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Mortality surveys in conflict and post conflict Angola 1990 - 2006

Mortality surveys in conflict and post conflict Angola 1990 - 2006. Sibylle Gerstl , Harold Noël, Vincent Brown Epicentre, Paris, France. History. 1974. 1975. 2002. 2006. end of colonialism. civil war. April 6: cease-fire agreement signed.

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Mortality surveys in conflict and post conflict Angola 1990 - 2006

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  1. Mortality surveysin conflict and post conflict Angola 1990 - 2006 Sibylle Gerstl, Harold Noël, Vincent Brown Epicentre, Paris, France

  2. History 1974 1975 2002 2006 end of colonialism civil war April 6: cease-fire agreement signed great potential fordevelopment (oil, diamonds)

  3. Consequences of the war 1975 2002 2006 civil war cease-fire agreement • 500 000 people killed • Thousands of people internally displaced • Resettlement areas • Landmines • Ranked 161/177 on theHuman Development Index

  4. MSF in Angola 1982 MSF in Angola 1975 2002 2006

  5. MSF in Angola 1975 1990 2002 2006 1982 9 surveysEpicentre/MSF

  6. Surveys Epicentre / MSF in Angola 2000 1990 2002 2006 9 surveys Epicentre/MSF 3 during civil war 5 in resettlement areas justafter the war 1 in rural area post - war

  7. Geographical distribution of surveys Democratic Republic of the Congo Post - war During civil war Xa-Muteba (2006) Malanje (2000) Kuito (2000) Zambia After the war ANGOLA Cubal (1999) Camacupa (2002) Bailundo (2002) Bunjei (2002) Bie (2002) Mavinga (2002) Namibia

  8. Survey methodology • Two-stage cluster sampling • 30 clusters x 30 households • Standardized questionnaire • Recall period 2 – 14 months • CMR (crude mortality rate) • U5MR (under five mortality rate) • Reported causes of death

  9. Deaths / 10 000 / day 10 CMR U5MR 9 8 7 4 3 2 1 during civil war just after war post - war

  10. Main causes of death Violence Malnutrition Infectious diseases [%] post - war just after war during civil war

  11. A closer look at the post-war surveyXa-Muteba, 2006 • 85.4% (41/48) died at home • 10 deaths were ≤ 1 month (10/48) • Fever / Malaria leading cause of death • Total: 37.5% (18/48) • < 5 years: 51.6% (16/31) • MSF will close Xa-Muteba, July 2007

  12. Discussion The health emergency continues evenafter war and displacement subside • CMR and U5MR remain unacceptably high • Typical pattern of infectious diseases Did these surveys have an impact for the health of these populations? How do we use mortality surveys to focus attention on post-war health crises? Do we really even understand post-war health crises? WHAT NOW?

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