![]() | Medical Assistance to Self-settled Refugees (Tropical Institute Antwerp, 1998) |
![]() | ![]() | (introduction...) |
![]() | ![]() | Preface |
![]() | ![]() | Introduction |
![]() | ![]() | 1. Guinea, Liberia & Sierra Leone |
![]() | ![]() | Three poor countries |
![]() | ![]() | Different histories, different economies |
![]() | ![]() | A patchwork of ethnic groups |
![]() | ![]() | The Forest Region of Guinea |
![]() | ![]() | The influx of refugees between 1990 and 1995 |
![]() | ![]() | 2. The health system in Guinea, 1988-96 |
![]() | ![]() | (introduction...) |
![]() | ![]() | The Bamako Initiative at the health centres |
![]() | ![]() | Hospitals: rationalisation, cost recovery... but low utilisation |
![]() | ![]() | The administrative structure of the health system |
![]() | ![]() | Human resources in the health sector |
![]() | ![]() | Cost and funding of the health system |
![]() | ![]() | The Guinean health care system and PARLS |
![]() | ![]() | 3. The refugee-crisis: between self-reliance and pragmatic assistance |
![]() | ![]() | Wave 1: rural refugees from Nimba county, January-March, 1990 |
![]() | ![]() | (introduction...) |
![]() | ![]() | The Initial Assistance |
![]() | ![]() | More Refugees |
![]() | ![]() | Wave 2: urban refugees or returnees? May-June, 1990 |
![]() | ![]() | (introduction...) |
![]() | ![]() | The same assistance ..... |
![]() | ![]() | ... But not for everybody |
![]() | ![]() | Wave 3: rural refugees from Loffa county, June-August, 1990 |
![]() | ![]() | Wave 4: refugees from Sierra Leone, March-April, 1991 |
![]() | ![]() | (introduction...) |
![]() | ![]() | More active interventions |
![]() | ![]() | A period of relative tranquillity: the refugees remain and PARLS is consolidated |
![]() | ![]() | Late arrivals: the subsequent minor waves, 1992-95 |
![]() | ![]() | Cross-border movements in both directions |
![]() | ![]() | Early versus late arrivals |
![]() | ![]() | New agencies and changes in PARLS |
![]() | ![]() | Settlement patterns of refugees |
![]() | ![]() | The number and distribution of refugees* |
![]() | ![]() | 'Integration' of urban refugees |
![]() | ![]() | Rural refugees: between 'integration' and 'segregation' |
![]() | ![]() | 'Refugees live in camps' |
![]() | ![]() | 4. Food aid |
![]() | ![]() | (introduction...) |
![]() | ![]() | A rational basis for deciding on food aid? |
![]() | ![]() | Refugee registration |
![]() | ![]() | Assessing the nutritional situation |
![]() | ![]() | (introduction...) |
![]() | ![]() | Monitoring of market prices |
![]() | ![]() | PMC monitoring |
![]() | ![]() | Anthropometric surveys |
![]() | ![]() | The limitations of anthropometric surveys |
![]() | ![]() | Delivering food aid |
![]() | ![]() | A major issue right from the start |
![]() | ![]() | On counting calories (1991-95)* |
![]() | ![]() | 1996: Better supply and less fraud |
![]() | ![]() | Of evidence and pressure |
![]() | ![]() | Expert opinion versus anthropometry |
![]() | ![]() | Decision making in food aid |
![]() | ![]() | 5. Control of epidemics |
![]() | ![]() | (introduction...) |
![]() | ![]() | Epidemics: bio-demographic burden & psychological impact |
![]() | ![]() | Control of epidemics |
![]() | ![]() | Epidemics and forced migration |
![]() | ![]() | (introduction...) |
![]() | ![]() | Why does forced migration result in excess mortality? |
![]() | ![]() | Reducing excess mortality in forced migration |
![]() | ![]() | Epidemics in the Forest Region |
![]() | ![]() | (introduction...) |
![]() | ![]() | Bio-demographic burden of epidemics in the Forest Region |
![]() | ![]() | Measuring control of epidemics |
![]() | ![]() | Control of cholera, measles, meningococcal meningitis & beriberi |
![]() | ![]() | Control measures in the forest region |
![]() | ![]() | Costs and effects of controlling epidemics in the Forest Region |
![]() | ![]() | (introduction...) |
![]() | ![]() | Cholera |
![]() | ![]() | Measles |
![]() | ![]() | Meningococcal meningitis |
![]() | ![]() | 'Routine' vs. 'Intervention' |
![]() | ![]() | Epidemics in context |
![]() | ![]() | Deaths in 'natural' situation vs. 'Routine' & 'Intervention' |
![]() | ![]() | Cost of 'Interventions' vs. Cost of the health system |
![]() | ![]() | Is cost per death averted an adequate measure? |
![]() | ![]() | Managing epidemics: balancing response to burden and fear |
![]() | ![]() | 6. Health services for refugees: between primary health care & emergency medical assistance |
![]() | ![]() | (introduction...) |
![]() | ![]() | Health services organisation in development & emergency* |
![]() | ![]() | (introduction...) |
![]() | ![]() | Development, disaster & emergency |
![]() | ![]() | Paradigms of PHC & EMA |
![]() | ![]() | Characteristics of PHC and EMA health services |
![]() | ![]() | Strategic aspects |
![]() | ![]() | Between development and emergency |
![]() | ![]() | Health services for refugees in Guinea |
![]() | ![]() | Management: MOH & its field partners |
![]() | ![]() | (introduction...) |
![]() | ![]() | Effective decentralisation or foreign substitution? |
![]() | ![]() | N'Zérékoré, Yomou & Lola |
![]() | ![]() | Macenta & Guéckédou |
![]() | ![]() | Health services supplied |
![]() | ![]() | (introduction...) |
![]() | ![]() | First line health services (FLHS) |
![]() | ![]() | Referral health services |
![]() | ![]() | Ancillary services |
![]() | ![]() | Resources used |
![]() | ![]() | (introduction...) |
![]() | ![]() | Human resources |
![]() | ![]() | Supplies |
![]() | ![]() | User fees vs. Free access |
![]() | ![]() | Total cost |
![]() | ![]() | Health care provided |
![]() | ![]() | (introduction...) |
![]() | ![]() | First Line Health Services |
![]() | ![]() | Referral services |
![]() | ![]() | The host population benefited from PARLS |
![]() | ![]() | Why health care utilisation by the refugees remained low |
![]() | ![]() | Was PARLS the best solution possible? |
![]() | ![]() | 7. Towards a more balanced refugee policy |
![]() | ![]() | (introduction...) |
![]() | ![]() | From saving lives to promoting health |
![]() | ![]() | The bio-medical approach to refugee health |
![]() | ![]() | Refugees as a product of a disrupted society |
![]() | ![]() | The determinants of health status & coping ability |
![]() | ![]() | A theory of human need: health & autonomy |
![]() | ![]() | Becoming a refugee as a way of coping |
![]() | ![]() | The central role of settlement patterns |
![]() | ![]() | Refugee policy as a balance between self-reliance & assistance |
![]() | ![]() | Assistance in lieu of self-reliance |
![]() | ![]() | Assistance in support of self-reliance |
![]() | ![]() | References |
![]() | ![]() | Preface & introduction |
![]() | ![]() | Chapter 1 |
![]() | ![]() | Chapter 2 |
![]() | ![]() | Chapter 3 |
![]() | ![]() | Chapter 4 |
![]() | ![]() | Chapter 5 |
![]() | ![]() | Chapter 6 |
![]() | ![]() | Chapter 7 |
![]() | ![]() | Abbreviations & Acronyms |
[* 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
Prefecture |
Guinean population |
Refugee population |
Ratio refugees/Guineans |
Guu |
206,326 |
251,438 |
1.22 |
Yomou |
103,211 |
86,712 |
0.84 |
Macenta |
237,075 |
121,333 |
0.51 |
N'ZkorR> |
301,568 |
66,232 |
0.22 |
Lola |
153,239 |
26,595 |
0.17 |
Beyla |
196,667 |
26,536 |
0.13 |
Total Region |
1,198,086 |
578,846 |
0.48 |
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.