![]() | 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 |
Contrary to the diverse realities described above, staff of aid agencies and government bodies tended to speak of 'the refugees' without making any distinction. The name given to a refugee settlement, was invariably the name of a Guinean village with the suffix 'camp'. For example, Noonah is a small Guinean village, and the refugee camp was called Noonah camp. But also in Badou, where one hundred refugees lived in huts on one side of the village, the refugee quarter was called Badou camp. All refugee settlements, paired villages, new villages or real camps were invariably referred to as 'camps'. To some extent this was a way to distinguish the host population from the refugees, but the visibility of the relatively small proportion of refugees living in camps strongly shaped the image aid workers and government officials had of all the refugees. 'Putting all refugees in the same bag' obscured the fact that the coping mechanisms of the refugees and the degree of self-sufficiency achieved differed strongly between refugee communities.
The medical part of PARLS in Guinea concentrated on giving refugees access to health services and control of epidemics in the refugee-affected areas. Also food aid was a major aspect of PARLS, although only the assessment of the nutritional situation was carried out by the medical actors. The following chapters cover medical assistance for refugees. They describe in more detail food aid (Chapter 4), control of epidemics (Chapter 5) and health services for refugees (Chapter 6). Other aspects of PARLS, such as provision of shelter and drinking water, organisation of basic education, and assistance for income-generating activities, will not be covered.