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close this bookMedical Assistance to Self-settled Refugees (Tropical Institute Antwerp, 1998)
View the document(introduction...)
View the documentPreface
View the documentIntroduction
close this folder1. Guinea, Liberia & Sierra Leone
View the documentThree poor countries
View the documentDifferent histories, different economies
View the documentA patchwork of ethnic groups
View the documentThe Forest Region of Guinea
View the documentThe influx of refugees between 1990 and 1995
close this folder2. The health system in Guinea, 1988-96
View the document(introduction...)
View the documentThe Bamako Initiative at the health centres
View the documentHospitals: rationalisation, cost recovery... but low utilisation
View the documentThe administrative structure of the health system
View the documentHuman resources in the health sector
View the documentCost and funding of the health system
View the documentThe Guinean health care system and PARLS
close this folder3. The refugee-crisis: between self-reliance and pragmatic assistance
close this folderWave 1: rural refugees from Nimba county, January-March, 1990
View the document(introduction...)
View the documentThe Initial Assistance
View the documentMore Refugees
close this folderWave 2: urban refugees or returnees? May-June, 1990
View the document(introduction...)
View the documentThe same assistance .....
View the document... But not for everybody
View the documentWave 3: rural refugees from Loffa county, June-August, 1990
close this folderWave 4: refugees from Sierra Leone, March-April, 1991
View the document(introduction...)
View the documentMore active interventions
View the documentA period of relative tranquillity: the refugees remain and PARLS is consolidated
close this folderLate arrivals: the subsequent minor waves, 1992-95
View the documentCross-border movements in both directions
View the documentEarly versus late arrivals
View the documentNew agencies and changes in PARLS
close this folderSettlement patterns of refugees
View the documentThe number and distribution of refugees*
View the document'Integration' of urban refugees
View the documentRural refugees: between 'integration' and 'segregation'
View the document'Refugees live in camps'
close this folder4. Food aid
View the document(introduction...)
View the documentA rational basis for deciding on food aid?
View the documentRefugee registration
close this folderAssessing the nutritional situation
View the document(introduction...)
View the documentMonitoring of market prices
View the documentPMC monitoring
View the documentAnthropometric surveys
View the documentThe limitations of anthropometric surveys
close this folderDelivering food aid
View the documentA major issue right from the start
View the documentOn counting calories (1991-95)*
View the document1996: Better supply and less fraud
close this folderOf evidence and pressure
View the documentExpert opinion versus anthropometry
View the documentDecision making in food aid
close this folder5. Control of epidemics
View the document(introduction...)
View the documentEpidemics: bio-demographic burden & psychological impact
View the documentControl of epidemics
close this folderEpidemics and forced migration
View the document(introduction...)
View the documentWhy does forced migration result in excess mortality?
View the documentReducing excess mortality in forced migration
close this folderEpidemics in the Forest Region
View the document(introduction...)
View the documentBio-demographic burden of epidemics in the Forest Region
View the documentMeasuring control of epidemics
View the documentControl of cholera, measles, meningococcal meningitis & beriberi
View the documentControl measures in the forest region
close this folderCosts and effects of controlling epidemics in the Forest Region
View the document(introduction...)
View the documentCholera
View the documentMeasles
View the documentMeningococcal meningitis
View the document'Routine' vs. 'Intervention'
close this folderEpidemics in context
View the documentDeaths in 'natural' situation vs. 'Routine' & 'Intervention'
View the documentCost of 'Interventions' vs. Cost of the health system
View the documentIs cost per death averted an adequate measure?
View the documentManaging epidemics: balancing response to burden and fear
close this folder6. Health services for refugees: between primary health care & emergency medical assistance
View the document(introduction...)
close this folderHealth services organisation in development & emergency*
View the document(introduction...)
View the documentDevelopment, disaster & emergency
View the documentParadigms of PHC & EMA
View the documentCharacteristics of PHC and EMA health services
View the documentStrategic aspects
View the documentBetween development and emergency
View the documentHealth services for refugees in Guinea
close this folderManagement: MOH & its field partners
View the document(introduction...)
View the documentEffective decentralisation or foreign substitution?
View the documentN'Zérékoré, Yomou & Lola
View the documentMacenta & Guéckédou
close this folderHealth services supplied
View the document(introduction...)
View the documentFirst line health services (FLHS)
View the documentReferral health services
View the documentAncillary services
close this folderResources used
View the document(introduction...)
View the documentHuman resources
View the documentSupplies
View the documentUser fees vs. Free access
View the documentTotal cost
close this folderHealth care provided
View the document(introduction...)
View the documentFirst Line Health Services
View the documentReferral services
View the documentThe host population benefited from PARLS
View the documentWhy health care utilisation by the refugees remained low
View the documentWas PARLS the best solution possible?
close this folder7. Towards a more balanced refugee policy
View the document(introduction...)
close this folderFrom saving lives to promoting health
View the documentThe bio-medical approach to refugee health
View the documentRefugees as a product of a disrupted society
View the documentThe determinants of health status & coping ability
View the documentA theory of human need: health & autonomy
View the documentBecoming a refugee as a way of coping
View the documentThe central role of settlement patterns
close this folderRefugee policy as a balance between self-reliance & assistance
View the documentAssistance in lieu of self-reliance
View the documentAssistance in support of self-reliance
close this folderReferences
View the documentPreface & introduction
View the documentChapter 1
View the documentChapter 2
View the documentChapter 3
View the documentChapter 4
View the documentChapter 5
View the documentChapter 6
View the documentChapter 7
View the documentAbbreviations & Acronyms

The number and distribution of refugees*

[* All population data should be treated with caution, as they are quite unreliable.]

UNHCR made a distinction between refugees registered in 1990-93 and those registered in 1994-95, the former being identified as the 'old' refugees, the latter as the 'new' refugees. This distinction did not coincide entirely with the distinction between early arrivals (1990-91) and late arrivals (1992-95). Old and new refugees were entitled to different quantities of food, the assumption being that the old refugees were self-sufficient by 1996, but that new refugees were not. This distinction was maintained despite studies showing that food insecurity was not linked to time of arrival but to area of residence.18

Figure 14: The concentration of refugees, Forest Region, mid-1995


Guinean population

Refugee population

Ratio refugees/Guineans

























Total Region




The concentration of refugees was different from one prefecture to another (Figure 14). In Guu in mid-1995, there were more refugees than Guineans. The concentrations were also very high in Yomou and Macenta. Within the prefectures refugee concentrations also varied. This variation is shown for Guu prefecture.

The Mano, KpellLoma and Kissi refugees lived mainly in the rural areas among their kinsmen. The Mandingo lived mostly in the cities. The Mende and Gbande who had no kinsmen in Guinea settled in the south-west of Guu where refugee concentrations were highest (Figure 14). The place where refugees settled was determined mainly by ethnic origin and established cross-border contacts, and by their rural or urban origin.