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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 documentIntroduction
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
View the documentContingency Planning Tasks
View the documentCharacteristics of a Good Plan
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close this folder5. Initial Assessment, Immediate Response
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View the documentOrganizing the Assessment
View the documentImmediate Response
View the documentProtection and Material Assistance
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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 documentCoordination
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
View the documentSpecial Considerations
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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
View the documentHuman Resources
View the documentFamily Tracing and Reunification
View the documentGroups at Risk and Vulnerable Groups
View the documentEducation
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close this folder11. Population Estimation and Registration
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View the documentPopulation Estimates
View the documentRegistration
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close this folder12. Site Selection, Planning and Shelter
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View the documentOrganization of Response
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 documentWhen to start distribution
View the documentChoosing a Commodity Distribution System
View the documentComponents of Distribution Systems
View the documentThe Role of Refugee Women
View the documentMonitoring
View the documentKey References
close this folder14. Health
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View the documentHealth Assessment, Planning, Monitoring and Surveillance
View the documentMain Health Programmes
View the documentOrganization of Refugee Health Care
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
View the documentKey References
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close this folder16. Water
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View the documentAssessment and Organization
View the documentThe Need
View the documentImmediate Response
View the documentWater Supply Systems
View the documentWater Sources
View the documentPumping Equipment
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View the documentDistribution
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close this folder17. Environmental Sanitation
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View the documentBasic Principles And Standards
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View the documentHuman Excretia Disposal
View the documentSolid Wastes
View the documentWastewater
View the documentPest and Vector Control
View the documentGeneral Hygiene
View the documentDisposal Of The Dead
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close this folder18. Supplies and Transport
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View the documentOrganization of the Supply Chain
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close this folder19. Voluntary Repatriation
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View the documentUNHCR's Role in Voluntary Repatriation
View the documentConditions For a Voluntary Repatriation
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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View the documentEmergency Staffing
View the documentBudget and Finance
View the documentNon-Expendable Property and Office Supplies
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close this folder21. Communications
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View the documentCommunications Management
View the documentTelecommunications
View the documentUNHCR Telecommunications Network Field Preparations
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close this folder22. Coping with Stress
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View the documentIntroduction
View the documentIdentifying Stress Symptoms
View the documentTechniques for dealing 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 documentIntroduction
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

Techniques for dealing with Stress

Preventing and Minimizing Harmful Stress

16.

It is important to recognize that it is impossible to take care of others if you do not take care of yourself.

17. Being well prepared, both physically and psychologically, is an important way to reduce the chances of harmful stress. This preparation not only includes understanding stress and how to handle it, but also educating oneself in advance on the living conditions, job, likely problems, local language and culture. It is important to be both physically and psychologically fit to work in a particular situation.

18. To prevent stress overload during an emergency, firstly, know your limitations. In addition, there are several practical steps to take:

i. Get enough sleep;

ii. Eat regularly;

iii. Control intake of alcohol, tobacco and medicines;

iv. Take time for rest and relaxation;

v. Take physical exercise. Physical exercise releases tension and helps maintain stamina and good health (any sort of exercise for at least 20 minutes per day). Beneficial exercise for stress reduction also includes deep breathing and muscle relaxation exercises;

vi. Give expression to the stress: Put words to the emotions you feel - find a colleague whom you trust to talk with;

vii. Keep a diary, it may not be as effective as talking, but it can help.

The expression of emotion has proved to be an effective technique in reducing stress.

19. Other ways of reducing stress are:

i. Inward coping: When a person performs difficult work in physically and emotionally threatening conditions, internal dialogue can add to the stress if it is highly negative and self-critical. To remain focused on the task, avoid unhelpful internal dialogue such as, "I'm no good at this. Everything I am doing is making things worse". Instead make positive helpful statements to talk oneself through difficult moments. For example, "I don't feel like dealing with this angry person right now, but I have done it before, so I can do it again";

ii. Peer support: Use the "buddy system": staff members may agree in advance to monitor each other's reactions to identify signs of excessive stress and fatigue levels;

iii. Setting an example: Supervisors in particular have an important role to play as they can provide an example in the way they handle their own personal stress, e.g. by eating properly, resting and taking appropriate time off duty. The team leader who tells a colleague, "Remind me to eat, and get me out of here the moment you notice any sign of fatigue. I'm no good when I'm tired", is setting a positive example for the staff;

iv. Permission to go off duty: In a crisis many staff members need to be given permission to take care of themselves. People do better in difficult situations when they feel that other people care about them. Team leaders are responsible for giving such specific permission to themselves and to their staff, for example, by giving permission to take the afternoon off, etc. The correct use by staff members of Mars and Vari can serve to alleviate stress.

Dealing with Critical Incidents (Traumatic Stress)

20. Stress defusings and debriefings are ways of protecting the health of staff after crises. The person or people who experienced the critical incident talk about the incident, focusing on the facts and their reactions to it. They should take place in a neutral environment, and never at the scene of the incident. They should be led by a trained professional. The information given below is intended to illustrate these processes and does not give sufficient detail to enable an unqualified person to perform either a debriefing or a defusing.

Defusing

21. Defusing is a process which allows those involved in a critical incident to describe what happened and to talk about their reactions directly after the event. A defusing should take place within a few hours of the event, its format is shorter than that of a debriefing. It consists of three steps:

i. Introduction

Introduction of everyone present, a description of the purpose of the defusing, and stimulation of motivation and participation;

ii. Exploration

Discussion of what happened during the incident;

iii. Information

Advice to the participants about potential reactions to the incident, guidance on stress management, practical information, questions and answers.

Confidentiality is important. It should be possible to express strong emotions, secure in the knowledge that this will stay within the group.

22. Angry feelings can be a normal reaction to an upsetting event and staff should be able to "let off steam". This is not the time for criticism of professional performance - this should be dealt with at a separate meeting.

Critical Incident Stress Debriefing (CISD)

23. In cases where staff have to deal with intense distress, defusings may be insufficient and need to be followed by a formal debriefing from a mental health professional. Debriefing is a process designed to lessen the impact of a critical incident. It occurs in an organized group meeting and is intended to allow those involved in a critical incident to discuss their thoughts and reactions in a safe, non-threatening environment. The team leader or a responsible member of the emergency team should request the Division of Resource Management at Headquarters to provide or help identify a mental health professional to conduct a debriefing. Sessions are normally held for groups of staff having undergone intense stress. They aim to integrate the experience, provide information on traumatic stress reactions, and prevent long-term consequences including Post Traumatic Stress Disorder, and help staff manage their own personal reactions to the incident.

24. If a debriefing or defusing is not offered spontaneously after a trauma is suffered, request one. Information on individual consultations for UNHCR staff members and workshops on stress related issues can be obtained from the Staff Welfare Unit, HQ Geneva.

Telephone: 00 41 22 7397858

Confidential Fax: 00 41 22 7397370