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Introduction to Public Health in Emergencies

Introduction to Public Health in Emergencies. Learning Objectives. Humanitarian Principles - the ‘code of conduct’ Lessons learned in response to emergencies over the last thirty years New structures in emergency response as a result of lessons learned. Humanitarian Conventions.

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Introduction to Public Health in Emergencies

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  1. Introduction to Public Health in Emergencies

  2. Learning Objectives • Humanitarian Principles - the ‘code of conduct’ • Lessons learned in response to emergencies over the last thirty years • New structures in emergency response as a result of lessons learned

  3. Humanitarian Conventions • International Humanitarian Law • International Human Rights Law • Refugee law • The Code of Conduct for the International Red Cross and Red Crescent Movement and NGOs

  4. Humanitarian Principles • International Humanitarian Law • Assistance to civilians in time of conflict • Distinction between combatants and non-combatants • Refugee law • Principle of non-refoulement: a principle in international law, specifically refugee law, that concerns the protection of refugees from being returned to places where their lives or freedoms could be threatened

  5. Humanitarian Principles Contd • The Code of Conduct • Humanitarian imperative • - Assistance based on need • - Aid not used to further other aims • - Aid not an instrument of foreign policy • - Respect culture and custom • - Build on local capacity • - Involve beneficiaries • - Reduce future vulnerabilities • - Recognize dignity of disaster affected populations

  6. Actors in Emergencies • United Nations: WHO, UNICEF, WFP, OCHA, UNHCR • Donors: ECHO, DFID, OFDA, PRM, CIDA, SIDA • Organizations with special mandate: ICRC, IOM, IFRC • INGO: MSF, SC, ARC, IRC, CARE • FBO: WVI, ADRA • Government: MOH, Military, Disaster Minister • Local NGO: National Red Cross/red crescent, FBO • Military: national, Foreign, UN • Policy and advocacy: Amnesty international, Human rights watch, Physicians for Human Rights, International Crisis Group, Africa Watch • Conflict resolution: Carter center • Private foundations: Gates, • Academic institutes: Columbia, John Hopkins • Others: CDC, Epicenter

  7. History of Emergencies 1977 -1985: Afghan refugees in Pakistan: Ethiopian refugees in Somalia, and Sudan (measles epidemic, scurvy) 1987-92: Mozambique, Malawi – general food distribution, lack of minerals/vitamins (Pellagra epidemic) 1991: Iraq – role of military, ‘non - refoulement’ 1992-3: Somalia – UN military role 1992-95: Bosnia- Herzegovina – role of NATO, UN military, Sexual violence, ethnic cleansing 1993: Thailand (Cambodian refugees) 1994: Rwanda, DRC- Goma – genocide, refugee, quality of response, accountability, SPHERE

  8. History of Emergencies (Contd.) 2000: Kosovo – developed country, different public health perspective 1998 - 2000: Ethiopia – food insecurity, measles, quality of nut surveys 2001: Afghanistan – independence, civil-military 2004: Tsunami – coordination, community participation, accountability 2005: Pakistan – ‘gender’ in humanitarian response 2005 – the Humanitarian reform: cluster approach, financing (CERF …), coordination, partnership 2006: Lebanon – quality of response, role of local CBOs

  9. Crude Mortality Rate (CMR) Evolution in Different Emergencies(Salama Peter et al 2004)

  10. CMR in Camp Versus Non-camp Situations 2004: lessons learned from complex emergencies over the past decade

  11. Natural Disasters Reported 1990 - 2006

  12. Summary of Lessons Learned • Emergency response must be based on accurate information and use a public health approach • Major causes of mortality in emergencies are preventable through well-proven, low-cost public health interventions • Protection of affected populations, maintenance of humanitarian space and safety of humanitarian workers is becoming increasingly difficult

  13. Summary of Lessons Learned (cont.) • Emergency response has evolved as a specialist field with its own indicators, policies, procedures, manuals, and reference materials • Agencies that have developed institutional expertise in the key technical areas of humanitarian aid and invested in staff training have proven their effectiveness • Relief agencies must be accountable to agreed standards • Better outcomes with involvement of host government staff and use of local skills • Preparedness and coordination between agencies is key for effective response.

  14. Steps Taken • Code of conduct • Some agreement on use of mortality and malnutrition indicators • The SPHERE guidelines • Cluster approach

  15. Coordination • Coordination between international organizations, NGOs, host country government, local community, displaced population • Common objectives being pursued • Maximize use of resources and manpower • Ensure all sectors are covered • Avoid duplication of efforts • Sharing of information

  16. Cluster Leadership Approach Objective: Address identified gaps in response and enhance the quality of humanitarian action by strengthening partnerships….aimed at improving effectiveness of response by ensuring greater accountability, predictability and partnership

  17. Cluster Leads • Logistics WFP • Shelter UNHCR • Health WHO • Nutrition UNICEF • WatSan UNICEF • Protection UNHCR • Camp Mgmt UNHCR / IOM • Communications OCHA • Early Recovery UNDP • Education UNICEF

  18. Thank You Questions? Comments?

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