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Health

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Each person to Think of

one Major Effect of

Emergencies on healthTime to Think- 60

seconds

Time for reply-10 seconds

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Morbidity

Mortality

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Measles-Specially Children

Diarrhoeal Diseases Acute Respiratory Infections

Malaria ( where prevalent) Malnutrition

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U

N

H

C

R

Correlation between malnutrition and disease/death especially amongst children is well established.

(TB, Meningitis, Sexually transmitted diseases, hepatitis, typhoid, typhus are also observed amongst refugees but the overall burden of these diseases are relatively small.)

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Endemic

Epidemic

Pandemic

What do they mean???

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Terminologies:

Reference to a disease that appears regularly in a given area or populationEndemic

Significant increase in cases of a disease compared to baseline.

Epidemic

Epidemic that crosses continents.Pandemic

IN YOUR AGENCY HOW DO YOU IN YOUR AGENCY HOW DO YOU CONSIDER THAT A HEALTH RELATED CONSIDER THAT A HEALTH RELATED ISSUE IS NOW AN EMERGENCY? ISSUE IS NOW AN EMERGENCY?

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The rate of death in the entire population of both sexes and all age. CMR can be expressed with different standard population denomination and for different time period however the most commonly used during emergencies is daily mortality rate per 10,000 population. Also called CMR for short.

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Page 260 and 301 of Sphere Handbook

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As a thumb rule when for adults the CMR is 1.

For Under 5 years, if it reaches 2.

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as per Sphere-When the CMR as per Sphere-When the CMR becomes double of baseline data. becomes double of baseline data.

(Guidance note 3, Page 260)(Guidance note 3, Page 260)

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RegionRegion CMRCMR CMR CMR emergeemergency ncy ThresholThresholdd

U5 CMRU5 CMR U5CMR U5CMR emergeemergency ncy thresholthresholdd

Sub-Saharan Sub-Saharan Africa-Africa-

0.440.44 0.880.88 1.141.14 2.32.3

South AsiaSouth Asia 0.250.25 0.50.5 0.590.59 1.21.2

East Asia & East Asia & PacificPacific

0.190.19 0.40.4 0.240.24 0.50.5

UNICEF-2001Page 261

there were 2 deaths in a refugee camp of 5,000 people in one day, what is the CMR and would this be defined as an emergency?

There are 20 ‘under 5’ deaths in a refugee camp with ‘ Under 5’ population of 10,000 in one month. What is the CMR? Is this an emergency situation?

There are 39 deaths in a month in a refugee camp of the population of 26,000, What is the CMR?Is this an emergency?

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Q1- 4, Emergency Q2- 2/3, not yet Q3- 0.5, not yet

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Total death during10,000

the time period

CMR= ---------------------- X ------------Total population Time

period in number of days

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(Page 301 of Sphere Handbook)

Location and Year CMR

Somalia (Baidoa), 1992Somalia (Baidoa), 1992 17/10,000/day17/10,000/day

Goma, Zaire(DRC), 1994Goma, Zaire(DRC), 1994 > 30/10,000/day> 30/10,000/day

Southern Sudan, 1998Southern Sudan, 1998 > 20/10,000/day> 20/10,000/day

Kosovo, 1999Kosovo, 1999 < 1/10,000/day< 1/10,000/day

Ethiopia, 2000Ethiopia, 2000 3-4/10,000/day3-4/10,000/day

21 Source: Table compiled by CDC Source: Table compiled by CDC

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Age and Disease Issues-Let’s see an example

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Drought in Ethiopia

1999-2000

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Age Distribution for Mortality, Gode District, Ethiopia, December 1999- July 2000

Age

Source: P. Salama, CDC.

Source: P. Salama, CDC.

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Causes of Death in Children <5 Years, Gode District, Ethiopia, December 1999 – July 2000

Causes

Source: P.Salama CDC

Source: P.Salama CDC

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Mortality Trends, Gode District, Ethiopia,December 1999 - July 2000

Source: P. Salama CDC

Source: P. Salama CDC

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Introduction 252

1.Health Systems and Infrastructure258

2.Control of Communicable Diseases 273

3.Control of Non-Communicable Disease 285

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Form 3 groups-health people redistribute Read the three major parts of Health chapter:

1. Health system and infrastructure2. Control of Communicable diseases3. Control of Non Communicable diseases

Present summary of Important/key standards(not all) indicators with guidance notes. DO NOT read from the book. Add your suggestions/recommendations /experience

30 Minutes for reading & preparation5 Minutes per group for presentation

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a. At your tableb. Design a quick Health

assessment TOR for an emergency in your area

c. You can only ask a maximum of 6 questions

d. Time 5 Minutes

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Demographic Profile-total and under 5

Base line health and disease epidemiology.

Existing health coverage & infrastructure

Mortality and Morbidity Rates Available Resources Gaps and needs 34

At the heart of any health related strategy in emergencies is the fact

that the emphasis is onPREVENTIVE rather than CURATIVE

action alone.

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Logistics

Water & sanitation

NutritionHealth

Epidemiology

Food

Shelter

People from the affected community

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Conclusions Understand before doing

Control problems of disease and its spread (usually caused by failures in other sectors)

Provide adequate health care for men, Women, and children

Do this in a way that helps build health service capacity in the community

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Thank you