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GH > WK 8/9- Refugee Health > Flashcards

WK 8/9- Refugee Health Flashcards

1
Q

What is the definition of a refugee

A

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

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2
Q

What is the definition of an asylum seeker

A

A refugee whose request for sanctuary has yet to be processed

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3
Q

What is the definition of a prima facie refugee

A

Mass movement due to conflict or violence

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4
Q

What is the definition of an internally displaced person

A

Mass movement due to conflict or violence but person has not crossed a border (is within their own country)

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5
Q

What is the international humanitarian law

A

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

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6
Q

What is the UNHCR

A

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

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7
Q

What is the crude mortality rate

A

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
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8
Q

What are the top 10 priorities in refugee health

A
  1. Initial assessment
  2. Measles immunisation
  3. Water and sanitation
  4. Food and nutrition
  5. Shelter and site planning
  6. Health care in the emergency phase
  7. Control of communicable diseases and epidemics
  8. Public health surveillance
  9. Human resources and training
  10. Coordination
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9
Q

Why is an initial assessment important

A

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
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10
Q

Why is measles immunisation important

A

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.

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11
Q

Why is water and sanitation important

A

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

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12
Q

Why is registration of incoming refugees important

A
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13
Q

What are the 3 outcomes of an exit from the refugee camp

A

-Voluntary repatriation: returning home on own accord
-Resettlement:
moving to another country/area
-Local integration:
integration into local community as a citizen

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14
Q

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
A

-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

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15
Q

What distance requirements are needed for toilets

A
  • <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
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16
Q

What requirements are needed for rubbish removal in refugee camps

A

100L bin/10 households, Pit <100M from households, 2 collections/week, appropriate medical waste and dead body disposal

17
Q

Why is shelter and site planning important

A

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.

18
Q

What measurements/distances are required;

  • between tents
  • for fire breaks
  • space per person
A
  • 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
19
Q

What is the minimum number of calories needed per person per day

A

2,100 Kcal/person/day

20
Q

Why is food and nutrition important for refugee health

A

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.

21
Q

What are the 4 levels of health care needed for refugees

A
  • 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
22
Q

How are communicable diseases prevented

A

-Clean water
-Sanitation
-Hygiene facilities
-Shelter
-Sufficient and safe food
-Personal protection & vector control
-Vaccination
-Surveillance & early detection of
cases → prompt treatment

23
Q

What are the top 4 communicable diseases responsible for mortality/morbidity in refugees

A

Measles, Malaria, Upper resp infection, Diarrhoeal diseases

24
Q

What is the implication of measles in a refugee camp

-how can it be prevented

A
  • 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
25
Q

What is the implication of malaria in a refugee camp

  • how can it be prevented
  • how can it be responded too
A

-Endemic in many countries, major
cause of morbidity and mortality
-Prevention- impregnated mosquito nets, environmental control measures, chemoprophylaxis
Response- Surveillance and timely response, appropriate treatment (Artemisinin-based
combination therapy – ACT)

26
Q

How can URTI be prevented in refugee camps

A
  • Adequate shelter
  • Blanket distribution
  • Vaccination (measles, diphtheria, pertussis)
  • Vitamin A supplementation
27
Q

How can deaths from diarrhoea be prevented

A

hygiene and sanitation, surveillance for early detection of potential outbreaks, prompt re-hydration (IV/ORS), trained staff, education

28
Q

What are the main types of diarrhoeal diseases present in refugee camps

A

Shigella-> acute bloody diarrhoea= dysentry

Cholera-> acute watery diarrhoea

29
Q

Why is controlling communicable diseases and epidemics so important

A

The four most frequent communicable diseases responsible for the highest morbidity and mortality rates are: measles, diarrhoeal diseases, acute respiratory infections and malaria. Diarrhoea is one of the main causes of death, mainly due to dehydration. Administration of ORS helps to decrease the mortality rates. Morbidity and mortality reduction can also be through early intervention in the initial phase of an outbreak, rapid treatment of the disease and prevention of the disease through vaccination (ie. Measles).

30
Q

Why is public health surveillance important

A

Allows for information to be collected and formation of the daily crude mortality rate (CMR) which is the most useful health indicator when monitoring an emergency phase. If the CMR is over 1 per 10,000, this indicates an emergency situation.

31
Q

How can malnutrition be prevented

A
  • Food distributions
  • Monitoring food security for early detection of risk
  • Nutritional surveillance
  • Meeting micronutrient and caloric standards
32
Q

What other health issues are important to address in refugee camps

A

-Injury care
-Mental health
-Non-communicable diseases – prevention
and management
-Obstetric care
-Comprehensive aid (surgery, blood transfusion)
-STI/HIV/AIDS management

33
Q 
In terms of human resources and training, how many;
-doctors
-nurses
-midwifes
are required in a refugee camp
A

Minimum of:

  • 1 doctor/50,000
  • 1 nurse/10,000,
  • 1 midwife/10,000
34
Q

How is SDG 6 relevant to the health needs of victims of armed conflict

A

SDG 6→ 6.2= By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations

35
Q

How is SDG 2 relevant to the health needs of victims of armed conflict

A

SDG 2→ 2.1= By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year
round

36
Q

How is SDG3 relevant to the health needs of victims of armed conflict

A

SDG 3→ 3.1= By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births
and under-5 mortality to at least as low as 25 per 1,000 live births
3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, waterborne
diseases and other communicable diseases
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being ETC

37
Q

Disease outbreaks in refugee camps is a major concern. Which of the following is routinely vaccinated against in refugee/IDP contexts to prevent outbreaks?

  • Measles
  • Pertussis
  • Typhoid
  • Influenza
A

Measles

38
Q

Who is International Humanitarian Law intended to protect?

A

Anyone not actively involved in conflict

GH (10 decks)

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