An analysis of mortality trends among refugee populations in Somalia, Sudan, and Thailand

A review of mortality data from refugee camps in Thailand, Somalia, and Sudan indicates that crude mortality rates were up to 40 times higher than those for the non-refugee populations in the host countries. Acute respiratory infections, diarrhoeal diseases, malaria, measles, and undernutrition were the causes of most reported deaths, the majority of which could have been prevented by adequate food rations, clean water, measles immunization, and an oral rehydration programme

Reports and comments : The historical development of public health responses to disasters

The first of a series of state of-the-artreviews commissioned to mark disasters'21st anniversary, this paper consuiders key publications on public health aspects of natural disasters, refugee emergencies and complex humanitarian disasters over the past Twenty-odd years. The literature is reviewed and important signposts higtlighted showing how the field has developed. This expanding body of epidemiological research has provided a basis for increasingly effective prevention and intervention strategies (AU)

Reports and comments : The historical development of public health responses to disasters

The first of a series of state-of-the-art reviews commissioned to mark disasters'21st anniversary, this papers considers key publications of public health aspects of natural disasters, refugee emergencies and complex humanitarian disasters over the past twenty - odd years. The literature is reviewed and important signposts highlighted showing how provided a basis for increasingly effective prevention and intervention strategies (AU)

Prevention of excess mortality in refugee and displaced populations in developing countries

More than 30 million refugees and internally displaced persons in developing countries are currently dependent on international relief assistance for their survival. Most of this assistance is provided by Western nations such as the United States. Mortality rates in these populations during the acute phase of displacement have been extremely high, up to 60 times the expectedrates. Displaced populations in northern Ethiopia (1985) and southern Sudan (1988) have suffered the highest crude mortality rates. Although mortality rates have risen in all age groups, excess mortality has been the greatest in 1-through 14-year-old children. The major causes of death have been measles, diarrheal diseases, acute respiratory tract infections, and malaria. Case-fatality ratios for these diseases have risen due to the prevalence of both protein-energy malnutrition and certain micronutrient deficiencies. Despite current technical knowledge and resources, several recent relief programs have failed to promptly implement essential public health programs such as provision of adequate food rations, clean water and sanitation, measles immunization, and control of communicable diseases. Basic structural changes in the way international agencies implement and coordinate assistance to displaced populations are urgently needed (AU)

Mortality rates in displaced and resident populations of central Somalia during 1992 famine

Famine and civil war have resulted in high mortality rates and large population displacements in Somalia. To assess mortality rates and risk factors for mortality, we carried out surveys in the central Somali towns of Afgoi and Baidoa in November and Decemmber, 1992. In Baidoa we surveyed displaced persons living in camps, the average daily crude mortality rate was 16.8 (95

CI 14.6-19.1) per 10.000 population during the 232 days before the survey. An estimated 74

of children under 5 years living in displaced persons camps died during this period. In Afgoi, where both displaced and resident populations were surveyed, the crude mortality rate was 4.7 (3.9-5.5) deaths per 10.000 per day. Although mortality rates for all displaced persons were high, people living in temporary camps were at highest risk of death. As in other famine-related disasters, preventable infectious diseases such as measles and diarrhoea were the primary causes of death in both towns. These mortality rates are among the highest documented for a civilian population over a long period. Community-based public health interventions to prevent and control common infectious diseses qre needed to reduce these exceptionally high mortality rates in Somalia(AU)