Refugee health care: Similar but different?

The present review sets out to identify differences between refugees and other more stable communities living in less developed countries: demographic, mortality, morbidity, nutritional and selected epidemiological data are discussed. Although generalizations are difficult because of the variability of refugees and their differing circumstances, the health problems and diseases do not appear to differ qualitatively, although they may be quantitatively more severe. The areas of particular concern lie not so much with the problems but with approaches to their solutions: the need to respond rapidly and appropriately to emergencies, the importance of attending to the priorities of nutrition, shelter, sanitation and water; and the necessity of providing services which are sufficiently flexible and sensitive to the changing needs of the refugees as they move from the acute emergency to the long-term settlements. The review highlights certain areas where insufficient information is currently available, notably mental illness and the long-term issues of health and development, and outlines the implications of the conclusions for policy makers, with particular reference to training and research.