Table 1 The Top Ten Priorities for Refugee Health
1.Initial assessment | Quantitative and qualitative information on background to the displacement, population, risk factors related to the main diseases and requirements in terms of resources through observation, interviews, sample surveys, mapping. |
Usually approximate, results may need to be corroborated later. | |
2.Measles immunization | Displacement, overcrowding and poor hygiene are factors that encourage emergence of large scale epidemics. |
Mass vaccination of children from 6 months to 15 years should be a priority during the first week. | |
3.Water and sanitation | Prevention of diarrhoeal diseases and survival |
Ensure immediate provision with temporary water supply until more permanent solutions (wells) can be found | |
Indicators in regard to water supply and latrines must be monitored. | |
4.Food and nutrition | Malnutrition is often associated with displacement |
Provision of food ration to cover daily minimum needs | |
Feeding programs for specific groups are supplementary feeding for moderately malnourished and therapeutic or intensive feeding for the severely malnourished. | |
5.Shelter and site planning | Provide protection from environment |
Prevent transmission of diseases with epidemic potential link to overcrowding and inadequate shelter | |
Ensure sufficient infrastructure for providing services (e.g. health facilities) | |
6.Health care in emergency phase | Create a decentralized network of health facilities |
Provide manuals and guidelines for standardization | |
Ensure medical material and drugs in sufficient quantity and quality – (i.e. Kits of essential drugs and material) | |
7.Control of communicable diseases and epidemics | Four greatest killers: measles, diarrhoea, acute respiratory infections and malaria |
Higher risk of communicable diseases: measles, cholera, shigellosis, meningitis etc. | |
Preventative measures are to be privileged when possible (e.g. vaccination campaigns) | |
8.Public health surveillance | Monitoring the health status of the population |
Daily collection of selected health data – only cover diseases or other health problems that can be controlled by preventive or curative interventions. | |
Most useful health indicator is the daily crude mortality rate | |
Objectives: warn of an impending epidemic, monitor the main diseases occurring In the population and measure the impact of health programs | |
9.Human resources and training | Determine staff requirements after identification of activities |
Human resources management including recruitment and training | |
Important to ensure the link with the community: Home visitors | |
10.Coordination | Must be organized at the onset of the crisis |
A good system involves: overall clear leadership with good communication lines and that overall policy is standardized |