Handbook for Emergencies - Second Edition (UNHCR, 1999, 414 p.): 14. Health: Introduction

Handbook for Emergencies - Second Edition (UNHCR, 1999, 414 p.)

(introduction...)

Using the Handbook

Introduction

Abbreviations

UNHCR's Mission Statement

1. Aim and Principles of Response

(introduction...)

Definition and Aim

Responsibilities

Principles of Response

2. Protection

(introduction...)

Introduction

Protection in Emergencies

Initial Actions

Physical Safety of Refugees

Emergencies as a Result of Changes in Government Policy

Other Persons of Concern to UNHCR

Durable Solutions

Key References

Annexes

3. Emergency Management

(introduction...)

Introduction

The Key Emergency Management Functions

Stages in Refugee Emergency Operations

Key References

4. Contingency Planning

(introduction...)

Introduction

Planning as a Process

Contingency Planning Tasks

Characteristics of a Good Plan

Key References

Annexes

5. Initial Assessment, Immediate Response

(introduction...)

Introduction

Organizing the Assessment

Immediate Response

Protection and Material Assistance

Key References

Annexes

6. Operations Planning

(introduction...)

Introduction

Operations Planning Tasks

Allocation of Responsibilities

Annexes

7. Coordination and Site Level Organization

(introduction...)

Coordination

Organization at the Site Level

Key References

Annexes

8. Implementing Arrangements

(introduction...)

Introduction

Implementing Arrangements

Implementing Procedures

Monitoring, Reporting and Evaluation

Special Considerations

Key References

Annexes

9. External Relations

(introduction...)

Relations with Government and Diplomatic Corps

Relations with the Media

Funding and Donor Relations

Formal Written Communications

Annexes

10. Community Services and Education

(introduction...)

Overview

Introduction

Organizing Community Services

Human Resources

Family Tracing and Reunification

Groups at Risk and Vulnerable Groups

Education

Key References

Annexes

11. Population Estimation and Registration

(introduction...)

Overview

Introduction

Population Estimates

Registration

Key References

Annexes

12. Site Selection, Planning and Shelter

(introduction...)

Overview

Introduction

Organization of Response

Criteria for Site Selection

Site Planning: General Considerations

Site Planning: Specific Infrastructure

Shelter

Reception and Transit Camps

Public Buildings and Communal Facilities

13. Commodity Distribution

(introduction...)

Overview

When to start distribution

Choosing a Commodity Distribution System

Components of Distribution Systems

The Role of Refugee Women

Monitoring

Key References

14. Health

(introduction...)

Overview

Introduction

Health Assessment, Planning, Monitoring and Surveillance

Main Health Programmes

Organization of Refugee Health Care

Human Resources and Coordination

Key References

Annexes

15. Food and Nutrition

(introduction...)

Overview

Introduction

Organization of Food Support

Nutritional Assessments

General Feeding Programme

Selective Feeding Programmes

Infant Feeding and use of Milk Products

Key References

Annexes

16. Water

(introduction...)

Overview

Introduction

Assessment and Organization

The Need

Immediate Response

Water Supply Systems

Water Sources

Pumping Equipment

Treatment

Storage

Distribution

Key References

17. Environmental Sanitation

(introduction...)

Overview

Introduction

Basic Principles And Standards

Human Resources And Organization

Human Excretia Disposal

Solid Wastes

Wastewater

Pest and Vector Control

General Hygiene

Disposal Of The Dead

Key References

Annexes

18. Supplies and Transport

(introduction...)

Overview

Introduction

Organization of the Supply Chain

Supplies

Transport

Reception of Goods

Storage

Stock Management

Key References

Annexes

19. Voluntary Repatriation

(introduction...)

Overview

Introduction

UNHCR's Role in Voluntary Repatriation

Conditions For a Voluntary Repatriation

On Route

On Arrival in Country of Origin

Key References

Annexes

20. Administration, Staffing and Finance

(introduction...)

Introduction

Emergency Staffing

Budget and Finance

Non-Expendable Property and Office Supplies

Office Premises

Official Transport

Office Organization

Key References

Annexes

21. Communications

(introduction...)

Introduction

Communications Management

Telecommunications

UNHCR Telecommunications Network Field Preparations

Key References

Annexes

22. Coping with Stress

(introduction...)

Introduction

Identifying Stress Symptoms

Techniques for dealing with Stress

Key References

23. Staff Safety

(introduction...)

Introduction

The UN Security System

Essential Plans

Security

Security Management

Key References

24. Working with the Military

(introduction...)

Introduction

Categories of Military Forces

Possible Roles of Military Forces in Humanitarian Operations

Coordination Between Military Forces and Civilian Agencies

Key References

Appendix 1 - Catalogue of Emergency Response Resources

Appendix 2 - Toolbox

Appendix 3 - Memoranda

Appendix 4 - Glossary

Introduction

1. Good health, depending as it does on so many non-medical factors, is too big a subject to be left only to medical workers. This chapter is directed at non-specialist staff in the field. It does not pretend to give "medical answers" to health problems. It does however seek to show that proper assessment of problems, needs and resources, appropriate organization and coordination of public health and medical services based on a Primary Health Care (PHC) strategy are more important to the overall health status of refugees than curative medicine alone, see figure 1. These crucial organizational factors are often the responsibility of non-medical UNHCR staff.

2. In an emergency, many refugees will be exposed to insecurity, poor shelter, overcrowding, lack of sufficient safe water, inadequate sanitation, inadequate or inappropriate food supplies and a possible lack of immunity to the diseases of the new environment. Furthermore, on arrival, refugees may already be in a debilitated state from disease, malnutrition, hunger, fatigue, harassment, physical violence and grief. Poverty, powerlessness and social instability, conditions that often prevail for refugees, can also contribute to increased sexual violence and spread of sexually transmitted diseases including the Human Immuno-deficiency Virus (HIV).

3. The World Health Organization (WHO) has summarized the concept of Primary Health Care as follows: "PHC is essential health care made accessible to everyone in the country; it is given in a way acceptable to individuals, families, and the community, since it requires their full participation; health care provided at a cost the community and the country can afford. Though no single model is applicable everywhere, Primary Health Care should include the following: promotion of proper nutrition, an adequate supply of safe water, basic sanitation, reproductive and child care, including family planning, appropriate treatment for common diseases and injuries, immunization against major infectious diseases, prevention and control of locally endemic diseases, education about common health problems and what can be done to prevent and control them".

At the heart of such a strategy there is an emphasis on preventive, as against curative care alone.

Figure