Natural Disasters and Complex Humanitarian Emergencies

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The Importance of Natural Disasters and Complex Emergencies to Global Health
-They lead to increased death, illness, and disability
-Large economic impacts
-Measures can be taken to reduce costs of disaster and conflict

Disaster definition
any occurrence that causes damage, ecological destruction, loss of human lives, or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from out the affected community area

Characteristics of Natural Disasters
-Droughts, hurricanes, typhoons, cyclones, heavy rains, tsunamis, earthquakes, and volcanoes
-Natural disasters are increasing, affecting larger numbers of people, causing more economic losses
-Cause damage to health systems and other infrastructure

Biggest relative impact of natural disasters is on
the poor in low- and middle-income countries
(90% of the deaths from these disasters occur in low- and middle-income countries)

Health Burden of Natural Disasters
-Direct and indirect effects depend on type of disaster
-Some effects are short-term such as death; others are long-lasting, such as mental health problems
-Very old, very young, and very sick are most vulnerable

Complex humanitarian emergency:
“complex, multi-party, intra-state conflict resulting in a humanitarian disaster which might constitute multi-dimensional risks or threats to regional and international security”

Characteristics of Complex Emergencies
-Often go on for long periods of time
-Sometimes groups that are fighting will not allow humanitarian assistance to be provided
-Combatants often target civilians
-Systematic abuse of human rights
-Food shortages
-Breakdown of publicly supported health system
-Unhealthy living circumstances in refugee camps

Health Effects of Complex Emergencies
-Large and underestimated because of difficulties in collecting data
-Between 320,000 and 420,000 people killed each year as a direct result of CHEs
-Malnutrition, lack of safe water, food shortages, and breakdown of health services can lead to illness, disability, and death

Causes of Death in Complex Emergencies
In the early stages, most deaths occur from diarrheal diseases, respiratory infections, measles, or malaria

Populations affected in Complex Emergencies
generally poor and have poor nutritional status

The Health Effects of Complex Humanitarian Emergencies >Women
Violence Against Women>
-Security conditions put women at considerable risk of sexual violence
-Rape is used as a weapon of war
-Economic distress and chaos may force women to trade sex for food or money

The Health Effects of Complex Humanitarian Emergencies>Mental
-Social and psychological shocks due to changes in way of living, loss of livelihoods, damaged social networks, and physical and mental harm
-Children and adults can suffer from high rates of depression and post-traumatic stress
-Important to help people rebuild their lives and social networks as quickly as possible

Refugee:
a person who is outside his or her country of nationality or habitual residence; has a well-founded fear of persecution because of his or her race, religion, nationality, membership in a particular social group or political opinion; and is unable or unwilling to avail him- or herself of the protection of that country, or return there for fear of persecution

Internally Displaced Persons
-people who are forced to flee or migrate and leave their homes during a disaster or complex humanitarian emergency but stay in the country in which they were living

Addressing the Health Effects of Natural Disasters
-Assess the health situation immediately
-Address needs of immediate trauma cases
-Help other injured people who are in need of early care and treatment
-Establish continuous disease surveillance
-Provide food, water, and shelter

To be helpful in addressing the health effects of natural disasters, external assistance will have to:
-Include all of the external partners
-Be based on a cooperative relationship among the partners
-Have partners working in ways that are complementary to each other
-Be evidence-based and transparent
Involve the affected communities

Disaster preparedness plans can be formed to:
-Identify vulnerabilities
-Develop scenarios of what might happen and the likelihood
-Outline the role that different actors will play in the event of an emergency
-Train first responders and managers to deal with such emergencies

Assessment and Surveillance when Addressing the Health Effects of Complex Humanitarian Emergencies
-Carry out assessment of displaced population
-Establish a system for disease surveillance
Check weight for height of all under-5 children
-Assess the daily crude mortality rate
(Daily rate twice the baseline rate signifies a public health emergency )

A Safe and Healthy Environment when Addressing the Health Effects of Complex Humanitarian Emergencies
-Maintain environmental and personal hygiene
(Adequate clean water
Recommended: 15 L per person per day;
Adequate number of toilets, segregated by sex
Recommended: 1 toilet per 20 people)
-Provide effective and culturally appropriate shelter

Food when Addressing the Health Effects of Complex Humanitarian Emergencies
-Provide at least 2,100 kilocalories of energy per day for adults
-Ensure female-headed households and children get their rations
-Give Vitamin A given to all children
-Provide urgent nutrition supplementation to severely malnourished children

Disease Control when Addressing the Health Effects of Complex Humanitarian Emergencies
-Handle injuries and trauma first
-Vaccinate all children aged 6 months to 15 years old for measles
-Properly manage diarrhea and malaria
-Provide health education and promote hygiene
-Provide minimum package of care for pregnant women
-Attend to urgent psychiatric conditions

Vulnerable Populations
women, children, elderly and chronically ill, people with physical and mental challenges, health workers

why are women a part of the vulnerable populations?
Increased security needed; subject to potential abuse, e.g., physical/sexual assault

why are children a part of the vulnerable populations?
-Unique physiological needs: illness, malnutrition, hydration, stress
-Subject to harm if lost/separated from family
-Keep with family/loved ones, neighbors, friends

why are the elderly and chronically ill a part of the vulnerable populations?
-May depend on others for their physical needs
-Need reliable supply of medication
-May be more likely to sustain illness/injury or die

External assistance challenges:
-Management/ Coordination
-Appropriate Response, e.g., personnel, supplies, priorities, working with local teams, etc.
-Length of response

Immediate, life-saving response is always
local

Challenges with disasters and emergencies
1.Reducing negative health impact
2.Developing and using standard approaches among all actors
3.Responding with the most cost-effective approaches

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