难民和流离失所者. 战争,饥饿和公共卫生
1Centers for Disease Control and Prevention, Atlanta, Ga 30333.
JAMA
|August 4, 1993
概括
全球流离失所人数急剧增加,难民和国内流离失所者,特别是儿童的死亡率高. 可预防的疾病和营养不良是导致死亡的主要原因,需要改善国际干预和救援计划.
科学领域:
- 全球健康 全球健康
- 人道主义危机 人道主义危机
- 人口统计学 人口统计学
背景情况:
- 全球越来越多的流离失所:由于战争和内战,超过4300万难民和国内流离失所者 (IDPs) 需要援助.
- 持续高死亡率:流离失所人口中的原始死亡率 (CDR) 与其原籍国家的基线率相比仍然显著上升.
- 受影响不成比例的弱势群体:五岁以下的儿童,在某些情况下,女性的死亡率要高得多.
研究的目的:
- 分析难民和国内流离失所者当前的死亡率 (CDR).
- 确定流离失所人口中死亡率和风险因素的关键原因.
- 评估现有救援计划的有效性,并建议改进.
主要方法:
- 在流离失所人口与非流离失所人口中,对原始死亡率 (CDR) 的比较分析.
- 自1990年以来,对来自全球各种难民和境内流离失所者背景的死亡率数据进行了审查.
- 确定主要的死亡原因,包括传染病和营养不良.
主要成果:
- 在一些东道国的难民中,CDR是基线的5-12倍;在伊拉克,索马里和苏丹的境内流离失所者中,CDR是12-25倍.
- 在5岁以下的儿童中,死亡率显著更高.
- 可预防的疾病,如腹疾病,麻疹和呼吸道感染,加上营养不良,是导致死亡的主要原因.
结论:
- 尽管难民援助得到了一些改善,但国内流离失所者的情况可能已经恶化.
- 在涉及流离失所的复杂人道主义紧急情况中,迫切需要更早的国际干预.
- 援助计划必须优先考虑基于证据的健康和营养策略,重点关注住所,食物,水,环境卫生和疾病预防,特别是针对弱势群体.
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