WK 8/9- Refugee Health Flashcards
What is the definition of a refugee
someone who has been forced to flee their country of origin for fear of being persecuted for their race, religion, nationality, membership of a particular social group, gender or political opinion, or due to natural disaster
What is the definition of an asylum seeker
A refugee whose request for sanctuary has yet to be processed
What is the definition of a prima facie refugee
Mass movement due to conflict or violence
What is the definition of an internally displaced person
Mass movement due to conflict or violence but person has not crossed a border (is within their own country)
What is the international humanitarian law
Set of rules designed to limit the effects of armed conflict through restricting the means of warfare–> ie weapons, tactics, protecting the wounded
-aims to protect those not participating in hostilities
What is the UNHCR
UN refugee agency that has the responsibility to look after displaced people through providing emergency assistance (blankets, clean water, sanitation, healthcare, shelter and sometimes food)
-provide a safe refuge to those who are unable to return home, but also arrange transport/assistance for those returning home after fleeing
What is the crude mortality rate
key indicator of health status in all phases
- if the CMR is greater than 1 death per 10,000 people per day, this indicates a state of emergency
- monitoring the CMR allows you to manage the overall health of the population
What are the top 10 priorities in refugee health
- Initial assessment
- Measles immunisation
- Water and sanitation
- Food and nutrition
- Shelter and site planning
- Health care in the emergency phase
- Control of communicable diseases and epidemics
- Public health surveillance
- Human resources and training
- Coordination
Why is an initial assessment important
Rapid collection of data regarding the background to the displacement, the population itself, the risk factors related to the main diseases and the requirements in terms of human and material resource allows for identification of health priorities
- allows you to deliver information to potential sponsors/donors
- allows you to identify specific health needs
Why is measles immunisation important
Measles is one of the most severe health problems and is intensified by displacement, overcrowding and poor hygiene. Mass vaccination of children from 6 months-15 years should be conducted within the first week, along with distribution of Vitamin A, to prevent mortality and morbidity.
Why is water and sanitation important
Poor water supplies and inadequate sanitation lead to diarrhoeal diseases. To prevent this, a water source should be established within the first few days and allow for a minimum of 7.5-15L of water per person/day, then moving to 15-20L per person/day.
Organisation of latrines and waste disposals = one latrine per 20 people
Why is registration of incoming refugees important
What are the 3 outcomes of an exit from the refugee camp
-Voluntary repatriation: returning home on own accord
-Resettlement:
moving to another country/area
-Local integration:
integration into local community as a citizen
According to WASH;
- What is the minimum amount of water needed per person/day
- How many taps are required/person
- How many water containers are required
- How much soap is required/person
- How many toilets are required/person
-Water: 7.5-15L/person/day
(absolute min for drinking, cooking & hygiene)→ needs to be accessible
-Taps: 1/250 persons (7.5L/minute)
-Water containers: 2 x 10- 20L/household
-Soap: 250G/person/month
-Laundry soap: 200G/person/month
-Acceptable material for menstrual hygiene
-Toilets: 1/20 people, arranged by households and +/- segregated by sex
What distance requirements are needed for toilets
- <50 M from dwellings to make them accessible
- +/- toilet paper
- latrines have to be at least 30M from groundwater source (to avoid contamination)
- Bottom >1.5M above groundwater level (to avoid seeping into water source)
- Incl. handwashing
What requirements are needed for rubbish removal in refugee camps
100L bin/10 households, Pit <100M from households, 2 collections/week, appropriate medical waste and dead body disposal
Why is shelter and site planning important
In order to prevent the transmission of epidemic diseases, such as measles, meningitis, typhus, cholera etc, inadequate shelter and overcrowding must be prevented. Protection against the sun, rain, cold and win is also required to maintain refugee welfare. Construction materials should be purchased locally in order that shelter can be provided for the refugees as quickly as possible.
What measurements/distances are required;
- between tents
- for fire breaks
- space per person
- 30-45M2/person plus all the common areas/health centres (size of whole site), Min area 3.5M2/person
- Fire break 50M every 300M
- 1-1.5M between tents
What is the minimum number of calories needed per person per day
2,100 Kcal/person/day
Why is food and nutrition important for refugee health
Malnutrition is an important contributory cause of death and vitamin deficiencies and can lead to diseases such as scurvy and pellagra. Basic food rationing to prevent malnutrition should contain a minimum of 2,100 kilocalories per person per day. When there is a high level of malnutrition within the camp specific feeding programmes will be established containing supplementary feeding.
What are the 4 levels of health care needed for refugees
- First level of care: Need a central hospital→ most commonly the host hospital→ might have to pay them/supply them with equipment/give extra training, would want surgical theatres and a lab
- Second level of care: health centre at site, would want to have access to emergency care, 24 hours, non-surgical birthing, dressings, injections, may not have a doctor at this level
- Third level: outpatient clinics- very basic care→ main diagnosis and tx (of malaria, diarrhoea, URT, etc)
- Fourth level: community health worker from population, act as communication, may need to be trained
How are communicable diseases prevented
-Clean water
-Sanitation
-Hygiene facilities
-Shelter
-Sufficient and safe food
-Personal protection & vector control
-Vaccination
-Surveillance & early detection of
cases → prompt treatment
What are the top 4 communicable diseases responsible for mortality/morbidity in refugees
Measles, Malaria, Upper resp infection, Diarrhoeal diseases
What is the implication of measles in a refugee camp
-how can it be prevented
- Case fatality rates can reach > 10%
- Outbreaks frequent in overcrowded camps
- Preventable with vaccine Immunisation–> mass vaccination of children 6 mths to 15 yrs
- Measles and Vitamin A at the same time→ vit A is protective of mucous membranes
