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close this bookHandbook for Emergencies - Second Edition (UNHCR, 1999, 414 p.)
View the document(introduction...)
View the documentUsing the Handbook
View the documentIntroduction
View the documentAbbreviations
View the documentUNHCR's Mission Statement
close this folder1. Aim and Principles of Response
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View the documentDefinition and Aim
View the documentResponsibilities
View the documentPrinciples of Response
close this folder2. Protection
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View the documentIntroduction
View the documentProtection in Emergencies
View the documentInitial Actions
View the documentPhysical Safety of Refugees
View the documentEmergencies as a Result of Changes in Government Policy
View the documentOther Persons of Concern to UNHCR
View the documentDurable Solutions
View the documentKey References
View the documentAnnexes
close this folder3. Emergency Management
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View the documentThe Key Emergency Management Functions
View the documentStages in Refugee Emergency Operations
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close this folder4. Contingency Planning
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View the documentPlanning as a Process
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close this folder5. Initial Assessment, Immediate Response
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close this folder6. Operations Planning
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View the documentAllocation of Responsibilities
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close this folder7. Coordination and Site Level Organization
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View the documentOrganization at the Site Level
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close this folder8. Implementing Arrangements
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View the documentImplementing Arrangements
View the documentImplementing Procedures
View the documentMonitoring, Reporting and Evaluation
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close this folder9. External Relations
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View the documentRelations with Government and Diplomatic Corps
View the documentRelations with the Media
View the documentFunding and Donor Relations
View the documentFormal Written Communications
View the documentAnnexes
close this folder10. Community Services and Education
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View the documentOrganizing Community Services
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View the documentFamily Tracing and Reunification
View the documentGroups at Risk and Vulnerable Groups
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close this folder11. Population Estimation and Registration
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close this folder12. Site Selection, Planning and Shelter
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View the documentCriteria for Site Selection
View the documentSite Planning: General Considerations
View the documentSite Planning: Specific Infrastructure
View the documentShelter
View the documentReception and Transit Camps
View the documentPublic Buildings and Communal Facilities
close this folder13. Commodity Distribution
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View the documentChoosing a Commodity Distribution System
View the documentComponents of Distribution Systems
View the documentThe Role of Refugee Women
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close this folder14. Health
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View the documentHealth Assessment, Planning, Monitoring and Surveillance
View the documentMain Health Programmes
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View the documentHuman Resources and Coordination
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close this folder15. Food and Nutrition
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View the documentOrganization of Food Support
View the documentNutritional Assessments
View the documentGeneral Feeding Programme
View the documentSelective Feeding Programmes
View the documentInfant Feeding and use of Milk Products
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close this folder16. Water
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View the documentThe Need
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close this folder17. Environmental Sanitation
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close this folder18. Supplies and Transport
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close this folder19. Voluntary Repatriation
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View the documentOn Route
View the documentOn Arrival in Country of Origin
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close this folder20. Administration, Staffing and Finance
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close this folder21. Communications
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close this folder22. Coping with Stress
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close this folder23. Staff Safety
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View the documentThe UN Security System
View the documentEssential Plans
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close this folder24. Working with the Military
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View the documentCategories of Military Forces
View the documentPossible Roles of Military Forces in Humanitarian Operations
View the documentCoordination Between Military Forces and Civilian Agencies
View the documentKey References
View the documentAppendix 1 - Catalogue of Emergency Response Resources
View the documentAppendix 2 - Toolbox
View the documentAppendix 3 - Memoranda
View the documentAppendix 4 - Glossary

Overview

Situation

It is well known from experience that emergencies result in excess loss of life (high mortality) and increased incidence of diseases (high morbidity). The diseases mainly responsible for high mortality and morbidity are measles, diarrhoeal diseases (including cholera), acute respiratory infections (pneumonia), malnutrition and malaria. The factors which increase the risk of disease and which should be addressed in any emergency response include an unfamiliar environment, poverty, insecurity, overcrowding, inadequate quantities and quality of water, poor environmental sanitation, inadequate shelter and inadequate food supply.

Objectives

· To promote the enjoyment of the highest attainable standards of physical and mental health1, and to prevent excess mortality and morbidity.

Principles of Response

· Priority should be given to a Primary Health Care (PHC) strategy focusing on the vital sectors of water, food, sanitation, shelter and physical planning. In addition, preventive and basic curative health services should be provided. The health of the majority of the refugees is more likely to be affected by these measures than by individual care;

· Refugee participation in the development and provision of health services is essential;

· Services provided for refugees should be at a level equivalent to that appropriate to host country nationals - i.e. there must be parity;

· The health programme should also be sustainable. It is sometimes better not to start activities which cannot be maintained, than to cease supporting activities which both implementing partners and beneficiaries have come to take for granted;

· The health services must be of a quality that ensures that programmes, providers and institutions respect patients' rights and comply with nationally and internationally accepted health standards and principles of medical ethics;

· Many countries will not have sufficient human and material resources to respond adequately to the extraordinary needs generated by an emergency. Experienced national and international NGOs should be mobilized to initiate urgent life saving measures. Rapid integration with the Ministry of Health (MOH) is essential;

· Health services should take into account the particular vulnerability of children under five years during emergencies. Priority should be given to immunizations, feeding programmes, oral rehydration therapy, Vitamin A prophylaxis, basic curative care and family health;

· Health services should also take into account the special needs of women who play a central role as primary health care providers and at the same time bear a disproportionate share of suffering and hardship;

· A UNHCR Health Coordinator should be appointed with responsibility for the health programme and for ensuring that nationally and internationally accepted standards and best practice are adhered to, in close coordination with the national health authorities and other organizations.

Action

· Assess the health and nutritional status of the population and identify the critical health risk factors in the environmental conditions;

· Establish priority needs, define the required activities to meet those needs and determine the required human, material and financial resources to perform these activities;

· In accordance with these activities, set up community-based health services and devise the appropriate organizational and coordination mechanisms both with the health partners and the other relevant sectors of assistance;

· Promote basic health education for the refugees and train refugee health workers;

· Monitor and evaluate the effectiveness of the services and adjust as necessary;

· Ensure that decisions about the health services are based on proper assessment and surveillance;

· Communicate information about the emergency situation and the health services for advocacy purposes.

1 International Covenant on Economic, Social and Cultural rights", 1996, Article 12.