Ending Neglect of Older People in the Response to Humanitarian Emergencies

Karunakara, Unni; Stevenson, Frances

doi:10.1371/journal.pmed.1001357

Cited by 24 publications

(25 citation statements)

References 8 publications

(5 reference statements)

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“…Older participants had poor health and these results are supported by other studies on IDPs [22]. Longer duration in the IDP camp was also associated with poor health [11,17].…”

Section: Discussionsupporting

confidence: 83%

Predictors of social support, physical health and mental health among food insecure internally displaced persons in Turkana, Kenya

Gichunge

Mutiso²,

Brynjarsdóttir

2020

Confl Health

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Background: Food insecurity and the mental and physical health of internally displaced persons (IDPs) is a public health concern. The aim of this study was to determine the predictors of social support, physical and mental health among food insecure IDPs in Nakwamekwei IDP camp in Turkana, Kenya. Methods: A cross sectional study was conducted among 159 household heads living in the camp. Analysis was conducted using statistical summaries, logistic regression and linear regression. Results: Ninety four percent (94%) of the households were severely food insecure and the rest of the households had moderate food insecurity. Majority of the household heads (77%) had symptoms of depression and those with five or more children were 3 times (95%CI, 1.31-9.24; p = 0.015) more likely to be have symptoms of depression, while those who were married were less likely to have the same (95%CI, 0.14-0.92; p = 0.038). Seventy six percent (76%) of the household heads had anxiety symptoms; none of the predictor variables were significantly associated with anxiety symptoms in the adjusted analysis. Those who had spent many years in the camp, were older, and had more children had significantly poorer physical health (p = 0.042, p = 0.001, and p = 0.047, respectively). Those who were married and those who had experienced violence in the current camp had significantly higher social support (p = 0.001 and p = 0.006, respectively). Conclusions: Participants have been living in camp for the last 10 years hence the need to improve their living conditions, address their physical and mental health as well as food insecurity. This can be done by providing the participants with safe drinking water, constructing pit latrines to prevent communicable disease and adhere to the Sphere recommendations for sanitation and hygiene as well as training them in income generating activities to mitigate the high unemployment and food insecurity rates. The IDPs should be integrated into the local community to bring an end to their protracted displacement.

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“…Older participants had poor health and these results are supported by other studies on IDPs [22]. Longer duration in the IDP camp was also associated with poor health [11,17].…”

Section: Discussionsupporting

confidence: 83%

Predictors of social support, physical health and mental health among food insecure internally displaced persons in Turkana, Kenya

Gichunge

Mutiso²,

Brynjarsdóttir

2020

Confl Health

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“…In 2006, 11% of the world's population consisted of people over the age of 60 years (Inter-Agency Standing Committee, 2008;United Nations, 2015). By 2050, this is expected to increase to 22% with a simultaneous rise in the proportion of older people living in developing countries (60% to 80%), and the fastest growing subset is the over-80 age group (Inter-Agency Standing Committee, 2008;Karunakara and Stevenson, 2012). The proportion of older people affected by forced migration only stands to increase due to the rising number of violent conflict situations, especially in the Middle East, Africa, and Asia (Inter-Agency Standing Committee, 2008;Karunakara and Stevenson, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…A wide range of additional age-specific factors may compound the mental health impact of forced migration among older people (Burton and Breen, 2002;Karunakara and Stevenson, 2012;Loi and Sundram, 2014). Psychological distress induced by forced migration may occur on a background of existing age-related neurological and mental disorders such as dementia, depression, un-recognized alcohol abuse, and general reduction in mental capacity (Inter-Agency Standing Committee, 2008;HelpAge International, 2012;World Health Organization, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Psychological distress induced by forced migration may occur on a background of existing age-related neurological and mental disorders such as dementia, depression, un-recognized alcohol abuse, and general reduction in mental capacity (Inter-Agency Standing Committee, 2008;HelpAge International, 2012;World Health Organization, 2015). Chronic physical illnesses, disability, reduced mobility, and nutritional deficiencies can also compound psychological stress (Inter-Agency Standing Committee, 2008;Karunakara and Stevenson, 2012;Loi and Sundram, 2014). Such chronic geriatric conditions usually require regular monitoring, medication, and resources (e.g.…”

Section: Introductionmentioning

confidence: 99%

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The impact of forced migration on the mental health of the elderly: a scoping review

Virgincar

Doherty

Siriwardhana

2016

Int. Psychogeriatr.

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This review highlights the dearth of evidence about the impact of forced migration on the mental health of older adults. Further research is needed to explore the risk factors and processes that contribute to adverse mental health outcomes among older adult populations. This is essential to the development of interventions for this vulnerable and at-risk population, particularly in resource-poor settings.

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“…Most interesting is the discrepancy in the proportion of emergency operations performed per age group. Due to altered physiological responses, decreased mobility, and decreased support, the elderly often have delayed presentations to the hospital and are more likely to undergo urgent interventions [ 13 , 14 ]. In our study, however, the proportion of urgent surgical procedures performed in the elderly was less than half the proportion in the younger adults.…”

Section: Discussionmentioning

confidence: 99%

Operative Procedures in the Elderly in Low‐Resource Settings: A Review of Médecins Sans Frontières Facilities

et al. 2014

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BackgroundAs the demographic transition occurs across developing countries, an increasing number of elderly individuals are affected by disasters and conflicts. This study aimed to evaluate the elderly population that underwent an operative procedure at MSF facilities.MethodsA retrospective review of prospectively collected operative cases performed at MSF-Operational Centre Brussels (MSF-OCB) facilities between June 2008 and December 2012 was completed. Baseline demographic data, American Society of Anesthesiologists (ASA) physical status and surgical indications were collected for each patient. For each procedure, the degree of urgency, anesthesia type, and intra-operative mortality were noted. All patients aged 50 and over at the time of the procedure were considered elderly, as proposed by the World Health Organization (WHO). Comparisons were made with the 18–49 age group in order to elucidate differences between older and younger individuals.ResultsWe reviewed a total of 93,385 procedures performed on 83,911 patients in 21 different countries. Patients aged 50 and over comprised 11.5 % (9,628/83,911) of all patients. While most procedures (57.6 %) in the comparison group were urgent, this proportion decreased substantially in the elderly. Intra-operative mortality was considerably lower in the 50–59 group (0.12 %) but increased with each age stratum. The most commonly performed surgical procedures in the elderly included herniorrhaphies, simple and extensive wound debridements, abscess incision and drainages, minor tumorectomies, and urological procedures.ConclusionsIn light of the increasing elderly population in developing countries, efforts should be made to better quantify and address their surgical needs.

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Ending Neglect of Older People in the Response to Humanitarian Emergencies

Abstract: Unni Karunakara and Frances Stevenson argue that humanitarian policy and practice must adapt to ensure that the needs of older people in humanitarian emergencies are addressed.

Cited by 24 publications

References 8 publications

Predictors of social support, physical health and mental health among food insecure internally displaced persons in Turkana, Kenya

Predictors of social support, physical health and mental health among food insecure internally displaced persons in Turkana, Kenya

The impact of forced migration on the mental health of the elderly: a scoping review

Operative Procedures in the Elderly in Low‐Resource Settings: A Review of Médecins Sans Frontières Facilities

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