基于上海市11个气象站1971-2000年的大雾数据和城市基础地理信息,利用地理信息系统和层次分析法,结合专家调查法,建立了上海市大雾风险的评价指标体系和权重,开展了上海市大雾的风险特征及地理区划研究,获得了1 km空间分辨率的上海大雾气候特征图、上海城市对大雾敏感性特征图和上海市大雾风险区划图。初步研究表明,这种方法对城市大雾评估和风险区划是可行的。     

电网生产作业现场视频的深化应用

针对当前生产作业现场视频监控方式和监控手段缺失,以及电网统一-视频监控平台(Unified Video Platform,UVP)功能单一、人机交互功能不够完善等问题,采用UVP的视频资源与电力生产管理系统(Power Production Management System , PMS)的工作票信息集成的方式,并运用图像自动识别等技术,将线下的检修计划收集转为线.上自动汇总,通过关联视频摄像头引导视频监控快速定位到工作现场,使UVP的功能更加完善和人性化。应用结果表明:该功能的开发提高了生产作业现场视频监控的准确性、易用性,提升了工作效率,简化了工作流程。     

KYN28-12高压配网开关设备物联网集成设计与应用

KYN28-12高压配网开关设备是10 kV配电网中应用量大、面广的成套开关设备,本设计提供了1种有别于传统配电室局域网信息化管理,能随时随地对开关设备健康状况可视化的方法:物联网网关、噪音、灰尘、温度等传感器与开关柜二次系统集成设计到开关柜仪表室内,将设备重要的工况、运行指标实时数据进行主动采集和发送,传递到云平台进行实时监测、评估和预警等。通过现场使用及周期测试,结果表明:该设计提供了1种开关设备全生命周期管理的实现方法,尤其是对数据分析为基础的设备健康管理体系提供了有效支撑,催生了基于数据的电力配电站精准运维服务新业态。     

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.     

An adaptive governance approach to disaster-related behavioural health services

This paper explores the provision of disaster-related behavioural and mental health (DBH) services as a problem of institutional collective action in the United States. This study reviews the challenges that providers have in surmounting multi-organizational disconnects, unstable professional legitimacy, ambiguous information, and shifting disaster needs in developing a system for delivering DBH services. Based on the adaptive governance framework, it argues that existing protocols such as the National Incident Management System (NIMS) and Incident Command System (ICS) may be helpful in advancing collective action, but that real progress will depend on a recognition of norms, expectations, and credentials across many spheres-in other words, on the ability of responders to continuously adjust their procedures and administrative boundaries for behavioural health institutions.     

九江5.7级地震建筑物安全鉴定

介绍了九江地震中瑞昌市和九江县教育系统、医疗卫生系统、生命线系统、劳教所等各类公共建筑和重要建筑安全鉴定工作的基本情况。基于现场调查得到的资料，论述了九江地区建筑物地震破坏的原因，并对这次地震现场建筑物安全鉴定工作进行了分析总结。指出震后现场建筑物安全鉴定是一项重要的地震应急工作，应予以充分重视。     

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.     

HIV risk and prevention in emergency-affected populations: a review

While basic guidelines on HIV prevention in emergencies have been available for several years, international agencies involved in the provision of health services have not placed sufficient priority on the prevention of the human immune deficiency virus (HIV) and other sexually transmitted infections (STIs) in complex emergencies. This paper reviews the factors that may increase the risk of HIV transmission in populations affected by complex emergencies and outlines recommendations for research and programmes. Research into the most appropriate methods of carrying out HIV surveillance and interventions in these settings is needed. In the post-emergency phase programmes need to be far more extensive than those offered under the Minimal Initial Services Package (MISP). While the potential for stigmatization represents an important constraint, there is a need to prioritize HIV/STI interventions in order to prevent HIV transmission in emergency-affected populations themselves, as well as to contribute to regional control of the epidemic.     

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.