Health in Humanitarian Crises

Health in Humanitarian Crises: Definitions & Scope - Crisis Chaos Defined

• Humanitarian Crisis: A serious disruption of a community's functioning causing widespread human, material, economic, or environmental losses that exceed the affected community's or society's ability to cope using its own resources.
• Types of Crises:
  • Natural Disasters: e.g., earthquakes, floods, cyclones, droughts.
  • Man-made Disasters: e.g., armed conflicts, industrial accidents, transport accidents.
    • Complex Emergency: A humanitarian crisis in a country, region, or society where there is a total or considerable breakdown of authority resulting from internal or external conflict, which requires an international response.
• Key Affected Populations:
  • IDP (Internally Displaced Person): Forced to flee home but remains within their country's borders.
  • Refugee: Forced to flee their country due to persecution, war, or violence, crossing an international border.

⭐ Complex emergencies are characterized by extensive violence, mass displacements, and a need for large-scale, multifaceted humanitarian assistance, often complicated by political and security constraints.

Health in Humanitarian Crises: Health Impacts - Aftermath Ailments

• Communicable Diseases:
  • Water-borne: Cholera, Typhoid, Hepatitis A/E (poor sanitation).
  • Vector-borne: Malaria, Dengue, Leptospirosis (vector proliferation).
  • Crowding: Measles, ARI, TB, Meningitis.
• Non-Communicable Diseases (NCDs):
  • Exacerbation: Diabetes, HTN, CVD, Asthma.
  • Interrupted care & medication.
• Malnutrition:
  • PEM: Marasmus, Kwashiorkor (children <5).
  • Micronutrient deficiencies: Fe, Vit A, Iodine, Zinc.
• Mental Health (MHPSS):
  • PTSD, anxiety, depression.
  • ↑Substance abuse.
• Injuries:
  • Physical trauma from event/unsafe conditions.
  • Wound infections.
• Reproductive Health:
  • ↑Maternal/neonatal mortality.
  • Sexual & Gender-Based Violence (SGBV), STIs.

⭐ Measles outbreaks are a major killer in camps; Case Fatality Rate (CFR) can exceed 10% in vulnerable groups. Attack rate is high in non-immune.

Health in Humanitarian Crises: Needs Assessment & Surveillance - SOS Sizing

• Needs Assessment: Identifies health priorities, resource gaps.
  • Initial Rapid Assessment (IRA): Within 72 hrs.
  • Methods: Surveys (MUAC), key informants, observation.
  • Focus: Mortality, morbidity, nutrition, WASH, security.
• Surveillance: Ongoing health data collection & analysis for action.
  • Key Indicators:
    • Crude Mortality Rate (CMR): Emergency >1/10,000/day.
    • Under-5 Mortality Rate (U5MR): Emergency >2/10,000/day.
  • Alert for epidemic diseases (measles, cholera).
• SOS Sizing (Sphere Minimums):
  • Water: 15 L/p/day.
  • Food: 2100 kcal/p/day.
  • Shelter (covered): 3.5 m²/p.
  • Latrines: 1 per 20 persons.

⭐ CMR >1/10,000/day or U5MR >2/10,000/day signals a major public health emergency.

Health in Humanitarian Crises: Intervention Priorities - Aid Action Stations

• Initial Rapid Assessment (IRA): First 1-3 days; assess urgent needs.
• Key Intervention Areas (Sphere Standards):
  • WASH:
    • Water: Min. 7.5-15 L/p/d; Target 15 L.
    • Toilets: Max. 1 per 20 people.
    • Soap: 250g/p/month.
  • Nutrition:
    • GFD: 2100 kcal/p/d.
    • SFP (mod), TFP (SAM).
  • Shelter: Min. 3.5 m² covered area/person.
  • Health Action:
    • Measles vax (6m-15y), Vit A.
    • MHPSS, injury/NCDs.

⭐ MISP for Reproductive Health: Prevents sexual violence, ↓HIV transmission, ↓maternal/neonatal mortality/morbidity, plans comprehensive RH services.

• Coordination: Cluster approach (Health, WASH, Nutrition).

High‑Yield Points - ⚡ Biggest Takeaways

• Humanitarian crises overwhelm local capacity, requiring external aid.
• The Sphere Project sets minimum standards for humanitarian aid (e.g., water, food).
• Communicable diseases (Measles, Diarrhea, ARI) are key causes of M&M.
• Acute malnutrition (screened by MUAC) is critical, especially in children.
• Mental health issues (e.g., PTSD) are significant and often overlooked.
• WASH (Water, Sanitation, Hygiene) is vital for preventing disease outbreaks.
• Rapid needs assessment & triage (e.g., START) are crucial initial actions.