Prevention of excess mortality in refugee and displaced populations in developing countries

Abstract

More than 30 million refugees and internally displaced persons in developing countries are currently dependent on international relief assistance for their survival. Most of this assistance is provided by Western nations such as the United States. Mortality rates in these populations during the acute phase of displacement have been extremely high, up to 60 times the expected rates. Displaced populations in northern Ethiopia (1985) and southern Sudan (1988) have suffered the highest crude mortality rates. Although mortality rates have risen in all age groups, excess mortality has been the greatest in 1- through 14-year-old children. The major causes of death have been measles, diarrheal diseases, acute respiratory tract infections, and malaria. Case-fatality ratios for these diseases have risen due to the prevalence of both protein-energy malnutrition and certain micronutrient deficiencies. Despite current technical knowledge and resources, several recent relief programs have failed to promptly implement essential public health programs such as provision of adequate food rations, clean water and sanitation, measles immunization, and control of communicable diseases. Basic structural changes in the way international agencies implement and coordinate assistance to displaced populations are urgently needed.

Health service utilization and access to medicines among Syrian refugee children in Jordan

“…The highest mortality rates among displaced populations worldwide are in children younger than 1 year of age, followed closely by children under 5 years of age (Toole & Waldman, 1990; Toole & Waldman, 1997: Guha‐Sapir & Panhuis, 2004). Since the beginning of unrest in March 2011, the Syrian conflict has affected an estimated 14 million children (United Nations Children's Fund (UNICEF), 2015).…”

Effective Use of Household Water Treatment and Safe Storage in Response to the 2010 Haiti Earthquake

“…Emergencies have higher crude mortality rates 12 and likelihood of outbreaks because of population migration 13 ; and, a higher level of funding affects what water and sanitation technologies are selected in emergencies.…”

Ethical considerations for vaccination programmes in acute humanitarian emergencies

“…In most emergencies, mortality in children under the age of 5 years is generally two to three times higher than crude mortality. 39 Vaccinating children could reduce mortality in all age groups because epidemics often arise and spread among children. 40 Parents' refusal to have their children vaccinated should be respected if the risk of disease is low or the disease is mild.…”