Casualties of war and disasters: the science of displaced people

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The WHO defines displaced people as ‘people who have had to leave their homes as a result of a natural, technological or deliberate event’. But whatever the reason, displaced people often have to live in cramped camps with low levels of hygiene and lack of medical care. They also have to make the difficult decision about whether to return home, become integrated into their new country, or move on.

One of the difficulties for aid agencies such as the IFRC and governments is knowing exactly how many people are involved so that they can be provided for. The UNHCR employs full-time statisticians to keep track of the number of refugees, which it publishes in the annual Global Trends report, and the Norwegian Refugee Council also releases annual global figures for internally displaced people. In 2011 the UNHCR estimated that there were more than 42 million displaced people worldwide -10.5 million of which were refugees with the UNHCR and a further 4.8 million in camps looked after by the UNRWA.

Section of Bairro Esturro. Image copyright DigtalGlobe

But a study published in the International Journal of Health Geographics may make the difficult business of counting people easier especially during the acute phase. Researchers from the London School of Hygiene and Tropical Medicine used high resolution satellite imagery alongside estimates of numbers of people per household provided by public reports, and in each of the 11 cases population counts were quickly calculated (in 2-5 days) and produced similar results to census, apart from where residences were very dense and difficult to distinguish. Given the speed of counting compared to census this method could be very useful in monitoring population sizes and how they change.

 

 

 

One of the major problems of people living in camps is disease. As a case study Médecins Sans Frontières, who have provided emergency aid to people affected by armed conflict, epidemics, natural disasters and to people without healthcare since 1971, looked into the effect of disease during 2011 in the Dadaab refugee camp complex, Kenya. This article in Conflict and Health found that during the five and a half month survey period there were 360 deaths amongst the 200,000 displaced Somalis, over half of which were children under the age of five. More than two-thirds of all deaths were associated with diarrhoea, breathing difficulties, or with fever, and 17% were due to a measles outbreak. Almost 3% of deaths were due to malnutrition.

This case study highlights the difficulties and failings of aid organisations and governments to help displaced people. Alarmingly the authors conclude that  the high death rates and malnutrition were due to ‘at least a partial failure of the various humanitarian and governmental actors to adequately safeguard the welfare of this population’ and that the ‘outbreak of measles and long delays before registration should not have occurred’.

Other research in BMC International Health and Human Rights shows that the population is also sexually vulnerable. Erosion of traditional communities within camps and a lack of information about reproduction and sexual health can leave adolescent girls at an increased risk of sexual predation, pregnancy, and sexually transmitted diseases including HIV.

Image copyright Gabriele Volpato, Pavlína Kourková and Václav Zelený

But it is not all bad news. Sahrawi refugees in South Western Algerian refugee camps maintained their making and use of traditional cosmetics, hair case, teeth cleaning,  sunscreen, perfumes, and remedies to heal skin problems. Reported in the Journal of Ethnobiology and Ethnomedicine, the Sahrawi people used 55 traditional plant species and 18 animal or mineral products in their remedies, going to extra lengths to procure them. These products play an important role in the wellbeing, and cultural and social identity of the Sahrawi’s, and the also research demonstrates that that refugees are not simply passive recipients of aid, but are able to maintain their traditional ethnobiological practices in exile.

 

 

Recent analysis by IRIN show that refugees are looking for self reliance not handouts. Organisations such as HIP provide links between innovation, technology and the private sector in order to build on the skills and aspirations of displaced people with training and resources. A good place to start might be within the cultural traditions these people bring with them.

By Dr Hilary Glover, Scientific Press Officer, BioMed Central