Malnutrition and anaemia among Somali refugee children in long term camps

In a long term Somali refugee camp where nutritional and general health status of children is now considered satisfactory and stable, a randomized community based survey of 300 children under five years was undertaken. Results indicate that the prevalence of protein-energy malnutrition is rising again: 17.3% of children are <80% median weight/height and 1.7% are <70%median weight/height. In addition, there is a high prevalence of anaemia: 50.5% have a haemoglobin level <9g% and 10.8%≤6g%. This cannot be explained by chronic malaria as the spleen rate is only 2%. Stool examination of 161 children show 29.8% to have evidence of Giardia Lamblia infection but this is not statistically correlated with either anaemia or with protein-energy malnutrition. Other potentially pathogenic parasites are uncommon and no hookworm is seen. Examination of blood films of anaemic children shows hypochromia as a striking feature.
It is concluded that nutritional deficiencies are a likely major factor in the aetiology of the anaemia. Both protein-energy malnutrition and anaemia seem related to the weaning period. Food rations for refugees, although adequate for short term needs, may be qualitatively deficient for long term subsistence, especially as regards young children.     

Training Community Health Workers in refugee camps: A case study from Pakistan

In October 1983 a training programme for refugee community health workers was begun as the major part of a primary health care programme for Afghan refugees in Pakistan. The programme began with a pilot period in Badaber camp, situated near to Peshawar. The general issues involved in training auxiliary health personnel were answered by the use of a "knowledge, attitudes and practices survey" and involvement of the refugees from the beginning of the programme. The development of the training programme is discussed with reference to these issues and the constraints arising from the special circumstances of the refugees, in addition to those common to most national training programmes, are reviewed.     

A general assessment of the environmental impact of refugees in Somalia with attention to the refugee agricultural programme

This paper attempts to examine the broad features of Somalia's harsh physical environment into which several hundreds of thousands of refugees, with mainly a nomadic or semi-nomadic life style and culture, dramatically descended six years ago. The thirty-six rural camps in which at least half of them live are described as is the refugee agricultural programme which is training several thousand families so that they may be "self-supporting." The four regions where the camps are located are each briefly summarized in terms of their soils, their climates, their natural vegetation, and the type of agriculture which the refugee farmers practice. A more detailed analysis is then given on the following critical environmental concerns: Vegetation and erosion on refugee farms, the growing problem of refugee livestock, the destruction of trees, and irrigation practices and salinity on refugee farms. The paper concludes with an argument to preserve Somalia's environment from careless and destructive exploitation, which is leading towards desertification, and calls for an in-depth study of the situation.     

Training of expatriate refugee health workers: Principles and practices

Abstract—This paper describes in detail the separate components of an ideal expatriate refugee health worker training course. Emphasis is given to organizational aspects of such courses.     

The tragedy of Kampuchea

This paper, abstracted from the final report of the Kampuchea Inquiry Commission, analyses the population losses in Cambodia prior to 1979 and goes on to describe some of the unwanted side effects of the international relief programmes in both Thailand and in Kampuchea. The paper concludes that various opposition movements to the present Vietnamese backed regime in Kampuchea have been strengthened by international aid.     

A test of stress theory: relief workers in refugee camps

The purpose of this paper is to apply a stress model drawn from the literature to the relief and social service workers who have been active in refugee camps for a prolonged period of time. Working in difficult environments, social service workers deliver essential services to refugee populations around the world. A model of four work-stress determinants--tasks, management, appreciation and collaboration--was tested on 274 social workers in five regions of the Middle East (Jordan, Lebanon and Syria, as well as the occupied Palestinian territories of the Gaza Strip and the West Bank). Statistical fit indices were adequate but two relationships were statistically insignificant. The collaboration variable was dropped to create a modified model with tasks indirectly and management and appreciation directly affecting work-related stress. The five direct relationships and two indirect relationships of this modified model are consistent with stress theory, and all relationships--direct and indirect--are statistically significant.     

Cholera in Sudan: An account of an epidemic in a refugee camp in eastern Sudan, May-June 1985

In 1985 cholera has been a serious problem in the horn of Africa, particularly affecting the many famine victims and refugees in that region. In this paper the history of cholera in Africa is briefly summarized, as is the background to the current refugee situation in eastern Sudan. A cholera epidemic involving 1,175 cases in two adjacent refugee camps in eastern Sudan is described. In this epidemic there were thirteen inpatient deaths and thirty-eight known home deaths from cholera. The management of the epidemic is described in detail. Overall an average of 8 1. of intravenous fluid was used per case, a higher figure than was anticipated, probably because of the unexpected degree of vomiting and the shortage of trained nursing staff.
The relationship between cholera and malnutrition is explored and hypochlorhydria is suggested as the main reason for the increased susceptibility to cholera among malnourished populations. It was observed that severely malnourished adults and children appeared to nave less severe diarrhoea with their cholera, presumably because of reduced mucosal surface area and poor enterocyte function. Finally possible means of aborting cholera epidemics are discussed.     

The Pyrenees earthquake of 1660: Effects in France

Until 1975 or so, scientists' knowledge of the major earthquake of 1660 in the Pyrenees (in Bigorre) was largely restricted to the meagre information repeated in the classical catalogues. Useful material published in local learned journals was mostly unknown, and has only been unearthed and interpreted since 1976, when two year's work of analysis was started for the "Projet Sismo-tectonique" in France. During and since that project, further routine work necessary for the revision of the historical seismicity of France, has brought to light a new wealth of information from archive sources. This new knowledge, at least from the French side, is used as the basis for a brief macroseismic review of the event north of the Pyrenees, putting forward proposals for the isoseismal lines. Emphasis is placed on the number and quality of the sources, some of which are quoted for evidence of major rockfalls in the meizoseismal region and the wide extent of the felt area, as far north as Salnt-Maixent in Poitou.     

Health implications of the Tumaco earthquake, Colombia, 1979

A retrospective study of the effects of the Tumaco earthquake of 1979 shows a smaller number of deaths and injuries than in earthquakes of similar magnitude that have occurred elsewhere, which is probably related to the type of building. Most of the deaths were caused by a tsunami. Proportionally the mortality was higher in the 0 to 4 age group. Among the injured, most of the lesions were minor. Morbidity was higher in the over 45 years age group, and lower among the "under-fives." There was an evident need for a simple "disaster medical record card." Coordination among the different relief agencies could have been better.     

A preliminary investigation of socio-economic problems following the 1978 Thessaloniki (Greece) earthquake

The consequences of social and economic disruption in the city of Thessaloniki following the large earthquake in 1978 are investigated. Specifically, the phenomenon of organized life in camps for Thessaloniki residents over a long period of time is studied. With the use of a questionnaire, all data regarding each person in the camps were assembled and processed with the correspondence analysis method.     

Educational,psychosocial, and protection outcomes of child‐ and youth‐focused programming with Somali refugees in Dollo Ado,Ethiopia

Child‐ and youth‐friendly spaces have become a common feature of emergency humanitarian provision. This study reports on the outcomes of child and youth learning centres (CYLCs) in Ethiopia's Buramino Camp established for those fleeing conflict in Somalia. Eighty‐five youths completed baseline assessments shortly after arrival and follow‐up assessments three to six months later. Caregivers of 106 younger children completed similar appraisals. 693 children attending the CYLCs completed pre‐ and post‐educational assessments, which indicated major gains—significant at p<0.0001—in both literacy (younger children, t=9.06; youth, t=13.87) and numeracy (younger children, t=13.94; youths, t=17.10). Children's CYLC attendance increased reports of met needs among caregivers (t=2.53, p<0.05) and youths (t=2.57, p<0.05), and, among caregivers but not youths, significantly moderated protection concerns (t=2.39, p<0.05, and t=?1.90, p=0.06, respectively). There was general improvement in psychosocial well‐being over time for all children; CYLC attendance predicted greater reductions in reported difficulties only among younger children (t=2.51, p<0.05).     

The 'who' and 'what' of training far disaster relief

This paper defines the various levels within government, the voluntary agencies and the community which might benefit from training and makes suggestions as to where the emphasis should be placed. It points out that training programmes should be designed to meet the expressed needs of a particular group of trainees as well as be related to the current or potential disaster situation.     

Counter-disaster training in developing countries

This paper discusses both the need for training within a wider context of community disaster preparedness and the major alternatives in methods of training. Emphasis is placed on the importance of compatibility between the resources within a given country and appropriate training programmes.     

Aftermath of natural disasters: Coping through residential mobility

Most studies of population movement have concentrated on the more developed nations and on trends that have not been influenced by man-made or natural disasters. The experience of developing countries in the Caribbean basin, as studied after the Guatemalan earthquake of 1976 and the impact of Hurricane David in the Dominican Republic of 1979, highlights the importance of socio-economic factors in the decision to make permanent migrations after a disaster, regardless of whether the migrant had personally suffered losses. In many cases the opportunities for personal betterment created by the disaster acted as a catalyst and accelerated a previously-existing trend of migration.     

Practical experience with the management of a cholera outbreak in a refugee cAMP in eastern Sudan, 1985

From May to November 1985 most refugee camps in Eastern Sudan were affected by cholera. This article summarizes the experience from the refugee camp Wad Sherife with the emphasis on the practical aspects of management of cholera in a refugee context. Paramedical personnel from the refugee community were used to a great extent both in curative and preventive measures. The home visitors played an important role in the early detection of the cases and in trying to prevent the spread of cholera in the camp. A total of 1793 cases were admitted during a three month period. The results show a case fatality rate of 1.8%. A significantly higher number of women were affected in the age group 15–44. As seen in other refugee camps in Eastern Sudan, there was a relatively high intravenous fluid consumption with an average of about 6 litres in adults.     

An Ethiopian refugee village in Sudan: the question of employment

Abstract— There are some 460,000 Eritrean and Tigrean political refugees in Sudan. The numbers have increased dramatically since the mid-1970s, and as yet there are no convincing signs of peace which would allow the prospect of a speedy return home. Sudan is thus faced with one of the Third World's largest populations of long term refugees, and the capacity of the economy to absorb such numbers into its labour force is an acute and potentially violent issue. Discussion and planning has been hindered by a lack of specific information on the proportion of refugees who are of urban or rural origin and the proportion of those who might undertake skilled or unskilled employment. The following report of a census and survey of a refugee village in eastern Sudan offers some insight into the problem and suggests steps towards its solution.     

Is the environment becoming more hazardous?—A global survey 1947 to 1980

This paper examines the assertion that natural disasters are increasingly destructive using evidence from disaster reports during the period 1947–1980. The criteria for judging the impact of a given natural disaster are chiefly loss of life and the extent of the geographical area affected. In spite of uneveness and bias in the reporting of sudden impact disasters the conclusions are that both the frequency of disasters and number of people killed are increasing. Further research into the social consequences of disasters and the need for disaster preparedness training programmes are recommended.