Part 41 - cd3wd441.zip - Offline - United Nations High Commissioner for Refugees Handbook for Emergencies: Field Operations

Part 41 - cd3wd441.zip - Offline - United Nations High Commissioner for Refugees Handbook for Emergencies: Field Operations
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Published by:
United Nations High Commissioner
Pa2ais des Nations
CH-1211 Geneva PO
Switzerland
Available
fr:im:
United Nations High Commissioner
Palais des Nations
CH-1211 Geneva 10
Switxer%and
for
Refugees
for
ReZr.qees
Reproduction
of this microfiche
document in any
form is subject to the same restr,ictions
as th.OSe
of the original
document,
UNITEDNATIQNS
PART(rJE: FIELD OPMTIOS
GENEVAlheaber
1982
Usiaffthe
hardbook
Chapters may b;e located quickly using tti
key opposite.
Each chapter starts with an amotated list
of contents.
In chapters 5-11 this is follorJeQ by au overview page setting out key considerations.
Sections within these chapters aai chapter I.2 start with sum&es.
Points worthy
of special attention
are underlined [email protected]
the text.
Cross-references
are by chapter, section and paragraph,
e.g. “see ch.9.5.3.”
For cczvanience, “Rapresentative”
is used to refer to the
Hig:~ Gmnissioner’s
representative
in the country &re
ttx tz%xzrg~~cy occurs ) regardless of the representative ’ s
&fi y~&gJ- tirle.
Weadquar ters”
refers
to UMCR Headquarters ia iA?Imva. As is explained on page 1, “ref see”
ia ~:.g& to describe any person of coucern to UNHCR.
“Rag:,, LeLpmi %t~.tutory” refer to the Statute of the HQh
C.m~iss.6~~~ ’ s off ?ce (General Assembly resolution
428 (v)
of 14 flayer
1950). ‘Operational
partner”
is used for
ccmmi:m~
tc describe an organization
implenrenting all
or part of ?AE UMICR emergency programe, wittmt
distinction as to fur~3ing. (The phrase more correctly
describes
an orgmization
contributing
its own resources to the program;
an organization
wholly fuz!&d by LIWCR is termed
an “*lgmenting
agency”.)
Part One of the ha&book may be freely
reproduced ami adapted, with acknowledgent
to UIWCR. It is also available in Frrench and will he produced in
Spanish; IJNEX rwould be grateful
for
copies of any translations
into o&r
Languages
l
b
Foreword, introduction
-.
1
and list
TRW
J”
of abbreviations
Aim and principles
1
,^
1
ProteCt iou
3
Needs assessment and inmediate reqmise
4
Implementing atrangeaxmts and personnel
Supplies and Q&tics
Annexes: 1. Stardard specif icatiOns
6 . Site selection,
23
-
2. Control
Systeap
3. Conversion factors
31
planniug ar4 shelter
55
r’ 7
Health
Annexes:
1. Surveillance
report
2. Imunization
an! vaccines
69
1
8
9
Food ard nutrition
Rapid asswsmenk of nutritional
Annex:
status
of young children
95
Water
113
.A0
I
11
” I.2
Sanitation
and environmntal
services
Social services ati education
AXlMx:
Unaccompanied children
Field level mnqgement
Annexes: 1. NGOco-ordination
Index
134
registration
form
2, Situation
report
!ls
UNITED NATlONS
THE HIGH COMMISSIONER
FOR REFUGEES
LE HAUT COMMfSSAl~E
POUR LIES REFUGIf%
Palals dsa NatIona
CH42tl asnevs IO
6ulsae
Deceniber 1982
MREWOFG3
TO ‘II-E FIRST EDIT?ON
This first
edition of the Handbook for Emergencies is
iritended to provide guidance on the management of refugee
emergencies.
It is the>result
of a considerable
process
of consultation,
review and improvement .
It replaces the
provisional
version issued in 1981 on which cments
were
invieed .
Although the Handbook will be subject to modification and change in the light of future experience,
I believe
that as it now stands it provides a common basis for action
for all those, both inside and outside UNHCR, involved in the
management of refugee emergencies.
1
Poul Hartling
‘Ihe handbk
is in two parts y
Ihis,
the first
part,
is a guide
to setting
up emergency operations
for large-scale
influxes
of refugees. ‘Ihe second part deals specifically
with
the internal
UIWCR
dimension
of decision-making
and
oreization
in emergencies.
The
first
is available
to all
those
who work with refugees ; the second
part is for staff m&hers of UIWX.
The handbook was first
produced as a single volume in a provisional
versioil
in September 1981.
Comaents were invited
from reviewulwx
staff
rzlembers.
and
%&rly
the most tangible
of the
swestions
that
have
been
WV
irrorporated
is
the
change
in
size:
the provisional
edition
in
its bulky bitier
is replaced
by
two smaller more canpact volumes.
In addition
to UNi(x,
many
irtternational
and national
organiimportant
roles,
zations
have
while governments of asylum have,
a special
ard unique
of course,
responsibility.
Al though addressed
primarily
to
UWR
staff,
the
first
part of the handhook seeks
to offer a basis for ccsnnon action
for all
those involved.
‘ihe need
and responsibility
for the action
suggested
in the different
chapters
will,
however,
vary
greatly
.
each emecgerrcy . Unless
this
galification
is borne in mind, a
reader may get the false
impression that the necessary action
is
always the responsibility
of uNI(x.
Ihis
first
edition
reflects
the growing attention
both within
UNicX and outside to improving the
managent
of refugee emergencies.
These sudden and sanetimes largescale threats
to life
call for an
organized
systematic
response.
At
all le\Rls,
from the solution
to a
technical
problem in the settlement itself
up to that of co-ordi-
nation
bebeen
a government
and
participating
international
and
voluntary
agencies,
there are lessons from past emergencies which
should
inform
the management of
new ones.
Drawing
on this
accumulated
experience,
the
handbook
is
a
manager ’ s
guide.
Principles
of
response
and possible
solutions
are proposed. However it makes no
pretence to have all ttz .mwers.
Each emergency poses ia
own set
of
problems.
Those
interested
should look at scw of the growing
number of actual
case studies
of
emergencies : both UNHQi evaluation
reports , which
are
limited
to
internal
circulation,
and published articles. 11 Although not itself
includingcase studies,
the
handbook has set out to distil
these
experiences
into
useful
principles.
Better
informed management is
not however a substitute
for professional
expertise.
Indeed
a
major theme of the handbook is how
to select the right expert advice.
Nor does the handbook replate
initiative,
commitment and the other
personal
qualities
which
have
enabled managers in the field
and
at Headquarters
to pit
together
successful
emergency prograarnes in
the past. But a UMICR officer
who
confronts
an emergency can now
employ the handbook, and as a consequence will
be much less likely
to repeat
the mistakes
of
the
past, Ihose who suffer
most from
management errors
are of course
those whose voice is usually
least
clearly
heard in the confusion
of
an emergency,
the refugees
themselves.
the drafting
of
the
During
ha&book
it sometimes seemed that
there should be a third
part in
addition
to the present two parts.
1j
See, for example, Disasters,
the journal
of the International
Disaster
Tnst i tute, which of ten contains
articles
on refugee emergencies,
and ROSS
Institute
(1982) Publication
No. 14: Refugee Camp Health Care: Selected Annotated Ref erenzes .
-_
.; .j ‘;
(
..,
;.
,.>.z.’
.,
;.
-‘-
:
,.:
I.
- &troduction
-
.-,
‘Lhis- .ti#i -p$rt wuld he- a ‘Refugees’ a~imbbok” and would si$gest
to thaiu ways of coping with relief
a&i.- the relief Warker. In the last
few: years much. -ttr>q&t has been
given to developing servi~les
and
infrastructure
for refugee settlements that art? simple mh
to
w-k yet capble of meeting the
nebjs. -of l~r&~;zrs
of people
Interest
co~entrated
hastoo often not, gone’bey&
this
essentially
,” technical
puzzle to
*
wstep: how the : refugees
might- civ~cq115 the -strangeness of
their crowded new enviromx!nt and
actimly
participate
in its evoTw often - the refugee
lution.
remains .daur&ed. a -psssive recipient of a relief *se
system he or
she d&&x not urderstand.,
The refugees are often most
able to help -themselves, and thus
be least reliant on outside assistance, if they are not grouped
together
in
highly
organized
Progrplanners
must
-wsovercane their inst inot to endorse
camps because
they are convenient
for the efficient
delivery of outside emergency assistance.
That
early
convenience
too
often
beccxnes a long-tern
burden for
refugee, host government and donor
alike.
-11,
less formal groupings of refugees, provided their
protection,
access to land and
related
econanic
rights
are
assured, often enjoy much better
prospects of self sufficiency
than
large highly planned but
artificial settlements.
Xndeecl improvenSnts in the
techniques of relief.. ‘alone that
are hot matched by an ,increased
refw
3nWlvement ,m be selfdefeatirQ3.
It
is, increasingly
first
t. :.?-a that
a refugee’s
; reception in the country of asylvn
can Ccrititilly
deteopine his or
her .c&bility to becane self-suf ficient .2/ Ill-considered
assistance
at thZ start, however efficiently
delivered, can create a dependency
syndrane which may last for years.
A first
rush of inappropriate and
unfamiliar relief goods can stifle
the potential
enterprise
of the
refugees and inxease their sense
TIE cowed and
of alienation.
silent refugee squattie
on inhospitable terrain awaiti% a relief
harrlout has becane an image of our
times. Relief can impose its own
imprisdnt.
Nevertheless refugee settlements of the CElllp type seem to be
here to stay. lhe various pressures of mass influx on countries
of asylum and the occasional need
to group refugees tqether
for
their own protection make it probable that
these unsatisfactory
and artificial
institutions
will
survive.
This handhook seeks to
make even these institutions
as
“un-camplike”
as
possible
and
ensure that with active refugee
participation
achieve
an
they
appropriateness in terms of servi ces and infrastructure
that neither sets them too far apart from
local ~cnmunities around them nor
puts them in so close a dependence
on international
assistance that
they can never escape it.
Within the limits of the host
goverrment’s laws, refugees rmst
,he persuaded to take responsibility for their own welfare; inputs
of outside assistance must be a
sensitive
response to needs that
the refugees genuinely cannot meet
on their own.
individuals
and
V-Y w
organizations have helped UWCR in
the preparation of the handbook,
not only directly
but also indirectly
through their work with
UNNX in recent emergencies. This
help is most gratefully
acknawledged . Particular
mention should
Acknowledgwnts
.,
2/ See, for eqle,
Robert &an&s
‘Rural Refugees in Africa ; Past ExperiZixe, Future Pointers”, Disasters, Vo1.6, No.1, 1982.
- Introduction
be made of the assistance receiwd
from the Centers for Disease Control (USA), The International
Committee
of the Red Cross, The
International
Disaster
Institute,
Intertect,
3x2 League of Red Cross
Societies, Oxfam, The Oxford Polytechnic Disasters and Settlmts
Unit, lbe Refugee Wilth
Unit of
the Ministry
of Health, Somalia,
The Register
of Engineers for
Disaster Relief
(793, Se Ross
Institute
of the London School of
Hygiene and Tropical
Medicine,
UNDRO, UNICEF, LB0 and WEJ?. Mr
Ludovic van Essche of UNDID kirx3ly
prepared the graphics. The hand-
-
book has also drawn on many of the
publications
listed
as “further
references” at the end of chapters.
The handbook will
be revised
periodically ;
important
changes
will,
of course, be carmunicated
to TJ’WCRstaff without delay. X&sponsibility
for errors rests with
to
IJNKR. Readers are rqtiested
bring these, and sqgestions
for
improvements, to the attention of :
The Bnergency Unit,
UNHCR,Palais des Nations,
CH,1211 Geneva 10,
Switzerland.
FAO
Food arri Agriculture
United Nations
ICM
Inter-Covermental
ICRC
International
Camittee
II13
International
Labour Organization
LRCS
League of Red Cross Societies
lG0
Non-govermental
CAU
ljrganization
PAHO
Pan American Health Organization
UNDP
United Nation& Developnt
‘UNDRO
office of the United Nations
Co-ordinator
UNESCO
United Nations Educational,
Cultural Organization
UNICEF
United Nations
UNIFAC
UNICEF Packing and Assembly Centre,
WFP
World Focxi Programe
Organization
Cumittee
Children’s
World Health Organization
[Viii)
for Migration
of the Red Cross
organization
of African
of the
(voluntary
agency)
Unity
Progrmme
Disaster
Relief
Scientific
ard
Fund
Copenhagen
u
List
of Contents
Section
Contents
1.1
.” efinition
1.2
Responsibilities
l- 2
3- Q
;- 9
Goverments and UNHCR
UN organizations
Other organizations
The ref qyees
Principles
;: :
1EZ
16-17
and aim
PaRe
2
2”
3
3
of response
Priori ties
Appropriateness
Dwolvement of refugees and self-sufficiency
Durable solutions
PImi+or ing ef feet iveness
2
4
2
1
._.;,
;
. j-
1. The majority of UMX’s prograrmes begin as a result of an
of
emergency: a sudden influx
refugees &/. The organization anl
procedures of ‘uMI(x reflect
this;
muA! of UNICR’s norms1 work: is
in effect an emergency response.
tiever , situations
T&re ~ are,
what are clearly exceptional. his
handbook addresses the needs of
such situations.
is one of
2. lhe distinction
definition
degree: a theoretical
for the purposes of this handbook
might be that an enetgency is any
situation
in which the life
or
weil.-beiq
of refugees will
be
threatened
unless innmdiate and
appropriate action is taken, and
rwhich d&s
an extraordinary
response and exceptional measures.
It should be noted that an emurgen=y csn develop in an existing
programne.
3. that is important is less a
definition
than the ability
to
recognize in time the development
of situations
in which an extraordinary response will be required
of UNIX in order to safeguard the
life or well-being of refugees.
Much of t*he handbook is conwith
guidelines
on the
material assistance likely
to be
needed when large n-r8
of refug=s, often of rural origin, cross
Such
to seek asylun.
frontiers
emergencies are, of course, not
the only situations
which dearerrd
extraordinary
Equally swift?ZEZ
Af
i&Ix.
intervention
will
be required in
emergencies that concern protection, for example when events suddenly place in danger refugees who
had previously enjoyed asylum in
safety. However, action in these
depend to such
emergencies will
a large extent on the specific
4.
CC?rned
circumstances
chat too detailed
guidelines are unlikely to be useful.
The aim of ?ZtNX’ 8 emergency
r&onse
is to provide protection
to
rsons of concern to UIWX and
at the necessary assistIensure
ance reaches them in time.
Governments ati UNH(X
1. Goverrrsents are responsible
for the security and safety of,
assistance to arxl law and order
terriamongP refugees on their
tory.
UNMX provides
material
assistance
to refugees at the
request of governments. Ihe statutory function of providing international
protection
to refugees
and seeking permanent solutions
for their
problems is, however,
always UIWCR’s responsibility.
2. Whatever tb
organizational.
manner in which IJMCR provides
assistance in response
-w-v
to a governuent request, UNHCRis
responsible for ensuring that the
imnediate needs of the refugees
are met in an ef feet ive and appropriate manner. however responsibilities
for practical
implentation
are allow ted ) all
those
involved, both inside anJ outside
the UN system, should have clearly
defined responslbllitles
within a
single overall programne, whether
the aid is provided through multilateral
bilateral
channels.
d uplication
m
thu;
will
of
effort and gaps be avoided.
UN organizations
for
co-ordi3. Responsibility
nating the response of the UN system to a refugee emergency normally rests with UNHCR. In certain
cases special arrangements may be
made by the Secretary-General.
l/
Ebr convenience, “refugee” is used in this handbook to refer to all
persons of concern to UNHUL Ihe different
categories are described in
chapter 2.2.
2
- Aim and principles
4.
The material
needs of refugees are likely
to cover sectors
for which other
organizations
in
the UN system have special
ccmpetence, as, for example, FAO, WFP,
WHO arrl UKlCEF in the food, health
supply
sectors.
UNHCR
and water
will
seek assistance
and expertise
frcm such organizations
and from
UNQP as appropriate,
and the implementing
arrangents
agreed with
the goverrxnent may give specific
to other UN orgaresponsibilities
nizations.
-
gees in emergencies.
So have a
great many non-governmental
organizations
(D&X%). These organizations often act as UNHCR’s operat ional partners , in which case the
division
of
responsibilities
is
determined
by
the
implementing
arrangements
agreed between them,
the goverment
and UNHCR. Similar
arrangements
would
set
out
the
responsibilities
of
inter
any
goverrmental
or other goverrrnental
organizations
involved.
The refugees
5.
‘Ihere is a clear distinction
between
UNHQX’s responsibilities
arrl those of the Office
of the
Relief
United
Nations
Disaster
point
in
Co-ordinator , the focal
the UN system for disaster
relief
matters.
UWRO is,
inter
alia,
responsible
for the co-ordination
of relief
assistance
to persons
compelled to leave their
homes as
a result
of, or as a precautionary
measure against,
the effects
of
natural
and other disasters
such
as
earthquakes,
volcanic
eruptions,
droshts,
floods,
storms,
and epidanice
and also aviation,
industrial
or
nuclear
maritime,
radiation
accidents.
Where victims
of such disasters
include
ref uresponsible
for
gees , UNMX is
helping
to provide
the refugees
with
the necessary
assistance
in
clcsc co-ordination
with UNDROr
complex
exceptional
or
6.
In
disasters
which do not fall
solely
within
the mandate of any single
for example one with
organization,
both natural
and man-de
origins,
causing both internal
arrl external
population
displacents,
special
arrangements
will
be made by the
Secretary-General
to designate
a
lead entity
with overall
responsibility
for co-ordinating
the response of the UN systen.
Other organizations
Comnittee
7. The International
of
the Red Cross
(ICRC) , the
Red Cross
Societies
League
of
(LRCS) and the national
Red Cross
and Red Crescent
societies
have
long provided
assistance
to refu-
8.
Beyond the right
to international
protection
under the Statute of UNHCR and under the 1951
Refugee Convention and 1967 Protoco1 , if applicable,
all refugees as indeed
all
persons
- have
certain
basic human rights.
These
are enshrined
in the Charter
of
the United
Nations
and in
the
Universal
Declaration
of
Human
Rights : the ftindamental
right
to
life,
liberty
and security
of person; the protection
of the law ;
freedom of thoeht,
conscience and
religion;
and the right
to own
property.
Refugees have the right
to freedcm of move-&,
although
it
is recognized
par ticuthat,
larly
in cases of mass influx,
considerations
and the
security
rights
of the local population
may
dictate
restrictions.
Chapter
2,
describes
’
Protection,
detail
the rights
of re~~geer?~~
humani tar ian law.
and displaced
perRefugees
9.
sons also have, of course, responcountry
sibilities
towards
the
where they
have sought
refuge.
These are set out in Article
2 of
the Convent ion : “Every refugee has
duties to the country in which he
finds
himself,
which require
in
particular
that he conform to its
laws and regulations
as well as to
measures taken for the maintenance
of public order .‘I
1.3 Primi&2s
of resixmse
the
Whatever
1.
for
‘responsibility
emergency,
refugee
framework
of
a particular
certain
pr in-
3
- Aim and principles
ciples
of response are likely
to
be valid.
Sune of these are cQmyln
themes in the chapters
that follow, where they are discussed
in
more detail.
2.
By definition,
the needs of a
refugee
emergency must be given
priority
over other work of WCR.
This is essential
if the aim of
ensuring
protection
ard
timely
assistance
is to be met. Of particular
imuortance is the nrioritv
are
.lity
in an emergency.
required
of
The measures must be appropriate
3.
An appropriate
response
in
the provision
of material
assistacre requires
an assessment of the
needs of the refugees
that takes
into
account
not
their
mlY
material
state and the resources
available,
but also their
culture
and background
and those of the
nationals
in whose country
they
are granted asylum. What is appropriate will vary with time: in the
early stages of a major emergency
special measures that rely heavily
on
assistance
may be
outside
necessary but, as a general principle,
the response should draw to
local
the
pssible
on
extent
resources,
materials
and methods,
for
example,
avoid
and should,
regimented
refugee
camps. Sollltions should be sought that can be
readily
implemented with existing
resources and simple technologies.
4.
It is an important
respsnsibility
of UNHCR to determine with
the
goverrrnent
and
operational
partner(s)
the standards of ass is-;
tan=e that are appropriate.
This
requires
expertise
in a ntier
of
in
disciplines.
,The guidelines
chapters
6 to 11 suggest general
considerations,
to be tiified
in
light
of the circumstances
of each
emergency. What is to be decided
for
each sector
is the correct
4
-
level of
sources.
total
assistance
from all
5.
As a general
principle,
standards
of assistance
must
lect
the special
needs of
refugees as a result
of their
dition,
physical
situation
experiences,
while
at
the
time taking
account of the
dards
enjoyed
by
the
population.
the
refthe
conand
same
stanlocal
6.
If
the standards
have been
correctly
determined,
they cannot
later
be lowered without
risk
to
the refugees . The refugees
must,
for
example,
receive
a minimum
basic
food
ration.
‘Ihe outside
contribution
required
to meet the
statiards
will,
however, naturally
be reduced as the refugees becane
self-sufficient.
7.
A final
general principle
in
considering
the appropriateness
of
the measures
is
that
from the
start
resources
must be divided
between the &mediate
imnediate
needs and
andaction aimed at longer-term
improdevoted to general public
health masures
as well as to the
treatment
of individual
diseases,
which will
include many that could
be prevented
by better
water and
sanitation.
Involve
the refugees
their self--sufficiency
and
promote
8.
Inherent
in the foregoing
is
the need to involve
the refugees
in the measures
taken
to meet
their needs and to plan all compcnents of t’he operation
in such a
their
aelfway as to pronote
sufficiency.
Obvious as this principle
is,
the pressures
of an
emergency of ten make it easier to
organize a progranme from the outside for, rather
than with,
those
whom it is to benefit.
There are three levels to the
9.
involvement
of refugees.
The first
is in the overall
planning
and
the
for
organization,
example
determination
of what is the best
- Aim and principles
-
most appropriate
and culturally
solution
to a problem, given the
constraints
of the situation.
This
that
the refugees
level
requires
have a soctal
organization
within
their
camnnrity
that
is properly
As the
previous
representative.
social
structures
may have been
severely
disrupted,
this may take
time to develop but will be important to the success of the emergency operation
and the future of
urgent
Manwhile,
the
refugees,.
action
to meet evident needs must
of course be taken.
.
methods have to be used, imdiate
practical
instruction
is
essential.
Education
and guidance
of
this
sort
are best given by the
refugees, pith outside assistance.
10. The second level of involvement is in the practical
use of
skills
and resources
the refugees’
wherever
possible
for the implementation
of the programne. Where
suitably
qualified
or experienced
exist,
such as nurses,
refugees
teachers
and traditional
health
they must obviously
be
workers,
used. Where they do not, outside
should
ensure
that
assistance
refugees are trained
to take over
from those
who are
temporarily
filling
the gap. The appropriateness of this is evident:
the refugees themselves should run their
services
to
the
OWKl cannuni ty
extent pass Me.
Work for durable
other tra11. At the same time,
- for example in
ditional
skills
well-digging
construction
or
should be harnessed.
While speciself fic
to
develop
measures
sufficiency
will
vary with
each
their aim should always
situation,
be to avoid or reduce the refugees’ dependence on outside assisThe more successful
meatance.
sures are generally
those based on
methods and practices
familiar
to
the refugees .
12. ‘Ihe third level is the education of the ccmun~ty
on life
in
their
new situation,
which may be
markedly different
from their prePublic
health
experience.
vious
education
in such matters
as the
importance
of hygiene
in crowded
mother and child
care
conditions,
and the use of unfamiliar
latrines
is an example. A9 another example,
if unfamiliar
foods or preparation
13. If
the
emergency
operation
involves
the refugees in this way
from the start,
its effectiveness
will
be greatly
enhanced. Furthermore, such an approach Z?l
allow
the refugees
t0
IMitKr7i~
their
sense
of
dignity
ati
purg, ..G.,
Rind t31;:
encourage
self-reliance
to avoid dependency .
solutions
14. When an
emergency
occurs ,
actions
taken at the very outset
can
have
important
longer -term
consequences.
To secure protection
may be of
crucial
importance;
intervention
may be necessary
to
save lives,
and a clear and consistent
@icy
from the beginning
will
have an important
lorg-term
ef feet.
Similarly,
the imnediate
response of the international
community to a major influx
of refugees must take into account
the
ultimate
aim of prcmoting
a durable solution
to the problem. This
that
the response
both
requires
encourages the self-sufficiency
of
the refugees
and avoids prolonged
dependency on outside relief,
and
that
it does nothing
to prevent
the promotion of a long-term solution as soon as pass ible.
15. As a general
principle,
the
best solution
is always voluntary
Where this
is not
repatriation.
assimilation
within
the
possible,
country
of asylum (local
settlement)
is
in mst
circmstances
preferable
to &similation
within
(resettlement)
,
country
another
par titularly
for large groups and
in cases where resettlement
would
take place in a cultural
environment alien to the refugees.
There
be situations
in
however,
MY’
which resettlement
is the only way
to ensure protection.
It is evident that resettlement
is a solution
that
in sane circumstances
may effectively
foreclose
the passibility
of voluntary repatriation.
‘. .”
9.
I7‘
>-
“..
.
- Aim and principles
-
3,
i
I
I
&nit&
the
response
16.
.t
3,
;...i
8,
~I
1.‘!
:-
WbaWer
ef fectiEness
-,
Of
the
the nature
of the
the -action required
of
energe=y,
UNSX is .-likely
to vary with time
and as circuustances
change. It is
essential
that
the effectiveness
of the response is ‘kept constantly
under reioiew and action
adjusted
as necessary
ati
in time.
This
will
require
sound monitoring
and
reporting
systems, to detect deterioration
qr change, and also a
continuous
review of the aims of
UNicX’s assistance,
both in terms
of bringing
the emergency to an
early end and for
a durable solution.
the promotion
of
17. Such monitoring
must
also
ensure
that
the
funds
provided
voluntarily
to TJNICR by governments , NGOs ark3 private
individuals are being used to the best
advantage. This is inherent
in the
principle
of ~ appropriate
response.
It should
be borne in mind that
whatever funds may be available
in
the early stages of an acute humanitarian
emergency, the passage of
time will
produce financial
constraints.
Thus it is important
that
potential
donors can see that the
action
proposed is indeed essential.
List
of contents
Section
Paragraph
2.1
1-6
Introduction
2.2
l-6
Persons to whom UMR
2.3
1-6
The aim and action
2.4
1-5
International
2.5
1-9
ltre Geneva Convent ions and Protocols
the ICRC
Contents
Paae
8
Gxtenrls protection
to achieve
it
8
10
instruments
11
\
and
13
2.1
4.
Jg&pductim
1.
In an anergency it must first
be established
that the persons
in\Folved are of carem
to UNHCR
and thus entitled
to protection.
lbe legal basis for securirlg this
protection
and its aim must be
clearly
tierstood.
‘Ihis chapter
addresses these questions.
2. All UIWX staff mWt be familiar
with the key international
instruments covering the protection of refugees. Of fundamental
iqortance are the “Statute of the
CEfice of the United Nations High
corrmissioner for Refugees” (General Assembly resolution 428 (V) of
14 Dece&er 1950), which sets oilt
the High &anissioner’s
functions
ard responsibilities
towards those
who fall within its scope, the two
universal
international
instrumnts that set out the responsibilities
of States parties to them:
the ‘1951 CXmvention Relating
to
the Status of Refugees’* &
the
‘Protocol Relating to the Status
of Refugees of 31 January 1967”,
and on the regional lewl,
the
African
Unity
Organization
of
Wnvention
Governing the Specific
AEQECtS
of Refugee Problems i.n
Africa”
of 10 September 1969. The
Collection
of International
Instnmrents
Concerning
Refugees
(UIWR, Geneva 1979) the Harrlbook
for
Determining
Gfugee -- Status
(UIWX,
Geneva 1979)
lection
of
International
1
essential
3.
bXlusi&s
protection
nd - the col-
on1 the
of Refu-
cazplenentary reading.
The
Carmissioner’s
prohave been
placed
on him by the
General
Thus the international
Assembly.
protection
activities
of UNHCR are
not deperdant
upon a request
by
ThlZSC
comerned.
the
g6verrment
tection
High
responsibilities
activities
reflect UNKX’s universally recognized right of initiative in exercising its protection
respwrsibilities
as an entirely
non-political
social body.
8
hlrmani tar ian
atrl
‘Ihe need for imnediate action
to secure protection
will
frequently
occur before
a determination
of status is possible.
Where those
seeking refuge may be of concern
to mm,
the
Statute
of
the
Office
behalf.
secure
calls
for action
on their
Furthermore,
the aim is to
treatment
in
accordance
with universally
recognized hunanitarian
principles
not
directly
linked
to the
need. ‘In short,
5.
ure
Speed of
protection
status of those in
when in doubt, act.
intervention
to secwhere necessary
*
thus the first
priority.
Ihe moSts
effective
means of securing protection is a UNH(X presence where
the refugees are.
6.
It should be borne in mind
that action taken at the outset in
an emergency may have significant
long-term
consequences,
both
for
cant inued
protection,
including
perhaps for other groups of refugees within
the country,
and for
the pramtion
of durable solutions.
2.2 &rams to uhm UNNR exte&
Jmwectim
1. UNH0X’s fundamental
task
is
to provide
international
protection to refugees and to seek permanent solutions
for tbair
probletns. The need for international
protection
arises
from the fact
that
refugees,
unlike
ordinary
aliens,
no longer have the protect ion of their former home country.
The reasons for this are evident
from the definition
contained
in
UNNR’s Statute of a refugee as a
person who is outside his country
of origin
and who’ due to wellfounded
fear
of persecution,
is
unable or unwilling
to avail himprotection.
self of that country’s
2.
Persons wishing
to be admit ted into a country as refugees are
described
as
generally
9
seekers.
In sane cases they may
-Protection
considered as refllgees as a result
of a grog determination, as explained in paragraph 3 (2) below.
If, however, a decision on a group
determination cannot yet be made,
which my be the case at the start
of an emergency, the high Cmmissimer nevertheless intervenes on
behalf of asylum seekers in order
to ensure that they are granted at
least temporary asylum, and that
they are not sent back to their
country of origin or to any other
country where they may fear persepending the determination
cution,
of their
refugee
status
and the
granti&
of durable asylum.
A person’s
refugee status may
3.
be established
in three lnain ways:
(1) by the High Canmissioner,
as the result
of an itiividual
determination
that
the
criteria
in paragraph
6 of
the Statute are met;
(2) by the High cadomissioner,
as for (1) but for a caseload
as a whole on the basis of a
so-called
~rima facie
group
determinat ib. - This is cannon
at the start of an emergency,
where (1) would be impracticable ;
(3) by States party
to the
1951 Convention/l967
Protocol.
Assembly
General
Various
resolutions
have widened UNH(x’s
original
canpetence to act, extending this
beyonrl refugees
within
the meaning of UNUcfl’s Statute to:
4.
in the
(1) displaced
persons,
outside
persons
sense
of
their country of former habitual
residence
who may not
necessarily
qualify
as refugees within
the terms of the
Statute but who are nevertheless
in refugee-like
situat ions ;
(2) former refugees
and
placed persons repatriated
their country of or igin ;
(3) in
ject
disto
specific
cases
(subto a request by the Sec-
-
retary-General or the General
Assembly), persons displaced
of man-made disas a result
asters within
the territorial
Limits
of their
coi;ntry
of
origin.
5. Itme
extensions of UIWR’s
caupetence mean that the Office
also has protection
responsibilities
towards displaced
persons as
described
in (1). Persons described in (2) and (3) fall
outside
the terms of the Statute,
the 1951
Convention and the 1967 Protocol.
When providing
assistance
to persons in these
categories,
U&&CR
nevertheless
acrs in the spirit
of
the Statute
and has at least
a
to
ensure
moral
responsibi li ty
that
fundamental
and internatiorecognized
humanitarian
nally
standards are adhered to.
are,
however,
sane
6. There
of persons where caution
iPups
may need to be exercised:
UN-RR is
intervene
on
not
competent
to
behalf
of active
cambatants
and
persons
bearing
arms. Protection
of such persons may fall
within
the compet.ence of the ICRC. Attention is also drawn to the exclusion clauses in Chapter II,
7 (d)
of the Statute relating
to persons
for whom there are serious reasons
to consider
that
they have been
guilty
of crimes
against
peace,
crimes against humanwar crimes,
serious
non-political
crimes
ity,
outside
the country of refuge,
or
acts contrary
to the purposes and
principles
of the United Nations.
It should be noted that the provisions of the Universal
Declaration
of Human Rights
on asylum from
persecution
are similarly
qualified by the exclusion
of such persons. Persons thus excluded do not
fall
under the High Comnissioner’s
however,
mIt
is,
canpe tence.
likely
that all
those in a major
influx
would be so excluded,
and
when protection
is
clearly
an
need,
humani tar ian
urgent
benefit
of the doubt should %
accorded at least
until
a considered
opinion is available.
Headcourse,
be
must,
of
quarters
action
inrnediately
of
informed
9
’
- Protection
taken
sary.
2.3
arxl advice
sought
as neces-
'Ibe aim ad action to achieve
1.
The aim of international
protection
is to ensure that treatment of refugees is in accordance
with
internationally
accepted
basic
standards,
and especially
the principle
of non-refoulement
according
to which refugees
may
not
be forcibly
returned
to a
country where they have reason to
fear
persecution.
This principle
figures
in paragraph 1 of Article
33 of the 1951 United Nations Convent ion, to which acceding States
may not make a reservation:
“No
Contracting
State shall
expel or
return
(“refouler”)
a refugee
in
any manner whatsoever to the frontiers
of territories
where his
life
or freedom would be threatened on account
of his
race,
religion,
nationality,
membership
of a particular
social
group or
political
opinion.”
(Paragraph
2
of Article
33 provides
for very
limited
exceptions
for
refiigees
reasonabljr regarded as a danger to
the security
or camnunity of the
country where they are. )
them. An on-the-spot
presence and
quick action are generally
crucial
to
the
attsirnnent
of
UMIcR’s
objectives,
particularly
where
there is danger of refoulement
or
abuses of hlPnan rights
such as
arbitrary
detention
or mistreatment.
It
should
be noted
that
UNH(x does not,
as a principle,
famur the granting
of merely temporary
asylum or refuge,
preferring rather
to emphasize the need
to grant durable asylm.
However,
this may not be inmediately
possible, and Representatives
and field
officers
may decide
that
in the
circumstances
only temporary
asylum should be requested,
without
prejudice
to subsequent efforts
to
obtain durable asylum.
4.
‘Ihe conclusions
of the Expert
Group on Temporary Refuge in Situations of Large-Scale
Influx
which
met in Geneva from 21-24 April
1981 state
that
it
is essential
that after
admission
asylum seekers should be treated
in accordthe following
minimum
ance with
basic human standards:
(a) they should
not be penalized or exposed to any unfavourable
treatment
solely
on the ground
that their presence in the country
is considered
unlawful
and they
should not be subjected
to restrictions
on their movements other
than those which are necessary in
the interests
of public health and
order;
2.
Before this aim can be realized, asylum seekers must of course
be admitted to the State in which
they seek refuge, without any discrimination
as to race, religion,
political
opinion
or
nationality,
physical
incapacity.
“Everyone has
the right
to aeek and to enjoy in
other countries
asylun from persecut ion”
(Universal
Declaration
of
Human Rights,
Article
14 (1)).
Operative
paragraph
2 of General
Assembly Resolution
428(V), adopting the Statute,
calls on governments to co-operate
with the High
Canmissioner
in the performance of
his
inter
functions ,
alia,
by
“admitting
refugees to their
territories”.
(b) they should enjoy the fundamental
rights
internationally
recognized,
in
particular
those
set out in the Universal
Declarat ion of Human Rights ;
3.
Thus when an influx
of persons who may be of concern
to
UNHCR occurs,
the overriding
priority
is to ensure that at least
temporary
asylun
is
granted
to
(d) there should be no discrimination
on the grounds
of race
religion,
political
opinion
nationality
or country of origin
10
(c) they
should
be treated
as
persons
whose
tragic
plight
requires
special
understanding
and
all
vw thy ; they should receive
assistance
and
necessary
thy
should not be subject
to cruel,
inhumane or degrading treatment;
- Protecti
(e) they are persons before
the
law enjoying
free access to courts
of law and other canpetent administrative
au.thorities;
(f)
the
location
of asylum-seekers should be determined by their
safety arrd well-being
as well as
by the
security
needs of
the
State.
receiving
Asylum-seekers
should,
as far
as possible,
be
located
at a reasonable
distarvce
from the frontier
of their country
of origin.
‘Ihey should not becane
involved
in subversive
activities
against their country of origin
or
any other State;
(g) they should be provided with
the basic necessities
of life
including
food,
shelter
and basic
sanitary and health facilities;
(h) family
pected ;
unity
should
possible
(i)
all
should be given for
relatives;
be
res-
assistance
the tracing
of
(j]
adequate provision
should be
made for the protection
of minors
and unaccanpanied children ;
(k) the sending and receiving
mail should be allowed ;
(1) material
friends
or
permitted;
of
assistance
from
relatives
should
be
(m) appropriate
arrangements
should be made, where possible,
for
the registration
of births,
deaths
and marriages ;
(n) they should
be granted
all
the necessary facilities
to enable
them to obtain a satisfactory
durable solution;
(0) they should
transfer
assets
brought into the
country where the
is obtained; arxl
(P) all
facilitate
be permitted
to
which
they
had
territory
to the
durable solution
steps should be taken
voluntary repatriation.
to
JF -
5. The same conclusions
cant inue ;
“Asylum-seekers
shall
be
entitled
to contact
the Office of
UMR.
UNHCR shall be given access
to
asylm
seekers.
UNHCR shall
also be given the possibility
of
exercising
its
function
of internationnl
protection
and shall
be
to
supervise
alloweit
the wellbeing of persons entering
reception or other refugee centres . ”
% :ae conclusions
were endor 6.
sed by the forty States Members of
the
Executive
Comnittee
of
the
t!igh Camnissioner ‘s Programne at
the Counittee’s
32nd Session. Ihe
standards
reproduced
above should
form the basis ard framework for
action
by UE~I(X, and particularly
by field
officers,
to ensure protection
in an emergency. Sane of
the international
instruments
that
may be invoked are discussed
in
the
next
section.
Actual
courses
L
action
to secure
the rights
&cribed
in this chapter are outlined in Part 2.
2.4 International
instrunents
1.
In addition
to the Statute,
1951 Convention and 1967 protocol,
there are a n&er
of international instrunents
that may help protect refugees.
In all circumstances , the Charter
of the United
Nations and the Universal
Declaration of Human Rights place certain
general
obligations
on
Member
States
of the United
Nations
of
relevance
to m-m’s
particular
international
protection
futmztion.
The Charter and Universal
Declaration
are the two best known and
least
challenged
of the expresof
hunanitarian
principle
sions
that
may be invoked
by UNHCR,
as they do faith
in
reaf f inning
the
human
rights,
fundamental
principles
of justice
and internat ional law and the equality
of all
before the law.
Attent ion may also be drawn
2.
to the International
Covenants on
human rights,
and in par titular
paragraph
1 of Article
2 of the
International
Covenant
on Civil
and political
Rights:
11
- Protection
‘Qch State. Party to the present
Covensnt undertakes to respect and
to ensure to all irrlividuals
within its territory
ad subject to
its jurisdiction
the rights recognized in the present Covenant,
without distinction
of any kind,
such as race, colour , sex, langureligion,
political
or other
national or social oriIgLtn,
or other
gin., property n birth
status.”
‘Ihe principle
of non-refoule3.
ment has found specific expression
instruFvar
ious international
ments adopted at the universal or
levels. . The principal
regions1
instruments are the United Nations
Declaration on Territorial
Asylun,
the Final
Act of the United
Nations Conference on the Status
of Stateless
Persons, the a4u
Refugee Convention, ard the Mican Conmntior
on Hman Rights.
For example:
“No person (entitled
to invoke article
14 of the Universal
Declaration of Hmsn Rights) shall
be subjected to measures such as
rejection
at the frontier
or, if
he has already entered the territory in which he seeks asylun,
expulsion or canpulsory return to
any State where he may be subjec&
to persecution.”
0.N. Declaration of Territorial
Asylum, adop2312
ted
by G. A. resolution
(XXII); 1967, Article 3, psra. 1.
“In no case may an alien be
deported or returned to a comtry,
regardless of whether or not it is
his country of origin, if in that
country his right to life or personal freedan
is in danger of
being violated
because
of
his
religion,
nationality,
race,
opistatus, or political
social
American
tinvention
-on
nions. ”
liuman Rights
(“Pact of San Jose,
1969, Article
22,
Costa Ri&*
paragraph 8.
Instruments
for
the benefit
4.
established
at
the
of refugees
regional
level have important
impiications
for UN-RR’S protection
function. A notable example is the
12
-
C&W Convention, under which the
term “refugee“ is defined in Artit:le 1 not. only as in the Statute
Of the Off ice, 1951 Convent ion and
1967 Protocol but, more broadly,
as applying:
“to every person who, owing
to external
aggression,
occuption, foreign danination or events
seriously
disturbing
public
order
in eithm part or the whole of his
country of origin or nationality,
is cunpelled to leave his place of
habitual
residence in order to
seek refuge in another place outside
his
country
of
nationality.”
origin
or
In this par titular
case the wider
definition
of the term “refugee”
is broadly Fonsistent
with the
term “displaced
person” as used in
paragraph 2.2.4 (1) ard has the
same implication
tection
for
responsibility.
UIWR’s
pro-
Where both
universal
and regional
instruments
with different
definitions
or provisions
apply,
U&B-RR should seek
to ensure that the more liberal
is
followed.
In countries
that are par ties
instrument (s)
the
relevant
&WS
function
is
protection
naturally
facilitated.
Article
35
1951 Convent ion obliges
the
of
to the Convention
States
parties
to co-operate
with UNHCR in the
exercise
of its
functions
and in
particular
to facilitate
LWHR’s
duty of supervising
the application
of the Convention’s
provisions.
Even when an emergency
occurs in a country
not party to
instrunents ,
international
the
these may nevertheless
be brought
to the attention
of the government, for they define standards of
internatiowhich
are
treatment
nally
recognized,
as evidenced by
the large
numbers of Contracting
moral
Similarly,
the
States.
the
of conclusions
of
strength
Executive -ittee
is not limited
to States Members, for tt’e Members
are elected
by and act on behalf
of the international
ccomunity as
a whole.
5.
- Protection
of fences ccmnitted
before
t ion, also provides :
2.5
1.
lhe ICRC, as a promoter of
law,
hunani tar ian
international
plays an important role in reinforcing
the international
prctecand displaced
tion
of refugees
particularly
in situapersons,
tions of armed conflict:
protection of refugees is an important
international
preoccupation
of
applicable
in
humanitarian
law
armed conflicts.
In addition
to
supervision
the
functions
of
entrusted to the Protecting
Powers
by the four Geneva Conventions of
August 1949 and their
additional
Protocols
of 1977, the ICRC is
also entitled
to visit
and assist
all the persons protected
by the
Convent ions.
It may even assthe hunanitarian
tasks imparted to
the Protecting
Powers by the Conventions whenever no such mers
could be designated.
2.
Refugees and displaced
persons are protected
persons under
the Fourth Geneva Convention when
they “f iti themselves, in case of
a conflict
or occupation,
in the
hanis of a Party to the conflict
or Occupying Power of which they
This Convenare not nationals”.
tion
further
provides
for
the
reunion of dispersed families,
for
places
super vis ion of all
the
where protected
persons are, and
hunanitarian
act ivifor general
ties.
Article
44 of the Fourth
3.
vent ion provides :
-
Con-
“In applying the measures of
control
mntioned
in the present
the Detaining
Power
Convent ion,
shall
not treat as enemy aliens
exclusively
on the basis of theit
nationality
de jure of an enemy
State, refugees who do not in fact
protection
of
any
enjoy
the
government .‘I (emphasis added)
Article
70 of
the Fourth
4.
dealing
with
Geneva Convent ion,
occupa-
“Nationals
of the Occupying
Power who, before the outbreak of
hostilities,
have sought refuge in
the
territory
of
the occupied
State, shall not be arrested,
persecuted,
convicted
or
law - corunitted before the outbreak
of hostilities
which, according to
the law of the occupied State,
would have just if ied extradition
in time of peace. ” (emphasis added)
Persons who fled thei-: home country before the outbreak of hostilities
and found refuge or asylum
in the occupied country thus rank
as refugees.
5.
The relevant
provisions
were
further strengthened by Article
73
of Protocol
I additional
to the
Geneva Canventions and relating
to
the
victims
of
protect ion
of
international
conflicts,
armed
which states :
“Persons who, before the beginning of hostilities,
were considered
as stateless
persons or
refugees under the relevant interaccepted by
nationa:
instruments
the Par ties concerned or under the
national
legislation
of the State
of refuse or State of residence
shall beu protected persons within
the meaning of Parts I and III of
of the Fourth Convent ion, in all
circumstances
and without
any
distinction.”
(emphasis
adverse
added)
the reunification
Concerning
6.
of dispersed
families,
Article
26
of the Fourth Geneva Convent ion
provides :
“Each Party to the conflict
shall facilitate
enquiries made by
dispersed
families
member6 of
owing to the war, with the pbject
one
with
of
renewing
contact
another and f meetinp, if rossible. It shalf encourage, in particu!.ar , the work of organizations
engaged on this task provided they
13
- Protection
are acceptable
to its security
phas is added)
to it and conform
regulations.”
(em-
This Article
is concerned with the
rc-establistment
of
family
ties
and therefore
applies
solely
to
members of dispersed families.
The
parties
to the conflict
not only
must allow members of dispersed
families
to make enquiries,
they
must facilitate
such enquiries.
The main aim of this &r+icle
is
the safeguarding
of family unity
and the re-establishr*ent
of contacts between members of a family
group. The obligations
on the nar ties in this regard are reaff i&uzd
arrl reinforced
in Article
74 of
the Mditional
Protocol I.
7.
Concerning the supervision
of
places
where protected
persons
are, Article
143 of the Fourth
Geneva Convention,
inter
alia,
provides :
‘Representatives
or delegates
of the Protecting
Powers shall
have permission
to go to all
places
where protected
persons
particularly
to places
of
me,
internnent,
detention and work.
“They shall
have assess to
all premises occupied by protected
persons
and shall
be able
to
interview
the latter
without witnesses , personally
or through an
interpreter.
“The delegates of the Inter national
C;arittee
of
the Red
Cross shall also enjo] the above
prerogatives . ”
Owing
armed
14
to the roie
it
conflicts,
the
plays in
ICRC can
therefore
sometimes visit
detainees -.-who are of concern to the
High tiissizner
“6Z? to whom
UNHCR reprezntatives
may have no
access. These visl ts, which can
have great humanitarian value, are
a direct
complement to the action
of UNHCR.
8.
Concerning
general
humanitarian activities,
Article
10 of the
Fourth Convent ion provides :
“The provisions
of the present
Convenr ion
constitute
no
obstacle to the humanitarian activi ties
which
the
International
Conmittee of the Red Cross or any
other impartial
humanitarian organization
may, subject to the consent of the Par ties to the conf lit t concerned, urrlertake for the
protection
of civilian
persons and
for thei: relief.”
The above Art isle allows any initiative
or
activity
that
LLlily
appear necessary for the benefit
of protected
persons, even if not
explicitly
or implicitly
foreseen
by the Convention. Such right
of
initiative
granted to the TCRC or
to any other
impartial
humani tarian organization
is considered as
a prerogative
of umst
importance
by the International
Red Cross.
9.
Close
working
relationships
and regular
exist
consultations
between the ICRC, the league of
Red Cross Societies
anA UNMX in
matters
of cannon interest.
It
should be noted that the services
of the ICRC Central Tracing Agency
(see chapter 11) and ICRC travel
documents can be a valuable source
of protection for refugees.
I’
List
Section
3.1
.
of contents
Paragraph
l- 5
3.2 ‘.
l- 6
7
8
9
s!
12
I.3
3.3
Contents
Introduction
16
Needs acsessment
16
Organization
J%mberS, location, pattern of
arrival and *-rharacteristics
Hkalth status
Material condition
&aracAeristi~
of location
Social needs
Spontaneous arranguxi5mzs and
assistance being provided
&am to deliver assistawe
17
Imediate
1
f- 9
response
Protection
Orgmizational
considerations
Material assistance
1’;
19
15
3.1J,utmdmtim
1. To be effective,
emergency
assistarrce has to be based on a
sound assessment of the refugees ’
mst
irnnediate needs and no two
refug-e emergencies are alike.
2. The initial
assessment must be
carried out as quickly as possible
to allow
inmediate action.
More
detailed
assessments will
follow
as the emergency phase dovetails
into longer- term programnes. Needs
evolve in the course of an emeroperation
so
assessment
gew
never stops.
3. Guidelines
for specific
sectors of assistance follow in chapters 5 to 11. Here the initial
needs assessment is linked to the
inmediate respnse.
4. A number of organizations
may
already
be delivering
emergency
iCRy
will
be a valuassistance.
able source of information
on the
situation,
and the assistance they
are giving and intend to give must
be taken into account in deciding
UNHCR’s imnediate response. There
may be other progras,
established before the urgency,
which
can be extended to the refugees.
5. Where the emergency concerns
the imnediate protection
of refuthan their need for
west rather
the priority
material
assistance,
will
be to obtain information
on
the actual situation,
position
of
the governnent(s)
and possibilities
for resolution.
An on-thespot UNHcgi presence will
be very
important.
Aotion in such emergencies will
depend on the circumstances and is not considered in
this
chapter .
Certain
general
guidelines
are given in the previ ous chapter .
3-2 Needs assessment
Organization
1. An initial
assessment of the
situation
and needs must be carried out on the spot as soon as it
is clear that a refugee emergency
15
may exist.
This must involve the
gover went.
Inmediate
access to
the area where the refugees are
located is, of course, a prerequisite.
The emphasis must be on
quick, practical
steps : establishing a presence at or near the
refugee site for first-had
information,
interviewing
refugees,
utilizing
other available
sources
Of information
both in the area
an3 in the capital,
and mobilizing
local
expertise
and resources.
Rarely will relief
aid from abroad
arrive in time to preserve life in
the first days of an emergency.
2. While an organized approach is
necessary , time must not be lost
because the desired expertise
is
not imnediately available.
A quick
response to obviously urgent needs
must never be delayed because a
comprehens ive assessment has not
yet been completed.
3. A detailed
assessment must be
undertb;ken as soon as possible.
Brief indications
of the types of
expertise
that may be required are
given
below,
with
more detail
given by sectors in later
chapters. Local expertise
is generally
best when available.
Sources include government departments,
the
UN system, bilateral
aid and voluntary agencies, universities
and
consulting
firms in the country.
Headquarters ’ assistance should be
requested if necessary.
4. Where UNHCR is not already
the
present
in
the
country,
assessment mission will be organized by Headquarters . Whenever poss ible,
the assessment team would
include
those who are going to
implement the emergency operation
in the field.
The participation
of
who will
one or more officers
return
to Headquarters
with the
the assessment has
results
of
but
obvious
advantages,
where
UNHCR is already present,
initial
action must not be delayed pending
the arrival
of a Headquarters mission.
needs
5. Participation
in
the
assessment by other organizations
- Needs assessment and inmediate response and individuals
likely
to be involved in the emergency prograxae
will be extremely valuable.
6. To assess the material
needs
of refugees in an emergency is to
measure, as quickly
arrJ effectively as is possible,
their actual
condition
and the resources
at
their
disposal
against
what is
needed for
their
survival
ard
inmediate well-being.
So standards
establishing
what is needed must
be set. To the extent possible,
the needs assessment should first
answer the questions in the following sragraphs.
SCQE of these
questions may seem frcm a field
perspective
less
important
than
others.
-ever
this is in fact
the essential
minimun information
required
for the launch of an
emergency prograume which includes , arm% other
non-field
but
vital
aspects,
the alerting
of
potential
donors.
The exercise
will also prove to be a foundation
for
the field’s
own subsequent
progranming process.
IWbWS,
arrival
7.
location,
pattern
and characteristics
(1) Approximately
refugees are there?
(2)
of
how
many
Where are they located?
(3) Are u&e arriving?
Where?
%w many? Up to bow many could
cw?
(4) Are
they
arriving
in
groups
of scattered
Mividuals or as families,
clans,
tribal,
ethnic
or
village
groups and by what means are
they travelling?
(5) Did those already
there
arrive in a similar manner?
(8)
Sedentary
ground?
(9)
Skills
or nanadic
back-
and language(s)?
(10) Customary basic diet?
(11) Custcmary shelter?
(12) CustQnary
t ices?
Health status
8. (1) Are
numbers
persons?
(chapters
prac-
7 and 8)
there
signif icant
injured
or sick
of
(2) Signs
tion?
(3)
sanitation
of
severe
A high mortality
(4) Specially
ups?
malnutrirate?
vulnerable
(5) What was their
before the emergency?
gro-
condition
Assessment of the health status of
refugees
requires
expertise;
never theless
an early
assessment
is essential
and preliminary
conclusions must be reached as soon
as pass ible.
Material
condition
9. Have the refugees brought
are the following available:
or
!:I&
Sufficient
clothing,
bfanetc.
to meet immediate
need;?
(2)
Food?
(3)
Shelter material?
(4)
Danestic utensils?
(5)
Livestock?
(6) What are the approximate
proportions
of
men, warnen,
children
(ages O-4, 5-14, 15
and over)?
(6) Funds (and can they be
fairly
exchanged for local. currency) ?
(7) Ethnic/ge
raphic
(urban or rural gi ?
-(7) Other
cles. etc.)?
or igin
possessions
(vehi-
17
- Needs assessment anl immediate response Chsracteristics
of location
10. .lhese are gimn as site selection
criteria
in chapter
6; an
assessment based on the followcriteria
will
provide
the
is
information
on which a decision
can be made to try and move the
refugees if the location
is very
unsatisfactory;
if
this
is not
necessary,, it nevertheless
establislpes
the adqantsgas and drawbacks of particular
sites allowing
corrective
actions
to be incorporated
in the emergency actior.
plan.
(1)
Space;
(2)
Security;
(3) Are many refugees aesarated
from (3ther
members of
tE;e ir families?
=taneous
arrangements
stanLGTEing
nrovidGT-a-L
and assi-
12. (1) What arrangements have the
refugees already made to meet
their most immediate needs?
(2) What assistance is already
beirg
provided
by the local
population,
the goverment and
other organizations?
(all-sea-(3) Accessibility
son) and proximity
to sources
of
supplies
(build. essential
cooking
fuel
materials,
Zj;
a
(3) CEin the above provide
durable basis for their survival and well-being
at their
present location?
(4) Environmental
conditions
and seasonal variations;
present
(4) Is
likely
to continue,
decrease?
(5)
Water (chapter 9);
(6) Soil
dra in5ge ;
(7)
topogr+y
mans to deliver
and
Vegetation;
(8) Land rights
local population.
and impact on
(9) Is there grazing
potential
areas for
t ion?
land and
cultiva-
Expertise may be required in geology, physical planning and public
health
engineering,
especially
water and sanitation.
Social needs (chapter
11 )
11. (1) Are there individuals
or
with
special
social
g*ups
needs (for example, the mentally
o: physically
disabled,
unaccwnied
children,
single parent families,
the sick
and
destitute,
unsupported
elderly refugees)?
18
(2) Are their
Miate
mate-.
rial
and emotional needs being met satisfactorily
aild if
not what outside assistance is
needed?
assistance
increase,
sssistance
13. (I) Can effective
implementing
arrangements be made quickly
and locally (chapter 4)?
(2) If
not,
alternatives?
what
are
the
(3) Is there already an ident if ied refugee leadership
with
whom it will
be possible
to
co-ordinate
the delivery
of
assistance?
(4) What are the logist ical
needs and how can they brl met
(chapter 5)?
- Where will
the
supplies ccme from?
- How will
refugees?
they
- What
storage
where and how?
necessary
reach
is
the
needed,
- Needs assessment and immediate response ’ - Are th&re essential
items
which can only be obtained
0uCside
the
region
an.!
whose early supply will
1~
critical
‘of
importance
(e.g. food, trucks)? *
(5) What arrangements are required
to
co-ordinate
the
emergency programne with all
conoerned (chapter 12 )?
(6) What Lare t&
needs for
IIIWX personnel,
and experts
not provided *rider implementing .arrangements (chapter 4)
and UXiCR progranme
(off ices,
vehicles,
c%%t
cations, equipment, etc.)?
3.3
-IPrXection
1.
Unless the refugees’ right to
asylum is assured there an be no
programne I Action
;;;ist;z
to
3 and to ensure tl?eir
security
fundamental
human
ad
rights,
,as set out in chapter 2,
priority.
will
be the overriding.
The importance of a UMCR presence
where the refugees are has been
stressed in that chapter. Specific
measures may be needed, for 3xample to meet the special protection
needs of the vulnerable
(unacccmpanied
children,
single
YOU%
girls,
minorities
etc.),
and to
protect the refugees against arbitrary
actions
of outsiders
and
against
groups witbin
their
own
nunber who may pose a tbreat to
the safety of other refugees.
Organizational
considerations
--
2.
The priority
cme needs have
beg,
assessed
will
be to provide
.
assistanoe
the
wherever
refugees
are.
There will
also,
however, be key organizational
or
planning decisions
to take, tiu~e
of which may determine the future
shape of
the whole operation.
These of ten include
the points
snmar ized
below;
dec is ions
Or,
them should be seen as a part of
the imnediate response. If they go
by default or are wrong they will
be very difficult
to correct later.
(1) The location
of tbe refugees.
This -have
wi 1
influ&iFe
on all sectors of assistance:
If
the refugees are not concentrated
together
ir.
settlements,
they
should not be brought into them
unless there are ccmpelling
reasoLw for breaking
their
present
pattern
of
spontaneoils
informal
set tlwnts
. Xf tlYZy are already
in settlements which judged by the
criteria
in 3.2.LQ above are unsatisfactory,
move them. ?he dif ficulty in moving refugees from an
unsuita3le
site
increases
kedly with time. Even if tEe
already
there
t2tmlot be moved,
divert new arr ivals elsewhere.
(2 j RecepCion or transit
centres.
These a=-kenerally
reccmmen&d
when an influx is likely to continue . In some circumstances
they
are essential
for the protection
of asylun seekers.
(3) -Control
at the si*.
Deterin
mine rbe opC.mun population
advance and - plan for’ new sites
accord ingiy . Keep careful
control
of actual. occupation of the site
as reftigees arrive,
so that sect ions
prepared
in advance are
filled in an orderly manner.
(4) -Numbers and .+i-..&-*.
re istrction
An
accura& estimate ci.: nu ers 1s a
prerequisite
for
i;r!y effective
assistance.
Delivery
of help to
all in ne& will require at least
family
registraeio78
and a fair
distribution
systes.
The sooner
this
is est&blished
the better.
(See ch.12.6i
Material
-,L--.
assistance
imnediate mate3. While certain
rial
needs =will usually b? obvious,
the
specific
types
and
amounts of ~prp9~.y
assQ&ance
required will dcp.~rxl on tbs! etandards established
for each situatier\. An Imi.cation
of appropriate
general standards is given by sectors of assis%wc
in ‘he chapters
that fallow,
Z-.FLZX standards must
be adjur:ted in the light of three
main considerations:
the general
condition
of the refugee popla19
- Needs assessment and immediate response tion
(people in extreme distress
will
need extraordinary
measur&*s);
available
resources
ismediately
food may
(for example, unfamiliar
have to be used if there is nothand the customs and
ing else);
levels to which the refugees and
the local wutlation
are used. The
4. Gatheri&
the information
summarized in paragraphs 7-13 of the
previous section, on the one hand,
and the establishsent
of stanwill
allow
dards , on the other,
the ismediate unoet needs to be
most
urgent
determined.
The
actions must be taken with whatever local material
and organizaresources
are available,
tional
even if the information at hand is
parairrcomplete.
The following
graphs irrdicate
actions
that are
likely to be priorities.
5. Ensure the capacity
to act.
‘Ihe first
priority
is to provide
the organizational
capacity required to meet the needs of the emergency. Ehough UNXR staff of the
right
calibre
and experierre
must
Hnergency procedures
be deployed.
funds )
for
the
alloation
of
food
arrangmnts,
implementing
SUPplYt local purchase, and recruitment of personnel may need to
With the governrent,
be inmked.
the resources of other UN orgaparticularly
UNDP,
nizations,
UNXEF, WHO and WFP, and of the
NGO sectcz sust be mobilized within the framework of a plan for
iranediate action.
6. iJ%UX must establish
a presenCe where the refugees are, with
with
the
assured
ccmuunications
main office and theme with Headquarters.
Ihe organization
of *
necessary
logistical
capacity
to
deliver
the assistacre
will he of
critiral
importarre.
26
7.
&et the most urgent survival
needs :
food,
water,
mergerq
shelter,
health
care and sanitation,. ensuring fair distribution.
(i)
Involve
the
refugees
ati
promote
their
self-sufficiency
from the ’ start.
Involving
the
refugees in outsiders ’ plans for
their welfare is often difficult.
But if it is not done the effectiveness of the emergency assistance will he severely reduced, and
.an early opportunity
to help the
refugees to start to recover from
the psychological
effects of their
ordeal may be missed,
(ii)
Food. msure that at least
the rnmum
need for energy is
met; a full ration can follow. get
up special
&ziing
programnes if
there
are
indications
of
Establish
storage
malnutrition.
facilities.
Protect
existing
(iii) Water.
water sources from pollution
and
establish
maximum storage capxity
with the simplest available means.
Transport water to the site if the
need cannot otherwise be met.
(iv)
need
als
ble.
(e.g.
sary.
Bner enc
shelter.
&et
the
----ktJroo lne:mother
for
materifrom local” sources if possiQ11y request outside supplies
tents)
if absolutely
neces-
(v)
Bealth
care.
Provide
the
organizational
assistnecessary
ance, health personnel and basic
drugs and equipment in close consultation
with the national
health
author i ties . Although the intnediate need and demand may be for
curative care, do not neglect preventive and particularly
environmental health measures.
Isolc te
hunan
(vi) Sanitation.
excreta from sources of water and
accdation.
Take steps to meet the social
8.
families
if
needs and reunite
necessary.
S0r veys may be neces-
- Needs assessment arrl imediate
sary to identify
those in need,
wtm often do uet CUE forward.
Tracirg may be required.
If groups
of refeees
have been split
thsy
should be reunited.
Special measures to ensure the care of any
response -
unaccanpanied
priority.
children
will
be a
9.
Once these arrl other priori ty measures are urderway , begin
the wider planning process.
List of contents
Section
4.1
Paragraph
l- 8
4.2
1
2
3- 9
10-14
15
16
4.3
Contents
24
Introduction
(operational
and non-operational
Impleumting
arrangewnts
Role of the government
Role of UN organiz&ions
Other operational partners
Contractual arrangements
Alministrative
expenditure
operational par tner 6
Direct UN%X expenditure
by
Personnel
l- 2
;I !J
General
UNICR field
Experts
staff
:,”
~.
l . r”’
/”
requirements
role)
25
25
25
27
28
28
I
4.1 II&troduction
1.
arrangements
to
Appropriate
implement an emergency programne
will
be fundamental to its suc-
mU$s,thyb
‘zr$$!!
nal
partner(s),
other
organizations or are from BMlllg the refugees themselves. The right people
must be available
where and when
needed.
2.
possible,
Whenever
IlNim
seeks
to
implement
material
assistance
programnes through an
operational
partner,
rather
than
directly.
There are a nunber of
reasons for this policy,
the origins of which are refl&ted
in the
Statute of UNIQL Article
1 requires the High Carmissioner to seek
“permanent solutions
for the problem of
refugees
by assisting
Govermnents arrl, subject
to the
approval of the Govermnts
conprivate
organizations..
.‘I.
CWlt33,
In accordance with the first
sentence of Article
10, The High
Cunnissioner
shall administer
any
funds, public or private,
which he
receiws
for assistance
to refudistribute
them
gees , and shall
among the pr irate and, as appropublic agencies t?hich he
priate,
deems best qualified
to administer
such assistance.”
3.
UNCHRhas an ;urique statutory
responsibility
providing
international
protection
to refugees and seeking permanent solutions for their problems. No such
uniqueness, of course, characterizes arrangemenets for the actual
provision
distribution
of
emergency assistance
to the refugees.
‘Ihere are obvious advantages
.
implementing
prograume
Zrough national
org&izations
or
those already
familiar
with the
Many organizations
and
country.
agent ies , both govermmntal
and
non-governmental,
have as much, or
24
more, experience and expertise
as
UNHC2l in
directly
implementing
assistance
programnes for
refugees, because this is not normally
‘UNICR’S role.
4.
Whatever
the
implementing
arrangements,
overall
responsibility
remains with the government,
assisted by UNHCR. In a non-operat ional role,
UNUCR is responsible
for assisting
goverrxnents in the
assessment of needs and the developnent
of assistance
prograunms
to meet them, and for monitoring
and controlling
the impleemntation
by others of programnes financed
by uNH(x. UNHCR always retains
responsibility
for accounting
to
donors for the proper expenditure
or use of their contributions,
and
within
the
limits
of
ensuring,
available
means, that basic needs
are met.
5.
There are circumstances
in
which it may be clearly
in the
interests
of
the refugees
for
UNKR to assune greater
operational
responsibility,
at
least
during the initial
emergency phase
of the prograrrme. No general guidance can be given on the most
appropriate
implementing
arrangements and the &sired
degree of
UNH(x'S
opera t i ,.la1 involvement.
These will vary for each emergency
situation,
and also with time as
the
evolves.
UNHm’s~
progrrole may therefore range from conpletely
non-operational
to a high
degree of operational
responsibility.
Where the latter
is the
case, U’&I(X must take swift direct
action to ensure that the necessary personnel and expertise
are
available.
Mechanisms to ensure the co6.
ordination
of the overall
programne are discussed in chapter 12.
responsibility
for
UNHm'S
security , well-being
and proadministration
of its
%f
is self-evident.
While I.$%
has no legal
obligation
towards
others working for the refugees,
there is a clear moral responsibility
for UNHCR to do all that is
7.
the
- Implementing arrangements and personnel
reasonably
possible
to help the
goverrurr?nt to ensure their security.
Mministra t ive aspects,
for
example visas, ccmnuunications and
transport , are the responsibility
of Midduals
or their
parent
organization,
not UNKlL It
is,
in everyone’ s
however, obviously
interests
that such matters do not
himler the de1 ivery of assistance.
Sow common arrangements in the
context
of a . N;o co-ordination
mechanism may be possible.
Figure
4-l
overleaf
shows
8.
some of the considerations
discussed in this chapter in diagrammatic form in the context of the
overall emergerrcy response.
4.2
Role of the government
1.
The governxent ’ L CoITurrence
must, in accordme
with Article
1
cydStatute,
be so-t
on the
implementintr
arrangePm
ments o There are often a number of
factors,
both practical
and political,
to consider.
At the start
of an emergency, the govertrnent
itself
frequently
has full operational
responsibility.
For examis often first
ple, a new influx
assisted by the local district
and
provimial
authorities.
If
the
government assunes the role
of
operational
partner,
UIWX’s direct
operational
responsibilities
are likely to be limited.
Role of UN organizations
2.
In addition
to UNDP, psrticularly
where UNRX was not previously
present,
the
two UN
organizations
most likely
to be
directly
ccxlcerned in the early
stages of a refugee emergency are
WHOard WFP. Their roles are described in chapters 7 and 8 respectively.
Other possible formal implementing
arrangeumnts
in
the
phase might
emergency
involve
UNI0ZF, especially
with regard to
water supply.
Other operational
partners
3.
The scale and needs of the
be such that
a
=gew
my
number of different
implementing
arrangements
are needed in the
varJous sectors.
Qle organization
might have operational
responsibility
for health care, for example
the national
Red Cross Society
supported by the IRCS, and another
for logist its . Even within a sector,
operational
responsibility
may have to be “sub-contracted”.
For instance,
under the overall
responsibility
of the national Red
CkGSS
Society,
different
m
might have responsibility
for the
health care of different
refugee
groups
or
camumities.
Overall
operational
responsibility
should
not, however, be divided.
4.
Where the goverrtnent is not
the
operational
partner,
there
would be obvious advantages in the
selection,
with
the govermnent ’ 5
approval,
of a national
ormnization with the required
capacity,
or a MGO active in the country.
Some looally-based
organizations
may already
he delivering
emergency assistance. At least for the
initial
relief
phase, consideration should be given to using the
national Red Cross or Red Crescent
Society
in a wider implementing
role than just
health care; any
approach to them should be co-ordinated
with
the LRCS through
mm
Headquarters.
The lRcs may
be able to help strengthen quickly
the
capacity
of
the
national
society to implement the emergency
programne. Similarly,
non-national
IWB already working in the country may be strengthened by their
headquarters.
Where no suitable
operational
5.
partner
is imnediately
available
within the country, UNIQX may initially
have to assune a considerable degree of direct
operational
responsibility.
At the se
time,
steps should be taken to identify
and organize
others
to assure
these responsibilities
as noon as
pass ible. Direct UIWR operational
in\lolvement will require the rapid
25
-
- Jmplementing arrangements and personnel
!-b
I
Ekks,URe
-
coM&WbJlWl-ONS
r
PLANS
oJ*ct(ON
~QON
1 cwne&
E~~bLISl+MEIJt
APNG
MECWNIBMS,
LOC+lsflCCS.
ALWCA~C’N
O#
q
CO - ORDINb
C
a
OPEWiilONAC
DW%T
UtibkLR
MoBILIZA~O~~
PERSONNEL,
Wb
OF&AN
R6sou~~~s.
PICOCUEEEhE+r,
CO~AC-tWC6
owN#iiONAL
?-ION
:
OF
M~TtS3.C
lG’.~CW&L
E-/c.
4-l
26
BaqLy
~0b.l
.
A RRAq GfME+
IMPLEME~lb%
EMtLtUH5NC)’
Res-po~sE
0ptfq-l0NA
L
- Implementing arrangements and personnel
deplomt
of uore UNUi
staff
than would otherwise be necessary.
Key nndters
of the team should
already
have direct
operational
experiee
of the management of an
that is of
emergency prograrme,
the imnediate delivery
of assistance at the site level which is
normally the responsibility
of the
operational partner.
6.
IJlWX’s operational
responsibility
may extend beyorxl the overall management to 801~ or even all
of the sectors of assistance.
In
extreme cases this may also require UNKR to employ the specialists , such as doctors, nurses ati
public health engineers, who wvluld
otherwise
bee?;,,
b
the
operational
However,
every effort
sbuld
f&t
be made
to find
organizations
with
the
expertise
to implement these prograrmes . Many [email protected] have qreat
experierre
of refugee emergencies
and sune can deploy teans at short
notice,
both for specific
sectors
and for general
menagant.
In
addition
to their own staff,
they
will also ICLWUof a wide circle of
irrlividuals
with
the appropriate
skills and experience.
7.
A n&or
of
goverrmental
orpizations
have relevant expertise.
include
lhese
national
disaster
corps, organizations
concentratiw
on a specific
sector,
such
as
health,
and certain
goverrmental
overseas aid organizations.
Nstional
disaster
corps
are able to intervene quickly for
limited
duration
and
ienerally
best used ’ for urge::
clearlydef
ined and self -contained
tasks.
Headpuarters
should be consulted
on the prorosed
islementing arrammnts.
If suitable
onera tional
nsrtners
are
not
a;ailable
from- within the country,
detailed
information
on requirements , with
possible
swestions
for [email protected] them and other relevant factors (for example, political constraints),
should be conveyed to headquarters as soon as
possible.
In
certain
circun8.
-
stances,
cufmercial
contractual
arrangenkznts
may be made with
organizations,
i3gencies or industry.
9.
Special
implementing arrangements may be needed- in a protection Grgency
where as a last
resort refugees have to be moved
from one country
of asylum to
another,
often
by air.
UIWX’S
traditional
operational
partner in
many such situations
has been the
Inter-govermnental
Carmittee
for
Migration
(I(M),
while
the ICRC
may be closely involved and issue
travel
documents . Transportation
arrangements
should,
of
course,
not be delayed, but Mdquarters
’
advice must be sought at once,
both on implementing arrangements
and on financial
aspects, including reductions
in carmercial
air
fares and procedures for chartering aircraft
if necessary.
Contractual
arrangements
’
10. A formal signed agreement is
reouired
between UNiCR and
Y
party disbursing
UtWX funzls 2
certain
standard
clauses
must
figure
in
any such agreement,
Conclusion
and signature
of the
agreement may take time. Where a
suitable
operational
partner
is
available
locally,
ir
may be
necessary to exchange letters
of
intent
to conclude the agreement,
in order not to delay disbursgnent
of funds and the start of the prograame. Guidance is given in Part 2.
11. l’he Financial Rules for Voluntary Fur& Mministered
iyb;he iil~
Cuunissioner
provide
agreements may be concluded under
the authority
of a letter
of instruction
“when a representative
has
to cope with an urgent situation
and must conclude a sub-contract
with a local agency without delay”.
Subsequent agremnts
with operational
parmers
would normally be
drawn up hy Headquarters for signature in the field.
12. Ihe form of the agreement will
depend on the circunstarzes,
and on
the identity
of the operational
27
- Implementing arrangements and personnel
partner . Where the government is
not an operational
partner, a trisanetimes
partite
agreement
is
concluded between the govertmmnt,
UNICR arrd the operational
partner,
setting
out the responsibilities
for example the
of each party,
govermnt’s
undertakings
in respect of such matters as tbe facilitation
of the import and transport of relief
supplies
(traf fit
and larding
rights,
tax and custans exemptions, etc.),
cannunicaand its own contributions
tions,
to the programne (land, services,
separate
etc.).
Alternst ively ,
agreements may be concluded hetween UI?lCR and the government, and
IJIWX arkI the operational
partner(s).
I
I
the
agreement
with
13. l.he
government covering
the provision
is quite
separate
of, assistance
from the administrative
agreement
of the
that governs the status
High Czcmissioner ’ s representation
in the country.
Where such an
often
referred
to as
ag--rrt,
“Branch
Off ice
Agreement”,
the
special
needs to be concluded,
will
be given
by
instructions
ZIea&uarters.
14. For implement ir7g arrangements
with partners not already in the
country I agreements will generally
be concluded by Headquarters
in
close consultation
with the Representat ive, particularly
where the
transfer
of funds takes place at
Headquarters and not at the field
Operational
arrangements
level.
with other UN organizations
are
generally
made at Headquarters’
level.
Administrative
expenditure
tional partners
by opera-
15. As a general prirr:iple
UNICR
does not meet the administrative
costs
of other
organizations
or
agerries.
-ever,
the actual cost
of direct
programne supper t exuenditure
incurred by the o+zational
partner may be met, if necessary,
by UWX U&T
the terms of the
F;rrt,
whose f:ext and budget
d
make cleec
exactly
what
28
-
administrative
experditures
are to
be covered. Where the govertlnent
is the operational
partner,
the
necessary personnel are generally
regarded as a “matching” contribution. UNUCXdoes not meet unspecified general administrative
overhead costs or percentage service
charges.
Headquarters’
advice
should be sought on levels
of
administrative
expenditure
by
operational partners.
Direct
UNiiCRexpenditure
16. Even when UNHCRhas no direct
operational
responsibility,
there
is likely
to be a need for direct
UNICR project as well as programne
expenditure.
‘Ihis
might
support
for example, internatioinclude,
nal
procurement by UNHCR, clear .
storage and internal
trans2;
expenses for contributions
in
kind, and a limited direct
operaexperkliture,
t ional
particularly
initially,
by UNIBi field officers
at the site of the refugees. Contractual
arrangements with operatake
t ional
partners
should
this
as necessary,
account
of
funds
ident if ying
clearly
any
foreseen for such direct
expenditure
by UNHCR if
there
would
otherwise
be risk
of misunderstanding. A three-column budget or
schedule may be bzlpful,
showing
direct
expenditure
by the operational
partner , by UN1CR and the
total.
4.3
Personnel
General
1.
Many chapters
in this handbook, including
this one, stress
the
importance
of
experts
aod
appropriate
expertise
and experierre, par titular ly that gained in
the country
or region,
for the
management of refugee
effective
emergencies. This is indeed essential,
and an unprofessional
approach can have disastrous
consequences for the refugees. However,
experience suggests that the other
those Who manage
qualities
of
at whatever
refugee emergencies,
level and whoever they work for,
- Implementing arrangements and personnel
are even more important. No amXlnt
and experience
can
of expertise
substitute
for organizing
skills,
a readiness to improflexibility,
vise, the ability
to get on with
others ant! work under pressure no
matter
how difficult
the cordisensitivity
to other
tions,
tact,
cultures
ard particularly
to the
plight of refugees, a readiness to
listen,
ati, not least, a sense of
hunour.
8, for
meeting
2.
Responsibility
agreed personnel needs rests with
except w&e
speciHeadquarters,
fic authority
for local
recruitment has been given to the Repreare made
sentat ive. Where staff
available
to UN-K% by organizations,
the financial
arrangements
will depetxi on the circumstances.
UNKR field
staff
requirements
A staffing
table
should be
3.
drawn up as soon as possible. Much
implementing
will
depetrl
bu?
depending
on
arrangements,
the scale of the’ emergency, the
need for at least the following
international
staff should be cons idered :
Representative
lkpcty Representative
Field Officers deployed at the
site of the refugees
Protection Officer
Programne Officers
Public Information Officer
Finance Officer
Personnel Of f icer
Mministrative
Assistant
Secre tar y
Particular
attention
must be
4.
paid to the administrative
staff.
administrative
exper iemed
An
assistant
will
be an essential
men&r of the team if a new office
is bei%
opened, and in large
experienced
finance
emerge= ies
and personnel officers
are likely
to be necessary. Without persons
with these skills,
the effectiveness of the whole operation will
be prejudiced,
and the senior
staff will
have to devote a disproportionate
aa0unt of time to
-
UNHCX internal
administration
at
the expense of the refugees. bcal
administrative
staff
must,
of
course, be identified
and trained,
but this in itself
requires experienced supervision.
The overriding
staffing
prio5.
rity is to fill
the key managerial
posts I at the very least those of
the Representative,
Deputy , Senior
Progpmne Officer and the Heads of
field
or ;;Fhof f ices outside
the
capital,
experienced
IJNHCR
staff of the right calibre.
Prior
experience of an emergency operation is, of course, a great advantage. Ihis
requirement
may mean
a+, least for the durachw+x3,
tion of the emergency, the Representative
in a country where a
major emergency is added to a
small-scale
previous
prograume .
For emergenr:ies in countries where
UNKR was not previously
present,
it will inevitably
mean very short
notice redeployment
of senior and
middle-level
staff , Filling
the
key field
posts quickly
and correctly
is difficult,
but it
is
generally
simply
a question
of
relative
determining
priori ties,
and in a refugee anergency there
is no doubt where the priority
lies.
6.
If the need for professional
field
staff
cannot be fully
met
from within URKR, the choice is
broadly between turning to irriividuals known to UNHCR, or to organizations . The former may be the
better option where UNicR is less
operational
and the latter
where
UNNX is more operational
when, as
has already been swested,
it may
be better to met the needs with a
team rather than piecemeal. There
is, however, one special case of
the former : where scme suitable
UNtiCR professional
staff
can be
recruited
locally.
The procedures
to be followed in such circunstances are giwn in Part 2. The UN
Volunteers
Progranme is a potential
source of more junior-level
personnel .
29
- Implementing .arrangmts
m=ts
7. Each refugei emergency will
require a certain umber of specialist &ills.
t&ether these perSOM work for UNi(X or the operational partner will deperxi on the
implementing arrangements. Expertise- may also be required directly
by the govermmr: and UIWX for
the needZ assessmnt a& initial
phases of the aoergency. lb a certain extent this may be available
fran within UIWR, in the RnerSpecialist
g-y
ad
Support
Units. ‘An i&cation
of the types
of expertise which may be needed
in each sector is given in the
chapters that follm.
-.
_ Yk use of specialistrJ alLv
in the counh!y and taniliar
with
it
has obtious advantages.
Btperierce in refwee emergency
situatioaa will also ha very valuable.
and personnel Sources include the govertment,
universities
ad other teaching
centres, the UN system and the NW
camunity. Where suitable persons
are not available within the COMtry, how they are obtained will
again depeti on the implementing
arrangemnts . As a general rule,
it is better for UNHCRto seek
specialist assistance from organizations known to have such expertise and relevant experience before
approaching individuals directly.
iiim~,
!Tlr%i
fE!
have a clear irrdication of who is
required and why, and of what
resources are already available
within the couutry, it should be
possible to meet the iamediate
personnel needs in a refugee earn--Ù
gency quickly. This task must he
recognized as the prerequisite to
the success of the operation.
List of contents
Section
Contents
Paragraph
Overview
32
33
5.1
l- 3
Introduction
5.2
l-10
Organization
5.3
l-10
l2YJzGE
36
i%na of transport
37
l- 3
b-l.3
International
Internal
33:
5.5
l- 4
Transport
40
5.6
l- 5
StoraJEe
5.7
l- 4
Stock control,
5.4
5.8
Annex 2
Annex 3
support
33
capacities
40
inspection
and insurance
Cbnsintunent procedures and custms
:: 62
Annex 1
of logistical
42
clearance
Consignment procedures
Omtans clearance
::
Further refererres
46
Starriard specifimtions
for certain
relief items
Logistics control systems
Conversion factors
coamon
47
49
54
31
Need
-Refugee emergercies are often in
sources of supply and -ications
may be needed to ensure logistical
progrm
will fail.
The timely delivery
Principles
locations
raved
from the main
arteries.
Exceptional efforts
support.
Without it the whole
of the basic material
needs of the refugees.
of response
L?
ATra&ements must provide a single,
centrally
logistics
operation, with staxlardized
procedures.
r/
Most immediately needed supplies
Avoid overseas supply if possible.
D
Transport and storage arrangements must have a spare capacity:
thirds go wros and more refugees arrive.
are often
co-ordinated
available
locally.
Action
32
D
&lake logistical
arrangements an integral
ning from the start.
LT
Identify
and take the critical
overseas procurement of trucks).
/7
Take expert
possibilities.
advice on local
D
Seek outside
assistance
leadtime
conditions
if necessary.
part of overall
actions
(for
planexample
and assess implementing
-
-
- Supplies and logist its -
5.1
J&dLroduction
1.
‘ihe ability * to deliver
the
rinht supplies where and when tE$
are needed is a nrereouisite
for
an effective
emergency operation.
The vital role of logistic
support
must not be overlooked in the initial
planning,
ad
a logistics
specialist
may be required on any
assessment
mission.
lhe
more
remote’ the location
of the refugees, tbe more difficult
will
be
the logistical
problem, yet these
are the situations
where logistic
support or the lack of it becanes
the key to success or failure.
Ppotigi;~cz4~
P
sarrgtggE!nt~t
pa
musr
PacYbe
that which would
uffice
if
all
goes well.
There ‘are
high
risks
for the laistical
support
of any emergency operation
as a
result of many factors outside the
cotitrol
of UFHX: delays,
breakdowns, the vagaries of nature and
the
unpredictable.
Furthermore,
the numbers requir-irqz assistance
Fenerally
increase
through
the
emernency phase of an operation.
yond
3. ‘Ibis chapter does not cover
all the points that may need to be
considered in light of local conditions,
nor is this
a subject
where a single general plan an be
adapted to any local
situation.
Special expertise
is available
in
this sector as in others and must
be sought if necessary.
I&ever,
it is not hard to recognize when
things
are going wrong in this
sector.
5.2 &zanization
-
of
lazisticai
r/
centrally
co-ordiA sixle,
is essential
nated 0 ration
and dup p”ication
of logistical
services must be avoided.
17
requires a clear urderlliis
statrling of overall needs and
for
the
responsibilities
meeting them.
D heal
soeht
-ledge
must
be
, and outside
logistical
expertise
obtained
if
necessary.
1 m Every effort
must be made to
avoid
duplication
of logistical
services
by different
organizations and to ensure a single, centraY.ly
co-ordinated
operation.
SZiT
is
particularly
important
when local transport
is inadequate
and priorities
have to be set for
what is carried.
2. A clear understanding
by all
concerned of the needs is therefore efsential-:
what is being or
is to ne supplied, when, how, and
by whom. The UNHCR planning must
be comprehensive,
covering , for
example,
all
the
food
needs
regardless
of
action
taken
or
being taken by other donors, and
all blankets regardless of possible sources of supply. Where contributions
in kind, or purchases
with UHX
funds, have been made
against
the total
target
by the
time the UNNX progranme is promulgated, this must be taken into
account,
but the “start”
figure
must be the total needs. For example : “200,000 blankets are required to provide two for each refugee. By (date)
50,000 had been
purchased and delivered
by UNHCR
and 80,000 known to be delivered
or en route as contributions
in
kind
(whether
through UNXR or
bilaterally)“.
Requirements can of
course be altered at any time in
light of developments.
3.
The actual sources of fur&ng
contributions
in
kind
may
gf fer , but an easily urrderstood
cauprehensive list
of requirement:
is essential
as the starting
point
for meeting
the basic material
great confuneeds. Without
it,
sion
can result.
With such a
starting
point,
the balance
of
needs can be continuously
monitored, and the effect on this of
donations in kind, whether through
UNiC& or biiateraliy
, will
be
inmediately apparent, as will whether these are within
or outside
the scope of the UNHCR programne.
33
L
- Supplies and lc2’ istics
-.
Only with
such a comprehensive
approach will
it be possible
to
determine
whether
the refugees’
needs are being met.
expertise
is not availabie,
the
assistance
of a logistics
expert
should be requested
from Headquarters.
4.
7. Specific
arrangements to operate the logistical
support system
should depend on local resources
and knowledge to the extent possible.
Where there
is a strong
existing
warehousing and distribution
sys tE¶.Il, outside
assistance
should not be necessary.
Where
outside
assistance
is
required
seek Headquarters’
advice. Possible sources include :
The
circunstances
of
each
determine
will
what
-ge=Y
arrangements are required of UNICR
for logistical
support,
but whether directly
by UIWX, through an
operational
partner or as a commercial
seryice,
these
arrangements must provide when necessary
for overseas purchase and transswift
unloading
and dutyport,
free clearance on arrival,
local
prchase,
temporary storage,
onward
transportation,
regional
storage
and final
distribution,
with proper stock control at every
stee.
Figure 5-l shows the likely
major canponents of the system in
diagramrmtic
form. mare there is
a deBloped
local economy and an
adequate internal
transport
network, such arrangements may not
present
i&ere
major
problems.
there is not,
action
to ensure
logistical
support will
be a perhaps the - priority
task for
the field m*er.
5.
A close exchange of information between the field
and Headquarters on all logistical
aspects
is essential.
Particular
attention
shouid be paid by Headquarters to
giving the field as much notice as
possible
of
over seas
transport
arrangements , estimated
times of
arrival
(EM)
and changed schedules, and of contributions
in kind
in general;
and by the field,
to
acknowledging receipt
of consignment s , and advising
Headquarters
of contributions
in kind declared
locally
that fall within the prograume .
6.
An early
assessment of the
logistical
support requirements is
essent ial.
The national
authorities,
local UN camnunity and the
supply
or materials
managers of
large
carmercial
comerns
opera ti4
in
the country
will
be
important
sources of advice on
local capabilities.
If it is clear
that logistical
support will
present major problems , and if local
34
- a governuental
disaster
eiiergency corps ;
- a (large> NGO with
priate experience;
or
appro-
- the II&, which has experience in
this
field
and
would
identify
outs ide
consultants as necessary;
-a
specialist
or cannercial
organization
firm.
8. Where the local capacity
is
sufficient
and the main requirement is organization
of the food
SlrpPlY * this may be done by WFP.
In any event, :he operation must
be very closely co-ordinated
with
WFP.
9.
Whatever the arrangements in
the field,
the line of responsibility
to UNHcIi (or the operational
partner) must be clear. The major
policy decisions about both supply
and transport
should be taken
the same person. Decentra
izat ion
of operational
decisions
to the
regional
level may be necessary,
and should equally be to a single
person.
10. While it is rarely necessary
to have mobile cunnunications
sets
on surface transport , assured ccmmunications
between dispatch
and
--Tral
points is often essential.
In sane circumstances existi%-country radio or telephone CCEILXJnications
links will be inadequate
and a special network must be set
--.*--C
I..--
MA IN TUNSP0C.T
v--T
..,
- Supplies and logistics
up. Details
UIWCR radio
Part 2.
of hi to establish
network are given
a
in
5.3
Wnnlies
/7
Make at Least initial
purchases loc&ly
if possib3e;
it
is quicker aad the supplies
are
likely
to
be
more
appropriate.
D
Star&rd
specifications
been developed
for
items.
have
camyln
1.
‘Ihe consunable
and durable
equipment and material
supplies,
required
in a refugee emergency
generally
fall under the following
headiws:
food,
water,
medical
sanitation,
shelter
supplies,
(materials
bofztifF;
dwell$gs
and
coumuni ty
bulldings),
danestic needs (utensils,
soap and
cooking fuel),
cloth or clothing,
education materia’ls,
the means of
transport
that may be necessary to
deliver
the foregoing,
sufficient
spare parts,
and the fuel
for
vehicles
and ca5rmaL
services.
More details
of what may be needed
are given in the appropriate
chapter.
2.
At
least
for
an initial
the material
needs can
period,
probably be met from within
the
This possibility
must be
country.
fully explored before resorting
to
outside
sources:
the
emergency
supplies
that must ccine at once
from abroad are of ten limited to a
air-transportable
few
essential
itof relatively
small bulk.
The local purchase of imnediately
needed supplies has obvious advantages
including
quick
delivery,
more likely
acceptability
and stimulation
of the local
econuny ,
though local suppliers
often overestimate
their
ability
to supply
Large quantities
on time. To the
extent
possible,
Local purchases
should
require
delivery
to the
store nearest to the location
of
the refugees, but where there are
several suppliers
it may be better
to consolidate
orders and deliveries.
36
-
3. IDcal
rchase would normally
be TiiZdk&
UNHm’s operational
partner,
and it is important that field
staff are able to
monitor
the
progress
of
this.
Details
of procedures
for local
purchase by IJNHCR are given in
Part 2. Advice should in any case
be sought from the local purchasimW of ficere of other L! organizations,
particularly
UNICEF, and
procurement
advice
or personnel
assistance
requested
from Headquarters if necessary.
4. While local purchase is indicated given comparability
in cost,
quality
and availability,
in major
emergencies local suppliers may be
unable to meet continuing
demand.
‘Ibis is particularly
likely
when
the refugees
form a substantial
part of the total population of a
region or even the country.
In
such circumstances
bulk purchases
from abroad will becane necessary;
these will
generally
be made by
UIWR
Headquarters.
Otherwise,
local prices will rapidly
increase
as local
purchases dislocate
the
market, at the same time causing
resentment among nationals.
5. In a major emergency and when
the capacity
of the market is
limited,
care must in any case be
taken to avoid prices being forced
up by humanitarian
organizations
bidding against each other for the
same supplies.
Provided there is
clear agreement on the needs, coordination
of purchases and even
combined orders among the organizations concerned should be possible. Where supplies
are limited,
which organization
actually
pur chases the available
stocks
is
obviously
than
less
important
ensuring
that this is done at a
price
that
is not inflated
by
needless rivalry .
6. Par t icular ly
for
shelter,
Local materials
and types of conshould be used where
struction
pass ible, combined with tarpaulins
or polythene
sheeting
as necessary . While,
except for nomadic
tribes , tents are not a satisfactory
type of Long-term shelter,
- Supplies and logistics
they are a valuable last resort in
should
emrgen= ies . Groundsheets
be supplied
with tents.
Renumber
that tents may deteriorate
rapidly
if stored for any lergth of time,
particularly
if hllmidity is high.
Standard
specifications
have
kn
dewlored
on the basis of
previous experience for a n&r
of items that may be required at
short notice.
Ibese are given in
annex 1 to this chapter. lhe purpose is two-fold.
?%ere such iterns
are available
locally,
the standard specifications
may help in
drawing up terder requests or in
negotiations
with suppliers.
Where
items are not available
locally,
will
be able to
Representatives
request
supply through &adquar ters with a clear idea of exactly
what will
be supplied,
while the
itself
enables
standardization
more rapid supply. The purpose is
not to impose supplies with these
specifications
but rather to simplify
and expedite
supply.
More
care should be taken to
generally,
avoid variations
in quality
(and
of course quantity)
of itans supsites
different
plied
to
Other standardized
itg
iPupsimlude
the emergemy health kit.
(See ch.7.7.3)
A large nunber of other items
8.
are
with
standard
specifications
available
through the UNICEF Packing and Assembly Centre in Copen-
gy-&~$q~
lkip foa,re
gt;z
including
purposes. IQ11 details,
in
are ava i lable
illustrations,
the ONIPAC catalogue held by the
local UNICEF or UNDP office.
The
includes
the emergency
catalogue
stockpile
of items whose availability
is guaranteed. Certain emergency supplies are held by IJNKEF,
WHO, the Red Cross and NC& in
stockpiles
regional
or national
and may be available to OhHa.
ccemonly
9.
v
is
is
emenzencies but
offered
in
generally
an unsat%factory
way of
meeting a need for clothing
arrL
should be discouraged.
Experience
suggests that much will arrive in
-
poor shape, sane will be dirty and
badly sorted and little
will
be
appropriate
to the custcms of the
refugees.
Furthermore,
because of
its v01~1~ it is expensive to airfreight,
will
arrive
too late by
sea, and can be expensive to store
and transport
internally.
First
priority
should be given to meeting clothing
needs by the provision of cloth (and sewing machines
etc. as necessary)
for the refugees to make up themselves,
or
buying locally
made new clothes.
In either case care must be taken
that what is provided is culturally acceptable.
10. The Procurement Unit will provide field offices with an indication
of international
prices
of
the items listed in annex 1 and of
other
CaIrnonly
required
items.
This may be of assistance
when
prrpar$~,~
an
emergency
budget
in
.
but
for
items not
available
&ally
either make sure
that
the
basis
of
the calculation
.
clear
- for example: 20 OO9
i?ankets
at unit
cost
‘X’ plus
transport
‘Y’ , estimated total
‘2’
- or leave costing
to Headquarters.
Where cannon relief
items
are available
locally,
cable an
irdication
of prices to the Procurement Unit so that these may be
canpared
the international
with
market, and consideration
given to
overseas
procurement
of
further
needs
if
major
would
savings
result.
5.4 &ant3 of transnmt
D
Advance arrangements will
be
necessary
for
expeditious
handling
of
supplies
from
abroad.
arrangements .
D
If vehicles are needed and not
available
locally
their
procurement , with spares, will be
a very high priority.
0
Standardize
vehicle
fleets.
37
- Supplies and logistics
tenarce facilities.
D
If a special
fleet
is neces“grafting”
it
consider
sary,
haulage
on to
an existing
operation.
/7
Improve access roads
sary .
if
neces-
International
1. In the emergency phase, supflies
from overseas may arrive &
Standing arrangements should
air.
bemade in advance with the authorities
for clearance and landing
rights
for relief
flights
and for
priority
handling of freight.
If a
considerable
W~UIE of air traf fit
(whether
international
or interexpected,
a d&narche
nal)
is
should be made to have relief
flights
exempted from the ‘tax’
eiement of tbir
operations
(landis
fees, fuel tax) and charged
f,“,,, services
at cost
(handling
is done, proper
. If this
account of any concessions must be
taken in the contract
with the
otherwise the company and
carrier,
not UtWCRwill benefit.
2. Many ports are congested.
As
soon as details
of the arrival
of
relief
supplies by sea are known,
arrangements should be made for a
priority
allocation
of an alongside berth
(if
possible,
always
the same one) or lighterage.
In
relief
supplies
should
prirxziple,
be loaded only on vessels with the
capacity
for self-discharge,
and
discharging
alongs ide
whenever
they should do so directly
onto
With the possible
exceptrucks.
tion of food, vessels are unlikely
to be carrying
only relief
supbe subject
to
pl ies and will
delays.
frequent
diversion
aml
the arrangements for
Nevertheless,
onward movement of the supplies
and any interim storage necessary
must LX made well in advance of
the ETA.
38
-
3. If supplies
are being transported from neighbouring
countries
by road or rail_, careful
considerasm
given to the destination.
Trucks should of course
unload as dose
to the refugees as
practicable,
while the best discharge point for a train may not
be that ccrmr~nly used for rail
freight between the two countries.
Internal
4. Three modes of internal
transport are likely
to be needed: long
haul to regional centres,
intercnediary
from these to the Local
stores,
and final
distribution
to
the refugees .
5. In many countries,
existing
internal
transport
services do not
have a large spare capacity even
on normal. networks, which in any
case may not serve the location of
the refugees.
Expert local advice
will
be essential,
to cover such
rail
capacity
and
points
as
of reputable
delays, a short list
haulage contractors,
freight
rates
per mt/km, age ard serviceability
fuel supplies and
of the fleets,
maintenance facilities.
6. TJhere a suitable
rail network
this can be aneffective
exists.
movirg
way of
heavy supplies
internally.
however, many railway
systems are either
congested or
short of rolling
stock and long
WFP
delays
may be encountered.
often moves food for its own projects by rail
blilt the requirement
for speed may make road transport
preferab1.e even if
it
is more
expensive . In most cases, onward
movement by road to the final destination
will
be necessary.
In
sane countries
heavy loads can be
moved by inland waterways.
;’
wgn;;Wf
to 2
internal
transport
arrangements .
Where there is a government transport agency or suitable
ccxrmercial
these should be used if
fleet,
Local suppliers
should
pass ible.
be encouraged to quote prices that
- Supplies and logistics
include delivery.
At least in the
emergemy phase, this will be preferable to having to make separate
arrangements.
However,
transport
.
the worst
case no suitable
spacity
will exist and UIWX will
have to arrange for the establishment of a canplete transport
system. Sane suitable vehicles may be
Locally
or
in
the
available
consider
purchasing
region;
second-hand if suitable
vehicles
in good condition
are available.
If the overseas supply of vehicles
this
procurement
necessary,
is
action will have a very high prio-V
rity.
spares per vehicle
may suffice,
but for a fleet
of any size,
separate
arrangements
will
be
necessary and base and regional
workshops may have to be establiShed
solely
for
the operation.
Alternatively,
existing
goverrrnent
or UN facilities
may be strengthened.
In sane countries
ILD,
UNDP, or UNICEF have special workshops servicing
project
vehicles.
Mbile
workshops and heavy recovery vehicles
may be necessary.
attention
Particular
should
be
.
d to
adequate
supplies
of
tyre life may be no more
than 10,000 lan in rough desert or
rmuntain conditions.
-
8.
Ibe fleet must be standardized to suitable
type(s)
already
Grating
in the country and with
adequatebackup
and - servicing
facilities.
Depending on the road
corditions,
three basic types of
vehicle
may be needed: a truck
with trailer
with a combined capacity of 20-30 MI’ for long-haul on
hard roads, a 5-6 MI truck with
4-wheel drive and if necessary a
winch
for
intermediary
recovery
distribution
on poor roads and
tracks, and a 1 MT, 4-wheel drive
vehicle
or even animal or hand
final
distribution.
Cl3KtS
for
Observe how local movement of supplies normally takes place. If a
mixture of types of the long-haul
truck is unavoidable, it may still
be possible
to standardize
to a
trailer
Particular
single
type*
attention
must be uaid to the towIhe vehicles exclubar strer+$h.
sively
involved in the operation
should
be irdividuall
mb d
and distixtively
r&e
example, white with blue markings).
11. Sufficient
n&ers
of properly
trained drivers must be available.
local UN offices
may be able to
advise on existing
schemes and
possibilities.
Ensure that recanmended working hours are not exceeded : accident
rates
increase
markedly with over-tired
drivers.
In sore situations
careful briefing will
be required on alternative routes in case usual roads
are impassable. A system must be
established
to monitor an3 control
vehicle use.
l
9.
Assured supplies of fuel anrt
lubricants
must be available
where
they are needed. This may require
separate
secure storage
arrangements and an additional
fleet of
fuel tinker vehicles.
10. Other consmble
items (filters, shock absorbers, brake Linings etc.),
spare parts and proper
back-up services
must be available. For a small number of vehicles, a carefully
selected set of
-
.
12. Control
of a transport
fleet
requires
strong
administrative
skills,
good ccmnunica t ions and
very close co-ordination
with the
supply arrangements.
Careful cons idera tion should be given to the
possibility
of
“grafting”
the
transport
fleet
onto an existing
operation,
for
example a large
national or regional haulage organization.
A large
bus company
might serve equally
well.
That
organization’s
infrastructure,
including
workshops ,
inspect ion
pits,
offices,
etc. would than be
inmediately available,
as would be
its
accumulated
experience
of
operating
in the country. A clear
for
understanding
on priorities
fuel
and services
is,
however,
essential.
Nationals should in any
case be employed, and trained
to
take over from expatriates,
to the
extent possible.
Unless there is
setting
no practical
alternative,
up a separate establishment
should
39
- Supplies and leistics
-
be avoided, but major emergencies
may require a logistical
organization that irdudes
a self-&f
icienc transport unit.
the refugees . In difficult
conditions,
the theoretical
capacity
might need to be increased by 25X
or more.
urgent
situations
13. In
sune
action may be necessary in order
Local
to improve access roads.
advice will be of Mramount imuortame in deciding how impro&nts
sbDuld be made. These would northe
undertaken
by
mally
be
construction
and
national
road
authority,
maintenarre
refugee
!iEik!r .
sqportd
by
Short-term
outside
assistance
can
be provided
through Headquarters
if necessary.
3. To give an example: if
the
rainy season journey time from the
port of entry to a regional store
serving 30,000 refugees is 3 days
out and 2 days back, one day per
trip is allowed for routine maintenance , and the road surface can
take a truck and trailer
with a
combined payload of 20 MI, then
the theoretical
requireraent is for
such
trucks/trailers.
(1
4.5
truck/trailer
can move 20 MI’ every
six days ; for
six days 30,000
refugees require
90 MT of food).
In such circumstances,
it is clear
that six trucks/trailers
would be
the prudent minimuu.
5.5 ‘itansmtt
camcities
D
Food accounts for the greater
part of the required capacity.
/7
A substantial
margin of
capacity must be provided.
spare
1. The key commodity to be moved
is usually food; in the worst case
the refugees will need tctal outapproximately
side food support:
5OOg/person/day
or
15 ~/lo00
l’he bulk of this
refugees/month.
is likely
to be a cereal,
;a-rzked
in 50kg bags (20 bags per MT.). The
charterirg
of \nessels for overseas
cement
of food requires
speciainter
knowledge
(which,
lized
&,
WFP has) and is not co=
that arrihere. It is essential
vals are scheduled in a way that
capacity
takes account of port
(berths, unloading and storage) as
well as overall needs.
theoretical
capacity
2. The
necessary to move sufficient
food
inland to the refugees wiil depend
on how lq
a round trip
takes,
routine
maintenance.
A
in&ding
margin should be allowed to cover
the unpredictable
but inevitable,
such as breakdowns, accidents,
bad
weather, road and bridge repairs.
The size
of
this
margin will
depend on many factors
including
delivery
delays of new whicles,
ttre 1 ikelihood of new arrivals
and
the need for extra capacity while
building
up reserw
stocks near
40
4. Table 5-2 gives
of the capacities
means of transport.
an indication
of different
5.6 Storaee
D
Adequate storage capacity
and
reserve
stocks
of essential
items must be provided.
1. Supplies
may require
initial
storage near the port of entry.
Regional
(ax ial)
stores
may be
required at certain
key locations
and local (radial)
stores will be
required near the refugees. Stores
must be accessible
in all seasons
and weather. Arrangements to meet
this need must be made quickly.
Existing
government
warehousing
should be used if possible.
Security
of supplies
in stores and
transit
must be ensured. Storage
for local purchases should be the
responsibility
of
the
supplier
whenever
pass ible .
Particular
attention
must be paid to those
items requiring
special
storage.
distribution
and
Organize
the
storage
system so that supplies
are loaded and unloaded a minimum
times.
Remember the
number of
maxim “first
in, first out”.
2. A warehouse. should be of sound
dry and well-venticonstruction,
lated and provide protection
from
- Supplies ard logist its
$-7
Ransmrt
-
amcities
Carrier
Payload (L)
Stamlacd Railway truck
3cMr (52m3)
Standard container
18Mr (3f.hI3)
Large lorry
20f t/ 6. lm
40f t/l.2.2al
26m (6Sm3)
and trailer
Large articulated
22m
lorry
3OMr
Medium lorry
6-8Mr
long wheel base Lardrover/
Cruiser type pickup
l.m
Hand-drawn cart
300kg
CallIe
250kg (more for
short distances)
Donkey
LOOkg
Bicycle
1OOkg
--m-w
#i&
Payload/volune
B747
(1)
Runway length
[email protected]/46Ckn3
3ooom
DC10/3OF
65MTMQn3
300011
DC8/63F
44bW24Chn3
23001
B707/32OC
4[MT/165m3
210&l
CL&4
26MT/18Qn3 (3)
190&l
2lMTil2Q1.13 (ramp loading)
15oum
14MUlO!ill3
17ockn
3MTi4om3
12oQn
L-100-30
(Hercules)
DC9/33F and B737/200
DC3
(2)
(1) Approximate indication
only:
always check exact specification.
In part icular , figures for aircraft
will vary deperdiug on configuration
(e.g. if
cargo is palletized
usable volme may be reduced), operating range, airport
characteristics
etc.
Also establish
the size of aircraft
doors and, if the
airport
lacks facilities,
whether or not the aircraft
has self -Loading/discharge and self-start
capabiiity.
(2) ALso very approximate, for full load, sea level, L5”C, no wind. Markedly influenced
by aircraft
weight, altitude
and temperature.
ALways check
with local aviation authorities
which aircraft
types can operate.
(3)
Certain
versions
take considerably
greater
volume.
41
- Supplies and logistics
insects
anl birds.
The
rodents,
floor should be flat and firm and
the building
should be easy of
access, with suitable
arrangements
(e.g. ramp or platform)
for loading ard unloading.
The warehouse
must be secure against theft,
and
should be lit if possible. As long
as it has sufficient
loading doors
a single large building
is better
than several small ones.
3. If suitable
storage facilities
do not exist,
they may have to be
built.
Local techniques, materials
and practices are likely to be the
most appropriate,
but there are
also a number of specialized
techniques
or
structures
allowing
swift
construction
of
field
stores.
Expert advice should be
sought locally
or through Headquarters if required.
It may even
be necessary
to use tents
as
stores as a temporary measure. The
tents should be’ carefully
sited,
protected
by ditches from surface
water if necessary, and with raised platforms inside (e.g. pallets
or a groundsheet on sand) . The
contents must not touch the tent.
Within the tent,
food should be
fur tiler
protected
by
plasc ic
sheets.
4. ‘Ihe capacities
required of the
main, regional
and local
stores
will
depend on the nunbers of
refugees they serve and what out&By need. Reserve
side support
stocks of essential
items, particularly
food, should be built
up
close to the refugees. Sufficient
stocks should be on hand in secure
storage to cover likely
interruptions
in the delivery
schedule,
for example during the rainy season. Conversely,
care should be
taken
to hold
in
store,
not
against
some unspecified
future
need, items that are ismediately
required by the refugees, such as
blankets or hand tools.
5. The physical
dimensions of a
warehouse necessary
to store
a
given tonnage may be roughly estimated as follor;ls. First calculate
the volume of the goods. As an
indication:
42
-
1 MT of
occupies
approx .
grain
2m3
medicaments
3m3
blankets
(approx.
(compressed)
700 heavy blankets)
tents (approx. 25
family ridge tents)
blankets
4-5m3
4-5Ql3
(loose)
aTI3
Assuming storage to a height of
2m, the minimum surface area occupied by the goods will
be half
their
\Folume. Increase this surface area by at least 20% to allow
for access and ventilation.
For
example, the approximate size of a
store to hold 2 months’ supply of
the cereal staple for 30,000 refugees
receiving
an
individual
cereal ration of 350g/day would be:
350g x 30,000 x 60 days
= 630 MT.= 126Qn3
126On3 stored to a height of 2m
gives a surface area of 63Qn2,
add 20% for access = 75Qn2
of floor space
i.e.
;tibuii$ng
. .
some 5(3m long
by
5.7.
insurame
/7
Effective
stock control
and
security
are imperative
and
must cover the whole chain
through to final distribution
to families or individuals.
/7
Ensure inspection
and register
insurance
claims:
supplies can arrive
damaged or
be lost.
1.
A sound control
of stock
le\Fels and distribution
is essential
if losses are to be avoided,
potentially
critical
shortages
ident if ied
in
time
and final
delivery
to
the
henefici aries
assured. ‘Ihe system should identify what has been ordered, where
- Supplies at?d logist ica the goods are and when they will
This information
must he
arrive.
available
to all who need it and
particularly
those responsible
for
final distribution
. Control mechanisms will range from those verithe bulk
consignments
on
fYk3
arrival
down to individual
ration
cards or distributi-on
checks at
the sites and carefully
calibrated
measures for final
distribution.
of these mechanisms
The nature
will
depend on the circunstarrces,
but they must be in place from the
start and they must provide a real
and not just a paper control.
Ibe
sqplies
actually
distributed
to
the refugees must be reconcilable
with those known to have arrived
and those remaining in stare.
In the emergency phase cer2.
tain
basic
controls
should
be
established
at once, in addition
to the controls
over actual distribution
discussed in chapter 22.
They are described in annex 2.
In addition
to safeguarding
3.
the security
of relief
supplies,
they must be protected
from damThis may be physical,
for
?&ple
as a result of bad hanclling or improper stacking;
climathe adverse effects
of the
tic,
humidity;
cold
or
rain,
Sun,
and bacterioattacks
by pests;
decomposition
of
the
logical,
commdities
with
time
perishable
or when containers are damaged.
Sane damage is inevitable
and
4.
considerable
sums may be inmlved.
All overseas procurearent by or on
behalf
of UNHCR, and the great
Will
supplies,
majority
of all
have been fully
insured against
loss or danage in transit.
Overseas procurement
by lJNH(x will
also be subject to inspection by a
agency
(superintenprofessional
dence). Where supplies are purchased locally,
par titular
care must
be taken not to accept supplies
that do not meet contract specifiespecially
Purchases,
cations.
food, should be inspected on arrival at the site and rejected
if
necessary. If large quantities
are
involved,
organize
professional
quality
control
and inspection
at
the point of final
delivery
from
the first
orders. If local superintendence companies are unable to
do this,
seek outside
assistance
through
headquarters.
Insurame
claims must be registered
at once
and for overseas supplies
Headquarters
should
‘be informed
by
cable of major damage or shortfalls.
Special arrangements may be
necessary
for
the disposal
of
spoilt food or goods.
5.8
/7
zdzesa
17
Use the internationally
accepted marking
and cons igninent
procedures.
single
consignee
and
.
T;T Plan custom3 clearance procedures in advance and develop
and pranulgate
a clear policy
for NGOsand other suppliers.
Consignment procedures
1. Much trouble can he avoided by
using
a single
cons ipnee *and
items
all
address
f
eq
from abroa? for the UNHG %Tgency programne . This would normallv he the ReDresentative.
with
an &dication
in’ brackets of any
instructions,
for example
special
“FOT (name of LXX))“. However,
where UNHUZ was not previously
present it may be better to consign c/o a UN organization
already
for
well known in the country,
example UNDP, provided no delays
will
Similarly,
result .
there
should he a single consignee and
address at the regional
or site
leve 1.
made
2. Whether purchases
are
locally
or abroad, but particularly
in the latter
case, proper
labelling , marking, conpacki%,
signment ard insurance procedures
Long experience in
are essential.
relief
international
different
all
has shown that
operations
organizations
and donors need to
use a uniform system for marking
43
- Supplies and logist its or labelling
relief
cohsigfments.
UN%X emrgency operations
should
adopt the procedures the League of
Red Cross Societies
has devgelzi
co-ordination
with
’
in
Nations organizations.
The following is adapted from Annex 8, Red
Relief
Hans
CrOSS Disaster
(Geneva, League of Red Cross Societies, 1976) :
(1) Colour code. me colours used
for the relief
supplies most
often required after disasters
blue
are : red for foodstuffs,
clothing
and household
for
equipment, and green for a&iCal supplies and equimnt.
(2) Lahelling.
Make sure the consimaent also bears one of the
i&national
hazard
warning
sips
(fragile,
no hooks, keep
dry, etc.)
if necessary. (;onsivnts
of medicines, banded
should state on
with green,
the outside of the package the
medicines ’
content
and the
expiration
date and whatever
controls
temperature
are
necessary.
English
should be
used on all labels and stenc’lled
though
a
markings,
second language mm be added.
It is essential
that the final
destination
(or arrival
port)
appears at the bottan of the
label in very large letters.
(3) Size and weight.
Containers
should he of a size arxl ,weight
that
one person can handle
(ideally,
25kg; up to a maximum of 50kg) since mechanical
loading and unloading devices
are rarely
available
at the
receiviog end.
Relief
supplies
(4) Contents.
should
always be packed by
type in separate
containers.
Mixed consignments create many
problems
in warehousing
and
ultimate
distribution
at the
receiving end. The colour code
recanrended
loses
its
value
if,
for example, medical supplies are packed in the same
container as food.
44
(5) Advance notice to the cons ignee. To cover in one document
?iii the details
necessary for
safe transport
and ease of
handling at the receiving eml,
the following
information
is
;;ential:
$) name of sender;
name
consignee ; (3)
method of transport , inclxuding
the name of the vessel, flight
or truck nunher. and its date
E;;~si)
~i2Z$~fli%pa~i
weight,
d imensio& , and nunher
and
type of packages; (5) value in
the currency
of the sending
country ; (6) type of insurance, name of company, etc. ;
(7) the carrier’s
agent, including the name of the person
to be contacted in the receivestimated
03)
i&5 country ;
time of arrival
and (9) instructions
or special
requi.rements for handling and storing
the supplies . It
should be
noted Lhat in most instances a
pro forma invoice is required
authorities
in
the
by the
sending or receiving
country
or both.
(6) Acknowledgement by the consignee . It is important that an
acknowledgement
be sent
to
Headquarters
as quickly
as
possible
after
consignments
are received.
C;ustons clearance
or
3. UNHCR’S basic
project
agreement
with
the
government
should, of course, allow for the
duty-free
import of all items from
whatever
provided
that
source,
they are required
for the prograirme . The supplies coning in for
the operation may far exceed the
scope of tbe routine arrangements
between the authorities
ard the
local UN consunity
for the normal
handling
of office
vehicles
and
equipment and donest ic supplies .
The custm
officials
at the airport or ports may be unused to
for example, many tons
clearing,
Of
airfreight
or a shipment of
Problems and delays
heavy trucks.
- Supplies and logistics
may he avoided by discussing
the
procedures to be followed by UNHCR
officials
in
the
with
senior
foreign ministry,
custans department and airport
and port authorities before the first-arrival.
The
aim isiate
release of incanand special
proceing supplies’
dures adapted to the needs of tb
anergenzy may have to be developed.
4. UNHCR should be prepared to
urrlertake the custans clearance of
provided
relief
supplies,
these meet the purposes of the
emergency operationThis
will
allow so?le control
over the dispatch of clearly
unsuitable goods,
help in the co-ordination
of response in kind arxl help to ensure
equitable
distribution.
As NC-OS
face considerable
WY otherwise
duty-free
problems
in
custcYns
it would be in their
clearance,
interest
to co-operate
in this
way.
Repres;ntat ives
should
be
flexible
when deciding what falls
within
the purposes of the emergency operation.
Sane items unlikely
to be covered by UNHCR
fur& could nevertheless
be considered as appropriate.
However, as
a general rule, do not undertake
to clear duty-free
for NGOs supplies for their own _czz’grauxnesupport items such as off ice cars or
equipment. The only vehicles that
should be cleared in this way are
those foreseen in the UNHCR programne and which will
be placed
fully at the disposal of the programne (for
example, trucks
for
the movement of bulk fo&).
National Red Cross anl Red Crescent
Societie.5 have their own standing
arrangerlents
for the clearance of
relief supplies consigned to them.
-
5. The expenses incurred
in custans clearance,
handling,
storage
and onward movement of supplies
belonging to UNHCR- contributions
in kind or UNHCRprocurement - may
be met by UNHCR if necessary, for
example initially
throtgh an emergency letter
of instruction.
Subsequently , Representatives
should
propose
a specific
project
to
cover any such continuing
expenses. Where IW supplies are concerned , LNHCR will
be the “consignee of convenience”,
not the
“owner” or “donee”. All expenses
involved should normally be borne
by the GO. However, in certain
circumstances
and provided
the
foresupplies are itens directly
seen in the UNHCR prograume (for
example blankets , tents),
UNHCR
may also meet inland transportation
costs,
as would have heen
necessary had UNHCR had to purchase these itens itself.
strongly
recunnended
6. It
is
that local guidelines
on this be
drawn up as early as possible in
the operation.
They should make it
clear to all potent ial consignors
that UNHCRwill undertake to clear
only supplies for which notification is received prior to dispatch
arid which are considered
appropriate.
The guidelines
should be
made available
to all NGOs active
in the operation and to new NXs
This could be done
on arrival.
through the 1GO Co-ordinating
Ccmmittee. A copy of these guidelines
should be shared with Headquarters
ati reference to this general procedure made in any SO briefings
at Headquarters anJ in the first
few general telex sitreps.
A
s
45
- Supplies and logistics
-
Hall D.W. (1970)
Harxiling and Storage of Food Grains
in Tropical and Subtropical Areas -
FAD Agricultural
Development Paper
No. 90
Licloss/Mags
Steering Mttee
for Disasters
(1982)
lbrgensy Sq~ply Logistics Handbook
Basic guidelines for the procurement of
supplies for disaster relief operations.
Includes a number of specimen forms and
explanation of cannonly used trade terms.
(Also in Frenrb and Spanish)
(do
UNITAR (1982)
Model Rules for Disaster Relief Operations
Che of the proposed sets of rules is for a
bilateral
a&e&ent between an assisting
organization
an3 a receiving state, covering
such matters as waivers, traffic
rights,
priority
handling of relief supplies and
facilities
for relief personnel. (UNDROis
seeking to develop these into a draft
agreement or convention).
Policy and
Efficacy
Studies No. 8
Also relevant in this context,
on natural disasters,
are:
althoeh
(I) Annex II of the Report of the SecretaryGeneral on UNDROof 12 May 1977 (A/32/64):
hasures to expedite international
relief.
The recaunendations were adopted by consensus
by the General Assembly, and by participants
at the 1977 International
Conference of the
Red Cross.
(2) Rapport sp&ial s;n: un project d’accordtype relatif
aux actions de secours humanitaire adopted by the 59th Confc,ence of the
International
Law Association,
Belgrade 1980.
WFP (1979)
46
Food Storage : Handbook on Good Storage
Practice
-lustrated
guidance for storekeepers.
LRCS)
- Supplies sod logistics
!Xa&d
speeifkatiom
-
for certain cmmm relief
Annex 1
items
These specifications
have been developed with UNICEF to assist Representat iws in drawing up tender requests where local purchase is possible and to
give a clear indication
of what could otherwise be supplied at short notice
The UNIPAC catalogue reference is gi-n
in brackets
through Iidquarters.
the actual source of supply thrash
Headquarters would
where applicable;
deperrd on the circumstances and in particular
on any regional availability.
1.
Blanket,
heavy (similar
Woven, 30-4UZ wool
ends, size
of 50 pcs. Each ‘bale of
kg- Large quanti,ties are
with stitched
2.
Blanket,
E50 035 05)
anl rest other fibres
(cotton,
polyester)
blanket
150 x 2OOcm, weight 1.3kg, packed in pressed bales
50 pcs would be about 0.3W volune and weigh 65-70
generally available.
light
Cotton. size 140 x 19Ocm, weight approx. 85Og, usually packed in pressed
volune and weigh
bales of 100 pcs. Each bale of 100 pcs would be about 0.41113
Fairly
large quantities
generally
available
ex-stock
in Asian
85-9Okg.
region, more limited availabiiity
elsewhere.
3.
Bucket, plastic
(21 700 00)
Bucket/pail
10 litre
capacity,
polyethylene
with plated steel-wire
bail
harrile, conical seamless design, suitable
for stacking, reinforced
or turned
Plastic or galvanized buckets are like?3 to be available
locally
and
lip.
are very useful.
k.
Family cooking set, emergency (20 365 10)
4.
12 pcs aluminium utensils
-
as follows:
Cooking pot, 6 litre,
with bail handle and cover
Cooking pot, 4 litre,
with baif. handle
Dinner plate, aluminium (4 each)
Plastic mug (4 each)
Coffee pot, alurinium, 2 litre.
The set is packed in a cardboard carton 25 x 25 x 2Ocm, weight 2kg. ‘Ihe set
five stainless steeL soup spoons and one stainless
does not contain cutlery:
steeL cook’s knife, blade 15-17cm, could be supplied separately if not available Locally.
Utensils of a heavier gauge aluninium are normally supplied by
The advantages of the emergency set
NCR when some delay can be accepted.
Lt is therefore
particularly
are lower weight, packed volume and price.
suitable when supply by air is necessary.
5.
Plastic
sheeting
Black seamless polyethylene
sheeting,
250 microns (1000 gauge), width
5-8~1, supplied double-folded
in Lengths usually of 100-80&n, approx. weight
walls,
ground sheets, Linings,
lkg/4m2.
For multipurpose
use: roofing,
(There is a guide to its use, see page 67.)
etc. Widely available.
47
- Supplies and lxistics
6.
Tarpaulin
material
-
(E 50 860 i0)
4m wide, 5Om long (20&[email protected], in centre-folded
roll of 2m wide, 25Oma diaultraviolet
ray resistant;
meter.
Reinf arced polyethylene,
0.25~1~ thick
(275g/sqa).
Plastic eyelets both sides every i.i&re, dotible rotr of eyeiets
Approx. 50kg. Considerably stronger than
across every 5m. Colour green.
item 5.
7.
Tent, family,
for use in emergencies,
12scpl (E50 880 02)
Rourxl type (single bell).
3COglsqn cotton or cotton/polyester
canvas,
with grourd strip.
water ard rot proofed, natural,
Diameter 4m, centre
height 2.5m, wall height 60&m. Heavy duty sectional steel tube centre pole,
piasticlad
or galvanized.
Complete with ropes, pegs, mallet and patching
kit, with loose, reinforced
PVC grourxlsheet 25Og/sqn. In packsack.
Ceiling
ventilation
flaps.
Approx weight. 22kg. Apart frun a better resistance
to
high winds, the only general advantage of this tent over item 8 is its
Not recannended for use with
lighter weight when supply by air is necessary.
camp beds but can accarmadate up to 8 persons.
8.
Tent, Muse, ridge type, rectangular,
12sqm (approx 3 x 4x1) (E50 880 04)
4OOg/sqm COttOn or cotton/polyester
canvas, water and rot proofed, natural, with ground strip ilnd fly sheet.
Centre height 2m, wall height 6OCmn
with 1SQmmclearance between tent and fly sheet.
Heavy duty sectional steel
tube Roles, plasticlad
or galvanized.
Complete with ropes, pegs, mallets,
and patching kit, with loose, reinforced
WC grouudsheet, minimun 25Og/sqm.
In packsack. Approx. weight 40kg. The standard family tent, available from
a variety of suppliers
worldwide.
Can acconnodate 6 amp beds. See notes
for tent suppliers below.
Notes for tent suppliers
Tent specifications
are to be understood as minimun in material weight
and floor space. Only quality,
heavy duty, finished tents must be offered.
Canvas to be equally strong in warp anti weft.
Chemicals used for treatment
of the canvas must not smell offensive;
salamander flame retardant,
rot and
water proofing process, or equivalent.
Sufficient
iron or steel pegs and
pins to be supplied to anchor tent and fly every 5Ocm (pegs 4Ocm, pins 15cm
Stitching
- machine stitched with extra strong, weatherproof thread.
Ridges to be canvas or cotton tape reinforced.
Cabs and taps strongly
stitched at outer and inner ridge for upright poles.
Eyelets must be nonferrous.
Hens to be wide em-h to accept eyelets.
Entrance fasteners, zipclips, ties to be of heavy duty, where applicable non-ferrous quality,
p-s,
flaps well overlapping,
unless zippered.
All openings for ventilation
or
windows to be protected with mosquito netting.
Zippered door flaps to have
spare ties sewn on, in case zipper breaks.
Guy ropes to be equivalent in
strength to 12n~1sisal rope, ultra-violet
stabilized.
Wooden or bamboo poles
are not acceptable. Lengths of pole sections not to exceed 1.5m. Mallet
with 4Ocm harrlle (l&m diameter wooden or hard rubber head).
10%)
l
Tolerances:
ground area plus 10% acceptable.
Canvas weight plus 10%
acceptable.
Lightly
dyed colours (olive,
green, brown) might be acceptable
but must be indicated on offers or stock reports.
Each tent to be packed and bundled with poles,
in single packssck.
48
accessories
and hardware
,_
- Supplies and logistics
4#istics
can-1
-
Annex 2
smtans
1. ‘Ihe minimun level of controls necessary will vary with each operation.
TbWyxa--flives
an irdication
of the basic components of a system. Simple
accounting established
from the start will be much more ef fech
ti\le than r sophisticated
system later.
No system is likely to be effective
unless it is understood by those required to work it.
Specific training will
generally be rauired
for storekeepers.
Central controls
An overall
control card should be kept for each order or consignment
2.
(including
contributions
in kind), on which is recorded all stages from the
initial
request for goods through,
as applicable,
requests
for tenders,
placing of order/notification
of ship&,
planned delivery
time/place/ETA,
actual delivery/arrival
etc.
3.
A simple state board where progress can be monitored visually
is likely
to he very useful and can be set up at ooze. An example is given on page 51.
The purchase order
4.
Ihis is the document that defines the order:
specifications,
number of
units ordered, price/unit,
total
price,
packaging, date of purchase, supplier,
destination
etc.
It should make reference to the legally enforceable
standard conditions
of contract (the cotrditions under which UNHCX is willing
to do business, which should have been part of the request for tenders - see
UIWR Procurement Msnual) .
At each warehouse/store
5.
*atever
+he size of the warehouse or store and wherever it may be located, the minimum recaunerded book-keeping controls are those outlined below.
They must be cuuplemented by routine inspection to ensure goods are properly
stored and protected, and by a periodic audit.
(1)
Supply note/Maybill . Acccmpanies goods from supplier in duplicate
to enable warehouse staff to check against goods actually receiwd. Duplicate copy used by procurement staff to verify goods dispatched against those ordered (i.e. against wrchase order form).
Where the mo\lenent is betxeen warehouses e.g. regional to local,
use (4).
(2)
Store inwards ledger.
Basic details
of all inward consiwnts
are recorded here: description
of goods, quantity,
supplier,
naDe
of person receiving and date of receipt,
with cross reference to
s*ply note.
(3)
Stock card.
tie for each different
item.
history,
being used to record every in and
reference
to appropriate
ledger entry.
Where possible this should be maintained
actually receiving and issuing the goods.
page 52.
(4)
Requisition/Dispatch
requisiticxl
siped
list of authorized
given on page 53.
This gives the canplete
out movement with cross
Gives running balance.
independently
of those
An example is giwn on
form.
Ihe authority
for dispatch,
with the
by authorized
signatory
and verified
against
signatures held by storekeeper.
An example is
49
- Supplies and lsistics
(5)
-
Store outwards ledger.
Similar purpose to (2) for dispatches:
its simplest can be just the file of triplicates
of (4).
at
l!Io\Rment of mods
6.
‘I& easiest control to ensure that goods reach their destination
may he
to make (final)
paymmt (for the goods, of the driver or transporter,
as
applicable)
conditional
on return of the receipted duplicate
of the Supply
IWe/FJaybill
or the Requisition/Dispatch
form. More cauprehensive controls
ati measures (e.g. mnitors)
may be required later, and are anyway needed to
ensure that goods reach their destination
{in the worst case, this control
only indicates that they did not). But provided the signatories
for both
requisition
and receipt are carefully
chosen, and signatures controlled
(combinirg them with a UN%R/ stsmp is recarmended), this should he an effective
initial
50
safeguard.
- Supplies ad
logistics
-
- Supplies ad logistics
-
- Supplies and logistics
I%imle
of Requisition/Dispatch
-
Form
Ref. No.
Requisitioned
@
Siwture
Date
Ikstination
Quantity
required
Dispatchd
Receiwd
by
by
Quantity
received
Remarks
(discrepancies etc
Signature
Date
Signature
Date
Raised in triplicate
Original and duplicate sent with goods. Ori inal serves as supply note
for records at destination.
, D~li~~~*~~~~p~~pz.a~
i;f
dispatch ancl filed with triplicate,
s
licate retained and filed, forming ‘stores outward ledger’.
53
- @plies
and logistics
-
Annex3
To
Yards
Eletres
Wles (1)
Kilanetres
(1
(1
(l
(1
=
=
=
3ft = 36 i&m)
loom)
1,760 yds)
l,oOC&Q
Multiply by
htres
YadS
Kilanetres
Miles
0.9144
1.0936
1.609
0.6214
Metres2
Yards2
Hectares
Acres
Kilanetres2
Miles2
0.836
1.196
0.405
2.471
2.590
0.386
UK gallons
Usgellons
Litres
0.8327
1.2009
0.473 (0.568)
2.113 (1.76)
3.785 (4.546)
1.308
0.765
Area
usgalloM
UK gallons
lS (UK) pints
wtres
IIS (UK gallms (1 = 8 pints)
IHal
=lOOO litres)
EletIm 4 (1=1x
Yards3 (1 = 27ft3)
Feuds (lb, 1 - 1602)
Kilo (kg, l- 1,ooog)
W shxt tons (1 - 2,000lb)
USLollgtOtlf3(4JKtOM,
l-2OhlfIlCltedweight
(aWr)= 224Olb)
Bktric tons @lT, 1 = 1,OOOkg)
E2?
pints
Yards3
' M&red
-=aJ
tims
28.35
0.0353
Kilos
ZF
0:907
EbUIldS
Metric
tons
Metric tons
Us short tons
u-Qq$mn%
UK tons
1.016
1.102
0.984
Bmerature
Centigrade
Fahrenheit
Fahrenheit
Centigrade
1.8 and add 32"
subtract 32"
and multiply
by 0.555
We&#& of water (at 16.7OC, 62OF)
1 litre
(l)
54
- lkg;
Statute
1 US gal - 8.331b; 1 UK gal - 101b; lft3
(land) miles.
The international
nautical
= 62.31b
mile - 6,076ft
- 1.825km
List
secticm
of contents
Paragraph
Overview
56
57
6.1
l- 5
Introduction
6.2
l- 8
Organization
(including
6.3
&SE
contents
Criteria
of response
57
types of expertise)
for site
selection
General
water supply
Topograptry and drainse
Surface area,
Security and protection
kcessibili
ty
EhvirCxnE!ntal cotr;litions
Soil conditions
Vegetation
Land rights
6.4
1-11
6.5
1
32
4
ii- 8
6.6
Site
planning:
general considerations
Site
planning:
specific
60
considerations
Sanitation
water supply
Ibad8
Fire prevent ion
Mministrative
and comrnmity services
physical layout
63
66:
Shelter
61: ;
lo-l.3
General
Imnediate sction
Improved shelter
iii
Further
67
ref eremes
67
55
Need
The lack of a suitable ard well planned site and adequate shelter is
cammn in the early stages of a refugee emergency. This can adversely affect the well-being
Of the refugees, arrd in sane cases their
protection,
as well as the delivery of assistance.
‘Ib meet the heed for suitable shelter aml related
vices on an appropriate arrl properly planned site.
Primiples
buildings
and ser-
of response
/7
Avoid high-density
17
Involve the refugees,
/7
Gnly ml;&
water ,
r/
Site plannim
is essential,
arrl should reflect
a decentralized, small cmmmity approach, preserving past social arrangements as far as possible.
/7
Shelter must provide protection
from the elements, space to
live and a sense of home. Local materials
and designs are
best: take account of local standards.
D
So-called temporary arrangesmts
ger than expected;
thus a well
from the start.
/7
Site selection,
planning atd the provision of shelter reqlclire
expertise and must be closely integrated with the planning of
other services especially water and sanitation.
e,e;ite
v
refugee camps.
whose home it will
where
the
basic
be.
needs,
especially
for
often cane to last much lot+
planned response is necessary
Action
56
D
Assess the suitability
of the refugee
meets the ‘basic criteria.
site
and ensure that
/7
Simultaneously assess the need for emergency shelter
vide the necessary mterials
to meet iumdiate needs.
D
Take the most urgently required measures to improve site
nix and layout, arrl upgrade these as soon as possible.
it
and proplan-
- Site selection,
covers consi1. This chapter
relating
to the site
derations
where the refugees live,
the physical
layout
arsi organization
of
,their
canmmity,
arxl the shelter
they need. These factors will have
a major influence
on the wellbeing of the refeees.
Ihe need for sam&re
to
2.
live is a corollary
to the grantirg of asylus,
and the role and
responsibility
of
the
national
authorities
in site selection
is
obvious, and of fuadrmental importance. Equally,
the refugees themselws must be inmlti;
ideally,
the needs of the refuges catmunity
would determine the location,
size
and organization
of the site where
they live.
In practice
there has
to be a canpromise between these
needs and external
factors,
both
practical and political.
3.
Iard may be scsrce in the
country of asylum arrl no site may
be available
that nreets the des ired criteria.
If, however, the present or inter&d
site is clearly
unsuitable,
every effort
must be
made to move the refugees to a
better site as quickly as possible.
lhs problems which result
both from a bad site and the difficulties
inherent in a move increase with t*.
Ihe location
of the refugees
4.
may range fran spontaneous settlement over a wide area, through
organized
to
rural
set tlanent ,
correntration
in a very limited
area. Circusstances
can make this
last possibility
unavoidable.
but
the establish&t
of refugee - canps
resort.
A
must be Only a bSt
solution
that maintains and fosters
the
self-reliance
of
the
refws
is always preferable.
5.
The prospects
for a durable
solution nust be taken into consideration.
Rotection
or political
consideratims
may also be important. If no durable solution
is in
sight, thAs must be recognised and
the plannis
should assune a long
planning
and shelter
-
Unsatisfactory
stay.
temporary
arrangements can be hard to change
once established.
6.2
gmarkation of remon e
17
Site selection,
planning and
shelter
have a major bear iq
on the provision
of c&her
assistance.
/7
This subject
must therefore
be considered as an essential
part of an integrated
approach to needs assessment ami
response.
0
Expertise
is necessary as is
swift action for the co-ordinated planning of a new site
or the improvement of existim conditions.
1.
Site selection,
planning and
the provision
of shelter
have a
direct bearix
on the provision of
other assistame and these will be
important
considerations
in the
overall
assessment of needs and
planning
of response.
Decisions
must be taken as part of an integrated approach and. in light
of
the advice of experts and views of
the refugees.
Expertise may be required in
2.
the fields of geology, settlement,
engineering
(for
examplanning,
water
ple,
supply # sanitation,
construction),
public
health . and
perhaps social anthropology.
Familiarity
with local corxlitions
in
both th2 country
of origin
and
asyluu is important.
Prior experiellce in similar
emergency situations and a flexible
approach are
particularly
valuable.
Expertise
and advice should
3.
be sought frcm governnent , university or local imiustry sources, or
fmn
local
offices
of organizations
such as UNUP, the World
Bank, 5JH0, UNICZF and voluntary
agent ies . If necessary,
Headquarters assistance
should be requested.
Whenever possible,
set up a
4.
task force at the site level of
57
- Site selection,
planning
and shelter
-
all those concerti
with planning
the site (construction,
water srpsanitation
etc.)
ard
[email protected],
is its occupation.
The task force
prepare
a ccmprehens ive
should
plan of action.
graphy and drainage, adequate
surface
area,
security
and
protection,
accessibility,
enviro~ntal
and soil conditions,
vegetation,
and lad
rights.
The organization
of the refu5.
physical
environment
and
gees’
level of services should be appropriate to the needs of the emerge=y arxj colditions
in the country of asylum, while taking full
account of both the traditions
of
special
the
refugees
and the
requirements
as a result
of the
typically
crowded and depetient
circrmrstaaces
of a refugee emerIn the particular
ca6e of
w=Y
refugees who were normally nansdie,
ttMr
own solutions
are
generally
to be preferred,
provided space atrl suitable
materials
are available
and other considerations allow.
1.
General: The social and culturalFGE&round
of the refugees
will
be an important
determinant
of the most appropriate
trpe of
site, and must be a primary consideration
whenever possible.
muever, in many circunstances
choice
will be limited and any land that
meets even minimun starriards may
be scarce. In this regard, it may
be wise to establish
why the site
was not already in use, and examine whether the reason - for
example no water or because it
floods in the monsoon - does not
also exclude use by the refugees.
l
6.
The following
sections
provide guidelines
for advance site
selection
arki planning,
for example when refeees
are to be transferred to a new location.
In the
first
phase of an emergelry, however, it is rare that this will be
possible in practice.
There may be
little
opportunity.
for
advame
~w-~l
az *y$yp
Primimprove
existirg
sites.
7.
‘Ihere may be a need for
transit
centres ,
reception
or
throw
which the refugees pass en
route to a loser-term
settlanent
site.
Many of the considerations
set out in this chapter are also
relevant to such temporary centres.
8.
When a refugee influx
tinuirrg , new sites must be
fied and planned well in
ad the design capacity of
iw settlements respected.
6.3 Criteria
/7
58
is conidentiadvame
exist-
fa site selection
In addition
to considerations
specific
to tha refugees and
their
background,
criteria
irrlude
water supply,
topo-
2.
Water supply:
The availability
of an adequate amount of
water on a year round basis has
saved
in practice
to be the
single
most important
criterion,
and camronly the most problematic.
A site should not be selected on
the assumption that water can be
acquired mrely
by drilling,
digging, or hauling. Drilling
may not
be feasible
and may not provide
adequate water. No site should be
where the hauling
of
selected
water will be required over a long
period. Professional
assessment of
availability
water
should be a
prerequisite
in selecting
a site.
More information
on water is provided in chapter 9.
3.
Topograph;r
and
drainage :
Where water is readily
available,
drainage
of ten becaues the key
criterion.
The whole site should
be located above flooa level, preferably on a gently sloping area.
can present
serious
Fiat
sites
problems for the drainage of waste
arrl storm water. If possible,
the
site
should be a minimum of 3m
above the water table : avoid mar shes or areas likely
to become
marshy or soggy duri,rg the rainy
season. The watershed of the area
itself may be a consideration.
- Site selection,
Surface area: The site must
4.
allow sufficient
usable space for
the refugees . kItI0 reccnnierrls 30
lus the
=-l- metres per person,
er
necessary lard
for canmma
and
agricultural
activities
and livestock, as a minimum overall calcuOf this,
3.5m2 is
latirg
figure.
the .absolute minimun floor
space
per person in emergency shelter.
Ihe allocation
of the other space
is
the sections
&at
refeees
may arrive
selected should allow
expansion beyond the
tically
required
for
bers .
discussed in
follow.
IWre
and the site
for a major
area theorepresent nun-
Security
5.
al-d
protection:
Sites should be removed from th
frontier
and potential
militar;
targets in order to provide security and protection
for the refugees, atrl to prevent hostile activities by the refeees
against the
authorities
of their
country
of
origin
which would undermine the
prirr:iple
that
the granting
of
asylum is not an unfriendly
act.
This
criterion
is
specifically
mentioned in Article
II, paragraph
6 of tbe OAU Refugee Convent ion:
“For reasons of security,
countries of asyllPn shall,
as far as
possible,
settle
refugees
ata
reasonable distarre
from the . fron. ,,
tier of thzir country
f
g
chly where the intereits
% ‘%z
refugees would be better
served,
for example if
there are good
voluntary
prospects
for
early
repatriation
and
security
and
allow,
protection
considerations
should exceptions be made to this
rule.
Experience
however,
has,
shown that the arguments in favour
of settling
refugees away from the
frontier
often increase with time.
Iherefore,
Vwhen in doubt always
locate or move the site away from
the frontier.
to assured casmmications
links,
and preferably
also to sources of
the necessary
supplies
such as
[email protected]
fuel
and shelter
foo4
planning
and shelter
-
material.
Proximity
to national
canmmi ty services
is desirable,
particularly
with regard to health
care. There are generally
advantages in choosing a site near a
subject to consideration
of
LZible
friction
between local
inhabitants and refugees .
Enviromental
conditions:
Ihe
7.
area should be free of major envirormental
health hazards -such as
malaria,
onchocerciasis
(river
blindness),
schistosaaiasis
(bilharzia)
or tsetse
fly.
Climatic
conditions
should be suitable
the
round and careful
account
ye=
taken of seasonal variations:
a
suitable
site in the dry season
may be untenable in the rains. A
daily
breeze
is
an advantage,
while
aergency
and
temporary
especially
housing,
tents,
need
shelter from high winds. As far as
refugees should not be
possible,
settled
in an area where the climate differs
greatly
from that to
which they are accustaned.
For
e.xample, settling
refugees
from
malaria-free
high
ground
in a
marshy area where the disease is
endenic can be disastrous.
Soil
conditions:
8.
The soil
should allow water absorption
and
retention
of human waste.
the
Avoid excessively
rocky or iapermeable sites.
If possible,
select
a Site
Where
the
land
iS
suitable
at least for vegetable gardens and
small-scale
agriculture.
Specific
criteria
for the selection
of a
suitable
site for rural settlement
are given in the UNXR handbook
“Planning
rural
settlements
for
refugees”.
bushes,
trees).
Covering Ggetation provides shade, and reduces
erosion and dust. During construction care should be taken to do as
little
dmage as possible to this
vegetation
and topsoil.
If bulldozers are being used make sure
the topsoil
is not scraped off the
whole site,
as often occurs.
If
wood must be used, at least initias danestic
cooking
fuel,
ally,
59
- Site selection,
this should not camz from vegetaAlternative
on the site.
tion
8011;ces (ati mae efficient
cookers) that will
avoid irreplaceable
loss of surrounding wood must be
found as soon as possible.
other
&ople
(own&ship,
grazing
etc.).
This can be a major
rights,
resentnoent,
and
cause of local
there may be occasions when the
authorities
proposing the site are
unaware of custanary rights
exerpopulation.
cised
by the local
Often, sites are provided on public
land by ths government. Any
use of private land must be based
on forms1 leg&
arrangements in
accadarre
with the laws of the
UN-NIX does not purchase
country.
land for refugees (see ch. 12 8 1)
If
this
is a problem,
c;rr$lult
Headqiiarters at otie.
6.4 Site .plrtnnimc: zewral consl-.
deratl~
Tr
At the start
of a refugee
exmrgen=y the imnediate provision of essential
goods and
services
is gener;,‘yts
more
to
important
than
charge the way people have
thanselves
already
arranged
on a site.
D
As soon as time and needs
refugees are
permit, a tin
to be moved to another site,
site planning is essential.
/7
Site
planning
should
start
from the characteristics
and
needs of the individual
family, and reflect
the wishes of
the caununity as much as poss ible.
0
However, a refugee settlement
is not a natural
camnmity
and particular
care will
be
required
to ensure that special needs are met.
L7
The werall
physical
layout
of a site as well as other
planning
aspects
of
site
should reflect
a decentrali-
60
planning
and shelter
-
zed cuuuuni ty-based
focusing
on family,
or ethnic groups.
approach
village
1.
Site
planning
is necessary
because the physical
organization
of
a settlement
can markedly
affect
the health and well-being
of a carmunity.
The smaller the
area available
for a given nurher
of refugees the greater the importance of site planning, thoeh any
site must be planned to aiiow the
equitable,
efficient
and economic
distribution
of goods and services.
Whatever
the
circumstances,
the overriding
aim
must be to avoid artificial,
high density,
refupee camps.
2. Any refugees who are already
present on tha site will of course
have arranged themselves in scne
way. Ewn if
desirable,
radical
changes in their patterns of location may be a lesser priority
than
meeting the imuediate need for services and relief
goods. Wever,
for new arrivals
the layout must be
carefully
planned in advance. Once
refugees
are
settled
will
thy
understandably
resist
movement of
their
buses.
If the refugee leadership can be persuaded early on
of the importance of planning,
it
should soon be possible
for the
refugees to take responsibility
for
the organization
of new housing
(demarcating plots etc.) within the
designated
areas, with
the added
advantage of releasing
relief
workers for more urgent tasks. Other
site planning guidelines,
for example on the layout
of non-housing
areas, can be more fully
applied
later.
For a new site,
coapreknsive but swift planning is essential.
3.
An important
consideration
in
site
planning
is the layout preferred by the refugees and to which
they are accustmed.
For example,
sane camunities
may traditionally
site their place of worship in the
middle of their cannunity , sane may
wish to have open space and connon
ground in the centre,
others inay
.
- Site selection,
attach
particular
importance
to
caununal meeting places and their
siting,
such as by water distribution points.
Site planning should
therefore
be a locally-controlled
exercise to the extent possible.
it must be *yecog4.
-ever,
nized that the canrunity’ 8 preferred layout
will
rarely
be that
which would allow the most expeditious
delivery
of outside
emergemy assistsnce,
and that lack of
space a
of familiar
materials
will
often necessitate
scn~ outside
assistance.
Furthermore,
a
refugee settlement
is not a natuy
;“l cansunity.
Circunstances
force
arge groups of refugees to live
often in limited
space,
together,
with minims1 resources and without
their accustaned source of livelihood. For this reason, the regulating
mechanisms of
traditional
caawnities
may not work, at least
initially.
Refugee site
planni.ng
requires
special
care to ensure
that gpods arxi services are equitably provided an] c amunal responsibilities
are met.
Compromise
solutions
will
be required
to
recomfle
conflicting
cons idera; :A’ . For example, there may be
k . . : 1-“.: p
security
problems or
Sk’ .‘L difficulties
as a result
of saLal
disruption
that can be
lessened by organizing
the housillg. een when space is available,
in more canpact formations than is
custauary ) thus allowing an important measure of self-policing
by
the refeees.
5.
Outside
assistance
in site
planning
should
start
fran
the
perspective
of the needs, preferemes, and traditions
of the individual
refwee
family.
Begin by
considering
the needs of the individual household, such as distance
to water and latrines;
the relat ionship to other &ers
of the
camnmi ty (other relatives , clan,
or ethnic groupirps8);
ard traditional housing and living
arrangements. Developing the small cannunity layout in this way, and then
considering
the larger
issues of
planning
and shelter
-
overall
site layout,
is likely
to
yield
much better
results
than
beginning with a preconception
of
the
complete
site
layout
and
breaking it down into smaller CUP
munities,
finally
considering
how
the individual
family
fits
into
the scheme.
6.
Ihe
social
organization
of
the refugee population
should be
taken into consideration
as much
possible. Whether it is made up of
extended families and/or clans, or
nuclear
families,
whether
the
refugees cane from urban or rural,
village
or nomadic backgrounds,
are all factors
that will
influewe the physical
organization
of
a site.
Initially
, tbi s information, which is part of the basic
assessment
needs
described
in
chapter
3, should
be gathered
through discussions with the refugees
and others
knowledgeable
about their society. A full socioeconomic survey of the refugee
population
should
be conducted
once resources allow, and will be
important
in subsequent planning,
particularly
for
self-sufficiency
and durable sofut ior&.
Organization
and control
7.
The greater
the density
of
occupation that has to be imposed
on a. gi=n site,
the more important will
be firm,
co-ordinated
control
of its planning.
A task
force should be established
of all
concerned with construction,
sanitation,
water supply etc. and a
plan of action drawn up. I’he aim
of the plan should be to (1) encourage the refugees to help themselves ; (2) reduce the hazards of
density as far as possible (public
health
measures,
fire
control
etc.);
(3) facilitate
control
of
the emergency operation
an3 the
delivery
of assistance.
Figure 6-l
werleaf
shows sane of the considerations
for an ideal layout of a
high density
site;
in practice
compromises will
have to be made
to reconcile them.
61
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6-i
SOME
CONSIDE~TIONS
WHEN
PLANNING
CROWDED
SIT&5
FAClLltlB
,
-
g
r
F:
P.
- Site selection,
b. t&ire space is extremely limicontrol
of the percentage
ted,
allocated
to different
uses (houscamnmal and aclninistrative
im;
services;
roads,
f irebreaks
and
open space) will be more important
than calculations
based on desired
minima.
9. Together with the layout plan,
there must be a plan setting
out
the timescale
for cunpletion
and
progressive occupation of the settlement
bv the refupees.
whenever this -is possible.- It -is particularly
important
that,
having
allowed space for expansion, including
family
reunion,
this
is
safeguarded
until
really
needed.
Otherwise
the initial
settlement
will
occupy all
tie
space, and
major
upheavals
of
existing
arraseukzks
will
be necessary as
more refugees
arrive.
Sections
prepared
in
advance should
be
filled
in an orderly
manner and
early arrivals
should, of course,
play a major part in the completion of the site.
In some circumstances it may be possible to have
an advance
refugees
party
of
assisting
at the site
fran the
start of work.
10. Provided
sufficient
land
is
available,
the total
number of
refugees at each site should be
determined by practical
considerat ions
rather
than
arbitrary
limits.
The importarce of respectirg this nurher , and having other
sites ready for further new arrivals once it
is reached,
has
already
been stressed.
Previous
groupings should be maintained to
the extent
possible.
Any hostile
groups or factions among the refugees should! be kept apart. Much
more important
than absolute size
is the planning
of the site
to
foster ccummities
and a sense of
family and small group identity.
il. Thus, as many services as possible
should be provided at the
small cannunity
level,
for distinct
family,
village,
ethnic
or
other groups, and with the convenienze of the refugees as the criterion.
Centralized
ard impersonal
planning
and shelter
-
services should be avoided
extent practicable.
to the
6.5 Site ~larmimz:
snecific
infrastructure desim considerations
n
Under-estimation
of
space
required for cum-1una.1 services
is a ccsmon problem.
1. Sanitation:
While water requirements
of ten
determine
site
selection,
sanitation
requirements
often dictate site layout. If latare used,
rines
at least
one
should be provided for every 20
persons w They should be no further
than 50 metres from any house,
with the minimum distarxze from a
house determined by the type of
latrine
and space available:
as a
guide, 6 metres. Sufficient
space
must be left for replacement latrines.
If communal iatrines
are
unavoidable,
they should be accessible by road to Facilitate
maintenance. latrines
must not contaminate water sources.
The site
must also have an effective
drainage system, which is easy to maintain and repair,
both for rain;r;ty
and wastewater.
(See chapter
.
2. Water supply:
Where possible,
the maximum distance
between any
house anti a water distributiou
point should be 100 metres or no
more than a few minutes’
walk.
water will
often be pumped from
the source to an elevated point in
order to allow gravity
feed distr ibution.
Planning
of the site
take
this
into
should
account.
(See chapter 9.)
3. Roads:
Some communities will
not
be accustaued
to metalled
roads but provision
must be made
to deliver
the assistance.
A site
should have access and internal
roads and pathways [email protected]
the
various
areas
and
facilities.
Roads should be above flood levels
and have adequate drainage.
If
there has to be a significant
amount of vehicle traffic
on the
site,
it should he separated from
pedestrian traffic.
63
- Site selection,
Fire prevention:
A firebreak
4.
(area with no buildirqq)
50 metres
wide is recanner~Ied -for approximately every 300 metres of builtq~ area. This will
he an ideal
vegetable
growiw
or recreation
t& disarea. If space allows,
tarre between irrjividual
buildings
should be great enough tc prevent
a collapsing
burning building
from
touching
adjacent
buildings.
The
direction
of any prevailing
wind
will he a consideration.
Adadnistrative
and cmnity
5.
services: At the start of an wgency it may be difficult
to foresee- all the administratiw
and
comity
services that are likely
Where adequate
to be required.
space is a available,
free f;ar;t
must
be ’ allocated
for
expansion of these services. Undertestimstion
of the space required
for future
ccmnlmal needs is a
canmn problem in sites of limited
area. Buildings
for administrative
and camnunity services
should be
traditional
structures*
if possible of a multipurpcwe
design to
use,
facilitate
alternative
for
initial
example
buildings
for
services
which
could
-g==Y
later be used as schools or other
camnmity
facilities.
The following list
is of those administrathe
and canrunity
services which
are often required;
provision
of
the necessary space ti
buildings
must be considered in site plannirg . ‘Ihe division
is indicative
only;
the importarxze of maximum
decentralization
has already been
stressed.
(lj
Likely
to be centralized
Site administrative
off ice
Essential
services
co-ordination
offices
(kal th care,
feeding
water
pgr-s,
supply, education, etc.)
Warehousing and storage
Initial
screening
registration/health
area
Tracing service
64
planning
and shelter
-
Therapeutic
required)
feeding
(2) Likely
centre
(if
to be decentralized
Bathing and washing areas
Camnrnity
services
(health
social
service
centres,
centres,
etc.)
Supplementary
(if required)
FAication
feeding
centres
facilities
Institutional
centres
examp!.e, ror the disabled
unaccompanied
children,
required)
Recreation
Physical
(for
and
if
space
layout
6. bven after
taking due account
of space availability,
topography,
preference,
traditional
living
patterns
and the specific
design
considerations,
different
mnY
layouts
are possible.
The basic
pr irk2 iple
should be to organize
into
the site
small
ccnrnuni ty
units or villages
containing
the
decentralized
c-unity
services
mentioned
vi flage
above.
lhese
units are in turn organized around
the central
core services.
There
are obvious advantages in a pattern that allows the addition
of
units
father
while
preserving
open space.
7. The location
of the centralized services will
depend on the
specific
situation
and in particular
on the
space available.
Again, the views bf the refugees
must be taken into account. Where
available.
sufficient
mace
is
there may be A clear advantages in
havirlg the centralized
services in
Where
the centw
of the site.
space is scarce, it may be better
to have the centralized
services
located near the entrance to the
will
site.
this
In particular,
avoid the trucks delivering
upetc.
drive
plies,
having
to
through a densely populated site,
- Site selection,
t&
attendant
pr&lems
of
with
dust, noise ard danger to pedesgettrians , ati even of drivers
tiq
lost in a large site. If some
form of closed camp is unavoidat least
the centralized
able,
administrative
services will
probably have to be located near the
the
entrance. Whatever the layout,
stmuld
be near
the
warehouses
administratiw
office
for reasons
of security.
8. The linear
or grid
layout,
with square or rectangular
areas
separated by parallel
streets,
has
often
been used but should be
avoided if possible.
It has the
advantage of simplicity
of design
a~& speed of implementation,
a&
allows a high population density.
however,
as has already
been
health
envirommntal
emphasized,
problems ard disease are directly
proportional
to
population
density.
Furthermore
a rigid
grid
desis
makes the creation of community identity
difficult,
as the
refugees are not usually
accustQned to livirlg in such a pattern.
Where space is very scarce,
a
broadly
rectangular
grid
layout
may be unavoidable,
but should be
adapted to the Landscape, with
variations
in the shape of the
basic cocuumity unit rectangle ard
rlexibility
in
the
layout
of
houses witbin the comnunity unit.
6.6 shlter
/7
Shelter
must proviae protection from the elements, space
to live,
privacy and emotional
security.
/7
Provide blankets
if necessary.
0
ani clothing
Assess the adequacy of whatshelter
ever
-is-v
have
refugees
arrangements
already
made themselves and
roeet itunediate
needs through
local
simple
provision
of
materials.
The first
step is
to put a roof over people’s
heads.
plannie
and shelter
-
/7
-
Except for tents in certain circumstances,
prefabricated
or
special
emergency shelter
has
not proved to De a practical
option on either
cost or cultural grounds.
/7
peFl;
~~~~s~nua~tzy
.
priate
and familiar.
local
materials
are
available.
be culSuZEe
best if
/7
Individual
family
housing
whenever possible,
unless
multi-family
units are traditional.
-/7
Snelter must be suitable
the different
seasons.
L7
wherever
possible,
refugees
snould Duilcl their
own bouswith the necessary orgaia
nizational
anl material
support.
should be built
for
General
1. Shelter must at a minimum provide protection
from the elements,
spake - to live and store belongings, privacy and emotional security.
Shelter is likely
to be one
of the most important determinants
of general living
con3 it ions and
is often one of the largest items
of
expenditure.
non-recurring
While the basic need for shelter
is similar
in most emergencies,
such considerations
as the kind of
housing needed, what materials and
design are used, who constructs
the housing aml how long it must
last will
differ
significantly
in
each situation.
2. Particularly
in cola climates
or where there are daily extremes
in temperature,
lack of adequate
shelter
and clothing
can have a
major adverse affect on health and
nutritional
status. Tnus, in addition
to s&Ater,
provision
when
necessary of sufficient
blankets,
appropriate
clothing
and perhaps
even heaters will be a high priority.
(See chapter 5.)
65
,
- Site selection,
pre-fabricated
3. To date neither
specially
systems n0r
building
developed emergency shelter
units
have prow
effective
in refugee
emergencies. Reasons irclude inaphigh unit
cost,
propriateness ,
transport
problans including cost,
that
inflexibility
and the fact
arrangements
shelter
-=iserr=Y
will have been made before these
For similar
systarrs Can arrive.
reasons, tents are often not an
efgective means of providing shelter. They are difficult
to live in
ad pr0vide little
insulation
from
temperature.
There
extraes
of
circunstances
in
are,
homer,
which
tents
may be useful
and
example
when
for
appropriate,
local materials
are either
not
available
at all or are only seasonally available
or for refugees
of nanadic background. ‘Ihe life of
an erected tent depends on the
climate; it may be as much as two
years. Where tents are approprimaterials
should be
ate, repair
provided to the occupants. A Limited nUnber of tents may also serve
accucnmdation
while
as
transit
more appropriate
shelter
is construtted.
standard
specifications
for two types of tent are given in
annex 1 to cllspter 5.
4. The best way to meet emergency
shelter
needs is to provide the
same materials
02: skker
as would
be normally used by the refugees
or the 10~11 population.
Only if
quantities
cannot
be
adequate
obt;Ggzf’,
locally
should
quickly
material
be
aeqpcy
[email protected]
into the country. “;‘;P
structures,
and
;f
plea
intensive buildi%
methods, are to
be preferred.
Care should he taken
traditional
materials
to
treat
where this
is
with preservative
neeessa-ry (e.g. against termites) .
Seek local
advice
on effective
metiods .
5. Ihe design of shelter ad more
permanent housing should if possible provide
for modification
by
the occupants to suit their individual needs.
66
planning and shelter
-
Imnediate action
6. The provision
of shelter
is a
priority,
high
even when not
essential
to
survival.
Shelter
must be available
before
other
services can be developed properInmediate
action
should be
lY*
taken to assess the adequacy of
any arrangements already made, and
meet
to
obvious
sbor t-canings
through
the provision
of local
materials,
such as bamboo poles,
thatch,
matting,
wooden
rope,
boards and timbers
and perhaps
metal rOOfing. This may be supplemented if necessary by canvas or
plastic sheeting.
Details of suitable plastic
sheeting are given in
annnex 1 to chapter
5. To the
extent possible,
emergency materials should allow Fe-use later
in
the construction
of improved housirlg. Where local materials
are in
short supply or have a short life,
consideration
should be given to
more permanent materials.
other,
If a continued
high density
of
occupation
is
unavoidable,
fire
resistant
materials may be indicated. (See ch.10.7.2)
7. The key to providing
an adeis provision
Of
ii
quate shelter
roof. If materials
for a canplete
shelter cannot be provided, provision of adequate roof materials
will be the priority , as walls can
usually be made of earth or other
materials
found on site or locally
available.
8. Same shelter
may initially
be
found in national
public buildings
such as schools. Ihis is, however,
usually a very temporary solution,
unsuited
to
large
nu&ers
ati
resented hy the local population,
and to be avoided if possible.
9. While different
cultures
have
minimum
different
individual
needs, WHO recornnends a minimum
usable floor space of 3.5 sq. metres per person in an emergency.
Overcrowding is a corn-on problem
and has serious
implications
for
health,
- Site selection,
Improved shelter
10. Iiousiq
must meet the cultural
and social requiranents
of a haue.
housix
will
help
Appropriate
reduce the disorientation
and cmoticmal
stress
suffered
by refugees. ~b the extent possible, longer term housing must be similar
in design and construction
to that
with which the refugees are familiar,
while reflecti%
local conditions
and practice.
This will
generally mean single-faglily
shelters, unless the refugees are used
Although
to multi-fanily
units.
the benefits
to the
more costly,
refugees of individual
banes cannot be over-estimated.
The risk of
diseases
increases
cauwnicable
enormously in caununal shelters.
If multi-fanily
shelters
must be
used, no more than 35 persons, say
sane seven families,
should normally
be assigned
to any one
Experience
has shown
structure.
that there are likely to be social
ati
enviro~ntal
problems above
this nr;mber, while buildirgs
made
materials
may he
fran
local
their
structural
approaching
limits at this size.
11. Materials
and design
should
meet minirmnn technical
starrlards
planning
and shelter
-
for the different
local seasons.
Thus roof material
may have to
provide shelter from the sun, rain
and snow and resist
strong winds.
Raised flooring may be required in
areas of higb rainfall.
12. Wall material must afford privacy and protection
from the elements. Where the site lies in a
hazard-prone
area,
for
emple
subject
to earthquakes
or
lanes, the design of buildings %d
their siting should conform to the
hazard-resistant
criteria:
consult
the
authorities
and
national
DNDRD. In buildings
where cleanliness and hygiene are par titular ly
important , for example the kitchens of feeding centres
or in
bspitals , the floor
should be
cement or at least washable.
13. Even in an emergency, shelter,
includis
cannunal buildings,
can
- and should almost always - be
constructed
by refugees
themseladequate organizaprovided
=s,
tion
a&
material
support
is
given.
This will
help to ensure
that the housing will meet their
needs,
will
reduce
psrticular
their sense of dependance, and can
cut costs considerably.
Davis 1. (Ed.)
(1981)
Disasters and the -11
IMelliq
Renort of a 1978 conference which while
fot?used on natural disasters gives a
good overview of the subject, with less&s
from practical
experience.
Mward J. (1981)
Spice R.
Plastic Sheeting:
its use for emergency
housing and other purposes
A clear and practical technical guide.
UNDEXI(1982)
Shelter after Disaster :
Guidelines for Assistance
A cannrehensive studv on disasters and
&l&r
with clear p&icy guidelines,
which contains much of relevance to
refugee emergerxzies. Lists key references.
Planning Rural Settlements for Refugees:
Scme considerations
and ideas
Per-n
’
PCS/326
67
.
\
List
Section
7.1
of contents
Paragraph
l- 3
7,2
Contents
Overview
70
Introduction
71
Organization
l- 5
6
7-14
15
:76_18
7.3
of the health services
keds
The refugees
Personnel
The national health authorities
Role of the NorId health Organization
Organization of response
health assesant
and surveillance
Initial
assessoaent
Surveillance
Records and reporting
laboratory services
7775
7’:
Disease control
7.4
General measures
Inmunizat ion
Commondiseases
7.5
P
74
79
79
Refugee health care
;I ;
6-10
11-14
15
Appropriate care
Triage
The provision of health care
Mther and child health
health education
7.6
l- 8
Ekf erral
7.7
l- 6
kkdical
Annex 1
Annex 2
Pag;e
services
supplies
if
:33
84
84
&5
Further references
87
Surveillance
KiiiZzation
t:
report
and vaccines
69
Heed
Refugees, particularly
in an emergency, are exposed to many tactors
which increase the risks of disease.
Typically,
these factors incLude overcrowding,
inadequate water, poor sanitation
and inadequate
Urgent measures are therefore required to minimize the
food sqply.
effects of these hazards, ensure an appropriate level of health care
and reduce the number of new cases of disease.
Through effective
organization
\~ent, control and treat disease.
Principles
to promote good health
and to pre-
of response
/7
Refugees must be given responsibility
for their own health and
therefore be directly
involved in the development and provision
of health services.
/7
Health services should reflect
actual
proper assessment and surveillance.
/7
Priority
should be given to nutrition
and public health measures, as the health of the majority of the retugees is more
likely
to be affected
by these measures than by individual
care.
Therefore a proper health strategy will go weil beyond
the scope of this chapter to include all sectors of assistance.
,!T
A health co-ordinator
should be appointed with responsibility
for these measures and for ensuring standard and appropriate
treatment
ani services,
in close co-ordination
witb
the
national health authorities
and other organizations,
by
needs as determined
Pction
70
r/’
Assess the health and nutritional
status and environrental
conditions in order to identify needs and establish priorities.
D
In accordance with these priorities,
set up a ccurnunity-based
health service with the necessary referral
facilities.
/7
Mnitor
and evaluate the
adjust them as necessary.
effectiveness
of
these
actions
and
- Health 7.1
Introduction
Good health,
depending as it
1.
does on so many non-medical
factors, is too big a subject to be
left only to doctors. This chapter
is directed
at the administrator.
It does not pretend to give ‘Wical answers” to health problems.
It does however seek to show that
good organization
of public health
and medical
services,
and an
appropriate
primary health
strategy are more important
to the
overall
health status of refugees
meflicine
alone.
curative
than
These crucial
organizational
factors are often the responsibility
of the UNKR field manager.
The conditions
faced by many
2.
favour
not
refugees
do
&O~
health.
In an emergency, the dangers to the health of the refugees
will often be increased because of
over crowUing ,
shelter
ard
EZ
of sufficient
safe water,
inadequate or inpoor sanitation,
appropriate
food supplies
and a
possible
lack of imnunity to the
diseases of the new environment.
Ihese factors heighten the risk of
diseases.
Furthercamumicable
on
arrival
the
refugees
may
-e,
already be in a debilitated
state
disease,
malnutrition
or
from
fati-7-r.
6Ihe health services
provided
3.
to the refugees should be based on
health
the
concept
of primary
care. The general approach is summarized by kH0 as follows.
“Priessential
tlealth
Care
is
=Y
health
care made accessible
to
care
tibe country,
everyone
in
given in a way acceptable to indiard the carmuviduals , families,
nity, since it requires their full
health care proviparticipation;
ded at a cost the ccnrnunity and
the COUntSy Can afford.....
[email protected]
mdel
is
applicable
no s i&e
Health
Care
everywhere,
Primary
should irrlude
the following:
proan
motion
of proper nutrition,
adequate supply of safe water ;
basic
sanitation,
maternal
and
child care, including
family planappropriate
treatment
for
nillg,
diseases
and
comyln
injuries ;
itnnunization
against major infecdiseases,
t ious
prevent ion
and
control
of locally
endanic diseducation
eases ;
about
carmDn
health problems and what can be
done to prevent and control them. ”
In other words, at the heart of
such a strategy there is an emphasis
on preventive,
as against
curative, care.
7.2
$ksanization
u
‘Ihe health services
developed with not
the ref ugeer
f7
&arly emphasis should
correcting
environrental
tors
which adversely
health:
/7
Early appointment of a suithealth
coably experienced
ordinator
to UNUCX’s staff is
important .
J!7
assistance
can be
Outside
but the
mobilized
quickly,
use and developnt
of local
expertise is preferable.
/7
‘Ihe national
nealth authorities am services must be as
closely involved as possible.
/7
‘lhe Lvorld health Organization
must be closely involved.
services
of
the
health
must be
for
just
be on
facaffect
1.
At the start of an emergency,
first
priority
is to obtain
information
on the number of the
their
state
of health
refugees,
and imnediate needs, and an indication of their age/sex distribution.
Ibis
information
will
help
establish
priorities
for intuediate
action. These may well be the improvement of water and food supply
rather tban the provision of medical assistance.
the
The health services must aim,
2.
from the start,
to prevent as well
as cure illness% to make and keep
the retugees healthy.
The healtn
of
ok a cotmnunity , aM theretore
the majority
of the refeees,
is
71
--
- l-lealtb by pubgenerally
more influerred
lic health measures than by individual care. Chly through preventive measures, catibined with the
control
of caununicable
diseases,
can good health be maintained ard
the number of new cases of disease
be reduced. Safe water, environmental Ix2alth measures, appropricarmunicable
disate nutrition,
mother arrl child
ease control,
care, health education and training of the refugees are integral
parts
of
refugee
health
care.
IQually,
the location
of the site
and
the amount of individual
liv.
will
directly
affect
~lt??&rre
7-l illustrates
the
likely
relative
impact of these
measures.
72
3.
The level of health care provided will
be determined by the
corrlition
of
the refugees
and
resources available.
Extraordinary
efforts
may be necessary initially.
Indeed in theory the peak of
curative medical care should be at
this
early
stage, when refugees
are most vunerable to their
new
environnent
with
the
health
hazards it poses, and before it
has been possible to complete any
major public
health
improvements
in the sectors of housing, water
supply and sanitation.
In practice
the medical
staff
of ten arrive
later ati begin to build up curative services
at just
the time
when there is the possibility
of
dramatic improvement in the over-
- Health all health status of the refugees
if the emphasis is placed instead
on preventive care. tie
the imnediate health problems are controlled
the level
of tr&th
care
sh%Jld broadly reflect
what would
be appropriate
for the local population and must be one that can be
maintained.
Services and levels of
to the refugees
care available
should be starrdardized.
4.
Each refugee emergency will
have its
particular
health needs
and possibilities
ard problems,
for response. The following
broad
headings cover considerations
that
are likely
to be ccnmon: surveilof ccmlame,
reporting , control
municable
diseases and imnunization,
curative
health
care,
the
referral
system, mother and child
health,
health education,
medical
supplies,
and the personnel
and
required
resources
organizational
to establish
anb operate the services,
including
the training
of
refugee health workers.
5.
Community services
such as
curative
health care, mother and
supplementary
chi Id
services,
feeding prograurnes, social
services, ard health and nutrition
eduinterrelated
cation
are clearly
ard must be co-ordinated.
Circumstarces
will
dictate
how they
should be arranged,
for example
whether around the health clinic
supplementary
feeding
centre.
$ere
are obvious advantages m
grouping
these services
for t2
convenience of the refqees.
The refugees
6.
Tne refugees must be given
for
their
own
responsibility
workers
health.
health
Outside
must ur&rstand
the refugees’ own
of health
and disease.
COI-CeptS
beginning,
services
From
the
should be developed and operated
with rather than for the refugees.
If not, the serviEE will be less
may be distrusted
by
effective,
and are likely
to
the refugees,
collapse when key outside personnel leave.
Personnel needs
7.
Strong
emphasis
should
be
placed on the training
and upgrading of medical skills
of selected
refugees , particularly
in their
former roles within the camxmity:
full
account sbuld
be taken of
the experience of the traditional
healers
and midwives.
Provided
there
is proper supervision
and
referral
where necessary , experience has demonstrated the advant traditional
ages of encouraging
methods of health care in parallel
with
the other
organized
health
services. Refugees may seek traditional treawnts
for a variety of
problans
which
are beyond the
capacity of outside services.
8.
Even refugees with no prior
experience
can be very effective
health workers following
basic oninstruction
in a few
the-spot
relevant tasks. It should be borne
in [email protected] however that the educated
young refugee who is frequently
drawn into medical work may often
not enjoy the full
confidence of
other refugees ; also time invested
in his or her training
should be
weighed against the fact that if
there is any third country resettlement, such people are typically
arrmg the first to go.
9.
Ps a general principle,
the
order of preference for selecting
health personnel,
in co-operation
with the national services, is:
refugees ,
experienced nationals
residents ;
outs ider s .
or
Most emergencies will require scm~
combination
of these sources. An
important consideration
may be the
to foreign
government s attitude
including
such
medical personnel,
matters as the recognition
of qualifications
and authority
to practice medicine.
10. In major emergencies,
UNMX
will
iumediately
seek the assistance of WHO in
identifvine
a
health co-ordinator,
who will ybe a
73
- Health kea;ivF
of the USRX Represenprogramne staff.
The coordinator
would be reswnsible
for
planning and de\llelopir;% appropriate health care prograumes, estabstandards
(see 7.2.18))
list&-g
monitotirg
the quality of the services and ensuring proper liaison
acad co-ordination
with the health
ministry
and with other internaorganizations
on health
tional
Particular
attention
matters.
should be paid to the co-ordination of the activities
of EO and
non-national
health
teams.
other
The creation of a health sub-comwithin
the overall
IGO
mittee
co-ordinating
mechanism should be
encouraged.
11. If outside medical assistance
Haadquarters must be
is required,
informed.
Resides
WHO, sources
include
the
Xnternational
Red
Cross, (the ICRC can field medical
teams at short
notice
and the
local
Red Cross/Crescent,
which
sIT)IJld anyway be involved from the
start,
can be strengthened through
the LRB, and, in case of war,
through XX),
goverrxnental disaster organizations,
and K&s. Irdications of suitable
sources should
be given by the Representative,
for example an NGO already working
in the country might be able to
expand its health programne.
12. Any requests
should be for
specific
types of health workers:
not simply for so many doctors and
nur se6 , but,
for
for
example,
staff with relevant experience as
general practitioners,
epidemiologists,
or as specialists
in public
nutrition,
tropic&
medihealth,
paediatrics,
cine,
midwifery
and
visiting,
health
depending
on
priority
problem areas. Experit=nted personnel with the right personality
are more important
than
highly
trained
specialists,
*se
skills
are of ten inappropriate.
Familiarity
with
the local
culture, patterns of disease, and the
l/
Called either WPC (WHO Program
~ogramne Co-ordinators) .
74
public
health
services
is
important as an advanced knowled;:
of medicine and medical techniques.
13. A particular
requirement in a
large emergency may be for a pharmacist , to co-ordinate
all aspects
of the provision
of appropriate
medical supplies
(see 7.7). There
may also be a need for an experiexed
health
administrator,
for
example, to organize a vaccination
campaign.
Ihe national
health authorities
15. Whatever
the
implementing
ar rangmnts ) early involvement of
the government ’ 6 central,
provincial and district
health services
is essential.
To the extent possible, the services to the refugees
should be integrated
with national
services.
Direct
co-ordination
of
certain
treatment,
imnunization,
c0mnunicabl.e disease
control
and
surveillance
practices
will
be
particularly
important.
Promoting
the good health of the refugees is
clearly
in the interest
of the
local population.
Role of the World Health Organization (WHO)
16. There
are
WHO representativas lJ in almost every country
working- directly
with the health
ministry.
For normal operational
matters
in their
country,
they
depend on the WHORegional Direcwhile
for emergencies they
tor,
may deal directly
with both their
Regional Off ices ani WHOHeadquarters.
Because the major focus of
its work is health program
develimited
lopnent
WHO has only
financial
resources available
in a
Co-ordinators)
or NPC (WHO National
- Health refugee emergency, but is able to
provide advice and guidance, mobilize specialists
and, throqh
its
Supply Services in Geneva and certain
stocks,
emergency regional
needed medicaprovide
urgently
ments and supplies
with
UWX
funds. The response to the health
needs of the refugees should be
closely co-ordinated with NHO.
(3rjzanization
of response
117. A
pass ible
hierarchy
of
health
services
is outlined
in
figure 7-2 overleaf.
It assumes a
large-scale
emergency which engages a very large number of health
prsonnel,
both
national
ard
international.
A smaller
influx
will require fewer levels of organization.
In such cases one health
administrator
in the capital
can
service a team which is otherwise
exlusively
deployed in the settlements and in reinforcing
existing
local health facilities.
‘zhe indication of numbers of staff needed
as a ratio of the caseload is no
more than that,
an irrlication.
Prtual nunbers will depend on the
health needs, the degree of isolation of the settllements and so on.
There is often a minimum staffing
need as even in a small settlent
it is sometimes difficult
to get
with
less
than
two
senior
b
health workers.
18. Chce the pattern
of disease
and overall needs have heen determined, widelines
on standard procedures for health workers should
$f$gggQf
2
s:z!j:s,
y:r
Ming - such subjec.ts as the- basic
prim: iples,
how ihe services are
to be organized,
including
any
selective
feeding
programnes ,
standardized
treatment
schedules ,
drug lists
and supply, vaccination
and
The guidelines
reporting.
sfuuld
he prepared by the MICX
health
co-ordinator
in consultation with
ail
concerned,
issued
the aegis of the health
UKkr
ministry
if possible,
and reviewed
periodically I f OF example @ a
health
co-ordination
sub-cannittee.
The guidelines
should
he
translated
into
the language of
the cannunity health workers. All
organizations
providing
health
care to the refugees should be
required
to observe
the widelines,
which should also specify
the minimun period
of stay for
international
health
workers.
An
example of such guidelines
is listed in the further
references at
the end of this chapter.
7.3 J3ealt.h
assessmmt
ad
sur-
weillarce
/7
An assessment of the health
sod nutritional
status is an
essential
start to the provision of health services.
D
‘Ihis must be done by experts
with experience
of emergencies and, if possible,
local
knowledge.
D
%e
factors
affecting
the
health of the refugees must
be identified
and a surveillance
and repor t ing system
established.
Initial
assessment
1.
The aim of the initial
health
and nutritional
assessment is to
identify
needs and establish
priorities.
The factors
contributing
to health or disease in the refugee caununity must be determined
by establishing
the pattern
of
disease, the ef feet of the cultural anl social
influences
on the
refugees’
health,
and the effectiveness of any existing
health
This assessment is calservices.
led epidemiology.
2.
Much information
can be collected by observation,
for esample
on the adequacy of the water supply and sanitation.
Health workers
are an obvious further
source of
information.
Sample surveys will
reveal symptoms ard disease patterns and indicate distribution
in
the
Where possible,
c-unity.
mass screening on arrival
is the
most effective
method of initial
at first,
assessmeqt . At least
many sick refugees will he unaware
or shy of the health services.
75
7-2 - Possible organization
of health services
Uni t/lmation
Health staff
Refugee Health Unit
(with Ministry of
Health if possible or
as part of UtWR
programe team) .
Uealth Co-ordinatiqg
Comittee with NGOs
Regional/district
Hospital
Regional level
Health Centre
(with limited
beds for overnight stay, say,
l/5,000 refugees)
Each refugee settlanent
I
I
I
I
1 clinic for each
sectm of, say,
5,000 refugees
The conmmity
sector
in a maior emergency
I
IJ
I
level
(Xltreach services (organized by
section of, say, 1,000 refugees)
_
Outline
of major responsibilities
UNH(x Health
Co-ordinator
Health professionals
Nutritionist
Pharmacist
Health Administrator
- Planning and implementing prograrmes
- Preparation of guidelines on
standard procedures
- Overall co-ordination
and
supervision
- Procurement and supply of drugs
and equipnent
If necessary: say,
1 doctor, 2 nurses
to help existing
staff (plus material
support if required,
especially drugs)
- Complicated maternity cases end
surgical emergencies on referral from settlement
Say, 2 doctors,
8-10 nurses/20,000
refugees (of whom
1 doctor in centre
atd 1 covering sector
level, plus 1 nurse/
sector)
- Supervision of settlemmt
health services including
training health workers and any
selective feeding programnes
- Treatment/reGrral
of eases not
handled at sector level
- Security, distribution
and use
of drugs
Say, 1
above)
gee or
workers
- Sector level services, both
preventive and curative
- super vision of outreach
services
nurse (from
and 2-3 refunational health
per sector
Ref.ugee cumunity
health workers
- Identification
of public and
individual health and nutritional problms, treating
simple, referriog more diffi-
cult cases
- Home visiting
- Mother and child care
- Basic surveillance
and health
education
I
F3
s
9
,
- Health Therefore an initial
screening, in
the rare cases when the relief
workers arrive
at a site before
may be the only
the ref*eez,
early chacr=e to reach sane potenThis can be done at
tial patients.
the 8~
time as the registration
on arrival.
(See ch.12.6.7)
Health
wakers should make a quick examination checking in particular
for
coumunicable diseases. They should
refer any sick person for treatment; it is usually *ractical
to
treatnrent
in
the
WY to give
screeniline itself.
A swift
response is vital,
3.
but to be effective
the initial
assessnw?nt should be made by one
or more experienced persons with
an understac&ng
of epidemiology.
Relevant
practical
experieze
is
important.
are
obvious
There
or
advantages in usirrg national
locally-based
personnel,
but
appropriate
outside
expertise
can
be made available
quickly
and
should be requested through Headquarters if necessary.
Figure 7-3 overleaf illustra4.
tes sane msnagwnt
considerations
for action in light of the initial
asses-nt
.
Sur ve ill-e
A surveillance
system must be
5.
establisbd
quickly.
caO;efulbea;~
controlled
monitoring
and nutritional
status is essential if problems are to he identified
in
time
for
prevent fve
As an example, the inciaction.
dense of diarrhoeal
diseases may
be an important pointer
to environmental
problems.
Although
t’he
health
status
of the settlement
should improve as public
health
services start to function adequately and the refugees adjust
to
their
new envirormat , seasonal
variations
in the incidence
of
disease
because
will
remain
chases
in temperature,
and the
raiw
season in par titular , will
have an impact on health.
So a
vigilant
surveillance
system must
be maintained.
Continued monitorirg of the health status and dis-
ease
patterns
will
allow
the
health services to be adjusted and
resources
reallocated
as necessary . ?E , form of this surveillance, the data required,
who will
interpret
it arrj how to ensure
action on the results will he matters for early, and expert, decision. Only simple arrangements are
ef feet ive in emergencies. The system should be centrally
co-ordinated.
If the initial
assessment or
6.
subsequent reports
irdicate
specific
deficiencies
or carmunicable
diseases, special pnzasures narst be
taken to organize specific
surveys
by persons with appropriate
expprience.
Records and repor tin&
7.
Records take two forms: on
individuals
and on the carmunity
as a whole. The purpose of each is
different.
Individual
record carda
will he needed for recording imrmnizations
and the treatment
of
illnesses.
These cards should usually be kept by the refugees ati
in the case of young children
by
the nxXher. Fxperieoce has shown
that the cards will
generally
be
well cared for. Cumnmity reportirqg has a different
purpose. It is
an essential
tool for the planning
of services and the u0nitoring
of
disease patterns.
Statistical
data
on the ntiers
of cases identified
and treated
should be regularly
collected
and analysed.
A single
standard reporting
form is sqggested in annex 1. This will ensure
standardized
renortins
from different
settl&nts
r
National
health authorities
require
specifled
“not if iable”
carmunicable
diseases to be reported at oc1ce.
Laboratory
services
lb be fully
effective,
sur8.
veillance
requires rapid access to
laboratory
services,
but the refugees are of ten remote from such
facilities.
This is a problem that
should he raised with the national
health
authorities
at an early
stage. Very simple laboratory
ser77
- Health ,&?6ESSf+G3fl
7-3
NO
NO
-p+fcC
I~&D\Aps
y0
co
tqlzoL
Di%%“c.stiS
p.F?+G-E=S
P-eSPOt4SE
c-l-0 c=ftGcE;LLst)
ORG#w-rlZE
E-9lb’SMlGLO6-lCAL
s v Q’f&y
M(m5Rr
*qof4
REMO\/E
CPmuc
6rHl.1
1.
CAU’?=S
HEALfH
MwJarS),
CcvAMUt-J
AND
IS -P%RE
WAl-=ft
3\)WlClEN-/(at.9
,+I&
APpRwR\4fE
IC#tSLG
PI=+WAL
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I
2.
mw=
Bfm-l
cf
ht4
KCR&pa
-j-W-XT
IO,
s”A,F‘Z
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FIG
5)‘sl’=M
16-l-)
HE-hLW
?
5t5mlcrJq
OlZGArJlZC~
0t-l
OF flG.
7-2,
+N’a
IJ-ES
xDoE5
5ULVCI
LLANCE
INCWCATE
-lw+
WoazrG
4.J4kVE #-Ei%lJH CARE
G-ulbELIYES
(7.2.
$EEH
ISSUGD
AND
mey
FOLLOWED
7
5. AR6
DUG
APPEOPRIAJF
-lz~b
AND
(7.7)
78
?
la)
ARE
suPpLI=S
I si”
AssuReb
WRb
‘f’
- health
vices at the site
ally adequate.
level
are usu-
7.4 Disease ax&ml
D
vector control
and general public
balth education and awareness.
3.
conditions
be emzountered,
overcrowding,
the
spread
diseases.
-
likely
particularly
to
will
encourage
of comnunicable
D
*
The
aim
conE-0 1 lzoadpreE2
detect,
disease.
D
Improvement in environmental
conditions
will
play a major
role i;l prevention.
D
in
Avoid mass imunization
the emergency phase, except
against measles.
D
After
the emergency phase,
children
should be imnunized
within
the framework of the
national
imunization
progranme.
D
Specifically
medical emergencies such as epidemics require an imediate
on-the-spot
expert
assessment and close
co-ordination
of the response
with the national. authorities
aml WO.
1.
coumunieable
The risks
of
(infectious)
diseases are increased in a refugee emergency by
overcrowdiog and poor enviromiental conditions
and of ten further
exacerbated by the debilitated
state of the refugees. There is,
for example, a close association
between
malnutrition
and
the
effects
of camunicable
disease,
particularly
childhood
diarrhoea.
It is
tmwever, important to realize that the infectious
organism
has to be present to spread: for
example, if no one is carrying
typhoid,
it
will
not
suddenly
apt==*
2. kasures
to improve environcomiitions
mental
tmlth
are
therefore
very important:
enough
safe water, soap, proper disposal
of excre ta and garbage, rodent and
Expert
advice
is essential
for comunicable
disease control
arrl the management of epidemics.
Sam carmunicable diseases have a
seasonal pattern
and timely prevent ive measures must be taken.
Tmnunization
4.
There is often
considerable
pressure
for
an iumediate
inass
inmmization
programne . There are
strong reasons, both medical and
practical,
should
be
why this
resisted.
The most cam-m causes
of disease and death in the emergemy phase are generally
infections,
of ten aggravated by malnuthat cannot be effectivetrition,
ly prevented by immnization.
Mass
imunization
progranmes
require
large
nmbers
of workers,
the
hatiling
of vaccine in COntrOlkd
refrigerated
conditions
and careful supervisi.on,
all of which are
difficult,
and not necessarily
the
best use of resources even when
these are available .
5.
The only imnunization
imlicated in the early weeks of an aergency is of yorlng children against
measles. This is d high priority
even when resources are scarce.
6.
Al.1 other necessary itmunizat ions (for example, DPT, Polio amI
BC& should usually only be given
once facilities
allow, and
to tb extent possible within the
f ramewI>rk of the goverrment ’ s own
expanjed prodrame of imunization
imnunization
Details
of
schedules and vaccine storage are
given in annex 2.
ww
l
CZmon diseases
7.
The most canmnly
occurring
symptans and diseases among refugees are generally
not far removed
f mm those normally to be expected
in any cmunity
in a developing
country.
diarrtmea,
nutritional
respiratory
infecdeficiencies ,
tims,
malaria, worms, aoaemia and
problems.
however
geni to-ur inary
- health
the artificial
crowded corrlitions
are likely,
at least initially,
to
cause a higher than normal incidence of these diseases. In partias a consequence
cular diarrhoea,
of a new environment,
unfamiliar
and poor
density
of population
usually
services,
environmental
poses the [email protected] threat to refugee
health in the first
weeks of a
It remains a
settlement’s
life.
7-4
Disease
major risk should there be a sudden deterioration
in scme aspect
of the comnunal services,
such as
contamination
of the water supply.
The more ccsmon of these diseases
are outlined
in table 7-4 below
which illustrates
the environnental impact on disease and Micates those improvements in living
conditions
which will bear directly on the health of the refugees.
Camnon diseases
Major contributi
+
Preventive measures (1)
1.
Diarrhoeal
diseases
Cvercrowding , contamination of water
and food.
Adequate living space, public
health education, good personal and food hygiene, safe
water supply and sanitation as
specified in chapters 6-10.
2.
&asles
Overcrowding.
Minimum living space standards
as defined in chapter 6. IWJnization of children 9 mths to
5 yrs.
3.
Respiratory
diseases
Eoor housing, lack
cf blankets ard
clothing.
Minimum living space standards
and proper shelter (chapter
6)) adequate clothing,
suff ic ient olanke ts .
4.
Malaria
New envirorrnent with
a strain to which the
refugees are not
imnune. Stagnant water
which becanes a breeding area for mosquitoes.
Destroying mosquito breeding
places, larva and adult mosquitoes by spraying. -ever
the success of vector control
is dependent on particular
mosquito habits arxi local
experts must be consulted.
(See ch.10) Provision ot
mosquito nets. Drug prophylaxis only for those (e.g.
young children) who otherwise
might die on first attack,
rather than start to develop
immunity.
(1) Melnutrition
increases vulnerability
to serious attacks of all these illnesses; proper feeding is thus effectively
a preventive measure.
80
I’
1.
i
- health
Disease
Major contributix
factors
-
(1)
Preventive
measures (1)
5.
tiningococcal
meningitis
Overcrowding in areas
where disease is
erriemic (often has
local seasonal pattern).
Minimum living
(chapter 6).
after expert
veys suggest
nity is only
week.
6.
mberculosis
Overcrowding.
Minimum living space standards
(chapter 6) but where endemic
will ranain a problem.
7. Qphoid
arrl cholera
Overcrotiing . Ebor
personal hygiene, contaminated water supply,
inadequate sanitation.
Hinimurn living space standards,
safe water, proper sanitation
(chapters 6, 9 and 10). WHO
does .s re-ti
vaccination;
it offers only low, short-term
individual
protection and
little
or no protection against
the spread of the disease. Good
personal, food and public
hygiene and public health education are the most effective
measures.
8. Worms
especially
Overcrowdirlg . Poor
sanitation.
Minimm living space standards,
proper sanitation
(chapters 6
and 10) . Good personal hygiene.
l%e wearing of shoes.
9. Scabies
(skin disease
caused by
burrowing
mites)
Overcrowding.
Poor personal
hygiene.
Minimum living space standards,
enough water and soap for washing (chapters 6 and 9).
10 ., Xerophthalmia
(child
blindness)
Vitamin A deficiency .
(Xerophthalmia is
of ten precipitated
by
measles or other
acute infections.)
Adequate dietary
11. Anaemia
Malaria, hookworm,
poor absorption or
insufficient
intake
of iron and folate.
‘Prevent ion/ treatment of contr i -butory disease. Correction of
diet inluding food fortification.
12. Tetanus
Injuries to unimnuniaed population.
Poor obstetrical
priictice causes
neo-natal tetanus.
Good first aid, immmization of
pregnant wauen and subsequent
general immmization within
EPI. Training of midwives and
clean ligatures,
scissors,
razors etc.
tmokwcnns
space standards
Inmunization only
advice when surnecessity. Imnuachieved after a
intake of
vitamin A. If not available,
provide vi tamin A fortif ied
food. If this is not possible,
vitamin A capsules. Imnunization against measles.
81
- health
7.5
peflmee health m
fl
Diagnostic
techniques and the
treabnent of the major acute
should
he simplidiseases
fied, standardized
and appropriate.
/7
Most health problans do not
sophisticated
care
or
n-J
treatment arri shmld be provided through health centres
and clinics
within the carmuand to the extent pmnity,
sible,
by health workers from
the cannunity.
/7
Health
workers
must
sped
time quyg the cairnunity, not
in clinics
for
simply wait
sick persons to cane to them.
/7
Pregnant and lactating
wan&
and your
children
are vulnerable and special attention
must be given to their needs.
1.
care
must
Refeee
health
embrace both preventive and curative measures. The need for and
sccpe of the latter will vary with
each emergency and will depend on
the degree of prevention achieved.
2.
where
several
Particularly
organizations
are immlved,
close
attention
must be psid to ensuring
a ccmnm starrlard
of appropriate
health care arrl a fair distribution
of available
services
both
within arrl amrg sites. Opinion as
to
treatment
can
thus
vary;
centrally
developed
arid clearly
urrlerstmd
standardized
treatment
schedules are essential,
and will
also be of great importance to the
training
progrand in avoiding
confusion v
local arxl refugee
health workers.
IieTlce the importarre of the guidelines
described
in 7.2.18. Where qualified
personnel sre scarce and confirmed diagnosis not possible,
the standard
treatment should be given for the
presentirg
symptans. Mess
treat ment is administered on the spot,
clear oral and written guidarrce on
dosqe and schedule must be given
to each patient
ww-
in his or her lan-
3.
All concerned should be aware
that
treatment
inappropriate
to
the needs and circunstances
may
not only be useless and wasteful,
but can have an important nepative
effect
on the refugees’
attitude
to health care and preventive measures. Examples are the fostering
of&e
belief
that only injections,
rather
than tablets, -are
effective,
that intravenous fluids
are better than oral rehydration,
or that imported milk rather than
breast-feeding
can save the malnourished baby.
Triee
4.
This
is the selection
and
classif ication
of the sick and
wounded patients
for attention
in
the face of overwhelming needs and
insufficient
resources. The aim is
to provide priority
assistance
to
those
most likely
to benefit.
While it is a likely
requirement
after a severe natural disaster or
in times of conflict,
triage
is
rarely
necessary in refugee emergencies . If there is a need for
triee,
classification
is usually
categories : those who
by three
cannot benefit
from the treannent
available
under the emergency conditions
and are
therefore
not
ill
or
treated,
the seriously
injured,
who should be attended to
first;
and those who, after iniaid, can wait for meditial first
Cal attention
until
after
the
second category . The selections
must be made by the most experienced health worker available
but
the administrator
may well need to
impress on the health staff
the
vital importance of a triage system.
In many emergencies scme 75&% of patients
present with minor
which in most cases will
ailments,
cure spontaneously.
These patients
should not be treated at all during emergencies if,
as is likely,
resources are scarce. Public health
measures will
probably reduce the
incidence of such minor ailments.
- Health The provision
of health care
6.
The refugees must have easy
treatment.
access to appropriate
If the local national health facilities
cannot be strengthened
to
needs,
alternative
meet
the
will
be required.
arrangements
Chless treatment
is provided at
the hospitals
or
the right level,
will
be
health
centres
majm
refugees
swamped by
demanding
treatment
for simple corditions.
Thus what is required is a comuthat
ni ty-based
health
service
both identifies
those in need of
health care and ensures that this
is provided
at the appropriate
level.
Close co-ordination
with
other comunity
services is essential.
7.
Ibe first
level is therefore
the comunity
health worker, responsible
for a section
of the
refugees and working among them,
home visiting,
case finding
and
following up, and responsible
for
the basic comunity-wide
preventive
measures , including
public
bealtb
education.
The camunity
health
worker,
who should be a
refugee,
with
the
appropriate
would
traini%,
identify
health
ami nutritional
- and often social
- proolms
and if simple on-thespot trea&nent was not possible,
refer
patients
to
the clinic.
also
Refugees will,
of course,
present directly
at the clinic
but
it is important
to realize
that
some of those most in need will
not go to the clinic,
and that the
diseases of those who do may not
reflect
the mst camm problems
in the carmunity .
8.
As a general guide, one clinic might be appropriate
for every
5,000 refugees in crowded conditions but otherwise
in reasonably
good health. ‘Ihis should be a simple building
with facilities
for
consultation,
clinical
procedures
such as dressings ana inJections,
a smsll lock-up pharmacy, simple
equipment and sterilization
facilities
(electrici.ty
may not be
available).
Water and sanitation
are
essential
services
at
all
health facilities.
9.
In support
of the clinics,
there should be a health centre
for each refugee settlement.
Very
large settlements may require more
than one, while for small settlements, a single
health
centre/
clinic
may suffice.
The health
centre stmld
be able to handle
all
but
the
most complicated
maternity cases anj surgical emergencies. bore facilities
should be
available
than at the clinics,
including
basic laboratory
services ancl a few beds for overnight
observation,
perhaps in the order
of one per 5,000 refugees.
10. An indication
of the numbers
of health staff required is given
in figure 7-2 on page 76. tiferral
of the relatively
few cases that
cannot be treated
at the health
centre level
is covered in the
uext section (7.6).
Mother and child
health
11. In a normal camumity , children, especially
those under five,
and pregnant and lactating
women
are recognized as being vulnerable
infection
and
to
malnutrition,
other health problems. In a refugee emergency the risks are greatly increased and health services
should provide particular
care and
supervision
for
these wcmen and
children.
This should be integrated with any supplementary feeding
of this,
and
programe . Details
important
informat ion on car ret t
infant feeding, are given in chapter S.
12. As soon as schools are established,
special
health prograames
should be arranged for the pupils.
13. The need for and nature of
dental programes should be considered once resources allow.
Ihe
promotion of oral hygiene and prevent ive dental
treatumt
is of
benefit
than ird ividual
greater
dental
work, ‘Ihe use of simple
traditional
mett-mds such as chew
sticks
and tooth picks is more
appropriate
than the introduction
of tooth paste and brushes.
83
- health
information
14. &irnily
planning
should be available.
After proper
education suitable
tern tar
metbspacods of contraception* +id
be provided
on a
ir7g) should
voluntary
basis ensuring that the
free
their
refugees
understand
cbice in the matter.
Arrangements must be such that
referred
WlY those specifically
from the health centres are seen,
with no refugees presenting
themselves directly
to tbe hospital.
2.
At least
in the emergency
such referrals
should only
ph-3
be to save lives.
Health education
15. ‘Ibe wrtance
of health eduis
perhaps more widely
cation
rewized
than are the dif ficulties in persuading those most at
risk
to change long-established
habits,
however compelling
the
case for such a change may appear
At least
in the
to outsiders.
phase, the priority
emergency
irectl
topics
public
related
to the imnediate
health
problems, for example the
diwsal
of
human excreta
and
refuse. Many governnents and organizations
produce simple
health
education
materials
that may be
useful.
Trained teachers and resfran
the refugee
pected elders
cormnrnity are likely
to be more
effective
than outsiders
in carmunicating
the basic principles
and
practices
of health to their own
F-e*
7.6
Referral
services
-//
lhe health
centre
must
able
to refer
patients
hospitals for treatment.
fl
‘Ibis treatment should be made
available
in local hospitals
if possible.
/7
Arrangements must be made to
provide suitable
transport
to
and from the hospital.
be
to
1.
In order to ensure that patients who cannot be cared for or
treated at the site health centre
the necessary attention,
receive
an effective
referral
system to a
hospital
or rehabilitation
institute
is required.
Unless there
are large numbers of inJured, oiy3e
settlement
health
services
have
been established
the numbers of
such patients
should not be high.
84
Referral
3.
the
national
hospit:!
should Ear%
aim; this has obvious advantages,
not least that of imnediate availability.
Close ate direct co-ordination with the district
medical
officer
is essential.
The possibility
of expanrling
the existing
hospital(s) ,
for
example
with
tents in the grounds and addi tional health
personnel,
Should
De
considered. Care must be taken not
to swamp the hospital.
Facilities
at the hospital
must also provide
for the needs of relatives
and
allow parents
to be with young
chi ldren . Financial
and material
should
be provided
as
support
necessary . for example, if Emergency Health Kits (see 7.7) are
dispatched some of the drugs might
be placed at the disposal of the
hospital treating refugees .
4.
Special
refugee
hospitals
should be avoided if at all possible.
skilled -labour
T~=Y are
intensive
but provide only curative services,
can rarely continue
to be properly
run once outs ide
support is withdrawn,
and are in
any event unlikely
to be appropriate
to the longer-term
needs.
Once established
they are extremely difficult
to close. Thus such
hospitals
should only be provided
if a clear
and continuing
need
exists that cannot be met by existing or strengthened national
haspi tals . GJhere such a hospital
is
unavoidable
priority
consideration
should he given to the local construction
of a simple appropriate
structure,
to
be staffed
and
equipped to a level determined by
the local pattern of disease and
likel;l
demand rather than a theoretically
possible need for highly
specialized
treatvlent . Frm
the
start,
planning of such a hospital
- health
must take account of envirorrnental
factors
such as sanitation,
the
disposal
of hospital
waste, security
of drugs ard supplies,
ard
the provision
of latrines.
Ebspital floors should be solid,
washable and well-drained.
5. Ihe ntier
of hospital
beds
required will depeti on the state
of health of the refugees. As an
irriication
only, one bed might be
required per 2,000 refugees in the
early
stsges
of an emergency.
Again as an irxlication
only,
a
refugee
hospital
with
50 beds
might require two doctors and six
nurses plus auxiliary
support.
6. Field hospitals may be offered. While this is an alternative
to be considered in certain
cirfor example a major
clJnstames,
expansion
of
a local
hospital
through a field
hospital
in the
field
hospitals
may have
iP~S#
limitations
several
including
delays in establishuent
arrf cost
(especially
transport),
and can
be technologically
inappropriate.
Often over-sensitive
[email protected] or
equipent
dependant
on outside
SourCes of power cannot be made to
work. A field hospital is rarely a
satisfactory
way of meeting a continuing
need. It should also be
recognized that because of their
great
public
relations
value,
donors
en=ourage such hospitals
even when unsuitable.
7. Refugee emergencies are not
usually
characterized
by
large
numbers of injured.
However, when
this is the case thare may be an
initial
requirement for the rapid
deployment of a surgical
unit.
Such a need will
generally
be
self -evident,
and such units are
normally
quickly
available,
for
example through URC.
8. Whatever
arrangements
made for hospital
treatment
referral,
suitable
transport
be available.
are
and
must
-
7.7 @k&Cal sumlies
/7
Drugs should
/7
Special
emergency kits
have
been developed on this principle for irmxzdiate needs and
should be requested if local
sources are inadequate.
L7
Vaccine
requires
careful
handling.
It should be obtained locally
against
subsequent replenisbent
if possi-
be limited
to a
few basic standardized items.
ble.
/7
LJnsolici;~~
medical
supplies
are
unsuitable
and
should be subject
to clearance prior to dispatch.
1.
Ehnergency supply arrangmnts
should draw on in-country
resources and distribution
channels to
the extent possible.
however, initially
special arrangements may be
Unplanned response can
necessary.
lead to long and inappropriate
often
by brand rather
requests,
than generic names. Experience has
shown that what is needed are adequate quantities
of a few basic
drugs ard a strict
control
of
unsolicited
donat ions.
WHO and
UNLCR have drawn up standard lists
of drugs and equipment for use in
emergencies to meet this requirement . The lists
cover scfne 30
basic arugs/preparations
for use
by health workers, sane 35 drugs/
preparations
for use by doctors
and senior
health
workers,
and
basic medical equipment. Together
they comprise the contents of the
Emergency health
Kit.
Ihe lists
should be amended as necessary in
light
of local
conditions,
using
only drugs in the current
report
of the WHOI&pert Cunnittee on the
Selection
of Essential
drugs (see
page 88)) and then adopted as the
supplies
for
stadard
medical
health care in the emergency.
sources
c!annot
2. Whzn lOCal
meet the initial
demand for medical supplies,
the bergency health
Kit can be obtained in prepacked
furm at short
notice.
me kit
85
- health
theoretically
covers the needs of
10,000 refugees for three months.
Details of the kit and a number of
cons idera t ions
related
practical
are given in Part 2 and are also
from UMCR
available
separately
and WHO (see page 88). As soon as
consultation
Representatives,
in
with the local health authorities,
WHO and the operational
partner,
consider
that
the kits
may be
should
cable
a
required
they
including
request giving
details,
the n&er
of kits needed and desThe fact that one kit
tination.
can effectively
cover the needs of
30,000 for one month as well as
10,000 per sons for three months
stxxlld
be borne in mind when
considering
the nusber of kits
needed. Attention
is also drawn to
the UNIPAC catalogue
which concertain
specialized
tains
kits
(e.g. midwifery).
Once itnnediate material needs
3.
should
are assured , ar rangents
be made by the operational
partner
responsible
for health services to
the refugees for a regular supply
of appropriate
quantities
of the
standard
medical supplies.
lbese
available
locally
are generally
and this is the preferred
source,
but
if
necessary,
consideration
should be given to bulk ordering
abroad, as substantial
savings may
be possible.
It should be noted
that the Emergerry Health Kits are
needs
intended
to meet initial
pending thsse arrangements,
only,
and not for resupply.
E&-ordering
procedures should be standardized
In a major emerand centralized.
gemy this will
be a full-time
task for a pharmacist.
E&quests
for overseas procurement should be
made through,
co-ord inated
or
with,
headquarters,
who in turn
will
maintain
close co-ordination
with WHO, UNICELP, ICE, LRCS and
other
potent i al
suppliers
or
donors to amid duplication.
86
4.
When
necessary
vaccine
should
be borrowed
frcm local
stocks if available,
against subsequent
replenishsent.
The WHO
Representative
or medical co-ordinator will advise on this and also
on any regional
availability
of
WHOstocks (for example, in Africa
there are stocks in the WHOstores
at brazzaville,
Dakar , Kinshasa,
Nairobi
and Niamey).
If
it
is
apparent
that
imnediate
overseas
supply is necessary,
UNHW Headquarters
should
be informed
by
cable. Whatever the source, most
vaccines require refrigeration
and
careful
handling
if they are to
remain effective.
The transportation
links
from manufacturer
to
individual
imnunization
sre known
as the “cold-chain”.
The national
health
authorities’
network
of
cold-chains
should be used to the
extent pass ible, but thesa may not
of the
extend to the vicinity
refugees, without a cold-chain
the
immunization programne will
fail.
Time/temperature
indicator
cards
should be ordered and kept with
Further
information
the vaccines.
on vaccines is given in annex 2.
&.dical
supplies will require
5.
tight
security
control
to prevent
misuse and theft.
unsolicited
6.
Donat ions
of
drugs may be a problem in an emergerry. Quantities
arwl quality
may
donat ions
vary greatly ; typical
quantities
of mixed
are
small
drugs, free samples, expired medi tines,
inappropriate
vaccines, and
drugs identified
only
by brand
language.
names or in a foreign
(he of the health administrator’s
most important functions may be to
say “No”. UMIQ2’s policy is that
overseas medical
supplies
should
be sent only in response to a
prior
specific
request
or with
clearance; locally,
the WHOKeprediplaratic
missions and
sentative,
concerned should be
all
others
briefed accordingly.
- Health -
enenson A.S. (ed)
1980)
Control of Camnunicable Diseases in Man
Standard reference book for a wide
variety of communicable diseases and
their control. Discusses disaster implications of each.
(Also in French, Portuguese and Spanish) .
Aner ican Public
Health Association
13th edition
airn=lcloss S.
Enviro~ntal
Health Emineering in the
Tropics: An Introductory
Text
A copiouslv illustrated
introduction
to
the prins.iples and practices of tropical
enviromntal
health .
Wiley, John
enters for Disease
ontrol (1981)
Assessment and Surveillance of Health
Problems: Refugee Populations
Written primarily for CDC enidemiolcqists
but a useful guide for geneial health
personnel, nutritionists
and environmental
health workers.
Provisional version, first edition expected
in 1983.
US Public Health
Service
nternational
isaster Institute
Disasters Volw 5 No. 3
Medical Care in Refugee Camp
Covers a wide variety of pub&c health
topics.
ID1
:icg M & F
lar todipoero
:1981)
Primary Child Care
Hook (he: A Manual for health workers
Comprehensive child care in simple language
with many illustrations.
Hook Iwo: A Guide for the -unity
Leader,
Manager and Teacher.
Oxford Hniversi ty
Press/WHO
Emerge&v Health Management after Natural
Disaster
-for
decision makers and senior
administrators
that contains much that
Pa relevant to refugee emergencies.
(Also in Spanish)
PAHDScientific
Publication No.407
Epidemiologic Surveillance after Natural
Disaster
XGX&vant
to refugee emergencies.
(Also in Spanish)
PAIB Scientific
Publication No.420
Fnvirormental Health Management after
Natural Disaster
Also relevant to refugee emergencies,
particularly
with regard to imnediate
action in temporary settlements where
very high population density is unavoidable.
(Also in Spanish)
PAHOScientific
Publication No.430
kachm R.
1983;
‘AHo (WHO)
:1981>
‘?%z:wHO)
Western K.A.)
‘AH0 (WHO)
1982)
S.
1) See also ths further
hich are repeated here.
references
at the end of chapters
8, 9 and 10, only saue of
87
- Health -
silmlonds s.
Vaughan P.
Gunn S.W.
(1983)
Refugee Ccmnunity Health Care
Comprehensive guidance on planning,
man&eroent alld delivery of - refugee
health services.
Oxford University
Press
Simrrmds S.
Gabaudan M.
(1982)
Refugee Cams Health Care: Selected
Annotated References
A carpanion to above
Ross Institute
Publication No.14
Somali Ministry of
Health, Refugee
Health Unit (1982)
Guidelines for Health Care
A good example of guidexes
sort referred to in 7.2.18.
Third edition,
printed in booklet
form by Oxfam
Werner D.
(1980)
Where There is No Doctor
A very Practical villze
health care
handb&k with many ill&trations.
(Also in Khmer, Porteuese and Spanish).
Macmillan
UN (1977)
A Guide to Food and-Health Relief
for Disasters
(Also in Freru=h and Spanish)
Protein-Calorie
Advisory Group of
the UN
d;Gf;
de &yet
Geijer U:
(1978)
WHO(1982)
C. FLMsnasmnt
of Nutritional
srge Popllaticns
Elki tial readins
(Also in French &XI Spanish)
Control
of the
Operations
Emergencies
of Vitamin A Def icie.ncy and
$%%!%%ic,
Technical Report
Series 672
French ati Spanish)
WHO(1982)
The Emergency Health Kit
Lists of basic drugs and supplies with a
high probability
of being required in any
refugee emergemy. Includes quantities
for
10,000 persons for 3 months an;t possible
starrlard treatments.
(Developed jointly
with UNHCR)
WHO(1980)
A manual for the Trea.tment of Acute Diqr,rhog
(Also in French and Spanish)
WHO(1979)
The Selection of Essential Drugs
Second report of the WHOExpert Comnittee
Third report expected in 1983.
(Also in French ati Spanish)
Technical Report
Series 64’6
WHO(1981)
The Treamnt
and Management of Severe,
Protein-Energy mlnutrition
(Also in French and Spanish)
WHO
88
- Health EmmiLe of a Stamkd
Mmtih
Refwee
Serial
Location
of refugees ..............................
Nsr~ of reporting
1.
2.
officer
Annex 1
&mveiU.ame wmxt
kalth
no. of report
(1)
......................
[email protected] ...............
Year ......
. . . . . . ..*..................................*....
Refugee population
(1)
Total
(emof
lastmonth)
....................
+
(2)
New arrivals
(this month)
....................
+
(3)
Births
II
....................
+
(4)
Deaths
II
....................
-
(5)
left
II
....................
-
(6)
mtal
=
(em of this month)
Numbers of health personnel directly
working with refugees
(1)
Doctors
....................
(2)
Nurses
....................
(3)
Midwives
....................
(4)
Sanitarians
....................
(5)
hutri tionists
....................
(6)
Msdical technicians
....................
(7)
Ccsmnmity Health Workers .....................
(2)
(8)
(1) A separate report should be made for each major location
any corresponding
monthly report
by the national
health
attached.
(2) Add others as applicable,
e.g. traditional
personnel.
Imitate
those who are refugees.
he&h
of refugees.
authorities
workers,
dentists,
A copy of
should be
ophthalmic
89
- health
3.
-
hortality
Possible cause/
category (3)
Total
-7-
under
1 month
1-11
mnths
l-4
years
5-14
years
I
15+
years
Diarrhoea
Pkasles
Mslaria
Trama/
accident
konatal
Msternal
Total
L
(3) Add others
on effectiveness
90
I
The object is to list
as necessary.
of health care prograrmes.
deaths which may reflect
- Health 4.
Morbidity
Nuiher of individual
cases seen at all health centre(s)
with one of the
following headings as the major presenting condition.
Record the first
visit
for this condition only, i.e. ntier
of new cases.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Fever, no cough
Fever + cough
Fever + chill
Diarrhnea, no blood
Diarrhoea, + blood
lkasles
Whooping coeh
Eye infection
Skin disease
Venereal disease
Malaria
Dental
Trauna/accident
16.
Total
5.
Data on connunicable
disease control
programnes, for example:
Tuberculosis
Nu&er of patients
under treatment
WsJmbernew patients
Nu&er patients
treatment (this
(this
after
registered
of whom percentage attending
.................... +
. ..**..............*
month)
discharged
month)
Total number patients
(end this month)
(end last month)
full
for treatment
regularly
(4) Add other specific
diseases e.g. schistosaniasis
of public
sary. The object is to monitor effectiveness
+
.................... . . . . . . . . . . . ...*...*.
=
...................
“/,
(bilharzia)
as neceshealth measures.
91
- Health 6.
Supplementary feeding;
Category (5)
No. enrolled
Admissions
(eti last month) (this month)
Discharges
(this month)
Malnourished
(under 80%
wei&t/height)
/ Other young
children (under
115c.mtall)
Preppant
Lactating
t
Bkdical
referrals
I
Total
(5) Add other categories
within
vulnerable
groups as appropriate.
Total (end
this month)
I
I
~ 7.
- Health Therapeutic
feeding
-.
1
) Category
1,
NO. enrolled
(end last month)
>I
Admission! S Discharges
I.
--
I
to
Left although
Tota1
(end month
Marasmus
(no oedema)
” Ckzdema
others
(e. g .medical
or siblings)
t
Total
L-
f
Remarks: (slmnary assessment of overall situation,
8.
roles of agencies, surveys , particular
problems, remedial action taken or envisaged, timescale, visiting
health personnel during month, etc.)
- Health [email protected]
Swested
irmnmization
Annex 2
aul Vaccines
timetable
Vaccine (1)
!?a?
Ece
At birth
DPI’ 1st dose
Eblio 1st dose
2-3 months
DPT 2nd dose
Mio 2nd dose
At least 4 weeks after
first dose
the
DPT 3rd dose
Mio 3rd dose
At least 4 weeks after
second dose.
the
*asles
As soon as possible
months
(2)
UT
When the child
Temperature requirements
LbWL:
w;i;-;
J”;;;cz
mx~:;
MEASLES(4)
for vaccine storage
after
9
goes to school.
(3)
ENTEQ4LSTORE
up to 8 mnths
Deep frozen
ORAL POLIO (4)
-15OC to -25OC
DPT (5)
TETANIS llmm
(5)
94°C to +8OC maximum
BCG (4)
(1) BCG for protection
against
tuberculosis;
(whooping co%h) and tetanus; III’ against diptheria
DPT against
and tetanus.
diptheria,
pertussis
(2) Tmmmization of young children against measles is a priority
in a refugee emergemy. The vaccine can be given simultaneously with DPT and polio vaccines.
(3
Storee
times are maximum figures
- remember to check expiry dates.
temperature
irrlicator
cards should be kept with the vaccines.
The cards
ordered separately if they
m are not supplied with the vacc.i.ne.
(4) The live virus vaccines are sensitive to sunlight - avoid direct exposure.
(5)
Never freeze DPI’ or TEWWS (which both freeze at temperatures
94
below -3°C) .
Time/
can be
List
Sect ion
8.1
l- 6
2
5
7
9
l- 7
8.4
;:1:
11
3.2
;I :
6-11
12-16
l- 6
Introduction
97
of food support
Role of the World Fond Programne (WFP)
Responsibilities
and personnel
Role of the refugees and nutrition
education
Organization of response
;;
Assessment and surveillance
99
General feeding progranrse
100
Basic considerations
Dry ration distribution
Cooked food distribution
mnitoring
the general
102
103
103
[email protected]
(take home)
feeding prograume
;;
lke need
Aim and content
Admission and discharge
Organization
104
104
105
106
Therapeutic
107
Infant
8.7
l- 4
5- 8
8.8
feeding prograarne
feeding and milk products
Importance of breast-feeding
weaning foods
Other milk products
Provision
l- 2
3- 4
and
108
109
of the necessary food
Logistics and storage
Sources of supply
109
110
Basic facts about food and nutrition
8.9
;
2- 7
Annex
96
Supplementary feeding prograame
8.5
8.6
Overview
Organization
l368-
%7!&2
Contents
Paragraph
8.2
8.3
of contents
Nutrients
Energy and protein intakes
Food and diets (Table X2-3)
Protein-energy malnutrition
(PFM)
110
110
111
111
Further
114
references
Rapid assessment of the nutritional
status
of young children using the arm circumference method
115
95
Need
In an emergency refugees will
Scmemay need nutritional
port-
need partial
rehabilitation.
or canplete
food sup-
Aim
To provide the refugees with sufficient
quantities
food to maintain their health and where necessary
condition of those who are already malnoLTished.
Principles
of appropriate
to improve the
of response
/7
Measures to meet food needs should be appropriate
and standardized, with responsibilities
clearly defined, and the overall co-ordination
ensured by a single organization.
a
Specialist
mm
Whenever possible
needs and maintain
/7
Organize food distribution
own meals if possible.
/7
Pay particular
attention
to infant feeding
children and others vulnerable to malnutrition.
en
Maintain close
nity services.
nutritional
advice should be available.
use familiar
foods that meet nutritional
sound traditional
food habits .
to allow
co-ordination
with
families
the health
to prepare
their
and the needs of
and other
comnu-
Action
96
fl
Assess the health
soon as possible.
and nutritional
status
and food needs as
/7
Ensure the availability
of appropriate
food and the necessary
transport, storage, cooking fuel and utensils.
-n
Organize a general feeding programne for all refugees and
additional
selective
feeding progranrnes to meet the extra
needs of the vulnerable and/or malnourished if necessary.
/7
Monitor the effectiveness
of the feeding prograume(s).
- Food and nutrition
8.1 Infroduction
In an emergency refugees may
1.
be completely dependent on external food sources.
‘Iheir
nunbers
and condition
must be assessed as
soon as possible.
The types of
programnes needed will
be determined by this initial
assessment.
Continuous mdi?ltoring of nutritional status will ensure the empbasis betieen prograrunes is adjusted
to reflect changing conditions.
2.
Co-ordination
of the feeding
programne(s) with the health and
other coumunity services is essential.
-
full
response
chapter.
6.
set
out
in
this
A
SLUIIEEY of basic
facts
food and nutrition
is given
at the end of this chapter together with a brief description
of
protein-energy
malnutrition.
Particularly _z . where there is malnutri: .-~ &tv”ALd & ceau
” A”*., C..L” ;*ii;..y%&r
in conjunction
with ‘The Management of Nutritional
Rnergencies in
Loge Populations” (WHO).
about
8.2
\
D
WFP should be .closely
involved in meeting food needs.
3.
Assistance
must be appropriate
to the nutritional
needs
of the refugees
and culturally
acceptable.
Foods prepared locally
with local ingredients
are preferable to imported special
foods ,.
Infant
feeding
policies
require
particular
attention.
fl
Co-ordinat.i:Jn
ard
a clear
definition
of
responsibilities are essential.
/7
A single
organization
must
have overa 11 responsibility
for all aspects of food support.
4.
Certain groups are more vulnzrable
malnutrition
than
others.
like
include
infants ,
children,
pregnant
and lactating
women, the sick and the elderly.
Special
action
is
required
to
identify
the malnourished and vulnerable ard meet their additional
needs. Where the refugees
have
already suffered a prolonged food
ShortBe,
many will
be malnourished by the time of the first
assesmnent of their cord it ion and
needs.
/7
Most refugee emergencies warrant the early appointment of
an experienced nutrition
specialist
as the feeding prograurne co-ordinator .
r7
‘Ihe refugees must be involved
in the organization
and management of their feeding programs.
-m
Simple nutrition
education is
a part of effective
food support.
5.
If the refugees are already
suffeme
et fects of severe
food
short=e,
inmediate
action
must be taken to provide whatever
availabie
locally
and
food
is
7iG$ESle
to the refugees.
The
irst priority
is to meet energy,
YZier
than protein
requirements.
The sllpply of a bulk cereal is the
first
objective
of the general
feeding programne. If insufficient
acceptable
food
is
available
locally,
it must be broqht
in
from outside,
initially
by air if
necessary.
Flexibility
and improvisation
will
be required,
and
time may be needed to develop the
L-7
;sL=zl
“‘“y$=;;
to
fuel and utensils.
Role of
(WFP)
my be
cooking
the World Focd Prograume
1.
WFP has special
responsibility
for food within the UN system
and WFP’s procedures specifically
recognize
refugee emergencies as
qualifying
for assistance.
It is
imoortant
to note, however, that
WFP food aid does -not provide all
canponents of 3 complete general
ration.
The UNDP Resident RepreBive
acts as WFP Reyresenta97
- Food and nutrition
tive, but, WFP has its own professional field
staff
in many countries.
If necessary, WFP will consider sending a field
officer
on
mission.
The advice of the local
WFP field
staff
should be sought
from the start of an emergency.
n
WFP has certain
resources in
L.
food and cash to meet emergemy
fond needs, ard is also prepared
to undertake procurement and shipping with funis ma& available
by
UMI(x. Swift action a1u3t be taken
to ensure that the additional
food
items which will
be required but
are not available
throqh
WFP are
also procured ad delivered.
Use
of WFP resources
in a refugee
a government
emergency rqiiires
request to the Director -General of
FAO, and the latter’s
approval of
an emergency project on the advice
of the Executive Director
of WFP.
Petiix
or in the absence of a
goverruient request,
the practical
role
of
WFP will
be little
changed, but different
procedures
and funding arrangements will
be
necessary.
Details
of UNKR/WFP
emergency procedures are given in
Part 2.
Responsibilities
and personnel
3.
UNICIX ard WFP staff,
together
wie t-!-f ~tional
authorities,
the
operational
partner(s)
ard other
must be clear on
[email protected])
responsibilities
for assessing and
meeting the food needs. Close coordination
with bilateral
donors
Offers of inapprois essential.
priate food should be refused.
4.
Subject to the role of the
government and any special arranhave overall
gements, UNCR will
responsibility
for the emergency
Thus UMX’s
initial
operation.
all
planning
must cwer
focXl
those items of
needs, fncluditg
the general ration which will not
be provided by WFP. Depending on
sources of supply and implementing
arrangements , UNKR may entrust
specific
practical
arrangements to
WFP. However, every effort
should
be made to avoid dividing
the
overall
responsibility:
a single
98
-
person must
co-ordinating
food supplies.
be responsible
for
the provision of all
5.
In
most
emergencies
the
appointment of a feeding programne
co-ordinator
will
be warranted.
This is likely
to be a separate
responsibility
- to that for- food
L’sgistics outlined
in the previous
paragraph.
The co-otdinator
would
be responsible
for the establishment of appropriate
standard procedures ,
the
co-ordination
of
feeding programnes, the monitoring
and evaluation of their effectiveness and ensuring close co-ordination
with the health
and other
cormunity services.
The co-ordinatar should be a nutrition
specialist
with
current
experience
in
nutritional
emergencies and local
knowledge if possible.
A co-ordinator will
be particularly
necessary in situations
where non-specialist
organizations
and individuals have no alternative
but to
in\0 lve
themselves
in
feeding
operations.
If initially
there is
not
a nutrition
specialist
to
assign to this position,
the acting co-ordinator
should seek inmediate
professional
guida.Ice from
gover nnent nutritionists,
or from
within
the local UN (WHO, WFP or
UNICEF) and NGOcrmnunity.
Role of the refugees
education
and nutrition
6.
The refugees must be involved
from the start in the organization
and management of the feeding prog_ramnes. Special training
will be
necessary for selected refugees.
of simple nut7.
The provision
rition
education
for the refu ees
is .important when unfamiliar
---3x
or new methods of cooking and prearation
cannot be avoided and
ave to be introduced to the refueees . This should be organized in
aunction
with other hialth education activities
to provide guidinfant
feeding,
ance on proper
feeding
sick children,
treatment
of diarrhoea,
basic food hygiene
and the preparation
of availab1.e
foods
for
maximum nutritional
benefit.
- Food and nutrition
Ormization
of response
Sound organization
and plan8.
nix
are the key to success. The
arrangements must enlogist ical
sure
th
delivery
of sufficient
Adequate secure
food
in
tiw.
storage must be provided and the
food must be protected
against
inset ts , rodents and rain damage
both in the store sod in the home.
The necessary
cooking
pots and
utensils
must be available.l/
The
distribution
system must bZ fair
ard effective.
(See ch.12.6).
9.
Particular
attention
must
be
failure
to provide fuel
can quickly lead to destruction
of
the vegetation
in and arourxl the
site causing lasting damage to the
envirotment
anf friction
with the
local population.
Special arwngements may thus he necessary to
supply cooking fuel.
As a rough
indication,
a family cooking on a
simple wood stove requires
sane
5kg of wood per day. It may be
possible to utilize
local technology to modify existing
types of
wood or charcoal burning stoves in
order tC; mke them more fuel ef ficient . In stme areas solar cooking
equipment ;nay be an appropriate
solution
at least
for carmunal
needs ; a number of simple devices
are now being developed.
Advice
on this
from
should be soeht
Local exper cs, and through headquarters if !necessary.
8.3
Assesmec&
-i-.
,.sod surveillance
/7
The first
knowledge
nutritional
diet of the
requirement
is a
the
numbers ,
of
status and former
refugees.
-
/7
lhis
assessment should,
if
possible,
be the responsibility of an experienced nutrition specialist.
-17
Arrangements will
be necessary both to monitor the nutstatus of the coarnuritional
nity ard identify
individuais
who need special food relief.
1A. An initial.
assessment of the
health and nutritional
status
of
the refugees should be made as
soon as possible.
Preferably
this
speshould he done by a nutrition
cialist ; however if one is not
inmediately
available,
field staff
should
carry
out a preliminary
survey of their
own. Guidance on
how to do this is given in. annex
1. The amount of malnutrition
must
be established as this has important implications
for what form the
emergency
response
will
take.
Other basic information
which will
be required
to formulate
a food
aid plan includes
the nllnber of
refugees , their age/sex breakdown,
their present access to food supplies,
cooking fuel and utensils.
In addition
information
must be
food and
gathered on traditional
habits , and the
cooking
1-1
availability
of suitable food,
This information
will
enable
2.
the field and Headquarters to take
early decisions
on the components
of
the
rations,
total
amounts
needed,
the
logist ical
support
necnssary and on the requirement
for any additional
selective
feeding programnes. Figure 8-l on page
LO1 gives an indication
of the
considerations.
The initial
assessment should
3.
he followed by regular nutritional
i/
Special kits have heen developed by Oxfam to help set LF selective feedpending local supply
1% programnes . The kits may be useful at the start,
arrangements, and can be provided through Headquarters at short notice.
Kit
1 contains equipment for nutritional.
surveillance
and assesssent.
Kit 2 proUnless
vides equ ipnent to cover s upplernentary feeding of 250 children.
otherwise requested, Kit 2 is also supplied with equipment ident ical to Kit
1. Kit 3 provides. equipnent to cover therapeutic
feeding of up to 100
severely malnourished children.
‘The kits do not contain cookers.
99
- Food and nutrition
urrder ’ specialist
smveillame
supervision
to monitor the condition of the population as a whole
and the Mividual
progress of the
vulnerable
arr3 the malnouristid,
In an emergency a high child 5ortality
rate is very often associated with high levels of malnutrition
arrL this
is therefore
an
important
statistic
to record in
frealthjnutrition
surveillance
programnes .
surveillance
of
Nutritional
4.
the population
as a whole should
be done by weighing and measuring
a rat&m sample of the child population
at regular
intervals.
In
times of food shortage young children are the first
to show signs
of malnutrition
and are the most
severely affected.
For this reason
it is usually a rando5 sample of
chf ldren less than 5 years of age
(or less than l&m
tall)
who are
measured regularly
in a surveillarre
prograrme.
Their
condition
is used as an lndica tar of the
amount and degree of malnutrition
in tbe population as a whole. For
a refugee
population
of urder
10,000 a rat&n
sample of 200
children will provide a reasonably
accurate estirsate of overall child
malnutrition.
For a population
of
lO,OOO-20,000, a sample size of at
least 400 is required.
Initially
such surveys should be made every
two months. Wt5n conlitions
have
stabilized
once every 3-6 months
is sufficient.
Any change or trend
in nutritional
status can thus be
detected
and adjustments made in
the relevant feeding programnes .
and/Qr
conditions
Where
5.
results
of the initial
assessment
indicate
a need for supplementary
ind ivi therapeutic
feeding
gals
will
need to he ‘identified
2/
100
-
and registered
for
these
gramnes. Their individual
progF&
should then be monitored through
more frequent
weighing
at
the
feeding centres.
.
6.
Thus nutritional
surveillance
takes two forms: first,
monitoring
the effectiveness
of the food provided to the whole comnunity (the
general feeding prograame) by measuring a random sample of children; second, monitoring
the progress
of
vulnerable
individuals
and thereby the need for or effectiveness of selective
feeding programnes .
mlnutrition
can be recogni7.
zed by clinical
signs (see the
descriptions
on page 111 of marasmus, kwashiorkor
and marasmickwashiorkor)
and by body measurements. Wasurements
are required
for objective
assessment of nutritional
status and for purposes of
ccmpar ison with regular
surve illance data. The weight-for-height
method expressed as a percentage
of a reference
standard
is the
most sensitive
indicator
of acute
malnutrition
and ir; preferred
for
nutritional
surveillance
and for
measuring
individual
progress
in
emergencies Children of less than
80% weight-.for-height21
are classified
as 5alnourisGd
and those
of Less than 70% weight-for-height
as
severely
malnourished.
For
rapid screening of the young child
population
the Less sensitive
arm
circumference
measurement desc r i bed in annex 1 can be used.
l
8.4
/7
Every effort
should be made
EOOdprovide
familiar
to
tradistuffs
and maintain
tional food habits.
Percentages are those of the WHOInternational
Standard
- Food and nutrition
I
LOCAL
-
II-J-
Pl2OPfR
NUfRlflONA L
SURvEILL*hJCE
sq-
UP -pie
tdECfSSA(2Y
/
ff=-E-DINE
.
JUPPLfMENmey
’
8-l
KESPON-ISE
-ID
FOOD
ArclD
r-rU?RI~ONAL
-rtf&R~~bu~c
PRCJW?AM,V&S
Nis.EDc,
101
- Food and nutrition
-//
Average rations
must provide
the
following
aImunts
of
at least
1500 Kcal
energy:
(6.3 NJ)31 for initial
survival and -over 2000 Kcal (8.4
MJ) for longer term maintenance.
D
Tbe diet must satisfy
acd basic: vitamin
mnts.
/7
PaAlly
protein
require-
titular
attent ion to
nutrient
prevalent
def iciemies .
1.
Kvery effort
should be made
to provide familiar
foodstuffs
and
traditional
food
maintain
sold
habits.
Expert
advice
on
the
ration
is essential
and s-hould
take full account of local availability.
Staple
foodstuffs
should
not
be changed simply
because
unfamiliar
substitutes
are readily
available.
Inappropriate
foods
often lead to wastage arid malnutrition,
and lower the morale of
the refugees.
2.
Ihe aunt
ati
quality
of
food provided must satisfy
energy
alld protein requirements.
A survival ration should provide at least
I.500 Kcal, while over 2iIOO Kcal
(and 50g of protein)
are required
for 104er-term maintenance. Active
considerably
adults
may require
higher
energy
intakes.
Although
there is a marked difference
hetween the needs or‘ a young child
and an active adult it is strowly
recwnded
that a stardard ration
is provided for each refugee without dlstinctlon.
A typical
daily
xon
to provide sufficient
calories and protein
would be built
arourrl :
- a staple food which provideIe the bulk of the energy
protein
requirement,
e.g. cereal 35OJtOOg
an energy-rich
20-4og
food,
protein-rich
Lans 50g
food,
oil
e.g.
Other items such as vegetables,
sugar, spices, condiments, fruits,
and tea, should be provided accorrling to cultural
and nutritional
needs. However absolute
priority
must be given to the staole food.
A few items and assured- delivery
are better than a complex ration,
some of which fails
to arrive.
Advice on the lozistical
asnects
of
food supply, - in
terms= of
amounts to be moved, is contained
in chapter 5.
3.
Essential
vi tamin and mineral
requirements must also be met: a
varied diet is the best means of
doing so. Where adequate quant ities of certain
nutrients
cannot
be provided in the diet,
the inclusion
of
seasonally
ava i lable
will
vegetables
usually
prevent
mineral
deficiencies
vi tamin ati
arising.
Whenever possible
the
refugees should be encouraged to
varieties
of
appropriate
grow
vegetables
themselves. Local food
markets
within
the
settlement
should be encouraged.
Particular
attention
must be paid to any
locally
prevalent deficiencies
and
efforts made to include food items
which are rich in the missing nutrients.
The distribution
of multivi tamin
tablets
to
the entire
refugee population
is a waste of
time and money, since they contain
insufficient
quantities
of individual vi tamins to correct deficiences.
4.
Two deficiencies
are comronly
seen among refugees : vitamin
A
deficiency
at-d anaemia. Vitamin A
deEicie=y
in malnourished populat ions,
especially
in
children ,
leads to blindness.
Anaemia, which
31 Energy values are expressed in the thermochemical kilocalorie.
as a scientific
unit this has been superseded by the megajoule
Kcal = 4.184 MI; 1 MJ = 239 Kcal.
102
e.g.
However,
(MJ) . 1000
- Food and nutrition
is cauronly associated with parasitic
diseases or an insufficient
intake
of iron and folate,
can
lead to cardiac failure
ard death
in the most severe cases. Both
conditions
can be prevented by a
proper diet.
5.
The need for a fair,
efficient and regular ration distribution cannot be over-emphasized. An
accurate census is needed and a
monitorisystem must be established to ensure that the food is
actually
reaching every refugee as
Disruption,
interded .
diversion
will
inevitably
and corruption
lead to widespread discontent
and
suffering.
There are two main types of
6.
distribution:
dry ration and cooked meals. Whichever is used, it
is important to ensure that those
[email protected] the distribution
have exact
instructions
on the size of the
rat ions and are seen to follow
them. If scales are not available
or not a convenient way of measuring out food then cans or containers
be provided
whose
should
weight/volme
comparison is known
for each comnodity.
7.
The distribution
of food as
ratlons
is an unsatis~~~~~olurion
and is to be
Dry ration
distribution
(take home)
8.
This method has major advantses
over cooked food distribut ion. It allows families
to prepare their food as ttiey wish, permits
them to cant inue to eat
together as a unit and is generally more culturally
and socially
acceptable.
9.
Distribution
is usually
made
intervals.
Where an
at
weekly
and
accurate census is available
families
have food distribution
cards,
sane form of delegated
family
or group distribution
is
possible,
but in the initial
stages the best way to guarantee a
fair distribution
may be to have
every individual
present.
For a
-
discussion
ch.12.6.
of
ration
cards
see
10. In addition
to cooking pots,
fuel and utensils,
the refugees
must have containers
and sacks to
protect
and Ltore
their
food
rations.
Oil tins and grain bags
will be useful, and contracts with
suppliers ) at least
for initial
de1 iveries ,
should
not
require
their return.
Cooked food distribution
requi,res
11. This
centralized
with adequate utens i Is,
kitchens
water and fuel (although obviously
less than the amounts required for
family
cooking),
and
trained,
healthy
personnel.
The refugees
usually sit together in a feeding
in some circumcampoud altholsh
stances
families
can carry
the
cooked food to their
accannodation. At least two meals must be
served each day and the efficient
organization
of cooked food distribution
for
large
numbers is
Every effort
should be
difficult.
made to avoid having to resort to
mass cooked food distribution
for
the general ration.
Such distribution may, however, occasionally
be
stqes,
necessary in the initial
for example, pending the avaiL+riility
of sufficient
cooking utensils
and fuel. It may also, albe preferred by the
though rarely,
refugees .
Monitoring
program
the
general
Eeeding
12 A general
feeding programne
matching the standards elaborated
in 8.4 is the minimum necessary to
maintain a good nutritional
status
population.
Its
in
a heal thy
must
be
closely
ef feet iveness
monitored through the surveillance
The quality
and the
prograame.
quantity
of the rations should be
regularly
discussed with the refugees. Where there are complaints,
these should be investigated.
Proper arrangements must be made for
the inspection of food supplied by
contractors.
l
103
- Food and nutrition
8.5
~hT¶neIltarv
feedim
mm-
L7
In addition
to the general
feeding program,
extra food
may be required for the malnourished or to prevent malnutrition.
i7
The program
must actively
identify
those
who
need
Supplementary food ard ensure
they receive it.
D
The aim is to provide
at
least one high energy, high
protein,
low bulk extra meal
daily.
The need
1.
Where malnutrition
exists
or
the needs of the vulnerable groups
cannot be met from the general
ration,
special
arrangements are
required
to provide
extra
food.
This
is
organized
throqh
a
feeding
s\pplementary
prograume
(SFP) . Infants,
children,
pregnant
ard lactating
wanen and the sick
are the most seriously
affected by
food shor tee.
Their vulnerability
stems fran the greater
nutrient
requirement 8
associated
with
the production
of breast
g-tfi,
milk, repair
of tissues and production
of
ant ibodies.
Because
children are unable to eat a large
vnlulle of food, it is necessary
both to prepare food in a concentrated form, giving more nutrients
in less volll[ae, ard also to provide more frequent meals. Malnutrition
results
in lower resistacce to infection,
which in turn
in further
malnutrition.
results
9~11
children
a;;rs particularly
susceptible
to
.
cycle
of
infection
and malnutrition.
Sick
children must eat and drink, Ellen
if
they havle no appetite,
are
vomiti%
or have diarrhoea.
The
must receive additional
food w* never pass rble.
Certain other groups or irdi2.
viduals may be vulnerable
to malnutrition
for social
or econanic
These include
reasons.
unaccomchi ldren,
the
panied
disabled,
104
-
s i&e-parent
families,
and
haps
tbs
elderly,
particulZy
those without
family supper t. In
sane carmunities
specific
social
or cultural
practices
and taboos
may put constraints
on meeting the
nutritional
needs of certain
persons,
for
example pregnant
and
lactating
wanen or even sick children.
3.
Where the refugees are predominantly
women and children,
it
may be impossible (or unnecessary)
to provide this whole group with
supplementary
food.
Under
such
circmstarrces
it
is
better
to
adjust the general ration
to the
needs of the majority,
for example
by increasing
the overall
protein
‘content.
Supplementary
feeding
programnes
are
an increasingly
ccxrnon feature in refugee emergencies ; however, they may not always
be the most effective
response.
Table 8-2 outlines
general considerations
when deciding
on the
need for such a programne.
Aim and content
4.
‘Ihe aim is to provide extra
hi h, energy
high protein,
low
F-5
U meals, bnce or twice a day to
those who need it. Th
meals depends on the en
status of the population,
the nutritional
value
of
the
genera 1
ration and the age of the beneficiaries.
The size of the supplement also depends on the nutr itional status
of the beneficiaries :
but at least 350 Kcal and 15g protein per day should be provided.
Supplementary meals should be
5.
prepared as porridge or soup which
are easily digestible
and can be
eaten by people of all ages. The
food is generally
based on cereal
and legume blends with edible oil
added to increase the energy coningredients
tent.
can be
Other
added to give additional
nutrients
sf
flavour
(e.g.
and variety
sugar , vegetables,
fish,
milk).
There are sane prepacked cereal/
legme blended supplementary foods
available
thrash
UN agent ies
corn-soya-milk ; wsa )
(e.g.
CW
- Food and nutrition
8-2
Indicators
Major irriicator
of likely
(11
-
need for a supplanentary
feeding progrme
Other factors
General ration
averagim less than
1500 Kcal/person/day
None
lover 2UZ children
malnourished
General ration
averaging less than
2,000 Kcal/person/day
lo-20% children
malnourished
For all vulnerable groups (see
8.5.1 and 2) if resources
allow, as soon as possible
Severe public
health hazards
Signif icant diseases
(esp. measles)
prevalent or imninent
None
5-10% children
malnourished
Any of above
None
under 5% children
malnourished
Any of above
(1) Percentages are of children
Admission and discharge
supplementary
must be based
No SFP: individual
attention
to malnourished. (Whatever the
other factors, available
resources are probably better
used correcting/minimizing
t&l
under 5 years old under 80%.weight-for-height.
wheat-soya-blend) . These may be
useful at the start of an emergexy
feeding
programne if
the
ingredients
are familiar
to the
refugees.
However,
local
foods
should be substituted
as quickly
as possible and prepared in a more
traditional
and appropriate way.
6.
The
pronramne
Selective within vulnerable
groups: at least for all malmalnourished. See 8.5.8.
feeding
on the
active
identification
and follow
up of those considered vulnerable.
This reauires
a regular house-bvhouse or family-byzfamily
assesiment ,
usually
made by public
health workers operating
a referral system. As well as encouraging
those in need to participate
in
the
supplementary
feeding
prograarse and ascertaining
the reasons for non-participation,
cont inued hane-visiting
is required
to monitor the progress of infants
105
- Food ard nutrition
and
the
and
tity
tate
children.
Those identified
for
prograame should be registered
issued with a numbered idenbracelet
or card to facilifollow-Lp.
10. Children
should not be discharged from supplementary feeding
until they have been more than 85%
weight-for-height
for at least one
month.
a supplementary
In practice,
7.
feeding
prograume that does not
ident ify
those in need
actively
but simply operates on an open
basis
is most
“cane-if -you-wish”
unlikely
to benefit those in greatest need and is a very questionable use of food and organizat ional resources.
The criteria
for admission to
8.
a supplementary
reeding programne
will
depend on the condition
of
the refugees
arr.l the resources
The order of priority
available.
witbin
the vulnerable
groups is,
any malnourished person
generally,
(less than 80% weight-for-height
WHO International
Standard), young
children
(less than five years old
or l&m
in height),
wanen during
the last 3 months of pregnancy and
the first
12 rmnths of lactation,
medical referrals
ani the socially
Should
restrictive
vulnerable.
selection
be necessary because of
lack of resources
this will
in
part chaee the nature of the programne from preventive to curative.
‘Ihe amount of food required
9.
feeding
is
suppletnentary
for
likely
to be about 3MI per 1,000
beneficiaries
per month. Table 8-3
below shows how this estimate was
arrived at.
i-3
r-
11. Once
supplementary
by,
feeding must be considered necessary until such time as an appropriate
general ration is provided
that meets the needs of the vulnerable,
and as long as living
conditions
remain hazardous. It is
a mistake to discontinue
supmentary teeding as soon as the
nutritional
status
of vulnerable
ndividuals
or groups starts
to
im rove. The programne should not
:p
iscont inued until the surveillance
reflect
sustained
results
improvement and not more than 5%
of the children
remain malnourished.
Organization
12. An effective
programne requires the regular attendance of all
those registered.
The ident if ication of those in need is a preto be followed by carerequisite,
ful control of attendance and progress. Trained staff should weigh
and measure children
on admission
to the SFP and reweigh regularly,
preferably
monthly,
thereafter
to
monitor irrl ividual progress.
13. As for general rations,
the
programne
feeding
supplementary
may be organized
either
using
the ‘take home’ or ‘on-the-spot’
Supplementary food quantities
I
Typical daily
Pmjunt (g)
106
-
ration
Energy (Kcal)
Monthly amount for 1000 in MT
(Daily amount x 30 x 1000)
Protein
(g)
- Food and nutrition
require
careful
method.
Both
‘registration
and control.
The take
bane system is relatively
simple
to administer
but the supplant
is likely
to be shared within the
family . on-the-spot
supplwntary
feeding is the preferred
method.
Supervision
is
improved,
the
inten;led
beneficiary
is seen to
eat the correct amount of food and
follow-up
is easier as those in
need are seen more often and under
more controlled conditions .
supplementary
feeding
14. Any
program
must be closely integrated with the cgmrunity health care
progratnne. The supplementary feeding programne will give the opportunity
for health problems to be
identified.
Certain daily medications may best be given in the
course of the supplementary feeding programne, for example iron
for
and
folate
preparations
anaemia.
15. Feeding centres and kitchens
must be well organized and kept
clean. Long waiting
periods must
be avoided and the schedule must
not clash with family meal times
or other essential
carmunity activi ties.
Parents must be &de to
unierstani
that the supplanentary
feeding
program
is given
in
addition
to normal meals. Utensils,
bowls,
scales
an3 other
equipnt
will be reqclired and can
generally
be obtained
locally.
(See 8.2.8)
16. me
suppiemec.e,-;j
TeedirIg
centre can usually
handle up to
500 beneficiaries.
l%e centres
should be run by trained refugees:
an experienced
nurse should be
able to supervise 4 or 5 centres.
different
Where
organizations
establish
their
okn supplementary
(or therapeutic,
see 8.6) feeding
progrms
it
is most important
that these are appropriate
to the
needs, centrally
co-ordinated,
and
procedures
standardized.
The
health
guidelines
described
in
ch.7.2.18
should cover select ive
feeding prograurnes. See pages 92
ard 93 for examples of standard
reports.
The programnes must avoid
-
such a
assistance
individuals
dependence on outs ide
that they collapse when
or organizations
leave.
8.6
fl
A therapeutic
be needed to
of
severely
children.
program
save the lizz
malnourished
D
Treatment
of
the
malnourished
requires
s uper vi s ion.
/7
consists
of
The treatment
food of high energy and protein content given according
to the individual’s
nutritional requirements.
severely
medical
1.
therapeutic
feeding (TFP) is
required
to reduce deaths among
infants
and young children
with
severe protein-energy
malnutrition
(PEN). The forms of PEM are described in section 9. If severe PEM
exists,
therapeutic
feeding
will
initially
be a priority
to save
1 ives . However, if introduction
of
supplementary
feeding
is delayed
resources,
because
par titularly
trained
personnel,
are concentrated on therapeutic
feeding,
there
quickly
be such
mY quite
deterioration
in other less mala
nourished children
that the lifesaving achievements of a therapeutic prograame will be overtaken by
the life-threatening
consequences
of not having an adequately funct ioning
supplementary
programne,
hn&itiyg
z-iiry rr,rre pople.
2.
Food is the treatment
for
PEM. Unlike supplementary feeding,
Grapeutic
feeding
is solely
a
curative
measure and thus
in
theory a short-term
program.
The
need for
its
continuation
will
depend on the effectiveness
of the
general and supplementary
feeding
progranrnes
ai-d the
nutritional
condition of any new arrivals.
The usual criteria
for admis3.
sion to a therapeutic
feeding programne are oedema (kwashiorkor),
severe marasmus (weight-forless than 70%). Patients
eight
107
- Food and nutrition
stPuld remain on therapeutic
feedie until they are free from illness; at least 80% of weight-foroedema. &I
height
arr3 without
recovery
patients
would be discharged to the supplementary feeding programne.
-
s.7
-/7
Breast-f ceding
is best
for
babies arid must be promoted
and continued for as long as
possible.
feeding
Therapeutic
should
take place on an in-patient
basis
whenever possible,
as food must be
given every 3-4 hours.
Infection
and dehydration
are
the major
causes of death and patients
must
be closely
watched for medical
If weight does not
complications.
increase quickly on a properly run
TEP, the explanation
is likely
to
be that the individual
also has an
illness
which must be treated. The
iarmmization
of
-0u
child=
iig>
priorfty
~v+gs~
m$asl
mortality
associated with this disease in a
malnourished population.
D
Ban baby bottles
/7
Weaning foods must be appropriate;
foreign
baby foods
and special
foods often are
not.
-
/7
Infant
formulae
should
be
avoided, and never used except under strictly
controlled conditions,
with a cup
and spoon.
/7
Milk products and especially
powdered milk can cause problems and are often inappropriate.
5.
A therapeutic
feeding
prograatne must be run by experienced
and suitably
qualified
personnel.
Che centre
can usually
handle
about 50 children
arri will require
two experienced
supervisors
fulltime. It should be noted that most
doctors
ati
nurses have little
tra inirlg
in nutrition
or experierxze in treating
severe P&l. They
must therefore be given the necessary guidaze.
The refugees and
particularly
the mothers of patients must be involved in running
the therapeutic feeding centre.
1.
?he vital
imp0rtance of correct infant
feeding in an emergency must be understood.
4.
In addition
to a suitable
buiidirg
arx.i services,
2.m crtitre
a kitchen
and the
will
require
and equipment,
necessary utensils
which
can usually
be obtained
1ocall.y (see 8.2.8) . Treatment is
a diet which provides at least 150
Kcal and 3-4g of protein per kilo
body weight
per day for
each
patient,
via 5-7 meals at 3-4
thrmgtmut
the 24
hourly intervals
hOuCS. Boiled
water mixed with a
dried skimned milk/oil/sugar
mixture, or with a UNICEF K Mix II/
oil mixture,
can be used to initiA mixed diet
is
ate treatment.
introduced orxze the patient’s
condition
starts
to improve (usually
after 4-5 days).
6,
108
completely.
2.
Human milk is the best and
safest food for infants and children under 2 years. Breast-feeding
provides
a secure and hygienic
source of food, often
initially
the only source of food, as well
as ant ibodies
giving
protection
against some infectious
diseases.
Breast-feeding
must be encouraged
for as long as pass ible
effort must be made to p&notZ%
restimulate
lactation
even amow
sick
and malnourished
mothers.
Experience has shown that this can
be done. Mothers may need to’
extra
food to encourage
receive
the
breast-feeding
and provide
additional
calories
ard nutrients
This
should
be done
required.
through the SFP.
‘Ihe problems associated
with
infant
formulae and feeding bottles are exacerbated in a refugee
emergency. Clean boiled water is
essential
but
rarely
available,
careful
dilution
of the feeds is
of critical
importance but difficult to control,
mothers are unlikely to be familiar
tiith the use
3.
- Food and nutrition
of infant formulae, and the instructions
are often in a foreign
formulae, if unlanguage. Infant
should be distributed
avoidable,
from health
or feedis
centres
UlXk strictly
controlled
conditions
and
proper
super vis ion.
Infant
feedim- bottles
must never
be distributed
‘or used; they are
almost impossible to sterilize
an3
keep sterile
under such conditions
arr3
are
therefore
dangerous.
babies should be fed by cl&n cup
and spoon if necessary.
4.
While continuing
breast-feedweaning
foods
appropriate
irg,
should be introduced
at between
four ard six months of age. Weaning foods should be locally
aval’lable foodstuffs and as far as possable be prepared in the traditional manner. Overseas donations of
tinned
baby
fads
are
rarely
appropriate.
-
and unsweetened condensed milk and
evaporated
milk.
The ir appropr i ateness must be ascertained before
acceptance.
It
should be noted
that- if used, DSM must be vitamin .A fortified
(when it will have a
shelf-life
of six months).
Milk products
are useful
in
supplementary
and
therapeutic
feeding
prograames ,
administered
under supervision.
For example,
milk can be added to SFP cereal
mixtures to boost the protein content.
Milk powder is the usual
basis for early stages of treatment in therapeutic
feeding. Whenever used it- is imperative
that
the milk be correctly
prepared ard
served under controlled
and hygienic
conjitions.
Instruction
and
guidance must be given.
8.
8.8
Other milk products
5.
SOme populations
have long
considered milk as an ideal food,
while others rarely consit in
either
its
natural
or powdered
form, arm3 may even have a lactose
Milk
(milk
sugar)
intolerance.
should not be distributed
if i
not a traditional
part
of the
rereees ’ diet.
6.
Mjor
practical
problems are
often associated with milk powder.
E?otb proper
hygiene
and proper
dilution
will
be difficult
to
ensure, and contaminated milk, for
example because of unsafe water or
-.-- .c c_
r zi-_.“‘),
I KL,*is, s--iTi:LL ies , provi de&- -an ideal environment for bacterial
growth. For these reasons.
milk sh&ld not form part of the
M,P
with
main
meat;
cult
i% t-e!iZ~
a nanad& background wvhose
food was previously
milk and
meat is likely
to be diff ito supply in an emergency.
7.
In addition
to infant
formula,
the
products
carmonly
offered
in
mergerries
include
cl;izh
w~:F.~ miiEM)(CWM>, dried
sweetened
,
n
All
possible local sources of
appropriate
food must be
explored before resorting
to
over seas supply.
the
1.
This section assumes that the
refugees have no food supplies of
their own. Considerations
relating
to the choice of the ration
and
foodthe importance of familiar
stuffs
that meet the nutritional
needs and maintain
sound tradit ional
food
habits
have been
earlier
covered
*
sections.
Details
0; UNHQR/WFP procedures
fn
emergemy
are
food supply
given in Part 2.
Logistics
and storage
2.
Adequate logistics
will
be
the key to a successful emergency
and food will
be the
operation,
to be transported.
major
item
Logistical
considerations
are thus
important
and
sometimes
very
determining.
Particular
attention
must be paid to proper storage,
protection
against both the elelosses
pests,
and
ments
and
stock
theft.
Effective
through
109
- Food and nutrition
.
control
will
be essentis!. . &-6i derable
reserve
stocks
may be
Guidance on logiszics,
necessary.
including
a guide to calculating
total
alxNJnts to
be
probable
moved, is giwn in chapter 5.
Sources of supply
food
will
be
3.
Sources
of
determined by local circumstances ,
selected
will
which the ration
naturally
reflect.
The timely provision
of a Xm$ete
ration
may
require a combination of the followixlg sources :
(1)
Borrowing
from
national
stocks, WFP stocks on hand in
country
(direct
WFP
the
stocks or those available
to
WFP under reciprocal
drawing
rights)
or stocks of other
donor organizations
on hand
in the country ;
(2)
Purchase on the local
or from neighbouring
tries;
(3)
Overseas supply, either as a
result of diversion of WFP or
other stocks already at sea,
or overseas procurement , or
throqh contributions
in kind;
(4)
Bilateral
NGOS.
donors,
market
counl
including
4.
In cases of extreme urgency,
it may be necessary for Headquarters to make interim arrangements
for
the supply
of
appropriate
essential
food by air, but every
effort must be made to find acceptable
local
supplies
first.
Air
transport
is unsuitable
for large
quantities
of the appropriate
staple foods,
while
the processed
foods usually airlifted
are of ten
inappropriate
to the traditional
food habits of the refugees .,
Nutrients
1.
All foods are made up of five
basic types of nutrient:*
carbtats,
drates,
proteins,
vitamins,
and minerals,
in addition
to varii
able amounts of water. Carboh drates are mostly starches -ii&z
a
‘of- vegetable
origin,
being,
for
example,
a major
component of
cereals
and tubers.
They are a
source of energy. Fats and oils
provide
the
most
concentrated
source of energy, having more than
twice
the
energy
content
Per
weight of carbohydrates
~ncl proteins . In most poor countries,
most of the energy is derived from
the
staple
foods,
especially
fats
accounting
for
a
cereals,
much smaller proportion.
Proteins
body-building
are
SUB
required
for growth and tissue
repair.
Protein is found in foods
of animal origin
and in cereals
and leg-s.
Vitamins and minerals
are needed inmuant
i ties
of the
the adequate functioning
vitamins
and
Individual
MY.
minerals or cambinations are found
in all
foods in very variable
amounts .
Energy and protein
intakes
the
2.
If
energy
intake
is
inadequate,
some protein
will
be
burnt to provide energy and not
used for body growth or repair,
that is, it will be used in the
same ways as carbohydrate or fat,
which are usually less expensive.
Not less than 20% of the energy
requirement
should
be supplied
from fats and oils which greatly
enhance the palatability
of the
diet and increase energy density
(important
for younger children) .
requirements
vary widely
ErT5Y
even in normal individuals.
They
increased
are also
by physical
activity.
Much higher intakes are
4/ Adapted from “The Management of Nutritional
Tions”.
110
-
Fmergencies
in Large Popula-
- Food and nutrition
required
nutrition,
litation
for the treatment of mal‘when the aim is rehabirather than maintenance.
Fbod and diets
diets
in most coun3.
contain adequate amounts
tries Yj
of all-the
nutrients
required for
good health if enough of the diet
is taken to satisfy
the individual’s energy requirements.
Even a
growing child,
if healthy,
requires no more than 10% of the calories to be supplied
from protein
sources. The CWUKU&Y used foods
are listed in table 8-4 overleaf.
Protein-energy
malnutrition
(PEM)
4.
PJZM is a problem in many
countries,
even
in
developing
normal times.
l%st
commonly it
affects
children
bemeen the ages
months and five
of six
years
(especially
at the time of weaning) . Severe PEM is usually precipitated
by low food intake assoinfection.
c iated
with
Refugees
are particularly
vulnerable
and
W-RX staff
should be able to
severe PI%, which has
recognize
three forms r described below. See
also annex 1.
5.
Nutritional
marasmus results
from
prolonged
starvation.
Ihe
main sign is a severe wasting away
of fat and muscle, which ,have been
The
expended to provide energy.
child is very thin and may have an
“old man” face and loose folds of
skin. The children
affected
may,
active
bowever, appear relatively
-
and alert.
This is the most frequent form of PEM in oases of prolonged food shortage.
6.
Kwashiorkor is seen most commonly in areas where the staple
food is mainly carbohydrate,
for
example tubers and roots like cassava, but it is precipitated
by
many factors
other than protein
deficierry . The main sign of kwashiorkor
is oedema, that
is a
swelling
usually
starting
at the
lower extremities
and extending in
more advanced Cases to the arms
arri face. Oedema must be present
for the diagnosis
of kwashiorkor
but can also occur in other diseases.
’
Where there
oedema, the child may t&k ig;:
and be regarded by the parents as
well-fed.
Associated signs of kwado not
always
shiorkor , which
include
occur )
hair
changes
(colour
becomes lighter,
curly
hair becomes straight,
canes out
easily
with a gentle
pull)
and
skin changes (dark skin may become
in places,
lighter
the skin may
on the legs,
peel off, especially
and ulceration
may occur).
Children with kwashiakor
are usually
miserable arid withdrawn
apathetic,
and often refuse to eat. Profound
anaenia is a cannon complication
of kwashior kor .
7.
kwashiorkor
is
a
Marastnic
mixed form, with oedema occuring
in
children
who are otherwise
marasmic ark.2 who may or may not
have the other associated signs of
mixed
kwashior kor . In practice,
forms Mill of ten be seen.
5/ Appendix 7 of “A Guide to Food and Health Relief Operations for Disasters”
gives information
on the major foods and acceptable alternatives
in adult
diets in over 100 countries.
111
84
tiaracteristics
of casmon foods
Approx. protein
per lw3
Vitamins and
minerals
Ccnments
-
1.
8-12g
Cereal grains
(rice, corn, sorghum,
oats etc.)
350 Kcal
Legunes/oilseeds
b-ns,
peas, soya,
groundnuts etc. )
350/500-700 Kcals
20-25g
Provides energy in a sane beans can be
up to 40% protein
a compact form but
relatively
expensive e.g. soya
and requires careful
storage.
Contain vitamin B
however
these reduced by
milling,
i.e. the
whiter the flour
the greater the
loss of vitamins.
lhz main source of
both energy and
protein in most
diets.
B complex vitamins.
Pbst contain significant quantities
of iron and calciun.
Leguraes are part icularly useful
when eaten with
cereals as the
proteins complement each other.
Bulk and low protein content makes
them unsuitable as
staple foods in
emergencies.
and iron.
I
2.
3.
tlhole tubers and
roop (yams, tare,
cassava, sweet
potato, potato etc.)
4.
$eEbles
.
and
75-110 Kcals.
In
flour form contain
300-350 Kcals.
Very low in protein
Variable but
generally low.
Low in energy
Low in protein
lmpor tant source
of vi tamins. Variable quantities
of
B ati C vitamins.
Dark green leaves or
yellow/red pigmentation usually indicates vitamin A
compounds.
r
E
Ii
@
3
W.
$:
9
I
Wat, milk anrl
dairy products,
e&gs, etc.
150-550 Kcals
depending on fat
content
Generally in range
lo-20g except for
liquid milks 3-6g
Good sources of B
vi tmnins . Whole
milk and eggs also
good source of
vitamin A. Milk
and eggs provide
signif icant
amounts of calcium.
Usually consumed in
very small quant ities in normal
times. lhey are
more readily utilized by the body
than proteins of
vegetable or igin.
Therefore small
quantities
useful
to improve the
quality and palatability
of diet.
6.
Fish, dried
300 KcaLs
6%
Rich source of
calciun and iron.
Contains B
vitamins.
A concentrated
source of protein
for those who like
it. Therefore
accentabilitv
trials essential
before use.
7.
Fats and oils
900 Kcals i.e. the
most concentrated
energy source
nil
Rich source of
Vitamin A,
except for lard,
other animal fats
and vegetable
oils.
Useful way to increase energy intake
without increasing
bulk of diet. Improves palatability
and helps in food
preparation.
5.
s
I
- Food ard nutrition
-
Cameron M.
Hofvatier Y.
(1976)
,
Manual on Feeding Infants and Young Children
Third edition expected in 1983
(Also in French and Spanish)
Protein-Calorie
Advisory Group of
the UN
FAG 2nd edition
Centers for Disease
Control (1981)
(Graitcet P.L.)
A Manual for the Basic Assessment of Nutritional Status in Potential Crisis Situations
Provisional edition, revision expected in 1983.
US Public health
Service
Peel S.
(1979)
Selective Feeding Procedures
A simple guide for those running feeding
Revised edition expected
ET;F’ .
Oxfam
Rajrgopalau S.
Shiff&n M.
(1974)
Guide to Simple Sanitary I$easures for the
Control of Enteric Diseases
Contains a section on food sanitation.
(Also in Arabic, French and Spanish)
WHO
Simnords S.
Palghan P.
5nn S. W.
(1983)
Refugee Gomnunity Health Care
Coolprehensive guidance on planning,
management and delivery of refugee health
services
Oxford University
Press
silmnr&3 s.
Refugee Camp Heaith Care: Selected
Annotated Referemzes
A campanion to above
Ross Institute
Publication No.,14
JN (1977)
A Guide to Food and Health Relief Operations
for Disasters.
(Also in kench and Spanish)
Pro tein-Cslorie
Advisory Group of
the UN
Sdxu-lan M.
(1982)
ie Ville de @yet G. The Management of Nutritional
&man J., Geijer U. inarge
Powlat ions
(1978)
Essential reading.
(Also in French and Spanish)
JHO (1981)
Guidelines
for TraininP
Emergencies
Community Health
WHO
WHOoffset puhliwtion PJo,59
JHO (1981)
(l)
See also the further
aIre repeated here.
114
references
at the end of chapter 7, only some of which
- Food and niltrition
Ekylanation
-
Annex
a-
of I%2 principle
1.
I%e arm ci.rcunfereEe
technique is suitable
for a rapid assessment of
the nutritional
status of young children.
It measures a part of the arm
whose circumfeseme does not normally change sig!ificantLy
between the ages
of one and five, but which wastes rapidly with malnutrition.
The technique
is not suitable for mohitoris
the progress of individual children.
If proWsion&
help is available it ‘should of course be used but this
2.
assessme* can be done by those with no previous nutritional
experience
provided the g;ridelines below are followed.
The technique thus allows any
IlNi(X field officer
to provide an objective assessment ati hard facts rather
rewtiw.
’ This in turn allows a much more
than be l-imited to subjective
sifective reepouse.
Selection
3.
If
of the children
the refugee population
is 10,000 or less a randan sample of not less
than 200 children
aged between one and five years should be chosen. This can
be done on a house to house basis or by assembling all the children at one
site and measuring, for example, every fifth
child.
If a “cluster”
sample
method is used (e.g. sampling in different
sections of a large settlement)
not less than 30 children per cluster should be lroeasured to allow a comparison between sections.
Take care that the adults do not just produce sick
children in the belief that the test is to be followed by medical attention;
this will distort
the result.
A quick but crude way of ascertaining
that
children are approximately within the age range of one to five years is to
check they have more than six teeth but are less than 115cm in height.
For
mst people this would mean the children cane up to about waist height.
information
about where the
4.
Ihe assessment must be put in context:
children come fran and when t;hey arriwd should be obtained and reported, as
the condition
of this particular
group may not reflect
that of the whale
caseload.
The measurement
If custawnade
measuring tapes (possible sources ICRC and headquarters)
5.
are not available,
take a thin strip of plastic
of about 3Ocm in length at-4
mark off clearly a zero point, then 12.0~~1 and 13.5cm.
6.
Before measuring any child check for the presence of
lirg
seen in kwashiorkor)
by pressing a finger against
If a dent (‘pitting’)
child’s
foot for about 3 seconds.
has oedema ard should not be measured but marked down as
(See the suggested report
beiq
severely malnourished.
page* 3
oedema (the swelthe front of the
is seen the child
having oedema and
form on the next
7.
If there is no oedema, the circumference of the child’s
left upper arm
The tape should be wrapped
should then be measured at the midway point.
closely (but not tightly)
arorrnd the left arm midway between the elbow and
The arm should be hanging loosely.
the point of theshoulder.
The results
8.
Classification
of nutritional
status can be made as seen on the attached
form. The amount and degree of malnutrition
can be calculated as percentages
of the sample.
115
- Food and nutritb
NUTMTIWiL N&Y
icEpORTfIJIQl
-
Am circumference
istzict
Ibtal
pqiulation
pcqulation
method
Site.. . . . . . . . . . . . . . . . . . . . . . . Date . . ..=.......
..........r.....q.o...
refiee
-
at site
.......
ing
Method of sampl
sampling
Total nu&er of children from
’ :
whom ramlom sample taken . . . . . . . . . . . .‘. . .
Sur~yer ’ s nane/Organization
;
. . . . . ..Y........................
..Y....................
....
__
Satisfactory
I Malnutrition
(A)
1More than l3.5cm (approxiIma ely equivalent
to over
IBd weight-for-height)
!_
(B)
l2.0-13.5cm (approximately equivalent
to 70%79% weiehtforiheightj
-
&cord ntiers
only. As
this is for statistical
purposes there is no .neecl
to keep any other details
on these measured)
1
Total sample
=
% Mslnutri tion
=
% Severe Nalnutrition
of which % Kwashiorkor
=
A+B+C
=
(B + C) x 100
A+B+C
=
c x 100
A+B+C
oedema x 100
C
=
=
Observations ..................................................................
...............................................................................
...............................................................................
...............................................................................
116
’
4Severe Malnutrition
Less than
12cm (approx .
equivalent to
under 70%
weight-forheight)
(C)
ledem
List
seetion
of contents
Paragraph
9.1
l- 4
9.2
Page
Contents
Overview
118
Introduction
119
Assessment and organization
31: f
5- 8
9.3
General
Assessment
Personnel and material
119
121
121
The need
91:;
Quantity
Quality
l- 7
Inrrediate
9.4
9.5
ii;
response
123
Water sources and their
l- 3
4
i-10
11-12
2
9.6
General
Surface water
Spr iTs
Other ground water
Wells
&ain water
Sea water
Municipal and private
protection
125
I.26
126
ii:
ti:
I.30
systems
Pumps, storage and distribution
2: ;
1;:1:
9.7
General
Pumps
Storage
Distribution
130
131
131
I32
Treatment
i-11
The dangers
Treatment (storage,
methods, boiling)
Further
references
filters,
chemical
133
134
I36
.
Need
-_---
Water is essential
to life and health.
In emergencies it is often
not avail.able in adequate quantity or quality,
thus creating a major
health hazard.
Aim
To provide
needs.
Frimiples
enoqh
safe water for
the refugees
and to meet carmunal
of response
c#
closeiy with
Seek expert advice, co-ordinate
national services and involve the refugees.
-m
Ensure consideration
of the water supply at the site selection
ati planning s&e
and co-ordinate
response closely with public health and environmental sanitation measures.
/7
Provide a reserve sitpply and spare capacity,
difficulties
and the needs of new arrivals.
-n
Take account of seasonal variations.
ff
If at all possible,
avoid the need to treat
the appropriate
to meet temporary
water.
Action
I
I
118
c-tent
assessment of water
to needs.
D
Organize an itnnediate,
possibilities
in relation
/7
Protect
fl
Develop sources and a storage arid distribution
supplies
a sufficient
amount of safe water,
reserve.
0
Ensure regular
existing
supply
sources of water from pollution.
testing
of water quality.
system that
including
a
*
,.
--,-
s’+’ 1. Safe water
is esscnt ial
to
4,
life
and
health.
People
can
sur,,- ..T<
food than
without
longer
i.?.- vive
~
<-:’
needed for further
exploration
and
developrent
of new sources,
the
refugees should he wxred to a more
suitable
location.
Figure
9-l
overleaf shows sane of the considerations in diagraaxmtic form.
4.
Water and sanitation
are the
subjects of separate chapters. The
considerations
are, however, largely interdependent
and this chapter should be read in conjunction
with chapter 10 on sanitation.
aspects of water supply must he
since
assured,
interruptions
in
the supply may be disastrous.
To
avoid contamination,
all
sources
of water used by refugees must be
separated from sanitation
facilities and other sources of contamination. As a rule, in this as in
other sectors,
the simplest possible technologies
are
the most
appropriate in refugee emergencies.
2. Availability
will generally
be
the determining
factor in organizix the supply of sufficient
quantities
of safe water. It may be
necessary to make special arrangements for extraction
of the water,
storage acid distribution.
wasures
will
he required
to protect
the
water from contamination
and in
sane circunstsnces
treatment will
be needed to nake the water safe
to drink. The safety of the water
must he assured right
through to
consumption in the bane. The dangers
of
drinking
contaminated
water are discussed in 9.7.1.
3. Improvements in the existing
water supply may take time, particularly
where it is necessary to
drill
or dig wells. In many refugee agencies
only contaminated
surface
watyiver(s$tarding
water,
streams or
is initially
available
arid iamdiate
action
must be taken to stop further
pollution
and reduce -contamination. If it is evident that available
are
inadequate,
sources
arrasements
must be made to bring
in water by truck. Where even the
most basic need for water cannot
safely be met fran existing
sources in the area, ad wtm time is
9.2
Assessment adi orfzmization
r;Th
imnediate,
competent
assessment
of
local
water
supply possibilities,
invol *:ing the government author ities, is essential.
/7
pg;tise
is
required,
knowledge
is
arxl
lllO&
important.
17
D
g;p
t+
r$bg;fi
special
train
them to operate
maintain the system.
Technology
should he
appropriate
the country.
;;
and
and
equipment
simple,
reliable,
and familiar
to
General
imnediate
1.
An
on-the-spot
assessment of local
sources of
water
in relation
to needs is
ZGilt ial.
The government ’ s tentral
ard local water authorities
and experts should he invo5.ved in
this assessment. Knowledge of the
local
terrain
sod corriitions
is
in;l ispensable
and expertise
from
outside
the country
should
be
bro%ht
in
only
when clearly
necessary . An influx
of refugees
water
resources
lnay over-strain
used by the local population.
2.
Available
must
be
sources
protected
from pollution
at orxze.
Rationing
of scarce water may he
order
to
needed
initially
in
ensure survival
of the weak and
equity
in distribution
to the rest
population.
The
of the refugee
119
- Water 9-1
GEt.lEG%L
CO~lbG%~K’NF-
IN
+5lr\EceNCy
WA-/-k<
I-‘,.
_
CALCUlditz
4PPF?OXIMA‘tE
DA1 L-Y
-m-lwNE-5
cq*3)
i
&LIMfHATf
Oti~lOUS
i+xJ?Xt4AL
CON pe.AIl-lA~ON
PISIFT
WELL
*D,
,+/OID
fNl-f=Y
OF
w4DlVr
bUAL
Cok-tpdHGR5
e+.
0*4,-3)
2.
3.s=
ADVICE
VA
OM
APP-
---
r
i
- Watp-
establishnent~
and funcdesign,
F tioniw
of a, water supply and distribution
system must be closely
co-ordinated
with the site planning and layout and with health
ard environrental
measures, &
in
Particular
sanitation.
Assessrent
While estimating
the need for
3.
water
does not
require
special
assessment of supply
expertise,
possibilities
does I A distinction
may be useful between the ident ification
of sources on the one
harrd , arid their
development and
exploitation
on the other. Dependiq
on the situation,
sources of
characteristics
water
and their
may be identified
by: the local
refrlgees
thempopulation;
the
the
lie
of
the
lard
selves;
is often near the
(ground water
surface in the vicinity
of rivers
and in low places generally,
or is
inficated
by richer
vegetation);
maps and sur=ys
of water resources; ard national
and expatriate
(hydrologists)
;
water
experts
diviners
may be
useful.
ThE:
assessrmznt of water sources, which
must be the basis for decisions on
a water supply and distribution
system generally,
requires
expertise in water ewineerirg,
sanitapurification)
and
tion
(testing,
in sane cases logistics.
factors
must
be
4.
Seasonal
carefully
considered.
Supplies
that are adequate in the rainy
season may dry up at -other times.
Local knowledge will be essential.
Personnel and material
5.
Local sources of information
and expertise
are best and may
izlude:
central and local government departments
(e.g.
interior,
public
works, agriculture,
water
resources),
the UN system, especiaid proally
UNICEF, bilateral
grantnes, NGQs and engineering consultants and contractors.
If it is
clear
that
locally
available
expertise
will
not suffice,
Headassistance
quarters’
should
be
requested without
delay.
If out-
side assistance is necessary, this
should be provided whenever possible in suonor t of local exnerts .
Where a wa’t’er supply and d&&ution system has to be established
With the help of expatriates
‘and
mechanized . technology,
running and
maintenarre
by refugees and other
‘local
personnel
must be assured
before the departure of ths expatriates.
If this is not done, ewn
-best
system will break down.
6.
As the
provision
of safe
water is essential
to the health
of the carmmity , and impossible
without
its understanding
and cooperation,
the
system must be
developed with
the refugees
and
operated by them fran the start to
the extent possible. The refugees,
particularly
if
of rural
backmay themselves have relegrow,
vant skills.
For example,
sane
rural
cannunities
contain
irriividuals who are expert at digging
and maintainirg
wells. Others may
be familiar
with simple punps or
CamKxl pump motors. Such ski 11s
must be fully
utilized
in planning, developing ani operating
the
water
system.
Refugees
without
prior experience should be trained
as necessary. Basic public health
education,
for
example on the
impurtame
of avoiding
pollution
of the water by excreta atd the
use of clean containers
in the
home, trill be essential.
7.
While special
equipnent
may
be required in the exploration
for
new ground water sources or for
purification
of
surface
water,
material
and equipment to establish a water supply and distribution system should be found locally to the maximum possible extent.
As a general
rule,
should he kept simple. ?Pii%B
be appropriate
to the country and
draw on local
experience.
Where
p
and other lIlechanica1 equipunavoidable,
ment are
supplies
should be starrlardized
as far as
possible,
with local
familiarity,
availability
of spares and fuel
arrl ease of maintenance the priority considerations.
121
- Water ~0th organizational
and tech8.
the
cauplete
nical
aspects
of
water supply system need to be
Use of the
carefully
monitored.
atrl
system must be controlled
contamination
wastage
or
water
maint enanse must be
prevented,
breakdowns
assured, ,and technical
quickly repaired.
/7
Calculate on at least 15 litres per person per day plus
caummal needs and a spare
capacity for new arrivals.
-n
To preserve public health,
a
allamt
of reasonably
large
pure water is preferable
to a
smaller amount of very pure
water.
fl
E
w$
bee;:2
tmu;t
,reFtheless
,lje
and perio!iZ~~
and imnediately
following. ‘any outbreak of a
disease which might be caused
w unsafe water.
Quantity
Minimun water needs will vary
1.
with each situation
and will
increase markedly with air temperature and physical
exercise.
As a
general
indication,
the following
amounts of water are desirable:
Individuals:
15-20 litres
per person/day;
Health centres :
40-60 litres per patient/day;.
Feeding centres :
20-30 litres per patient/day.
:~::a
needs may include
livefacilities,
sanitation
services,
and
other ’ casmmity
irrigation.
The more convenient
the higher will
be
the supply,
consunption.
Reduction in tte quantity
of
2.
individuals
water
available
tc
directly
affects
their health. As
supplies are reduced, clothes can122
not be washed, personal
hygiene
suffers,
cookis
utensils
cannot
be properly
cleaned,
food cannot
be adequately prepared and finally
the direct
intake becomes insufficient
to replace
moisture
lost
from the body. The reduction
is
reflected
in increased
incidence
of parasitic,
fungal
arrl other
skin
diseases,
infections,
eye
diarrhoeal
diseases and the often
fatal
dehydration
associated
with
them. Even those individuals
who
may have traditionally
lived
on
less than the normally recarmended
amount of
water,
for
example
nanads, will
require
more in a
refugee c-unity
because of crowding and other environmental
facto+.
The needs of cannunity servi3.
ces vary widely,
for example from
sufficient
water to swallow a pill
and wash hands in a health centre
to the large quantities
required
in a health centre. Proper supplefeeding
mentary
arxt therapeutic
programnes
will
be
impos s ible
unless sufficient
water is available for preparation
of food and
for basic hygiene.
4.
The availability
of
water
will be a factor in deciding on a
sanitation
system.
For example,
one aquaprivy
has a water tank
volume of 1,000 litres,
to which
some five litres
per user must be
added daily to maintain the water
seal;
the Crxfam Sanitation
Unit
requires
up to 3,000 litres
per
day to serve 1,000 persons.
Water will be needed for any
5.
livestock
but care should be taken
to avoid pollution
or depletion of
scarce water sources by livestock.
As a rule of thumb, cattle
need
about 30 litres
of water daily and
small stock about five.
Water for irrigation
will
be
6.
necessary for the cultivation
of
food by the refugees. In the initial
stages of an emergency, only
waste water after danestic use may
be available , and may suffice
for
vegetable
patches.
Largesmall
scale irrigation
is a matter for
- Water expert advice and not considered
here,
though sources should he
reserved
at
an
aId
identified
early stage if possible.
7
: . Water will
probably
be of
.major
little
use in controlling
fires on refugee sites owing to a
lack of sufficient
quantity
and
pressure,
If more refugees are, likely
to arrive,
plans
must allow for a
spare capacity
over
Zubstantial
present needs. hs hes been explained in chapter 6, water is of ten
the determining
factor
in both
site selection and site capacity.
8.
tococci.
The presence of any of
these indicates
that ,the water has
been contaminated
by faeces of
humans or other warm-bloc;ded animals . The actual
test done will
de-pend on the normal practice
of
local water laboratories
and the
experience
of the local
sanitarians. The most widely used tests
are those that detect and enumerate faecal
coliforms.
Concentrations
of
faecal
coliforms
are
usually
expressed per 100 ml of
water. As a rough guide:
O-10
lo-100 faecal coliforms/lO&nl
= polluted
Quality
be
b&h
water
must
9.
The
acceptable
to tbe refugees
and
If it tastes and
safe tc drink.
looks
will
be
acceptable,
it
drunk, with the main dangers being
organisms.
from
microbiological
However these “water-borne”
diseases are not usually as serious
or widespread a problem as the
“water-washed”
diseases,
such as
skin and eye infections
and diarfrom insuf f irhoea, which result
cient water for personal hygiene.
Ihus a l?zge quantity
of reasonably sai-e water is preferable E
szmller amount of very pure water:
The most serious
threat
to the
safety of a water supply is contamination by faeces: once the water
has been contaminated it is hard
to purify
quickly under emergency
treatment
conditions.
Possible
considered in section
measures are
9.7.
drinkirlg
water
’
10. Where
brackish
or even sa;:
scarce,
water, if available,
may have to
be used for dmstic
hygiene.
11. New water supplies should be
tested
before use, and exisLing
ones periodically,
and imnediataly
after an outbreak of a typically
water-borne disease. ‘Ihe most useful tests
are those that detect
and en-ate
ccumon faecal bacteria.
such as faeral
coliforms.
Escherichia
coli or Eaecal strep:
faecal coliforms/lOQnl
= reasonable quality
loo1,000
faecal coliforms/lOO
= very polluted
ml
over
1,000
faecal coliforms/lOO
= grossly polluted
ml
In cases where the water is disinfected by chlorination
(9.7.9.)
it
is easier and more appropriate
to
test
for
the
presence of free
than for bdcteria.
chlorine
The
presence
of
free
chlorine
at
around 0.2 mg/l at the distribution point indicates
that the bacteria
have aknost certainly
been
killed
and that the water cannot
be heavily polluted with faecal or
other organic matter.
12. The water in storage
tanks
and any tanker trucks should also
be tested periodically.
The water
must, of course, be safe at the
time of consumption or use in the
home, not just at the distribution
point.
Mmestic hygiene and envirormental health measures to protect the water between collection
anl use are important.
9.4
/7
If even the minimum amount of
water cannot be made available in time from local sources , the refugees should be
moved.
123
B.
- Water,r/
Whatever
the
wster
source,
take im&iate
action to prewnt pollution by excreta.
-
f7
Organize a distribution
system
that prevents pollution
of the
source ard ensures equity
if
there is insufficient
water.
its quality:
it is likely
daxerously
contaminated.
&A-t’=
4NP
(LAlTiLfW5
FKoM
WELL
R!VkR
&ii%@,
FOR.
BAjltr&l~
WASHIH6
CldfW’Z
c/
AWAy
At-ID
be
2.
The refugees will
be using
either
surface
water
or,
less
often,
ground
water
(well
or
spring).
This is usually whatever
water is closest,
regardless
of
quality.
The best imnediate response is likely
to be organizational and should be arranged with
the
refugee
ccmmmi ty
leaders.
Whasever
the
water
source,
take
.
imnediate steps to prevent pollution by excreta. If the source is
supplies
must be drawn
fhmuz,
off ul;stream and a special
area
set aside for this. Then allocate
an area for washing and finally,
downstream
of
the
settlement,
allow any livestock
to water. See
figure 9-2. Fence off parts ol the
river
bank as necessary,
and
beware of any dangers
in the
water, such as crocodiles.
1. Short-term
emergerey measures
may be necessary while the longer
term srgply system is being developed or peniis
the move of the
refugees to a more suitable
site.
If
tile locally
availabb.2
water
sqply
is insuffjcient
to vzzet tb
miniiriuu needs of the refugee
arra~~+uents must be =de to br
in water by truck. If this is
z
possible,
the refugees
must :e
dmoved without
delay. Often,
ever, the quantity of water available will
meet initial
minimun
needs and the imoediate problem is
FEUCCb-Of+
to
,‘--
-#
--
- Water 3.
Where the source is a well or
sprirg,
fetre off, cover dir* control the source. Prevent refugees
drawi= water with irriividual
containers which may contaminate the
source. If possible make iunmdiate
arr3v jements to store water and to
distribute
it at collection
points
away from the source. Not only
does this help avoid direct contamination
but
storage
can make
water safer.
9.5
&t&r
sourcef3 ad
tection
/7b
in water, ground water from
springs and wells,
and water
from municipal
and private
systems is usually of better
quality
than surface
water
from sources such as rivers,
lakes or dams, and should be
used if available.
/7
physical
protection
source from pollution
essential..
/7
Avoid sources
that
require
treatment if at all possible.
From the start,
families will
5.
need to be able to carry and store
water
at
the household
level.
Suitable containers
(LO-20 litres)
are
essential.
sometimes =Pty
cooking oil containers or the like
are available
but if not, buckets
or other containers must be supplied. These must be kept clean.
D
Expert advice ati local knowledge
are necessary
before
sinking wells.
-/7
New or repaired
equipment should
ted.
6.
If the immediately available
supplies
of water are insuf ficient; action to ration supplies and
ensure equitable distribution
will
be a priority.
Rationme: is difficult to organize. The first
step
is to control access ro the sources, using full-time
watcbn
if
necessary;
uncontrolled
distributions are open to abuse. Distribution at fixed times for different
sections
of the site
sbuld
be
organized.
Vulnerable
groups may
need special
arrangements.
Every
effort
must be made to imrease
the quantity of water available so
that strict
rationix
is unnecessary*
1.
There are three main natural
fresh
water : surface
tyP=s of
water
(streams,
rivers,
lakes) t
ground water (underground or emerging at spri-s)
and rain water.
Considerations
in choosing between
alternative
sources of water in an
emergency include :
7.
In parallel
to these steps,
action must be set in hand to plan
how the need for water may be& be
met in the loser
term and implementation of thin plan set in harkI
as soon as possible. The following
sections
outline
the main considerations.
4.
At the same time, action must
be taken to improve the quantity
from existirlg
sources
and the
ef feet iwness
of any distribution
system.
&eir
pro-
of the
will ‘be
sources and
be disinfec-
General
(1)
speed with which
be made operational;
(2)
vollmle of supply;
(3)
reliability
of supply (taking
into account seasonal variations
and,
if
necessary,
logist its) ;
(4)
water purity , risk
mination and ease
ment if necessary;
(5)
rights
axI
ppulation;
(6)
simplici?y
of technology
ease of t&ntenatxe ;
(7)
cost,
welfare
source
of
of
of
can
contatreatlocal
and
125
- Water
Take careful
account of sys2.
tams and methods already
in use
of well-proven
locally . Aioption
canbined
and familiar
techniques,
with action to improve protection
pollution,
is often
a
against
sound solution.
In addition
to organizational
3.
measures to protect the water supply, s(3me form of treatment may be
necessary . However, sources which
treatment should be
would require
avoided if at all
possible.
The
purification
of unsafe water, particularly
in remote areas, can be
trained
difficult
and requires
supervision
to be reliable.
The
followirlg
paragraphs provide general information
on different
sourthe
ces of water and indicate
likely
need for treatment.
Table
9-3 shows sune of the considerations.
spring
is usua? ly pure at the
source and can be pir-3. to storage
and distribution
poi .:... It should
be taken off abovl. the site
if
possible.
Care shouts never theless
be taken to check the true source
of spring water, as soLne apparent
springs
may really
be surface
water which has seeped or flowed
into the ground a short distance
away. It is essential
that sprirg
water be protected
against poll.ut ion at the source by means of a
simple structure
built
of bricks,
masonry or concrete,
from which
the water flows directly
throllgh a
pipe
to a tank or collection
point. Care must also be taken to
prevent
contamination
above the
take-off
point . The supply
of
water from a spring may vary widely with the seasons and will be at
its minimum at the end of the dry
season: seek local advice.
Surface water
Other ground water
Water from streams,
rivers,
4.
ponds, lakes, dams and _reservoirs
is rarely pure, and its direct use
fs
likely
to require
treatment
measures; direct
acc.ess may also
cause difficulties
with the local
popl! ation.
However, where such a
source holds water year-round,
the
water table in the vicinity
can be
expected to be near the surface.
It is generally
preferable
to use
such ground water, as it will have
passed through the natural
filter
of the soil, rather than the surface water directly.
One or more
suitable
types of well may be
used. If the ground is not sufficiently
prous to allow extraction
of enough water from wells,
surface water may be the only option.
In such circumstances,
emergency
treaent
measures such as storse, sand filtration
or even chlorination
will
probably be necesSEkTY.
If surface
;Jater must be
used,
yescrTgdi+
cytqro21 g
access
in
. .
essential.
6.
If the need for water cannot
be met by springs,
the next best
option is to raise ground water by
means of tube wells, dug wells or
boreholes.
Ground water,
be.
naturally
filtered
as it
fl%
microbiourderground , is usually
logically
pure.
Tke choice
of
mett& will
depend on circumstanthe
ces in each case, including
depth of the water-table,
yield,
soil
conditions
and availability
of expertise
and equipnent . Table
9-4 on page 128 gives some basic
characteristics
of the different
types of wells.
Springs
5.
of
126
the ideal source
Spriw_are
water.
Water from a
groutvf
F-.-l-
7.
Without
good water resource
surveys, preliminary
test drilling
or clear local evidence from nearby existing
wells,
there is no
new wells
will
assurance
that
yield
the
necessary
amount of
water of the right quality.
They
can also be expensive. A hydrogeological
survey must be undertaken
any
ex tens ive
starmlg
before
drilling
progranme. It is often
better to try and improve an existing well that has an inadequate
yield rather than dig a new one.
9.-3 Srme general
Source
A.
Treatment
(see 9.7)
Rain
(1)
considerations
related
Extraction
(see 9.6)
to water sources
Distribution
(see 9.6)
Remarks
Uonecessary
Simple:
roofs
off suitable
Individual
collection
-sonal,
unlikely
to
meet total demand.
See 9.5.11
controlled
Individual
coliection or via
storage tanks,
optionally
through
piped system
Yield may vary seasonally
As for B
See table
Ground water
B.
Spring
Unnecessary
Simple:
access
C.
Deep well (low water
table, outside assistame may ‘be required.
Fach well likely to
serve more people
than D)
Unnecessary
Hand m
motorized
say
D.
Shallow well (high
water table, likely
to be many, often
self-dug)
Unnecessary if
properly located,
collstructed
end
maintained
Bandpumporhand
drawn container
Individual
collection
As for B
Of ten necessary:
sedimentation/
filtration/
chlorination
Controlled access
(see figure 9-2)
Motorized pumi> to
treatment and
storage
As for B
Yield often
seasonally
BeaLly always
necessary: as
for E
As for E
As for B
As for E
if possible
if neces-
9-4
Surface water
E.
Flowing
river)
F.
Standing
lake)
(e.g.
stream,
(e.g.. pond.
varies
-(1) An approxtite
deep well, shallow
-
rankis
of sources by likely
quality
would be: rain (unlikely
well. stream or river,
lake, pond (very likely
to be polluted).
to be polluted),
spring,
borehole,
- Water -
9-4
hype 0f ~~41
Apwxi-te
maximm depth
Characteristics
of wells
Technique
colmlec,ts
Driwn ?Me
well
lo-15 metres
Simple: special pipe
hammered into ground ;
can be sunk in 1 or
2 days
Small;
heavy
needs
“well
Pipe
Bored Tube
well
25 me&es
Simple: handbored
hole using an auger;
can be sunk in 2-3
days
Larger than driven tuba
well; augers may need to
be imported, but locally
available boring tools
can of ten be used
30-40 metres
Requires ski lied
workers otherwise
dangerous. Speed
depends on soil conditions.
For team of
4 men perhaps up to
week per 10 metres
depth
Of ten the most appropr iate solution, especially
if the refugees traditionally
dug such wells
Jetted ‘IMe
well
80 metres
More difficult:
water
pumped down a bole
and over-flowing
to
carry out and loosen
soil, enabling pipe
to be pushed down
Requires considerable
amount of water to sink,
and special drilling
equipment
Borehole
Over 100
metres
Large drilling
If more than some 50
metres deep ,hand pumps
cannot be used
128
rig
cannot be sunk in
clay, soil or rock ;
special filter
point” at tip of
--
- Wpter
8, The yield of a -11
depends
formatiQr2 in
on the geological
which it: is sunk, the contours and
gradients
of the land, tk
well
construct ion,
and the pump. Any
new w&11 or borebole must first be
“develqed”
to Full yield
by an
initial
period
of pumpi% et a
fast fate. 7%~. has the ef feet of
pumpic$ out Piner soil particles
atxI &us allowing
water
more easily
into the well? YE$
can be raised
by increasing
the
size of the ~211 below the watertable,
for example in the case of
a shall~~w well, hy an infiltration
gallery
across the line of ground
water flow. If wells are sited wo
yields
Will
be
close
tcge ther
reducea.
9.
and pumps
WSllS, boreholes
shtluld be disinfected
&mediately
after
repair
or
construction,
installation,
as thy
may have
been plluted
[email protected] the work. Two
or rhcee bucke cz of a 0.2% cfilorime stAution in water would be a
disinfectant
and
sui t abl.e
the
in the
te&niques
are described
technical guides.
,9 -5
10. Like springs,
wells must be
protected
from
pollution.
They
sbuld
he lccated
where s~face
water, and in particular
any seasonal rain or f load water, will
drain
away from the well
head.
They should be above and at least
15, preferably
30 metres away from
sanitation
facilities
and
any
their discharge. A well-head,
consisting of a headwall and drainage
apron, running off to a soakway,
is essential
to avoid direct
contamination
down the well.
The
headwall
should not be so wide
that people can stand on it. Rollers, pulleys or a windlass should
be provided to avoid pople leaning over the well. Individual
buckets must never be allowed down
and close supervision
the well,
and control will be essential.
See
figure
9-5. As nmbers using an
open well
increase
so does the
risk of pollution
and difficulty
in raising
sufficient
water
by
bucket. It is then better to cover
the well and use a pump.
PROl-ECp-4 5 Al-4 3Pet-l
ttOlSt
AVOID
WE
Ld
AFZL(LA)~~GE~J\=~
DC&WE
W&L
[
SttuuLD
I N G
L&YALI
EL5
E.-C%
f’ULL6-)’
MPLE
OR
WOObE3-,
c Los=
I MbLAs5
rtJafloN
NAIZROW
l+EabWA
USE-f=lJL
6lt.lGl.E
RDLL-?S).
PUBl-lC
LL
my
-
CttECK
Tvf+=~-
Cc7~fAINC.R
:
use
INDIVIDUAL
CO~lt--it3Z5
Of=
Pfzd4IBITE:Lj.
129
- Water
gain water
11. Reasonably
pure rain
water
can be collected from the roofs of
buildings
or tents if these are
This method
clean and suitable.
can only be the major source of
water in areas with adequate and
reliable
year-round
rainfall,
and
it requires
suitable
shelter
as
well
as
it-d ividual
household
storage facilities.
It is, therefore, not generally
the solution
However,
in refugee emergencies.
every effort
should be made to
rainwater
and
11
lcollect
lection
systems, for ese
u%g
local earthenware pots urr.Ier irrlividual
roofs and gutters,
should
be ecroursed.
Allow
the first
rain after a long dry spell to run
off,
thus cleaning
the catchnent
of dust etc. The supply of water
which it is possible to collect by
this
method
is
estimated
as
follows :
One millimetre
of yearly rainfall
on one square metre of roof will
give 0.8 litres
per year, after
allowing for evaporation.
Thus, if
the roof measures 5 x 8 metres and
the average annual rainfall
is 750
urn, the amount of rain water which
can be collected
in a year equals:
5 x 8 x 750 x 0.8 = 24,000 litres
per year or an averee of 66 litres per day (on many deys there
will be none).
12. gain water may be a useful
sqplement
to general needs, for
example throqh
special collection
for the cannunity services such as
health and feeding centres,
where
the safety of the water is nrost
important. It should also be noted
that surface water is particularly
likely
to be contaminated in the
rainy season. Thus rain water may
be a useful source of safe water
for irrlividual
use at a time when
other water is plentiful
but unsafe.
Sea water
13. Sea water can be used for
almost
everything
but drinki%,
thus reducing fresh water require130
ments . In locations
where no adequate sources of fresh water exist
but where sea water is near, desalination
is
one pass ible
but
costly option. Neither of the two
basic methods - distillation
using
the sun’s heat or the use of
modern desalination
plants
- is
likely
to meet iuznedibte
fresh
water needs in a major emergency,
so relocation
of the refugees must
be considered
as a matter
of
urgency.
Municipal
and private
syf: teus
14. Existing
municipal
and private water systch%s in the vicinity
of the refugees, for e&zxxle those
belongi%
to irdustrial
or agricultural
establishnents,
may be
able to meet part or all of the
need during the emergency phase,
and should obviously
be utilized
where possible
before unnecessary
measures to create other sources
are taken. A substantial
increase
in the yield and quality
of such
systems may be possible if expert
advice is taken.
9.6
m
pumps
will
often
. Seek expert local
advice on what is suitable
ati
remember the operators ,
fuel and spares.
r/
Eh;Fi.ai
/7
Water storage
be essent ial.
fl
Distribution
points should be
within a few minutes’ walk of
the users’ dwellings.
/7
Site the distribution
poi;;:
carefully
and protect
grourd around them.
_/7
Standpipes arrl taps are
ally best but vulnerable:
tap per 200-250 refugees.
facilities
will
usuone
1.
Once an adequate source of
established,
water
has
been
arrangements
necessary
to
are
store and distribute
the water in
minimum
a way that
guarantees
.
- Water
needs are met on a continuing
equitable basis.
and
In areas subject to seasonal
2.
or where the level of a
tloodirg,
markedly ,
varies
river
source
great care must be taken in the
sitirg
of any pumps, distribution,
storage and treatment systgns. It
may even be necessary to mount a
pimp on a raft.
can be raised
in two
ksic
ways: by hand using sane
kird of bucket or by using pumps.
A captive rope and \bucket carries
a low pollution
risk and is more
reliable
and much cheaper than any
pump. Where this system can meet
the demand it is to be preferred.
The importance of preventing refugees putting
their own containers
into
the
directly
source
has
already been stressed.
Water
4.
However i
in
a major
refugee
well
or to move it to storage
other
tanks
or
distribution
points.
All
pumps have moving
parts and require regular malntenpartiaxe.
Professional
advice,
curtirly
from locals,
should be
sought- on the selection and siting
of pumps. The basic hand pump can
lift
tiater
sane 50 metres (the
piston
is in a cylinder
at the
bottom of the well).
Such positive
displacement pumps use simple low
technology and are relatively
easy
to install
and maintain, and generally more reliable
than motorized
pumps. &s an appropriate
solution,
which will
minimise dependeme on
an outside supply of spare parts
and fuel, the handpump is strongly
to be preferred.
Surrounding villages are likely
to havn handpuolps.
However, in a refugee emergency a
sudden and large concentration
of
people requires that the output of
available
water sources be maximized. Motorized pumps have a far
greater
output and may therefore
be Mispensable.
If motors are
required,
local advice should be
-
sought.
l&al
familiarity,
fuel
supplies,
spares, ease of maintenance and above all
reliability
will
be major cons idera t ions in
pump selection.
Self-primicentrifugal
pumps are usually recanmerded when water has to be lifted
a considerable
height (up to 100
metres) or punped over a long distance.
5.
In some circumstances
pumps
powered by solar
panels may be
suitable.
The present
generation
are expensive for their output but
very
reliable
and
involve
direct
running
costs.
The neg
generation
of solar pumps should
be much cheaper. The ptanps naturally work best in direct
sunlight
but will
still
work with light
cloud cover. As a rough indication,
a solar
pump powered by
panels rated at 25aJ would lift
l-2 li tres/sec.
through 6 metres
on a sunny day. Thus a solar pump
might be a solution when the output of a hand pump would be insuf ficient
but large mechanized pumps
are not necessary.
6.
‘Ihe
theoretical
capacity
required
of the pump depends on
available
storage as well as likely demand, as the demand will not
be constant
throughout
a 24 or
even 12 hour period.
A reserve
for breakdowns, new arrivals
etc.
should be provided.
The minimum
daily period during which a pump
should be idle is that required to
allow the level of water< in the
source
to recover
to its
old
level. Pumps should not be operated at night. Always have a standby pump on a major supply system
to cover repairs and maintenance.
Storage
In nearly all systems it will
7.
be necessary to store water in
covered tanks between the source
aud distribution
points. This will
provide an essential
reserve, can
facilitate
distribution,
greatly
particularly
when water is pumped
up to elevated tanks, and helps
puriEy
water (see 9.7.4).
Where
sediumzntation
tanks are in use,
131
-. Water their
capacity alone should equal
a day’s consumption, thus allowing
sedimentation
to take pI.b:-e overnight. _ All refugee sit.35 mJst be
provided as soon as possible with
facilities
to store an adequate
reserve of water. The size of the
reserve
will
d&end.
bevorrd the
number of people,- on -the nature of
the water supply system in each
case and particularly
on its logistical
aspects.
Tank capacities
are calculated
as follows
(use
internal
dimensions and overflow
pipe heights) :
(a)
Rectangular tanks:
length x
breadth x height (in metres)
x 1,000 = capacity in litres;
(b)
Cylindrical
tanks: height x
radius2 (in metres) x 3140
= capacity in litres.
8.
‘In
certain
circumstances,
notably
in areas with pronounsed
dry ard rainseasons and where
altemat ive sources of water are
limited,
the construction
of a
reser\loir
to collect
water to be
used during the dry season may be
an option, despite the dangers of
pollution
and of mosquitoes breediq.
An erosion-protected
overflow
spillway
should always be provided. Catc&nt
tanks for collection of surface water can also be
considered in the drier
parts of
Pits are dug in the
the world.
ground
to catch and hold the water
which suns off hard sround during
heavy storms. They need special
lining
in order to hold the water,
and should be covered if pass ible.
9.
Above-ground
tanks
may be
needed where the water-table
is
very high and contamination cannot
otherwise be avoided. A number of
types
of
simple,
air-portable,
butyl
rubber
tanks are
storage
available
and sane can be supplied
together with a complete distribution system. Headquarters’
advice
should be sought if local resources cannot meet this need.
I.32
Distribution
10. The refugees must have easy
but controlled
access to water.
Ideally,
no dwelling
should
be
further
than 100 metres or a few
minutes’ walk from a distribution
point.
Experience has shown that
where persons have to fetch water
from considerable
distances,
they
tend either not to fetch enough to
limit
water-washed diseases or to
collect water from closer but contaminated
sources.
Hence
the
importance of availability.
Water
distribution
will
be an important
consideration
in the layout of the
site.
The
distribution
points
should not be in hollows. The area
round the point should be paved
with stones or gravel, or protected by boards, with a run-off
to
allow proper drainage.
11. Water can be distributed
to
individual
users in a nunber of
ways, depending on local
cordi-.
by
t ions.
Unc3ncrolled
access
irrI ividual
consmers
to primary
water sources must be avoided. A
distribution
system should have ?i
sufficient
number of sources
or outlets in relaticn
to the size
of the population
to ensure that
ople do not need to wait for
ong periods to have access. Quity in the distribution
of scarce
water is an extremely
important
consideratlcn.
While
vulnerable
groups (the sic!;, wounded, most
severely
malnourished,
children,
wcmen and
pregnant and lactating
the disabled)
should have adequate
and assured
allocations,
scarce
water must be evenly shared among
the rest of the population.
Refugees should
be encouraged
to
assume responsibility
for equitable
distribution,
and arrangements carefully
monitored in order
to detect and prevent abuses. In
some s i tua t ions , water meters have
proved a cheap and efective way of
identifying
excessive
users
and
reducing their consumption.
12. The most appropriate
method
of distributing
water
to large
populations
wiil depend on a nmber of variables
in each specific
situation,
,such as the kind, numof primary sourr,es ati the availability
of matetials , equipment and expertise.
Between source/storage
ati distriwater for danestic
bution point,
use should flow only in pipes in
order
to
protect
its
quality.
*se
must be watertight:
leakis
pipes will suck in .pollution
when
the pressure drops or the systen
is tutned off. Pipes may he made
of plastic,
metal, cement or barn-to be
boo. Baaihoo is unlikely
the
majority
of
suitable
in
and polythene
pipes
emergencies
are often the cheapest and easiest
to lay. Polytlmke pipirlg is available in lengths of coiled,
flexible pipe as well as in the form
of rigid [email protected],
caamnly of 3m.
Pipes should be buried for protection and sections
of the system
should have isolating
valves.
ber and location
13. As outlets,
standpipes
and
psh
taps are recamrended where
possible.
Taps are, however, very
vulnerable
and spares must be
Where water
supplies
available.
are limited and the site is crowdistribution
points
valve
d=&
which can be chained shut may be
the only effective
solution.
There
should be one tap per 2Om
refugees. The larger the number of
people usim a single source or
outlet
of water, the greater
the
risk
of
pollution
atd dw e.
Whatever the
f’ 1 distribut$on
this
aGs2 be carefully
systm
controlled
and supervised;
watchmen are of ten needed.
14. A certain
amount of waste
water will
be generated in the
camtunity,
both at the individual
and camnmal service level.
This
must not be allowed to becane a
darger to public
health,
but it
may be usefully
recycled,
for
example to water livestock,
irrigate vegetable gardens or in flush
latrines.
9.7
-/7
/7
The most serious
threat
to
the safety of a water supply
is contamination by faeces.
/7
Covered storage is
lest
method
of
water quality .
/7
Saml filtration
is an effective method of water treatment.
g
C&mica1
disinfection
for
large-scale
water
treatment
is generally
only recmmenjed
if storage and/or sand filtration cannot meet the need.
fl
Water
purification
tablets
and boiling
are not generally
appropriate
for
large-scale
water treatment.
the simpimproving
The dangers
1.
The water may contain pathocertain
viruens , particularly
ses, bacteria,
protozoa1 cysts and
worm eggs which are transmitted
from faeces to mouth. Water contamination
by human faeces is the
major
cmern,
although
animal
faeces in water may also cause
disease transmission.
Water contamination by urine is a significant
threat only in areas where urinary
schistosaniasis
(Schistoscana hael
matobiw$
is endemic. By far the
greatest risk associated with paliuted drinking water is the spread
of diarrhoeas,
dysentries
and infectious
hepatitis
(hepatitis
A).
The diarrhoeas and dysenteries
are
caused by a variety
of viruses,
bacteria and protozoa. The numbers
of viruses and protozoa in water
will always decrease with time anJ
will decrease most rapidly at warm
temperatures .
Bacteria
behave
similarly,
but in exceptional
circlanstances may multiply
in polluted water. The infectious
dose of
the viruses and protozoa is typically
very low, whereas the dose
of bacteria needed to establish
an
infection
in the intestine
may be
large.
All a&~ods of water treatment require
sane expertise,
regular
attention,
and maintenance.
I33
.
m
- Water Treatment
2.
‘Ihe importance of trying
to
find a source that does not require treatment has been stressed.
scale is best done by experts, a;d
if possible professional
engineering advice should be soeht.
Howmeaever, 8 imple and practical
sures can be taken before such
help is available.
Full explanations of types of treawnt
are
given in the technical guides; the
main systems are suanarized below.
All methods require regular attention and maintenance.
to the physical
3. In addition
measures to protect water at its
source and initial
disinfection
of
wells
and boreholes
(usually
by
chlorine),
there are four basic
treatment :
methods of
storage,
chemical disinfection,
filtration,
These can be used
and boilirlg.
singly or in combination.
4.
Leavi% water undisturbed
in
tanks
or reservoirs
containers,
quality
i.mproves
its
Storage
causes scme pathogens co die off
and any heavy matter in suspension
to settle
(sedimentation).
In an
anergerr=y where water
supplies
cannot be assumed to be safe,
inmediate action to provide maximun water storage capacity
is a
logical
first
step.
Storage of
untreated surface water for I.2 to
24 hours will already bring about
a considerable
improvement in its
the longer the period of
quality;
storage arrl the higher the temthe greater the improveperature,
ment. The clarification
of cloudy
water can be greatly speeded up by
sulthe addition
of aluniniun
phate. A two tank system is often
used, the first
tank being a settlie
tank with the second storing
the clarified
water. If treatment
is required
this can be done in
the second tank, an3 a third used
for storage
if necessary.
While
134
clear water may only require chlorination,
turbid
surface
water
will
usually require sedimentation
and/or filtration
before chemical
disinfection;
even
so
greater
doses of chlorine may be required.
5. Great care should be taken to
prevent pollution
of stored water.
Storage tanks must always be covered : the dangers of contamination
of open tanks more than offset the
advantages of direct sunlight.
The
storage area should be fenced off,
and if necessary guarded, to prevent children
playing or swimning
in the water.
6.
Longer storage can help control
schistoscmiasis
(bilharzia) ,
as the parasites
die if they do
not reach the fresh water snail
within 24 hours of excretion by an
infected
person, or a human or
animal host within
48 hours of
leaving infected
snails.
Thus two
days ’ storage
would provide
an
effective
barrier
to transmission
of the disease, provided snails do
not enter the tank.
7. Sand filtration
can be an
effective
method of treatment.
A
proper slow sand filter
works in
two ways. Passage of the water
throsugh the sand physically
f ilters out solids and, more important, a thin and very active layer
of algae, plank ton, bacteria
and
other forms of life
develops on
the surface of the sand bed. This
is
called
the
“schnutzdecke”,
where micro-organisms
break down
organic matter. The rate of filtration
depends on the surface
area,
depth and type of sand
through which the water is passed,
and the head of water, The usual
size range of the sand is 0.3 lum. Provided the rate of filtration is slow enough, the quality
of the treated water is very good.
The types of sand filters
are
8.
described in the technical
guides.
A packed drum filter
can be improvised if druns and sand are available ard may be a good way of providing limited quantities
of safer
water quickly,
for example for a
- Water The water passes
health
centre.
down throclgh sad on a 5cm. layer
of gravel and is drawn off at a
rate that should not exceed 60
litres
per hour for a 200 litre
drum. If a tap is used, unfiltered
water equal to the amount drawn
off is simply added to the top.
Other tvues of sand filters
include tg
horizontal
sand filter
and the river bed filter
(suitable
only where the bed is permeable).
These can be used to treat larger
amounts of water but are likely
to
be more difficult
to set up quickly and effectively.
For a river
intermediate
source
a possible
measure is to dig a well close to
the bank. The water recovered will
be river water but will have been
f i&red
through the bed an3 bank.
Chemical disinfection
as a
9.
on a
method of water treatment
large scale is, as a rule, reZEiK
&ruled only
in srtuations
where
storage and/or
filtration
cannot
meet the need. It will
however,
be required
initially
‘to purify
wells,
sand filters,
punps and
piped water systems. Path iodine
and various forms of chlorine
can
be used; chlorine
is more widely
used, cheaper and often more reaThe most generally
dily available.
form of chlorine
for
suitable
emergencies
is
talc iun
refugee
hypochlorite
powder. Methods of
chlorination
are described in the
technical guides. Expert advice is
essential
for large-scale
chlorination.
All systems require regular
attention
and will
be of
little
value if not fully
reliable.
Chlorination
should
take
place after
any sedimentation
or
filtration
process. It requires at
least thirty minutes to act.
LO. Care must be taken to ensure
strict
control
of any chemical
disinfection
process and part icularly to test the water for chemical residual
levels
after
each
disinfection
and before distribution.
After
chlorination
there
should still
be at least 0.2 parts
of “free active chlorine”
per million in the water, in other words,
still
available
to kill
bacteria.
The amount of chlorine required to
achieve this is usually
a broad
indication
of the level of pollution.
If
the amourit of “free
active chlorine”
is much above 0.5
parts per million,
people may not
be prepared to drink
the water:
over-chlorinated
water
tastes
unpleasant
and will
have
the
reverse of the desired ef feet if
people therefore
prefer
untreated
water.
Chlorine
arti iodine water
purification
tablets
are
also
available,
but are rarely suitable
as a method of water treatment for
large
populations.
They may be
-used in health
or supplementary
feeding centres.
11. Boiling
is the surest method
of water sterilization,
and at low
altitudes
simpiy bringing water to
the boil
will
destroy all pathogens that may be transmitted
by
drinking
water.
Boiling
should,
however,
be cant inued
for
one
minute for every 1,000 metres of
altitude
above sea levci,
as the
boiling
temperature
reduces with
altitude.
Prolonged vigorous boilis often recommended but is
is
not necessary to destroy the faeCal-orally
transmitted
pathogens;
it is wasteful of fuel and will
increase
the
concentration
of
nitrates
in the water. Water with
a. high concentration
of anitrates
dangerous
for
iibies.
Domestic fuel iGilie?h!$
in the longer term be the determining
factor;
boiling
requires
’ about lkg of wood per litre
of
water.
the refugees
However, if
have traditionally
boiled
the ir
water and can continue to do so,
this should be encouraged and, at
least initially
, may make the need
for other types of treatment less
urgent.
135
- Water -
plnder referewes
(1)
Cairncross S.
Feachem R.
(1978)
3~11 Water Supplies
A clear presentation with simple diagrams
and practical advice.
Cairncross S.
Feachem R.
(1983)
Ehviromental
Health Engineering in the
Tropics: An Introductory
Text
A copiously illustrated
introduction
to the
principles
and practice of tropical environmental health
Wiley, John
FAD (1977)
(Koegel R.G.)
self-he
wells
mu&iew
of simnle drillinr
and
diging methods with emphisis on use-of
local resources. (Also in Arabic)
FAD Irrigation
and Drainage
Paper No.3
Bward J.
(1979)
Safe Drinkiw Water
Information on treatment methods
Oxfam Technical
Guide
Rajagopalan S.
Shiffman M.
Guide to Simple Sanitary Measures for
the Control of Enteric Diseases
@Vera water supply and all aspects of
sanitation
including food sanitation
(Also in Arabic, French and Spanish)
vIHO
Pacey A. (1980)
Hand-rump Maintenarre in the context
cannunlty well projects
Oxfam/ Intemeciiatf
Technology Publications Ltd.
World Bank
Appropriate Technology for Water Supply and
Sanitation.
A 12 volume series.
Volume 12: Low-cost
Water Distribution
- A Field Mani-)
is particularly
relevant.
World Bank
WHO(1971)
International
Standards for Drinking Water
Third edition (also in French and Spauish)
Being superceded by Guidelines for Drinking
WHO
(1974)
~v:YlPz:
Water Supplies,
be par titularly
(1) See also the further
are repeated here.
136
references
of
ROSS
Bulletin
No.10
~‘E:~~k~
ty
expected end 1983, should
relevant.
at the em! of chapters
7 and 10, only som of whit
List of contents
-
Section
Page
Contents
Paragraph
.
Overview
138
10.1
l- 4
Introduction
139
10.2
l- 7
Organization
139
Disposal of excreta
10.3
ii:171
12-14
15-16
17-25
10.4
General
Inmediate action
Longer-term options
Selection of a system - basic considerations
Specific considerations
l&es-
l- 9
LO-13
141
142
143
144
144
of latrines
Dry systems (trench, pit, bored-hole,
canpost ing)
Wet systems (water seal, aquaprivy,
Oxfam unit)
145
148
10.5
l- 6
Waste water, garbage and dust
150
10.6
l- 5
Insect and rodent control
151
10.7
l- 3
Fires
153
10.8
l- 3
Disposal cf the dead
153
Further
154
references
137
Need
The social
ties
that
conditions
is taken.
disruption,
overcrowding and lack of sanitation
facilicharacterize
refugee emergencies can quickly
lead to
that are hazardous to health and offensive unless action
Aim
To prevent the spread of disease and promote a safe environment
the refugees .
Principles
for
of response
Tbe co-operation of the refugees is essential for success, and
prograumes must be developed with ati to the extent possible
run by them. The measures taken must be culturally
acceptable
to the refugees.
‘Ihe advice of an experienced
knowledge is required.
public
health
engineer
with local
Swift provision of a basic system for human waste disposal
better than delayed provision of improved systems.
‘Be simplest
technologies
possible
should be applied.
Individual
family allocation
of appropriate
host guarantee of maintenance and use.
Co-ordinate
is
.
latrines
is
the
with other public health programnes.
Action
L/2-7
Lo*z$e
defaecation
and prevent
contamination
of
the water
.
138
ff
Develop an appropriate
excreta disposal
system.
/7
Establish effective
services for disposal of garbage and waste
disposal of the dead, dust
water, insect and rodent control,
control where necessary, and fire prevention and control.
17
Establish an inspection and reporting
tion and environmental services, linked
r/
Provide education on sanitation
and environnental
a part of general public health education.
system for all sanitato health surveillance.
services
as
- Sanitation
and environmental
10.11.
Disruption
ati
the crowding
tcrgether of people who are accustomed to living
in different
and
less
conditions
crowded
makes
adequate
sanitation
of critical
importance.
The
facilities
to
which the refugees were accustomed
are no longer
available,
basic
services
are of ten lacking
and
habits may have to be changed. In
these
conditions,
indiscriminate
disposal of human and other waste
will
pse serious threats
to the
health
of
individuals ,
family
groups and finally
the whole community.
2.
Environmental
sanitation
is
of ten considered
to include : the
provision
of safe water; disposal
of human excreta, waste water and
g;b;lpe ; insect and rodent cont; safe food-handling
practices;
and site drainage. All these services, and the provision of health
care, are very much interrelated
and should be considered together.
In particular : this chapter should
be read in conjunction
with chapter 9 on water.
The key to reducing
health
3.
hazards is an acceptable and practical
system for the disposal of
human excreta. This must be developed in co-operation
with
the
refugees and be culturally
appropriate,
even
if
circumstances
necessitate
a departure from traditional
practices.
Special public
health education may be required;
the system must be one which the
refugees will use.
4.
lhe re f ugeeb must also run
the services to the extent possible.
control
will
be essential:
the effectiveness
of the services
will depend to a significant
degree on regular and thorough maintenarre and inspection.
10.2 mnization
/7
-rake full
account of sanitation needs in site selection
and particularly
layout .
services
-
/7
Seek professional
advice from
those with
local
knowledge
and above all consult and invo lve the refugees .
-
/7
Ensure maintenance and cleanliness of the syst~
and the
supervision of its operation.
r/
Educate the refugees as part
of the public
health education prograume.
1.
As has been stressed in chapter
6, environmental
sanitation
will
be a very important
consideration
in site layout,
and the
organization
an? operation of the
sanitation
services must be integrated with other ccmrnunity services.
2.
Developing
adequate
sani tation
in a refugee emergency is
difficult
and correcting
mistakes
is more difficult.
E&pert advice
should ba sought from a public
health
engineer
who is familiar
with the habits
of the refugees
and nationals
of the country of
asylum, and if possible has experience
of
refugee
emergencies.
Assistance
should first
be sought
from local sources such as government departments , the UN system,
NGos, universities,
consultants
or
contractors , If these cannot meet
the need, Headquarters’
assistance
should be requested.
There are,
however,
effective
measures that
can and should be taken at once.
Figure
10-l
overleaf
illustrates
some of them in diagrammatic form.
Good sanitation
depends to a
3.
great extent on the attitudes
of
the community and the people who
run the system. The systems and
services developad should be able
to
operate
effectively
with
a
minimum of ou ts ide
involvent
.
Selected refugees must be trained
to run the sanitation
and environ,mental prograurnes .
The most comnon cause of con4.
pleteTilure
of a sanitation
system is selection
of
s stem as a rm
ina equate
-+I==
+-lscussion with the refugees and a
139
- Sanitation
10 - 1
and environuental
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services
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- Sanitation
failure
to take all relevant
tors into consideration.
and environmental
fac-
5. The most camion cause of
break
designed
ante, even for properly
SiT installed
systetns . The best
guarantee of proper maintenance is
the individual
family
allocation
of latrines.
Breakdown of latrines
will lead to contamination of the
environment and a high risk
of
infection
and disease. There must
be regular inspection and maintenance.
6.
Even when in worki
latrines
will
not ba
famith y are clean. Individual
lizs will be responsible for their
own units, but where cannunal latrines
are
unavo idable,
special
arrarlgements to keep them clean
will
be
essential.
Particular
attentioil
must be given to the
maintenance and cleanliness
of the
latrines
serving cwnunity
facilities such ES health centrcs. Refugee workers and proper supervision
will
be r:-quired,
and it may be
necessary to psy or otherwise compensate those w&o are responsible
for
cannunal
latrines
keeping
clean
and operational.
Latrines
must he cieaned daily.
It should
be noted that disinfectants
should
not be poured into the pits
or
tanks of latrines
which dispose of
excreta by biological
degradation.
The regular
addition
of
soil,
if available,
to
ashes or oil,
trench or pit latrines
may help
control insect breeding and reduce
odour .
7. lhe public health education
prograame must place proper emphas is on the importance of sound
sanitation
envirorrnental
pract ices. The link between excreta contaminat ion and disease must be
clearly
understood by all.
Whatever the success of the sanit=
system rith xfts,
children
will.
present a special challew.
Chlldren are both the main sufferers
from excreta-related
diseases and
also the main excreters of many of
cause diarthe pathogens that
rhoea. Children are often fright,
services
-
ened by unfamiliar
latrines
ary3
particular
care will be needed to
ensure that the latrines
are safe
and physically
suitable
for children.
10.3
D
iurnediate
Take
action
localize
excreta disposal
prevent contamination
of
water supply.
D
Carefully
consider
and physical factors.
L7
Trench latrines
may be needed
initially
, but in most circunstances
individual
family
latrines are much better.
/7
Ensure
used at
priate
als are
to
arrl
the
cultural
that latrines
can be
night and that approanal cleaning materiavailable.
General
1.
Safe disposal
of excreta is
necessary because the agents of
most +rtant
infectious
diseases
are passed from the body in excre ta and may reach other people.
These are called the excreted infections
and fall
into four main
groups : viruses,
bacteria,
protoard worms (helminths) . F‘clrz=,
thermore,
unless properly
isolated, excreta can provide a breeding ground for insects, which then
act as direct
or indirect
transmitters of disease.
2,
‘Ihe specific
link between the
incidence
of diseases
and the
sanitation
system may not always
be obvious,
as often
the most
important human link in transmission of an infection
is a carrier
who shows little
or no sign of
disease. Conversely, persons in an
advanced state of disease may have
little
or no importance in transmission.
The links between diseases,
infections,
the means of
transmission,
and the sanitation
system must be kept utier constant
surveiilance.
141
L
- Sanitation
ard envirormeental services
‘&a safe disposal
of hunan
3.
than
excreta
is more wrtant
disposal. of animal waste, because
more diseases affecting
humans are
transmitted
by human waste than
animal. Humsn faeces are much more
darlgerous than urine.
For urine,
in an
it is probably sufficient
anergency just to prewnt contamination of the water, but in the
areas of Africa
and the fiddle
East where the Schistosoma haemsbilhar zia
speciesf
tobiun
ad
in allO areas where
occurs,
typhoid
is comnon and en%&,
of urine also requires
disposal
special attention.
6 . Ike main factors will
affect
the choice of an excreta disposal
system: the traditional
sanitation
practices
of the refugees and the
physical
characteristics
of
the
area, including
the geolw,
the
rainfall
availability
of water,
and drainage. Failure to t;:ke proper account of either of them can
easily result in the system itself
rapidly becaning a health hazard.
Consideration
with the refu5.
gees of their traditional
sanitation practices
and how these can
be modified or adjusted to reduce
health hazards in the circunstances of a refugee emergency is the
essential
starting
point.
Over
half the world’s
population
does
not use latrines.
Of those who do,
SCrne
cultures
require
privacy,
some separate the sexes physically
or hy time, others do not. Such
factors,
and the method of anal
must be considered
at
cleaning,
the planning stage and will directly
affect
the type of system.
Once they have been taken into
account, the cleanliness
of Latrines and their ease of access will
determine whether or not they are
W& fIhet
. : following may help as a
(1)
Previous
sanitation
and practices ;
(2)
Nzthod of anal cleaning;
(3)
Preferred
position
or squatting) ;
142
system
(sitting
-
(4)
Need for privacy;
(5)
Segregation
of
sexes
and
other
groups or individuals
with whom it
is culturally
unacceptable to share a latrine;
(6)
Cultural
ren ;
(7)
Cultural. taboos (for example,
against contact with anything
that may have touched excreta
of others) ;
(8)
Social
factors ,
including
likelihood
of comnunity action to ensure proper use of
propsed system;
(9)
Wed for special
(direction)
of
some cuitures;
practices
for
child-
orientation
latrine
in
(10) Systems
used
locally
neighbourhood of site.
in
6.
Arrargaents
must be made to
assure the availability
of appropriate
anal cleaning materials
at
Or
near all
latrines.
This is
essetltial
maintenance of
to the
hygiene.
7.
The latrines
must be safe for
children,
and must be able to be
used at
night.
For individual
units,
famill’es may be able to
arrange their own lamps, but for
cannunal units sare form of lighting should be provided.
Ismediate action
8.
‘Ihe refugees are likely
to be
defaecating
indiscriminately,
contaminat ing the ir envirorrnent
and
often the water supply. In consultation with the camnunity leaders,
the best first
step is to try and
localize
excreta:
controlled
surface defaecation.
Tf space allows,
designate
an area or areas away
from the dwellings and down wind,
but sufficiently
close to be used.
Fence the area(s) and provide privacy and a shallow
trench
and
spades, if necessary and possible.
Covering
excreta
lessens
risks.
- Sanitation
and enviromntal
Site such areas where the surface
run-off during rain will not cause
contamination
ad protect the area
with cut-off ditches.
9.
A Publicity
campaign will he
required to encourage refugees to
use these areas and not defaecate
near
dwellings.
inrliscriminately
At the same time measures must be
taken to prevent defaecation
or
in or near the water
urination
SupPlY This Gnnediate action can
already significantly
reduce public health hoards.
l
10. If the ground is flooded or
marshy or there is a high water
table,
arrangements must be made
as soon as possible
to try and
pbysicallY
contain the excre ta: in
the risks
to
such c ircumstarrces
public
health
are greatest
and
location of the area away from the
dwelliws
ati water source is even
more important.
Pending a proper
containment sys tern, simple raised
for example a Gooden
structures,
stqp
sane 5Ocm high,
may be
essential
to avoid the refugees
inmediately
being contaminated by
Alternatively
their
own excreta.
empty 200 litre
(45 gallon)
oil
dnnns can be used. Che end of the
drum is cut out and the drum
inserted
that end down into the
after
digging a hole as
grad,
deep as the water allows. The last
half metre of the drum is left out
of the ground and a sub311 hole cut
into the end of the drum to transform it into a squatting plate.
11. Nhere the site
is not yet
occupied, ismediate action will be
determined by the type of system
adopted
(see Mow).
The first
refugees moved to the site should
construct
the system if this has
not been done earlier.
Ionger-term
options
12. Expert advice will be required on the most appropriate
system. The nature of the soil will
be important;
if
it
is highly
sane systems will
be
impervious
The availability
of
precluded.
water will be another factor,
and
services
-
the importance of cultural
considerations
has already
been stressed. There are many simple options
that,
if properly
constructed
and
maintained,
will
meet all public
health requirements.
13. In hot,
dry climates,
where
sufficient
space
is
available,
localized
defaecation
areas
from the dwellings may also beaEg
best cant inuing arrangement,
particularly
for those whose normal
practice it would be. In time, the
heat and sunlight
rerrler the faeces harmless. Black rock is the
best surface.
If this solution
is
adoPted keep the Potent ial health
hazards under review and watch out
for increased numbers of rats in
the area.
In most emergencies,
however, s~Xir\esort of latrine
will
be required,
even for refugees unaccustomed to
them. The broad
division
is into dry latrines
pits
or boles in the
trenches,
ground - and Water-dePeendent latrines, which are flushed. In addition there are also systems based
on campost ing or the car tage of
excreta.
14. If the site is on the coast,
local practice may be to defaecate
in the sea. While this is less
harmful for the refugees than indiscriminate
defaecation
on lard,
it
should be discouraged
unless
there is no other option. The dangreatly
with numgers increase
bers. Faeces will
contaminate the
high-water
line,
and the practice
will
increase the health hazards
of washing
in
the sea. Where
defaecation
in the sea is unavoidable,
it should be localized
by
fencing
off
an area. Strut tures
should be built that permit defaecat ion away from the
imnediate
shore line and both the location
of these ard organization
of the
system should make use of tides,
currents
and prevailing
winds to
avoid direct
contamination
of the
foreshore.
Pumping untreated
excreta
far enough out to sea so
that it is carried
away from the
coastline
is one possibility.
l)efaecation
in bays, estuaries
or
lagoons where fish
or shellfish
143
- Sanitation
are caught
since
this
infection.
and enviroranental
should be discouraged
may be a source of
Selection of a systen
siderations
- basic con-
15. The selection
of an excreta
for
a
disposal
system suitable
particular
situation
requires consideration
of a number of factors.
In an mgercy
, however, time is
the critical
factor.
Pollution
of
the enviroment
by excre ta, with
all its attendant risks, cannot be
itrr&iate
sani tastopped without
tion measures. This the range of
choice is always much more limited
at the very outset of an emert-sew; weeks or months cannot he
lost in waiting for expert advice,
construction
to be completed or
material
to arrive. Temporary systems to meet the most iur&iate
needs will have to be improved or
replaced by others as soon as poss ible,
in order to maintain adesanitation
standards.
In
quate
&ergency
sanitation
act
first
a3
.
Unprove later.
cotd it ions
16. E)mergency
therefore
dictate
at least
it:
initial
use of trench latrines.
%ese can be dug quickly 3rd need
less space than individual
family
units. -While shallow trenches may
be a quick-action
solution
for a
initial
period
deep
very short
trench
latrines
are incombarably
more ef feet ive. bhere space and
the simnsoil
conditions
allow.
lest
and
coumonest
individuil
is the pit latrine.
family unit
Details
of various types of latrine are given in section
10.4.
Once a sys&n has been selected, a
pilot
protect
may yield
valuable
lessons.
Specific
considerations
17. There are three basic ontions
for the allocation
of latrines:
individual
family units.
centralized units with each latrine
allocated to an individual
family and
will
systems.
camxmal
People
al.ways make more effort
to keep
their
own latrine
clean and in
i44
services
-
good order than to do the same for
a cannunal facility,
and dirty and
smelly latri.nes will not be used.
Cons&ently ,
individual
family
units
are,
under normal co&itions, the preferred solution.
Cost, installation
and maintenance. The most appropriate
system is likely
to he the one that
and
is cheap, simple to install
easy to maintain. Haintenance problems often
prevent satisfactory
operation
of
otherwise
well
designed
and installed
systems.
Particularly
important,
the latrine must be easy to clean and the
surfaces round the hole washable.
Avoid uncovered wood if possible.
18.
19. Number and siting
of latrines. As a rule, at least one lat‘ri;ie should he Drovided for every
should be a’t
20 people. Latrines
least 6 metres from dwellings
if
possible,
further
away from feedcentres,
say a
ini: and health
minimum of 10 metres, and over 15
ard preferably
over 30 metres from
drinking
water
wells
or other
sources thoeh all these distances
depend on latrine
and soil type.
Latrines should he located no more
than 50 metres from user accannodation
and be easy of access.
Figure 6-1 on page 62 shows these
considerations
in the context of
site planning.
IE people have to
walk a considerable
distance to a
fatrlne
they will
defaecate in
more convenient
location
regardless of the health hazard.
will
densit
20. Population
affect the snace availa -I?le for the
excreta disposal
system and thus
the type of system. Che of the
major health hazards as a result
is that latrines
of overcrowding
are too close
to dwellings
ard
there may be insufficient
space
for individual
units. This must be
considered
in site planning.
The
site Layout should be determined,
among other things,
by the needs
sanitation
of the most suitable
system, not vice versa. Space must
he available
for replacement latrines where necessary.
- Sanitation
and environmental
21. l%e nature of the soil may
exclude certain
or&ions. For examrodcy soil may prevent the
pie,
digging of pit-type
systems ; sandy
soif will
demand special measures
for preventi%
side wall collapse
of pits; impervious clly soils may
exclude any system dependent upon
seepage. Account should be taken
of the differerre
between ‘dry season and wet season soil
conditions . If the ground freezes in
winter this may limit
the choice
can
of systems. Soil conditions
vary over a short distance and a
survey
is
thOl-OUgh
necessary.
Where there is a high water-table,
perhaps only seasonally,
care must
be taken to ensure it
is not
conteminated bv seenage from the
latrines.
In hod
Or” swampy conditions
the excreta must be conl
tained.
‘Ihe amount OE water available
determine whether disposal
systems which require water are a
possibility.
Itme
systems
are
generally
more
expansive
than
those which do not need water.
Refugee situations
are often characterized
by a lack of reliable
water sources, which usually means
that the excreta disposal
system
should not be dependent on water
availability.
However,
whatever
the system, many canuunities
reqilire water for anal cleaning.
services
-
order to prevent rain water filling the latrine,
causing contamination around it, or weakening the
surrounds. Make sure proper drainage off the roof is provided, away
from any soakaway. Special measures will
be necessary for the
manufacture of squatting
or sitting slabs, and U-pipes and other
material
for wet systems, if these
are not available
locally.
Where
refugees or locals have an established
method of covering
latrines,
for example with a wooden
lattice,
this is generally
to be
preferred,
eve- if it is less easy
to clean that, a special
plate.
There are, however, a number of
simple techniques which exist for
making the latter
on site,
for
example with reinforced
cement or
f ibreglass
from moulds . Guidance
is given in the technical references . Seek advice on local methods .
22.
will
23. All sites have rain at sane
time and seasonal rains may be
very heavy; it is necessary to
ant icipa te where surface run-off
will
flow and it may need to be
diverted
by cut-off
ditches.
The
possibility
of flooding. should be
considered
and dralnage provided
if
If
flood
water
necessary.
enters
the latrines
large
areas
may be contaminated.
24. Construction
material will be
needed. The structure
should be
made of local materials arwl these
should be used for reinforcing
the
pit where necessary. Refugees not
used to latrines
will
generally
prefer a largq enclosure with no
roof but there are of ten strong
arguments for cavering latrines
in
?
25. Biogas can be produced from
excre ta , with fertilizer
as a byproduct. While rarely likely
to be
a priority
in an emergency, this
possibility
should be considered
where fuel is short and effective
local
biogas
systems
already
exist. The applications
are generally
in carmunal services:
there
is a minimum effective
plant size
and conversion
of
a family’ s
excreta to biogas only yields up
to a quarter
of their
needs in
cooking fuel.
10.4 Tmes of latrine
0
There are many potent ially
satisfactory
of lattypes
rine: low cost, simplicity
of
construction
and
ease
of
maintenance
are the priorities once cultural
ati physical factors have been considered. The basic division
is
into wet and dry systems.
Dry systems
1.
In
dry
systems,
keep the
squatting
hole as small as possible and- ensure a close fitting
co;er is pm
and used, except
with VIP latrines
(see 10.4.4).
- Sanitation
and environmental
Shallow trench latrines
(very
2.
chea& . shallow
trenches
can be
dug “with
picks and shovels and
last
for only a few days. The
shallow trerrh
is usually
30 cm
wide and 90-150 cm deep. For every
100 people 3.5 metres of length is
,reccmnetied. After every use the
excre ta should be covered with
soil
from the digging
of the
trench, which is left on one side.
When the trench is filled
to within 3Ocm of the top, it must be
covered with soil and compacted.
Simple platforms
which can be
cleaned without
much difficulty
and moved on may be placed over
the trenches.
3.
Deep trench latrines
(cheap).
Dewp trtrges
can be used for a
If
necessary,
and
where space’ is available,
this
solution
can continue
for longer
with new trenches being
periods,
dug as old ones fill
up. Ihey
should be dyg 1.8 to 2.5m deep and
75-9Ocm wide. Recatmerded lex th
per 100 persons is again 3.5 metres. A platform and structure will
be needed, providing
a seat or
squattihole,
as appropriate,
services
-
with lid, and the trench should be
fly-proofed
to the extent possible. Adding earth,
ashes or oil
will
reduce flies.
Trench sides
must be shored up if there is a
danger of collapse.
4.
Pit
latrin;xcr2;heap)
: ‘Ihe
most
ccxnnon
d lsposal
system around the world is the
individual
family
pit
latrine
(figure
10-23,
which has major
advantages over a trench latrine.
It consists
of a superstructure
for privacy, and a squatting place
(or seat) above a hole in the
ground.
Individual
families
can
dig the pit and build the superstructure
and if used by only one
family these latrines
are usually
well maintained.
Pit latrines
can
also be used in clusters as cannunal facilities.
While the basic
variety has both odour and insect
problems, the simple improvements
shown in the diagram can reduce
these consider ably,
as will
the
addition
of oil and use of lids.
Where pit latrines
are used, the
ventilated
improved version
(VIP)
should be built whenever possible.
5UNNY
DOOR
2
‘IPE
%Acr2
-4QUA~lNE-
6LAB
REINFORCED
’
SIDE
PAW-lfED
“‘2
EEINl=oRLM
LINI~IG
.
‘COLLAF5E
cl~npEQ.vlous)
146
TO
-PEt.GLENJ
.
- Sanitation
and environnental
Pit latrines
are most suit5.
of low to
able
in conditions
medim population
density - up to
about 300 persons/hectare
- but
have been used satisfactorily
in
twice
this
density.
areas with
Space should be available not only
for the construction
of one pit
latrine
per family, but also for
the digging of new pits when the
old ones are full.
This is an
important
consideration
when pit
latrines
are
used as comnunal
facilities.
When the pits
are
three-quarters
full,
they must be
filled
with soil and the superstructure
ati
squatting
plate
moved to a new pit.
If layers of
ashes are applied as the pit fills
the excreta will deccmpose and in
time the site can be used again.
8.
services
-
Bored-hole
(cheap)
Pored-hole
latrines
(figure
10-3)
are dug with a hand auger or mechanical drill
and require a smaller
slab than a pit. The bore-hole is
35-45~~ in diameter and any depth
up to 7 mettes . ‘Ihe advantage of
the bored-hole latrine
is that it
can quickly
be constructed
as a
family unit if augers are available. The disadvantages
are that
the side walls are liable to fculing and fly breeding,
they are
smellier
than vented systems acd
the risk of ground water contamination is greater because of the
depth,
The pit should be about one
6.
metre across and over two metres
deep. The rim of the pit should be
raised
about licm
and cut-off
ditches dug to divert surface run
off. ‘Ihe pit should always be reinforced and the sides may need to
be reinforced
for one metre below
ground level to prevent collapse.
A light wooden squatting plate or
wooden lattice,
although harder to
than
clean, may be more practical
a heavy concrete one. The danger
of collapse may be further reduced
by digging
the pit as a trench
only 50-6Ocm wide or by having a
c ircular
pit , when the use of oil
drums as described
in 10.3.10
could be considered.
lbe vent pipe in a VIP lat7.
rine should be at least 15cm in
diameter,
about 2 metres high,
painted black and placed on the
side of the latrine
for
smv
maximum odour and insect control.
It must be fitted
with an insectproofgauze
screen, when it will
work as an excellent fly trap. The
hole should not be covered by a
lid as this impedes the air flow.
latrines
fZEMO’LA6E
IO - 3
MXED
co’J&fz
HOLE, iAJT.lt+k
147
- Sanitation
aid envirorrsental
After
11. Aquaprivies
(more expensive) .
Aquaprivies ~mgure
10-6) consist
of a squatting plate or seat above
a small septic
tank from which
effluent
drains
to an adjacent
soakaway. The aquaprivy requires a
minimum water tank volu
of one
cubic metre
(1,000 litres),
to
which sane five litres
per user
must be added daily. In areas with
impermeable soil such as clay it
is not possible to use a soakaway.
Tbe liquid
run off can be carried
in pipes and passed to an area
suitable
for disposal.
The mDst
ccnmon difficulty
with aquaprivies
is failure
to maintain the water
seal,
causing
serious
odour and
insect
problans . f&per ience has
shown they do not work satisfactorily where water has to be carried
to the latrine,
but as long as the
aquaprivy is kept topped up with
water there are few thizs
that
can go wrong. Aquaprivies are not
recaxrnended where solid materials
are used for anal cleaning.
Seek
Met systems
10. Water seal (pour-flush)
lat.
11
tines ( h )
(f-e
‘$3)
’ aRin$
ir%Z
r&l
desig$ but require a permeable soil
for their
soakaway. A
water seal is made by a U-pipe
filled
with water below the squatting pan or seat. It is flushed by
hand with sass l-3 litres
of water
into a pit or soakaway. This system is suitable
where water is
used for anal cleaning and where
refugees are used to flushing.
It
is
not
suitable
where
paper,
stoner
carmobs or other solid
DOUBLS
IO-4
-
BIN
Nq
IN
U4.L
I. e. UMWOS~ING,
SE5ALED
$ tXFD
145
BIN
(ENJCLOSU~E
C~~POsTIW-
Nq-
-
materials are used for anal cleaning. Water seal latrines
will
be
used properly
only if water is
readily
available.
A large container
with
a 3 litre
dipper
should be close by the latrine.
Pit latrines
can be modif ied to
beccn~ water seal latrines
where
soil conditions allow.
Compostzing latrines
(cheap).
9.
Such latrines
tender excreta harmless with time and produce fertilizer . Figure 10-4 shows one of
proEn
ef feet iveness, the Vietnamese double septic bin, suitable
for a family of 5-10. Urine does
not enter the bin, being diverted
each
into
a container
defeacation
ashes are sprinkled
over the faeces. Orr=e filled,
the
bin
is sealed
(e.g.
with
lime
cement or clay) and the adjoining
bin used. A full bin is left
to
compost for at least
two months
and the
contents
then removed
access door,
the rear
erw9J
which has also been hermetically
sealed during cnnpostirlg.
l
services
SHOWN)
tiJF?IfffL
- Sanitation
and envirormental
services
-
,
IO -5
SLOP& fzcq=
PCWR-UJ5l+
CPF)
LA~lE-IE
50 ‘-iHA+
-&/VE-N
JIM-j-IoV
- Sanitation
and enuiromnental
local advice before deciding betand water seal
ween aquaprivies
are less
latrines.
The former
easily blocked but have no other
majm advantage over the latttir,
which are cheaper.
12. Qxfam Sanitation
Unit
(more
expensive still).
The unit is a
canuunal
treatment
p&-packaged,
systen in which 20 squatting
platanks made of
tes, two flexible
nylon-reinforced
butyl rubber for
sewage treatment,
and all necessary pipes ati fittings
are pravided. As a unit designed specifically for emergencies , it has the
advantage of being a proven system
which can be assembled quickly and
is not affected
by soil
conditions.
One unit can serve up to
1,000 persons per day. Apart from
cost and problems of unfamiliarity , the main disadvantage
is
that it requires about 3,000 litres of water a day at full design
capacity. The unit is not suitable
ccxnnunities
using
solids
for
(stones, corn-cobs etc.)
for anal
cleanirg . The water must not be
saline.
The unit requires
a good
soakaway or
alternate
effluent
disposal.
It also requires a reliBefore deciding on
able operator.
this system, the advice of s-one
failiar
with it should be taken.
Waste
ponds
stabilization
(oxidization).
13. Where a liquid
effluent
has
to be disposed of, for example
from a ‘wet’ system in impermeable
soil,
waste ponds can provide a
simple and cheap solution.
Treatment is by natural biological
and
physical processes. As the rate of
treabnent
increases
with
tem\Jera-
time,
pXldS
are
particuZ.arly
effective
in hot climates. Various
systems are described in the technical
references . If
ponds are
used they must be securely fenced
off.
10.5 Waste water. mrbam and dust
r/
150
Sources of waste water must
be localized
as much as passible and drainage provided,.
services
-
-//
Improper garbage disposal increases the risk
of insect
and
rodent-borne
diseases)
and an effective
system must
be established
for the storand disposal
age, collection
of garbage.
-/7
Garbage disposal
areas must
be designated
and access to
them restricted.
-/7
Large amounts of dust can
health.
Preventing
damage
destruction
of vegetation
is
the best preventive
measure
dust;
against
spraying
of
roads and traffic
control are
addit ional measures.
1.
Waste water
is created
by
washing, bathing and food preparation.
The problem of waste water
should be dealt with by localizing
sources of waste water as far as
and by providing
local
possible,
If
this
water is not
drainage.
stand in
drained away, it will
stagnant pools providmalodorous
ing breeding places for inset ts ,
especially
mosquitoes, and becomes
an additional
source of contaminat ion of the environnent.
Washing,
for example, is often done near
water sources, causing many problems.
In
other
circmstances ,
refugees may wish to use the latrine, with its privacy,
impervious
floor
and drainage,
fcr washing.
To avoid these problems, special
separate washing areas with duckboards or stones and proper drainage should be constructed.
2.
All ccmmunities generate garaccumubage, and the uncontrolled
lation
of garbage is both unpleaRodent - and
sant and -unhealthy.
diseases
increase
inset t -borne
with improper garbage disposal.
An
effective
disposal of garbage must
&
provided
and the
therefore
needs reflected
in the initial
Free range chicsite
planning.
plz,
goats and pigs, when availwill
help control
garbage;
dogs’ will
spread it. The suggesfollow
particularly
t ions
that
concern high-density
sites , where
the problem and dangers will
be
- Sanitation
and environmental
greatest.
Established
routines
for
the storage, collection
and disposal of garbage and control measuDisposal
res will
be required.
should be accomplished by burying
locations
on the
at desisated
site, or removal off the site. The
open burning of garbage on site
should be avoided, and imineratars used if garbage is to be
burnt.
storage,
garbage
3. For solids
containers made of metal or plastic and with a minimm capacity of
50 li tres should be provided.
A
200 litre
oil drum cut in half is
often used. They should have lids
if possible and drainage holes in
the bottom. A ratio of one container per 10 families has proved to
be
effective.
The
containers
should be placed throughout
the
site
in such a manner that no
dwelli%
is more than about 15
metres away from one.
4.
The collection
of
garbage
from the containers
should take
place regularly,
daily
if possible. Mly
collection
arrangements
will also need to be made for the
waste from feedins centres.
The
safe disposal of afl medical waz
requires particular
attention.
and
5. Needles
scalpels
are
especially
dangerous.
Medical
waste should be treated separately, burning as much of it as passible without delay. The designated areas where garbage is to he
buried should be well away from
dwelliqs , arri be fenced to restrict
access. If garbage has to be
burnt,
each burning
after
it
should be covered with a layer of
soil.
6.
Large amounts of dust carried
in the air can be hanrimto
hunara
health by irritating
eyes, respiratory
system and skin,
and by
contaminatirrg
food. Dust can also
‘narm some types of equipnent which
may be needed on refugee sites.
The best
preventive
measure is
action to stop the destruction
of
vegetation
round
the site.
Dust
control can be achieved by spray-
services
-
ing roads with water or oil, especially
around health
facilities
and
feeding
centres,
limiting
traffic
and banning it from certain areas if necessary.
10.6 Insectandrodentcoatm1
-//
Insects and rodents carry and
spread diseases and can spoil
food supplies.
r/
Physical screens are the best
inrnediate measures.
d7R
eventive
action
to eliminate or limit
breeding areas
and conditions
favourable
to
the vectors is the best longterm solution.
D
Specialist
supervision
of all
chemical measures and local
knowledge of resistances.
is
necessary,
1.
The enviroment
in a refugee
emergency is typically
favourable
to the proliferation
of diseasecarrying
insects and rodents (vectors) I which can also destroy or
spoil
large
quantities
of food.
Flies tend to breed in areas where
food or hunan excreta are present,
mosquitoes where there is stagnant
water,
and rats where there is
food, garbage and cover. For both
flies
and mosquitoes,
the lifecycle from egg to adult, can take
less than two weeks. As a resu?t
of
and inadequate
over cro& ing
personal
hygiene,
lice,
fleas,
mites , ticks and other arthropods
may also cause health
problems.
Table 10-7 overleaf gives an indication of carnron vectors and related diseases.
2.
Reducing
the
numbers
of
flies)
mosquitoes
and
rodents
quickly
in an emergency is dif ficult and physical
screens may be
the best inmediate measure. Ihe
most effective
method of controlling insects and rodents over the
term
is
preventive:
to
longer
sani taimprove per sonal hygiene,
garbage disposal
tion,
drainage,
and food
storage
and handling
practices
and thus make the envi151
1
- Sanitation
and environmental
-
to chemicals ; a rotation
system,
using different
sprays,
may be
necessary.
Local
knowledge
of
existing
resistances
is required.
Poison and traps
may be used
against rats in food storage and
handling areas but particular
care
must be taken in disposing of dead
rats, which may carry plague-bear ing fleas.
Chemical spraying and
rodent poisons can be dangerous to
humans.
rorment less favourable
for the
vectors.
Examples of
practical
measures are the remwal of stagnant waste water, regular garbage
collection,
use of oil in latrines
and provision of soap and sufficient water for washing. ‘Ihe prograume should provide for regular
in-section
and be integrated
with
other pi’,lic health measures.
‘Ibe problems should be dis3.
cussed with the refugees and education given on the significance
of vector control.
Where solutions
unfamiliar
to the refugees
are
enployed these must be carefully
explained.
5.
The body louse is the only
proven vectti of louse-borne (epidemic) typhus and epidemic relapsing fever. The lice are found on
inner
clothing,
particularly
at
the seams, If there is a serious
increase in body louse infestation
quick action is required by protrained
personnel.
This
perly
generally
takes the form of dustindividuals ’ inner
clothing
ing
and bedding with an insecticide
or
the use of clothing
fumigants.
There is widespread resistance
of
lice to sore insecticides,
especially DIYI, and expert local advice
must be sought. Mass washing of
clothing
is unlikely
to be a solution as a water temperature of at
least 52°C must be maintained to
kill the lice.
4.
Detailed descriptions
of vector control methods using insecticides and poisons are given in the
technical
- references - S cialist
advice
and supervi{ion?ZYZi
ct=ncal
measures is essential.
These must be closely co-ordinated
with national
progra&es and pracespecially
with the natiotices,
nal
malaria
control
programne .
Whole areas or specific
insect
breeding grounds, an3 perhaps the
refugees’ dwellings,
can be sprayed. Insects may already have and
can quickly
develop a resistance
10-7
services
Vectors which may pose significant
health risks
Risks
Flies
Eye infections
(particularly
among infants
and children) ; diarrhoeal diseases
rb3qui toes
filariasis,
Malaria,
encephalitis
Mites
Scabies, scrub typhus
Lice
Epidemic typhus, relapsing
Fleas
Plague (from infected
Ticks
Relapsing
Rats
Rat bite
fever,
fever,
dengue,
fever,
fever
rats),
spotted
yellow
endemic typhus
fever
leptospirosis,
salmonellosis
- Sanitation
and enviromnental
10.7 pees
/7
Refugee sites are often very
vulnerable
to fires.
An alarm
system is essential
at highrisk sites.
D
The most effective
preventive
measure is the proper spacing
and arrangement of all buildings . Other measures include
controlling
the use of fire,
protecting
cooking areas and
safe storage 07 fuel.
D
unlikely
to
be
Water
is
available
for major fire control on reEugee sites.
Forcible
creation
of additional
f irebreaks,
manually
or by
may be a better
bulldozer,
control measure.
Refugee sites are of ten over1.
crowded, use light and highly combust ible
shelter
materials,
and
individual
cooking
have
-Y
fires.
Thus they are very vulner able to major fires.
wasures
to
prevent an3 control fires must be
considered from the start of emergerr=y assistance at refugee sites.
2.
The most basic and effective
prewntive
measure is the proper
nd arrangement of all
SpaCl
blg2ga
to provide fire
breaks
Other
measures
.6.5.4).
include allowing
individual
fires
for cooking only, outdoors if possible.
Where cooking takes place
in wooden
indoors, atd especially
or wattle-and-daub
buildings,
the
cooking area should be protected
with asbestos sheeti%
if possible. ‘Where large scale cooking is
taking place indoors, for instance
in a supplementary feeding centre,
an asbestos ceiling
and walls or
their equivalent,
should be mandaretardants
can be
tory.
Fire
applied to thatch roofing in dwellings.
Proper precautions must be
taken with regard to the storage
and highly
and uses of fuels,
synthetic
materials
inflammable
avoided.
3.
in
All
the
fires
first
can be controlled
few minutes with
services
-
modest resources
providing
quick
action
is
taken.
Therefore
an
alarm system, fire fighting
teams
and beaters must be orenized
in
advance and plans prepared. Sand
buckets are effective
if sand is
available.
Water will
generally
not be available
in sufficient
quantity
and at adequate pressure
for the control
of major fires.
The creation of a new firebreak by
taking down one or more rows of
dwellings
may be necessary.
This
can be done manually or with a
bulldozer
if available.
Take great
care to ensure that dwellings are
may be left
at
e0rp.W: children
hare by parents fighting
the fire.
I&en fighting
a large fire with
scarce resources,
the first
priority is to contain it, rather than
put it out.
10.8
f7
Suitable
arrangements
for
disposal of the dead are required from the start of an
emerr mcy,
although
dead
bodies are generally
not a
health risk.
D
Action should be co-ordinated
with the national authorities.
D
Burial
is the simplest
and
best method where acceptable
and
physically
possible.
Arrangements should be made
to allow traditional
rituals.
.
D
Before burial
or cremation,
bodies must be identified
and
the identifications
recorded.
Suitable arrangements for the
1.
disposal of the dead are required
from the start of a refugee emergency. The mortality
rate after a
new refugee influx
may well be
higher than under “normal” condit ions. The authorities
should be
contacted
from
the
outset
to
ensure
coup1 iance with
national
procedures,
and for assistance as
necessary.
2.
Dead bodies present a negligible health risk unless the cause
of death was typhus or plague,
153
L
- Sanitation
and environmental
when they may be infested
with
infected
lice
or fleas.
Bodies
must be protected
from rodents,
animals and birds.
Burial
is the
simplest and best method of disposal if it is acceptable to the
conunmlty and physically
possible.
Health considerations
provide
no
justification
for cremation,
for
which sufficient
fuel may often
not be available.
whenever possible, the customary method of disposal should be used, and the traditional
practices
and
ritual
should be allawed. Material needs,
for example for shrouds,
should
be met. l%e necessary space for
burial will need to be taken into
Peacham R.
Cairncross S.
(1978)
services
-
account
at
the
site
par t icular ly
in
stage,
conditions.
3.
Before burial
or cremation,
bodies must be identified
and the
identification
and, ifd Ji?c?*
cause of death recorde .
Of particular
importance to disease control,
registration
and
tracing.
If
the whereabouts
of
relatives
are
known, the most
imnediate relation
should be notif ied;
steps must be taken
to
assure the care of minors who, as
the result
of a death, are left
without
an adult
to look after
them. (See ch.11.5)
!&all Excreta Disposal Systems
A clear presentation with simple diagrams
a& practical advice.
Rajagopalan S. Guide to Simple Sanitary Measures for the
Shiffman M.
Control of Enteric Diseases
(1974)
Covers water supply and all aspects of
sanitation
including food sanitation.
(Also in Arabic, French and Spanish)
Ross Bulletin
No.8
WHO
mergency Vector Control after Natural
Disaster (1982)
ZZGTorin=ioles
also relevant to
refugee &merge&es.
(Also in Spanish).
PAHOScientific
Publication
No.419
Oxfam
Ihe Oxfam Sanitation Unit
A guide to the unit.
(A July 1975 Oxfam
l’ecbnical Paper describes th;? design and
testing of the unit.)
Oxfam
UNDRO(1982)
Disaster Prevention and Mitigation:
Sanitation aspects
masters
but oarts also
relevant to refugee emerger&s .
(Also in French arxi Spanish)
Volume 8 in
Compendium of
Current Knowledge series
World Bank
Appropriate Technology for Water Supply
Sanitation
A 12 vola
series.
Volume 11: A Sanitation
Field Manual (1980) is particularly
relevant.
World Bank
WHO(1982)
Manual on Environmental Management for
Mosquito Control (with special Fm hasis on
Malaria Vectors).
(Also id
WHOoffset publication No.66
(1) See also the further references
of which are repeated here.
154
at the end of chapters
7 and 9, only some
List
Section
of contents
Paragraph
m
Contents
Overview
156
157
11.1
l- 6
Introduction
11.2
l- 8
Organization
11.3
l- 6
Personnel
159
11.4
l- 4
Tracim
160
11.5
2:3
$1;
13-17
18-19
20
21-26
27-30
158
and family reunion
Unaccompanied children
160
Introduction
Definition
Causes of separation
General rules
Identification
and registration
Tracing
Assessment of needs
Guidelines for care
Organization of care
161
161
162
162
163
163
164
1.64
165
Education
11.6
l- 2
El’l
Annex
of the general services
General
Aims and guidelines
Organization
165
166
166
Further reference
167
Unaccompanied children
registration
form
168
155
Need
The trauna of becaning a refugee can be very great.
Social and
psychological
problems are created or exacerbated and appropriate
measures for resolving these problems are essential.
To help meet the special
gees.
Principles
-/7
social
and psychological
needs of refu-
of response
Recognize the need for the refugees to be able to talk over
their own problems among themselves and in their own ianguage, and to fashion their own responses where possible.
a
Build on the ccurmmity’s owu. resources to the extent possible and err=ourage individual,
family and group self-reliance.
Mm
Provide decentralized
services within a co-ordinated
nity plan, ati ensure they reach those in need.
/7
Where special institutions
for tie socially,
physically
or
mentally disabled are necessary, they should be small and a
part of the ccmmunity-, drawing on ccmrnunal rather than outside services.
/7
services
are developed as essential
Ensure that social
canponents of the overall
assistance programne, and in a
co-ordinated approach to agreed standards.
caunu-
Action
156
/7
Assess the needs, paying particular
attent ion to identifying
those who may have particular
difficulty
meeting basic subsisteme needs, such as unaccompanied children
or the disabled.
D
Develop services
/7
Take imnediate action
/7
Organize an appropriate
to meet their
needs.
to reunite
education
families.
programne.
- Social services
ll.lJntsuhtion
Previous chapters have consi1.
dered the material needs of refugees in an emergency. ‘Ihe shock of
having to leave hane and the circumstances of life as a refugee,
particularly
in the early stages
of an emergerrcy, create major emotional
and social
problems and
exacerbate existing
problems. I’he
trauna
of the flight
and its
aftermath may leave the refugees
confused,
frightened,
lonely
and
insecure, faciw
an unknown future
in a strange or ewn hostile environrent.
Separation
from or loss
of other family members is cannon
in
refugee
emergencies,
and a
major cause of e50tional
stress.
Family reunion is a priority.
important
llle most
action
that can be taken to help reduce
the shock and stress for the community as a whole is to provide
security and a sense of stability
as quickly
as possible.
In part
this can be done materially,
and
in part by ensuris
protection
anl
in\lolving
the refugees fraa ttix2
beginning
in the organization
of
all aspects of their new lives,
and in par titular
in the search
for durable solutions.
Social work
is in the broadest sense the vital
bridge between the refugee and the
goods and services of the new settlement . Without help in adjustiq
to this new environnent
the
sense of loss and isolation
can
deepen even in circunstances
of
relative material well-being.
2.
3. In every emergency there will
be refugess with family or individual
social
and psychological
needs of a nature
that require
part icular
attention.
Examples
are : the disabled
(the mentally
blind,
paraplegic,
;;~;ey~pe4
deaf,
lepers
etc.) ;
unacca&nied
children ;
single
parent
single
families ;
women; the sick and elderlyYo~~
the victims of such special problems as rape, drug abuse, physical
abuse or family
conflicts.
For
convenience,
“social”
is used in
this chapter to e&race all such
needs.
and education
-
4.
In stable non-emergency situations,
the canrunity
itself
usually develops methods for meeting
at least some of these needs. However,
the social
disruption
of
refugee
emergencies
not
OnlY
aggravates many problems but can
also result in these special needs
being overlooked unless appropriate measures are taken. The vulnerable
are even less able to
“Cope” in a new and strange envirorment . The services
to meet
these needs will
require personal
attention
to individual
or family
problems.
This
is
best
given
through
a ccumunity-based
social
w$fare
programne. Tbe provision
the social
welfare
services
that may be required
by special
such
as
unaccanpanied
groups,
children
and the severely disabled, usually
requires
the establishnent
of specific
units within
the settlement.
5. ‘Ihe iumediate objective of a
social welfare service in an emershould
be the
gency situation
ident if ication
of and assistance
to those persons whose basic needs
for
food,
water,
shelter
and
health care are not being adequately
met.
Particular
at tent ion
should be given to persons who may
be vulnerable
if they lack family
support:
children,
disabled
and
elderly
persons, and wanen. Other
groups within
the general refugee
population
may also
experience
problems in meeting their
basic
needs due to their
status as a
religious
or
ethnic
minority,
inequities
in distribution
systems
or other factors,
6. A social
welfare
service
should mobilize appropriate
cam~unity resources,
with outside help
as necessary, to screen rhe refugee population
for those facing
urgent problems ; see these needs
are met and ensure the general
welfare
of all
refugees.
Having
established
such a foundation,
a
social welfare service can proceed
to deal with such special needs as
rehabilitation
of the disabled,
establishing
self -reliance
and
training
programnes, and developing carrnunity activities.
157
- Social services
/7
Plan the social welfare
vices witb the refugees.
ser-
-n
Individual
individual
need
/7
be
Special
measures
for
per sonFy with
required
similar needs.
LT
Assess the needs by screening
the whole c-unity;
the most
vulnerable
rarely
cone forward themselves.
n
Take
account
of
national
policies arrl resources.
-
17
Develop
service.
17
Co-ordinate
with
closely
camrmi ty
other
services,
particularly
health care.
problems will
attent ion.
a
connuni ty-based
1.
The
organization
of
the
necessary social welfare
services
must be considered
as early
as
possible
in a refugee emergency
arxi the refugees themselves must
be involved in developing the services. A co-ordinated
approach by
all
organizations
concerned
is
essential,
with
clear
policy
guidelines and agreed standards,
2.
Experience segests
that even
in an emergency many social welfare needs can best be met by
that exist
within
the
resources
community. A social welfare
programne should thus be designed to
mobilize
these resources
throcbh
the establistnmnt
of cairnunitybased services.
Every cannunity
hEIS its
own beliefs,
social
values,
custans,
traditions
and
prefererres
for
how
problems
should be resolved. A social welfare programne should seek to enhance and improve existing
“coping
mechanisms”. These may be based on
the commmity’s
secular or religious
leaders
or elders
or on
other
arrangements,
for
example
through traditional
medicine practitioners
or midwives.
158
and education
-
3.
The first
priority
will be a
careful
initial
assessment
to
determine the most pressing social
problems ; to be effective,
this
should cover the whole comnunity .
In many cases the refugees themselves can identify
those in need,
but special surveys may be required to identify
persons with serious social
welfare needs, because
typically
they are least likely
to
seek assistance
and may otherwise
be overlooked. There is a need for
a social welfare progranrne to deal
with individual/family
problems in
most emergent ies . The need for
additional
special
progranmes ,
such as for family reunification
unacccxnpsnied children,
will
gpencl on the circumstances.
Tracing and family
reunion will
be
important programnes in many refuThe programne
gee emergencies.
developed
to meet the assessed
needs should take account of policies and resources in the country
of asylum.
4.
‘Ihe basic case work - identification
of individual
or family
problems,
assessment
of
needs,
developnent of solutions
or refer ral - will necessarily
take place
at the individual,
family or small
group level.
Social welfare prograrmEs therefore
generally
require
a decentralized
structure,
allowing cannunity workers to work
regularly
among the same refugees,
getting
to know and be known by
them.
5.
The general c-unity
activities,
for example cultural
events
and retreat ion, will
be, important
to the creation of a greater sense
of normality and security , and the
reduction of stress, as well as in
fostering
the refugees’
sense of
carmuni ty .
6.
Regular
home visiting
is
necessary both for identifying
the
persons or groups with
special
needs and for
monitoring
the
effectiveness
of the response to
these needs. Those with social and
psychological
problems
will
be
even more reluctant
to cone for ward and volunteer
for assistance
- Social services
when they find themselves confused
by their new environnent
Up-to-date
records and confi7.
dential
individual
dossiers should
and a simple periodic
b kept,
rc .-Yrting systen instituted,
focusirg on the needs ident if ied and
services provided rather than giving just statistical
data. It is
important
that case records are
with
when
refugees
transferred
they are moved. Unnecessary repetition
of basic interviewing
is
not only a waste of time but it
can also be psychologically
damaging.
required
8.
Co-ordination
*
between the social wzfare
services and other ccnumnity-based serhealth
care.
vices,
particularly
Rome visiting
services should be
closely
co-ordinated:
health wor ker s can of ten identify
social
problems and vice-versa.
Regular
social
welfare clinics
at health
may be a
or carmuni ty centres
useful canplement to home visitIn general, an active social
iq.
welfare
service
is likely
to he
the major referral
unit,
helping
to direct
people with needs to
available
resources and identifying areas of need to which other
services may be directed.
11.3 l&p$$gg
0%
themselves
refugees
should play the central role.
/7
Appropriate
outside
assistance will be required to cofor
the services,
ordinate
problems
training
and for
beyond the resources of the
refugees .
/7
Continuity
of
very important .
-
personnel
is
The refugees must be able to
1.
talk over their problems in their
own language
auDng themselves.
refugees
themselves
Ttws
the
should play the central
role.
In
traditional
cultures
the
k?ers
are especially
skiiled
at
resolving
psychological
problems.
and education
-
Outside assistance
will
be required for
the problems that
are
beyond the resources of the refugee6 . This outside
assistance
is
likely
to compromise both local
nationals
whose cultural
knowledge
and understanding
of the refugees
will
be important and international personnel whose role may be
limited
principally
to
overal 1
co-ordination,
training
support,
and liaison
with the authorities
and other organizations
concerned.
2.
Qnxmunity workers
who have
the necessary training
should be
the backbone of the services. They
would be responsible
for assisting
groups
and
individuals
through
outreach work within a given section of the ccoxnunity. The number
such workers
of
required
will
depend greatly
on the comnunity’s
mechanisms. As an
OWtl response
indication,
in sane situations
one
per 2,000 to 3,000 refugees has
been found appropriate.
In addition,
workers
social
are also
likely
to be needed in the health
centres,
as there is a tendency
for people with special needs to
be directed to these even when the
problem may not be medical.
Training of refugee ccemunity
3.
workers is a priority
task and
should draw both on the knowledge
of
the
conrnunity
and outside
from within
the host
expertise,
if
possible,
in social
country
ccxnruni ty development and
wmkr
public health.
with
social
4.
Familiarity
values and customs is essential,
and language barriers
can also
severely-limit
what outsiders
can
achieve in individual
case work.
Sympathy with and understanding of
the kinds of problems faced, and d
knowledge of local preferences for
the ir
are essential.
resolution,
Guidelines
should be provided on
the role of outside personnel. The
of professional
imparimportance
tial
conduct cannot be overstresrefused. Favours to individual
obtaining
resettlement
gees
in
places, for example, can be very
disruptive .
159
- Social services
1.
personnel
that may be
5.
required
for
tracing,
care
of
unaccanpanied children
and education are considered separately.
6.
Continuity
of personnel, whether from among the refugees or
important
outside,
is especially
for effective
social welfare serr
vices because of the fundamental
rt piayed in these services by
uman contact ard trust.
Tracirp: d
,‘7
Tracis
aaJ reunion bf separated family members must be
organized as quickly as possible.
/7
The International
Coumittee
of the Red Cross (I(X)
has a
special expertise.
D
fanilv
reunion
Il.4
Ree~ge~i~&i~
able to send
.
1.
The overriding
concern
of
their
refugees
separated
from
families
and friends will
be for
exchange of news and for reunion
as quickly
as possible.
In exercisirg
the mandate given to it by
ths
international
couxnunity
in
times of armed conflicts , the I(xC
has acquired a special experience
in the field of tracing. Hence its
arrl advice
expertise
should be
sought at once, either from their
field
delegation
or via UN-ICR
Headquarters
from their
Central
Tracing Agency in Geneva.
2.
.
‘Ihe possibilities
for ensurcarmunication
between those
arkd for
tracing
and
Z&rated.
reunion,
will
vary greatly
with
each emergemy. Individual
tracing
may take a lorg time and will only
really
be possible once the emergency is stabilized
and the refugees
registered;
it
are
involve
tL
country
of 0rigEy
However, imnediate action is often
possible,
for example to reunite
q erbers of an extended family or
village
who fled
at different
times or by different
means, ard
are thus in different
locations
in
the country of asylum.
160
and education
-
3.
Procedures for the reunion of
refugees
separated
within
the
country of asylun should be agreed
with the authorities
and implemented as soon as practicable.
For
example, lists
of names with photographs, posted on the carmunity
notice
boards
in the different
locations,
may provide a simple
and ef feet ive tracing
mechanism.
The tracing
arrangements must be
widely promulgated; a central contact point in each site is likely
to be needed. Tracing is a delicate task, and has to be organized
by people who have the necessary
exp2r ience
and skills.
It
of
course requires the involvement of
the refugees themselves, who will
play a key role in any tracing
service.
4.
Refugees have the right
to
send and receive mail. A properly
organized
exchange of news may
considerably
diminish
the workload of a tracing service and also
accelerate
the reunion of families. Refugee mail services may be
organized with the assistance
of
Neck. Close liaison
is required
with the national
postal authorities.
UNHCR should provide stamps
where necessary and appropriate:
a
franking machine in each location
may be a practical
solution.
If
normal
postal
services
do not
exist,
the ICRC may organize the
exchange of special Red Cross messages.
11.5
/7
Identify
unaccompanied children ard initiate
tracing
as
soon as possible.
-/7
Ensure that the children
are
cared for in ways that meet
both their physical and emot ional needs ; individual
care
is all important.
/7
Take no action that
vent family reunion.
may pre-
__-____-
-__
- Social services
/7
Where child czcz; c;Eznt;; aE
necessary,
decentralized
within
small,
the ccumunity, and integrated
into casnunity activities.
LT
Ensure respect of the principles herein by all involved.
Introduction
be separated
Ghi ldren
1.
from their
aiate
next-of-kin
during a refugee emergency. Those
who are, are of ten cared for by
the refugee cannunity,
frequently
within
an extended family.
Where
this cannot happen, special measures will be required to care for
such children.
In scme circumstances there may be considerable
outside
pressures
for
Wiate
third
country
adcqtion
and for
are
very
resettlement.
There
strong reasons for resisting
this
until
the possibilities
for family
reunion
or local
solutions
have
been exhausted.
humanitarian
2.
International
law has as a fundamental objective
the unity
of the family,
and
therefore
places particular
emphasis on the maintenance of family
ties and on family reunion.
The
welfare of children
overrides
all
other considerations.
Great importance is attached to keeping children who have been separated from
their
families
within
their
own
cultural environment .
Every child’s
emotional deve3.
lopnent and future well-being
is
dependent on the bond between the
child and the Mividual
who cares
for the child
(who is usually a
but may be someone else
pa-t,
This emoacti%
as a parent).
the
source of the
tional
bond
tender, .loving care that
is as
important as physical care and the
meeting of material needs, is parcritical
for
younger
t icular ly
children.
‘Ihe bond has been brc’zen
for unaccompanied refugee child1 .
as defined below, and a great rcspossibility
rests
on those who
organize the care “or such children: to ensure that each is place-’
and education
-
in the care of a substitute
parent
to whcm the child
can become
affectionately
attached.
Every
effort
must be made to keep the
child
with
the same substitute
parent until
the blood parents are
found. The child
will
then need
time to re-attach
to his or her
blood parent (6) . How lcrg
this
will
take depends on the child’s
age and the strength of attachnent
to the substitute
parent(s)
which
now has to be broken. Where years
have elapsed,
it has been found
that
the child’s
interests
may
even be better served by remaining
with the substitute
family.
Definition
child
is
4.
An unaccaxpanied
defined as a child under fifteen
years of age who has been separated from both parents
and for
whose care no person can be found
who by law or custan has primary
responsiblility.
This
sect ion
addresses the needs of children so
defined. Special measures may also
be necessary for those of fifteen
should be
and over ; assistance
given in a flexible
way. For instance if there are unaccompanied
young
wanen of over 15 they may
well require
special measures in
order to ensure their welfare.
It
is the usual UNMX practice
to
allow unaccanpanied children
over
15 to take decisions
concerning
durable solutions
for themselves ;
however, the legal age of majority
is determined by the laws of the
country of asylum.
“unaccaq2a‘Ihe description
5.
nied children”
should always be
used in place of “orphans”.
The
narents cannot be considered dead
merely because the child is not in
Even an
the ir
care.
imtediate
that the
assertion
by the child
parents are dead must be treated
with
caution,
as exper ieme has
shown such assertions
to be unreliable,
for a variety of psychological ard social reasons. Further the determining
factor
is
3ore,
not the death of the parents but
the separation
from them
rather
ard the absence of any person who
161
- Social services
by law or custom could take primary responsibility
for the child.
Causes of separation
A comprehensive assessment of
6.
the causes of separation is important because the varied ways in
can be separated
which children
from their
families
may significantly
affect
tracing
programnes
and planning
for long-term
soluCorrmon causes of separations.
other
than the death of
tion,
parents, include:
(1)
Accidental
separation,
particularly
during large populaor
tion
m0vements, fighting
refugee
movements
organized
when families becane split up;
(2)
Older children
leaving
ents/family out of choice;
(3)
When the facilities
and services provided for unacccmpachildren
are signif inied
those
than
better
cant ly
otherwise
available,
parents/
place
family
may actually
children in such special care;
I
par-
(4)
before or during
Similarly,
the flight
families may place
their children in the care of
others if they believe
this
will
irpzrease the chances of
the children’s
survival;
(5)
for example ambuOutsiders,
workers
lance drivers , relief
may remove a
or volunteers,
child from an apparently dangerous situation
without
infamily
or
forming
parents,
the comnunity. This is particularly
cannon if the child
clearly needs medical care;
(63
Inadequate or inaccurate
hospital
records and tagging in
an anergency .
Thus it can never be assumed
7.
that an apparently
unaccompanied
child
has been abarrioned or is
guardian
or
parents,
without
family until
a sustained and concentrated
effort
to locate
them
has been made.
162
and education
-
8.
Nor should a narrow limiting
definition
of the family be adopted in a cultural
context where,
despite the absence of the biood
parents, a child remains an integrated part of an extended family.
Otherwise an unaccompanied minors
prograrsne may even contribute
to
creating
rather
than solving
the
problem of unaccompanied minors.
General rules
9.
Care must be provided
for
unaccanpanied
children
through
measures that meet their physical
and emotional needs in a way that
iS
culturally
appropriate.
A
clearly
ident if ied
responsible
authority
appointed by the government or UNHCRmust take responsibility
for
the
chi ldren . But
although UNHCRmay not have operational
responsibility,
its international
protection
responsibilities
for
these children
remain
clear : hence the obligation
to
that
ensure
these
rules
are
enf arced.
10. As long as there
is any
chance that enquiries may lead to
the reunion of a family, no change
in the situation
of unaccompanied
children
which might prevent this
should be contemplated.
In particular there must be no adoption or
change of name. There must be no
transfer to a third country or any
other removal unless such movement
is vital for the health and safety
of children
generally,
and therefore
not organized
specifically
for unaccompanied children.
11. Every effort
must be made to
find an appropriate
durable solution as soon as possible.
In most
cases this has proved to be family
reunion as a result of successful
tracing.
12. Where children
do have to be
moved, full records allowing tracing of the child’s
location at all
times are essential.
Any agreement
must include
to move children
from all
the parties
assurances
involved
(governments
of as;::
agencies)
and resettlanent
- Social services
will
be expedited
family remion
ismediately
the missing
members
Where this
reunion
are located.
should take place will
depend on
the c ircunstances .
Identification
and registration
children
must
13. Unaccaapanied
be identified
as soon as possible.
The first
source of information
is
thenselves
and the
the refugees
ccmmmity leaders. A general registration
or census of the refugees
a suitable
occasion
may provide
identification.
A
initial
for
census
registration
or
general
will
also identify
those children
not alone but not with their iumewho thus require
diate
family,
an important
consideratracing,
tion which sbuld
not be overini tiai
selective
looked.
A
registration
may give the impression that children
so identified
status
and
special
will
have
advantses , which may lead parents
or relatives
temporarily
to abandon their children.
14. Nevertheless time lost before
interviewing
the children
is also
lost;
particularly
information
the
circLlmstances
of
a
about
family separation
which has taken
As soon as idenplace recently.
children
unaccompanied
tified,
should
be specially
registered.
required
will
information
depend on the circumstances:
the
annex gives a model registration
form, developed by ICRC, as an
indication.
The children should be
and the photograph
photographed,
should include,
for example on a
chi Id’ s
small
blackboard,
the
name, referecze
number and location.
Use a film
that
allows
subsequent copies to be made.
15. Individual
dossiers
must be
dewloped and maintained for each
relevant
all
child,
recordirg
information
including
arrangements
for care and tracirl&.
16. A sympathetic and imaginative
approach to interviewing
the children is very important.
Inter views
are best corducted
by carefully
and education
-
trained
refugees,
if possible
by
someone the child
already
knows
and trusts.
If an interview has to
take place through an interpreter,
the interpreter
must be well brie-.
fed, with his or her role limited
to direct
translation,
and mus.t
not be allowed to break personal
contact
between interviewer
and
child.
17. Children may react very differently
when asked to give information on themselves and their
families,
depending,
for example,
on the degree of their
trauma,
fear and shyness. Often a child
will confide in other children.
In
sane cases the presence of the
child’s
friend(s)
at the interview
can not only reassure the child
but also yield important information.
Any accompanying adults
or
persons who brought the child for ward should also be interviewed.
Consideration
should be given to
tape recording interviews
in order
that answers may be transcribed
or
checked later.
Tracing
unacccmpanied
18. As
soon
as
children
are identified,
efforts
must start to trace their parents
or families,
and ensure
family
reunion. Tracing for unaccompanied
children
requires
special
skills
ard
techniques.
As in general
tracing,
the expertise
of ICRC
will
be very useful.
Photographs
of the children
are generally
the
key to a successful
tracing
prograume . Che of the simplest
and
most effective
methods has proved
to be posting
the photographs,
which contain the reference nu.&er
bulletin
and name, on special
boards,
for example in c-unity
centres,
for public
view. Other
methods may include putting
names
and/or photographs in newspapers.
including
Also, the data sheets,
can be reproduced,
photographs,
bounj into volumes and circulated
among the tef ugees . Certain
1M;os
have acquired cons idera ble exper i such proence in implementing
grams.
163
- Social services
19. When the parents or family of
a child appear to have been traced
anJ a child is claimed, an adequate verification
will
be required, perhaps involving
a followLQ. careful
record of the verification, as of the movements of all
unaccompanied children,
is essential.
_Assesh
of needs
20. The needs of the children
will
vary greatly with their
age
and individual
circlanstances
an3
must be assessed individually.
,411
unaccompanied children
should be
medical Ly
screened
periodi~ca~
and those
with
special
and problems identified.
Reguiar
asses-t&
of the needs of unaccompanied children
and evaluation
of how they are’ being. met is
required
to ensure that adequate
care is provided.
aidelines m--for care
21. Che of the most important
in the Care of any
principles
child
is that relationships
must
be stable.
Unaccompanied children
will dewlop very close bonds with
other children
and adults.
Ikvelopnent
and maintenance
of
a
strong bond with the guardian of
the child, whether in foster ~CXREW
or in child care centres , is of
crucial.
importance.
cant ilhus,
nuity of the arrangements and personnel involved
in the care is
outside
fundamental.
Even for
involveaKnt ,
orgnizational
six
months should be considered
the
minimum. For those in intimate
contact with the children a longer
minimum stay
is
necessary.
As
national
staff
are usually available for lunger periods,
this is
another reason for using national
rather than international
staff at
the casework level.
22. The care
of
unaccompan: ,:d
children
should be under taken, as
far as possible, by persons of the
same cultural
britage
and social
background as the children.
Every
effort
should be made to place
children
under five in an approp164
and education
-
riate
and caring
foster
family
within
the community;
this
is
essential
for
children
under
three.
Arrangements
for
older
children should be made on a caseby-case basis,
seeking the solution that provides most stability.
In general, foster care is preferable to residential
care. Proper
material
support must be given to
the foster
family. However foster
care must be closely monitored and
relationships
must be documented
by a siged undertaking to release
the child
should family reunion
become possible.
Careful
account
should be taken of cultural
attitudes towards fostering.
For instance,
in
some s i tuat ions
the
family may find it hard to conceive of taking in a child except
as a servant.
23. The advantage of small residential
centres is over the short
term: if reunification
with
the
parents is expected to take place
such centres provide an
quickly,
efficient
way of caring for the
children
while at the same time
not losing
sight of them during
the upheaval and confusion at the
start of an emergency. However, as
tracing
usually
takes some time,
residential
centres
ara, in most
cultural
contexts,
a ‘yrgm “w;
intermediate
solution
children’s
point of view than fostering.
24. Uhere
special
resident in1
centres are required,
91~11 units
of five to eight children are prewith
the
ferable,
numbers of
determined
in light
houseparents
of the ages and particular
needs
of
the
children.
The centres
should be decentralized
and integrated in the local couxnunity but
care fully
supervised.
must
be
barge centres sho1:l.d be avoided.
Apart
from the likelihood
that
individual
attention
will
auf fer
experience has
in large centres,
shown that there fs a tendency to
services
in such
provide special
centres. As these services are not
available
to other children,
this
can actually
attract
children
who
are not unaccompanied.
- Social services
should live
toge25. Sibliws
certain
circumstances
ther.
In
may have
unacccmpanied children
z
;a.;xcj,~~th~
as a group
emotional
bonds
within the group. It may be in the
interests
of the children
to preserve such groupings, or relationships within them, where possible,
while at the same time establishing a substitute
parent relationship.
26. Material
needs should be met
to the leR1 and, to the extent
possible,
in the manner available
to other refugee children.
Thus,
every effort
sbuld
be made to
integrate
the children
into
the
life of the community. They should
go to
comnuni ty , not
special,
schools ) be treated at cannunity
health
centres,
and play
with
other children
on cusnon recreational
areas.
It
is better
to
avoid special
clothes or distinguishing tags which set them apart.
Organization
and education
29. Where outside
assistance
is
required,
the criterion
must be
caapetence to manage the specialized services needed. Any organization involved by UNHCRin the care
of unaccompanied children must be
in agreement with the principles
set out herein, and not have conflicting
objectives,
such as adoption,
resettlement
or religious
conver s ion.
30. Programnes for
the care of
unaccompanied
children
must be
carefully
co-ordinated
with
all
involved to ensure c-n
aims and
standards.
11.6 B
p7
Every child
has a right
to
education.
Even in an emerSXY I start providing appropriate
education
as soon as
possible.
/7
The priority
is to make prischooling
available
to
-Y
all.
/7
Special account must be taken
of the fact that the children
are probably
already
educat ionally deprived.
D
The educational
system should
be organized and run by the
refugees to the extent possible, with proper outside support.
of care
27. Where there are considerable
numbers of unaccompanied children,
the establistment
by the UNHCR
office
of a special unit for the
care of unaccompanied children
is
recommended. The assistarre
of the
national
author i ty ,
appropriate
UNICEF, and qualified
NGos should
be soeht.
The advice of a person
with provon experieme in the care
of such children
in similar
emergenies
is likely
to be valuable
in assessment and program
formulation.
If suitable
expertise
is
not available
locally
it should be
requested from Headquarters.
28. The best child care workers
are likely
to ‘be respected adults
within
the refugee community, for
example older parents with child
rearing
experience.
Child
care
workers must be properly
supervi sed , and supper ted with training
Unaccompanied
programnes .
YQUn%
wOlIlen who may themselves be par ticularly
vulnerable
can be recruited as assistant
child care workers, thus giving them useful work
as well as some measure of security.
-
1.
Every child has a right
to
education.
Schools for the refugees are thus essential.
Setting
up an education
prograurne will
make a significant
contribution
to
the well-being
of the whole carmunity,
and this
should only be
delayed if the characteristics
of
the emergency are such that it is
clearly
going to be short-lived.
Althoeh
priorities
in the emergency phase may mean that the full
elaboration
and implementation
of
an education prograxne is not passible,
a start must be made. Even
with
educational
supinadequate
pl ies , establishing
the discipline
of schooling through regular classes and organized activities
for
165
- Social services
the children
is important.
Simply
together
the
children
gathering
for a set period
each day and
keeping them occupied is a valuable first step.
Ihe tine
before
a durable
2.
possible
and the
solution
is
likely
nature of such a solution
are the key factors
influencing
the type and content of an education
prograrmie . Adult and vocational
education
facilities
and
prograrrmes
cannunity
developnent
will
be important
matters
for
priorities
ome
consideration
allow
and the longer-term
prospects for the refugees are clearer.
Aim and guidelines
Ihe first
aim of the educa3.
tion programne should be to profree but
education,
vide
basic
complsory ) to all refugee children. The level of the programne
will
depend on the educational
background of the refugees and on
the national
education
services.
As a general indication,
it should
of education
re flee t the level
in the host country,
available
with
the minimum objective
being
literacy
in the first
language of
the refugees and simple numeracy.
It is probable that refugee
4.
children will have had both their
formal education and the informal
family-based
learning
process disrupted.
‘Ihe desigfl of the prograome must take account of this,
must cater in
in particular,
a&
a consistent
way for the needs of
educationally
children
already
deprived, regardless of age.
primary
unified
A single,
5.
school system should be developed,
equally
serving the needs of all
the refugee children
without discrimination
between children
or
should be given
schools. Priority
to this over the establishnent
of
second-level
progranmes. The laninstruction
and text
guage of
books should be the first
language
of the refugees.
166
and education
-
6.
Rapid
regeneration
of
the
informal learning processes of the
home will
be equally
important.
This should start
to take place
automatically
as the
emergent y
situation
beccxnes stabilized
and
general
family
life
returns
to
normal.
Because of the disrupt ions, the involvement of parents
in their children’s
education,
for
example
through
parent-teacher
contacts,
will
be particularly
helpful.
7.
Snaller ,
decentralized
schools are generally
preferable
to
large schools.
The school buildings themselves should be of equal
keeping
standard
and in
with
others in the cormunity and with
local
practice.
Local materials
and construction
styles
are usually the most appropriate.
Organization
8.
‘Ihe organization
should take
account of the education
systems
in both the country of origin and
asylum. Specialized
advice on the
establishnent
of appropriate
eduprogrammer: should
be
cational
available
locally
and may also be
sought
from UNESCO, the World
aid
bilateral
programne
Bank,
organizers
and qualified
NGOS. An
education
director
may be useful
to develop and supervise the overall prograame.
Ihe
provision
of education
9.
may give the refugees a privilege
not enjoyed by the local population. In such situations
it is, if
the government is in agreement and
there is a c-n
language of insappropriate
to
usually
truction,
to the local
open the schools
propopulation.
The education
grsmne should from the start
aim
at a realistic
level of service
which it will be possible to sustain when international
support is
wi thdrawn .
10. To the extent possible,
the
educational
service at the CCFITINJnity level should be organized and
administered
by the refugees themas
selves, through such structures
- Social Services and Education
committees.
The most
education
appropriate
teachers are likely
to
be refugees with teaching experience. Refugee teachers may need to
receive some remuneration
if the
programne is to be sustained
in
term.
However,
the
the
larger
remuneration must be structured
in
such a way that it can later be
without
international
continued
funding.
will
be
11. Outside
support
required
for the development of
coiuaon curricula,
to ensure equality of standards between schools
UMCX
(expected 1983)
-
within
a comnunity,
and between
different
sites
if
applicable.
Help will also be needed from outside in the provision of education
materials.
As it is likely
that
more teachers will
be needed than
are available
and suitably
qualified within the coatnunity, special
teacher training
programnes should
be developed.
National
education
institutions,
such
as
teacher
training
colleges,
may be a valuable source of expertise
and may
be able to provide both teacher
training
and teachers
for
the
refugee progranme .
UN-ICRHandbook for Social Services
aidelines
for the orovision of social
services to refugee; in both rural and
urban situations,
witti a strong emphasis
on ensur it-g that the basic needs of the
vulnerable are met. Contains list of key
references.
(French and Spanish editions will follow)
167
- Social services
Fkxlel Rma for Redstration
and education
-
Annex
of Died
Children
1.
Each form shall bear, whenever possible
risk of harm to the child, the information
and whenever it
listed below.
2.
Information
may be added as required
by the situation.
3.
standard
As with any registration,
record replies w&never possible.
code indicators
should
involves
no
be used to
Reference no.
.............
ph0t0
1.
2.
3.
4.
6.
7.
8.
10.
12.
13.
14.
16.
17.
168
Bate and place of Registration:
Present Location of the Child:
..........................
...........................
Family name .......................
First name ad/or other given names ...................................
Alias or informal name used by family or others .......................
5. Bate of birth ...................
sex .........
Place of birth (village/city,
provirr=e, country) ......................
....................
Nationality
9. Native lawuage .................
Ethnic origin ..................
11. Other language spoken ...........
Religion .......................
Rome address ..........................................................
...........................
Any distinguishing
physical characteristics
15. Blood group .................
State of health ................
no ....
don’t know ....
yes ....
?Ibther 1 iving?
date of last contact
last known address
Name/maiden name
Father living?
yes .**a
don’t
no a=*i
last known address
know ,*..
date of last contact
- Social services
18.
and education
-
Other relatives
name
last known
address
date of
-iimr
date of last
contact
Grand father
Grandmother
Sister
Brother
Aunt
Uncle
Cbusin
Guardian/
codrmther
Guardian/
Godfather
Other (specify)
19.
Date and place of arrival.
20.
Date of arrival
21.
Date and location
Description
22.
_...._ _A
in counrry of asylum
in present location
of last contact with parents/family
of how they became separated.
Remarks (including
family) .
names of adults
at present
location
who know child/
Date canpleted
Hame of interviewer
169
List
Section*
of contents
Contents
Paragraph
12.1
l- 4
Introduction
172
12.2
l- 6
Needs assessment and planning
172
Allocation of responsibilities
-.-perecmnel mnagement
12.3
;:
;
9-12
173
174
174
Genmal
Personnel
Fersonnel. management
.Qrganization
12.4
and
and co-ordination
-175
176
176
General
NX co-ordination
Within UNHCZ
12.5
l- 9
Management at the site
Registration
12.6
level.
177
and distribution
178
179
180
Registration
Numbers
Distribution
12.7
l- 3
ReportAm,
mniiwriw
12.8
l- 8
Special cons
I- ic’ ,.erat ions
and evaluation
181
181
(administrat iv: expenditure, purchase
of band, pqment of refugees, assistance to ?om? population, corruption,
politica.! an2 eeiigious activities)
Further
Annex 1
Annex 2
re,‘ermces-
NGOco-ordination
Standard s f trep
184
185
188
t 12.1
‘Ihis
chapter
discusses
the
1.
in a
managenent of assistance
refugee emergency within the country of asylum: that is, the mecharequired
organization
nisms a&
to
combine the many different
per sons an3 priori ties
actions,
into a coherent overall
approach
that meets the refugees ’ needs.
requires
managent
Successful
leadership;
subject to the role of
the government , leadership may be
the most important single contribution of UN-ICK. Leadership requidecisions
are
that
once
res
implereached, they are properly
mented. ‘Ihis discipline
is essential in emergencies, when there is
often not time to explain the coninmlved.
As far as
siderations
possible,
those directly
concerned
to
de& ions
should
contribute
that af feet them, but fina;
responsibility
rests with the Reprasentative.
2.
Ihe nature of a refugee emergerry makes its management a cuuplex ard frequently
difficult
exercise in which practical
and political
problems must be resolved
quickly and effectively.
Much will
depend on the role of the government and the implementing arrangements. Management of a refugee
to have two
emergency is likely
and
levels : that of the capital
that of the location
of the refuwhich will
g-s , the site level,
involve the provincial
or district
authorities
of
the governnent ’ s
administration.
While the prirrciples segested
here are likely
to
be generally valid, action must be
adapted to the imperatives of the
situation.
3.
The initial
stages
in the
management process ccmpr ise : the
needs assessment, which determines
what must be done; the planning,
which determines priorities
within
a fraukzworV for action;
the allofor
cation
ef
respnCbilities
erziuring
the means for
action;
including
co-ordinating
action,
mechanisms, personnel and material.
172
4.
E’rom the start,
the management of a refugee emergency must
include
cant inuous
monitor ing ,
reporting
and evaluation
in order
to ensure that plans are adjusted
and that the action remains appropriate as circumstances change.
12.2
n
A canprehensive
plan of action
is essential,
drawn up
with the people who will implement it and taking account
of the views of the refugees.
1.. Assessment has been discussed
in chapter 3; it is the prerequi.site
to any response.
To the
extent
the assessment
possible,
must involve those who are to be
responsible
for the response, incthe refugees.
Needs can
only be assessed against a knowledge of what is required.
‘lhe
determination
of the standards to
which assistance
should be deliof fundamenvered is, therefore,
tal
importance.
his
must take
and culfull
account of social
tural factors,
including
the background of the refugees and the
conditions
of nationals
in the
country
of asylum; the response
must be appropriate.
JZxperienca
set
suggests
that
failure
to
the
appropriate
from
standards
start is a cani0n cause of management problems in emergencies.
Plans of action
2.
Response to the needs must be
planned. The best management tool
for
this
is a simple plan of
action
administrative
for
each
level.
At the start
of an emergerry there is a tendency to postpone plannieg , both because inforavailable
and
mation
is
not
because there are obvious urgent
needs which can be met piecemeal
This
without
a plan.
tendency
the more crishould be resisted:
tical
the situation,
the more
impartant it is for the Represenind the time to take
tative
to
~33:;
zet6ETp ol: priititA;ieds
ag
P
Pl
he
- done, when, by whom and how.
--
- Field
level management -
indication
of
further
3.
A
points that might be considered in
drawing up the overall
field plan
of action is given in Part 2. The
overall plan should include a plan
for each refugee site, drawn up by
overall
with
organization
the
operational
responsibility
at the
site level.
The plans at the two
letpr?ls are interdependent.
lhe most effective
plans of
4.
action are those developed by or
with the peopl who will implement
them.
bea
team effort
to the extent
direction
must,
pss ible ; clear
however, cane from the government
and/or UNKR. The plans must be
comprehensive, covering all needs
whether these are being or will be
met thro**h
UNIX or by other
sources
of
organizations
and
funds. Not only will
such a plan
clarify
issues of management and
it will
also proresponsibility;
vide a head-start
for the programming exercise.
In drawing up the plan, take
5.
accoL
most
gees. ‘Ihey .are the single
meeting
resource
in
important
their
own needs, and will
have
definite
ideas on how this may
best
be done.
‘Jhe plan
must
refugees ’
own
strengthen
the
resources and self-sufficiency
and
avoid creating
dependency thrash
ti7;J well-intentioned
provision
of
out.side assistance
that is either
in l:ppropriate
or uknnecessary . The
rLan should also reflect
the aim
of a durs.ble soiut ion.
The plans of action must he
6.
available to all who need them.
must
be
and under-
1’9
Responsibilities
clearly
defined
stood.
7
The personnel
necessary
to
implement the plan of action
must be mad.e available ; local
staff
will
be particularly
useful.
-l-7
Ihe quality
of personnel management and leadership
will
directly
affect
the success
of the emergency operation.
1.
The roles and tasks of all
inwlved
must be clearly
stated.
Delay in the definition
of responsibility
usually
leads
to each
party defining
goals independently
and setting
their
own limits
of
responsibility.
This in turn can
lead quickly
to confusion,
gaps
and duplication.
Responsibilities
should be defined for each administrative
level, and for both organizations
and individuals.
With
respons ibili ty , which
should
be
delegated
to the lowest possible
the
necessary
level,
must
Res&sibility
without
authority.
authority is useless.
2.
Implementing arrangements and
personnel needs have been discussed in chapter 4. Organizational
for
UNHCR’S
responsibilities
operational
partners will be def ined , in time, in the contractual
arrangements governing the co-operation.
If,
however, forms1 subagreements etc. have not yet been
drawn up, and the basis of co-operation remains a letter
of intent,
the definition
of responsibilities
contained in the plan of action is
more essential
than ever. The resnsibilities
of
NGOs wish to have
where individual
responsibility
for a specific
sector.
Final
authority
rests with
the government , and the Representative should consult closely with
To the extent
authorities.
tllie
possible,
however, any conflicts
should
be resolved
of interest
within
the framework of an NGO
co-ordinating
IrJechanism, such as
that described in the next section.
responsibilities
of
Defined
3.
must reflect
fully
organizations
those allocated
in the plans of
action.
173
- Field
level management -
Job descriptions,
even if the
4.
imperatives
of an emergency mean
their
frequent
revision,
are the
for
most cauuon mansement tool
resronsibiliindividual
def ininz
ties. kb descriptions
are important for regular UNiCR staff,
and
even more so for temporary staff
and people working as volunteers.
5.
A document setting
out the
concepts and princiassumptions,
ples behind the emergency operation has prowd a valuable canplement to the plans and detailed
responsibility
,
definitions
of
in
large
programnes.
especially
Such a document should include an
the
role
and
explanation
of
the governrespnsibilities
of
ment, UIWX, other UN organizaoperational
partners,
and
tions,
together
bilateral
donors,
any
with the standards in the various
sectors
ard any specific
guidelines
necessary.
Details
of the
co-ordinating
mechanisms should he
gi\Fen.
6.
There should be no delay in
carmitting
the necessary personnel
to emergemy situations.
The organizational
needs of an emergency
however, be met by the
cannot,
simple addition
of personnel;
the
of
plan of action and definition
determine
responsibilities
must
personnel needs, not vice versa.
Staffing must be flexible
and numbers are likely to vary over time.
locally-hired
staff
usually
prove
particularly
valuable.
7.
It is important that the difand
f erent
advantages of local
are
under international
staff
and that these different
stood,
strergtbs
are properly
incorporaVery
ted into a staffing
plan.
lOCal
menbers
obviously,
staff
urderstard
the local
situation.
They are sensitive
to issues that
often
escape the notice
of the
international
staff
member. In
addition,
the local staff members
will
often enjoy a wide range of
contacts that enable them to “get
things
done”.
Pinally,
and very
174
significantly
, they may speak the
refugees ’ language. Correspondingly, it must be recognized that in
the eyes of many of those involved
the
international
staff
members
bring to the progranme an impar tiality,
an embodiment of
its
international
character,
which is
essential.
lbey will
also have
experience from elsewhere to contribute
to the management of the
emergency.
8.
Local volunteers
- both nationals and members of the diplcxnatic and expatriate
communities may cane forward to help in the
face of evident needs. Ihe value
of outside
volunteers
will
vary
consider ably with
the situation,
the skills
of the volunteers,
the
time they can devote and the availability
of the management personnel needed to co-ordinate
and support them. Lack of proper supervisory support of ten leads to the
volunteer
taxing
already
over extended staff,
with the result
that the services rendered beccrne
ineffective
while
the volunteer
becones disillusioned.
Personnel management
9.
Sound personnel
management,
supervision
and leadership
are
very important
to the success of
an emergency operation,
but can
easily be over -looked. Administrative
aspects of UNHCR personnel
management are discussed in Part
2. The initial
motivation of those
involved is a major asset but, for
that do not
persons at levels
allow an overview of the operation, this can be replaced by disappointment
and frustration
if
supervisors
are too busy to plan,
organize, direct,
control and continue to motivate their staff.
10. Staff meetings should be convened regularly
from the start,
and everyone made to feel part of
the team. The welfare of that team
will have an important bearing on
emergency
the
success
of
the
Very long hours will
operation.
often be necessary,
but su ervisors must ensure that sta l!-z%G
- Field
level management -
time off,
away from the refugee
site, and do not get so overtired
that their efficiency
and the professionallsm
of
their
approach
suffer.
11. All field staff have a particular responsibility
to safeguard
their
own health,
for
example,
throeh
the regular taking of the
correct
anti-malaria
drug, ensuriq
vaccinations
are up to date
alth
obvious
avoiding
and
hazards like
unsafe water .l ‘i” The
need to hospitalize
or eGacuate
key staff can cause a major disruption in an emergency operation.
12. In an emergency there may be
see
when staff
occasions
WV
clearly
that by devoting time to
refugees
or
ird ividual
helping
families
in distress
they could
suffering
directly.
To
alleviate
seek to do so would be very under stanjable,
but it can lead to a
personal emotional
involvement at
the expense of the staff member’s
wider responsibilities
towards the
and to
refugees
as a whole,
resentment
among other refugees.
Sane staff may have direct responindividual
care,
for
sibility
though this is often best assumed
by the refugee camwnity,
but for
all staff,
canpassron must be tempered by a professional
approach.
Guidance by supervisors
is often
needed on this point.
32.4
7
A single co-ordinating
rity is required.
/7
UMX should take the lead to
ensure effective
I%0 co-ordination if this is not already
ensured.
/7
The actions
of UNH[x staff
must be properly co-ordinated.
-
autho-
General
1.
Effective
co-ordination
is
the result
of sound management.
Co-ordination
mechanisms set up
without the establishnent
of clear
objectives
and assignment of responsibility
and authority
will be
ineffective
and substitute
words
for action.
If co-ordination
is
not based on a good information
exchange,
particularly
with
the
site level,
it may even be counter-product ive.
2.
A framework within which the
implementation
of
the programne
can be co-ordinated
and management
decisions
taken is essential,
both
for the overall response and within UNHCR. Co-ordination
at central
and site levels will
involve frequent
informal
contacts
between
UNHa, the government , other UN
organizations
directly
involved,
operational
the
partner(s)
and
other
parties
concerned.
These
contacts should be complemented by
more formal regular meetings where
the overall
progress is reviewed
and plans adjusted.
Arrangements
for the general briefing
of the
diplomatic
corps and the UN system
are discussed in Part 2.
the
3.
Whatever
implementing
experience
arrangements,
suggests
that there are major advantages in
the establistroent
by the government of a single
co-ordinating
authority
(task force, carmission,
operations
centre etc.)
on which
all the ministries
and departments
involved
represented.
This
are
authority
should also be represented at the site level.
In countries
already granting
asylum to
other refugees, such a focal point
is likely
to exist, and may simply
need strengthening.
l/
‘Ibe Ross Institute
booklet “Preservation
Climates” (1980) gives comprehensive guidance.
r
of
personal
health
in warm
175
I
- Field level management NGOco-ordination
Effective
co-ordination
with
4.
and among the ND3 will be essential
to the success of the emergellcy operation.
Much will depend
on the position of the government,
which may wish to control and coordinate
KO
activity
itself.
Where a NC0 is an operational
partner
co-ordination
of IINKR,
should
already
be assured,
but
many NGOs may be operating
their
own prograrsre
for
the refugees
with their
own funds. will
have been active before the m(X
prograurne started
and many more
arrive
in a major refugee
=Y
emergency. Where there has previously not been a habit of interagency co-ordination,
the exchange
of inform&ion
may well
not go
beyond those who have participated
in the co-ordinating
meeting.
To
get the information
passed “down”
to the site level can initially
be
as hard as it was to get information passed %etween” the agencies.
5.
Subject to the policy of the
governnent , where a NGO co-ordinating
structure
does not already
exist
it is strongly
recarmended
that
IJMX
takes
the lead
in
errouragmg
the NGQS to set up
their
own co-ordinating
camnittee
and ~chanisms.
The role of the
government on such a carmittee
will
depend on tbe situation;
at
the least, a representative
of the
co-ordinating
govermnent’s
own
authority
should
atterrl
as an
obs er ver . UNIcR’s status might be
that of an observer, but an active
one, as the meeting of the cam-dttee will
provide
an important
opportunity
to brief
all NGOS on
progress, future plans and problem
areas, to request specific
assistaIy3e and to answer the quest ions
on UNi(x’s aims and policies
that
the IKXk3 may have little
other
chame of asking. In the absence
of other arrangements, there is a
strong case for UNiCR itself
organizing and chairing such meetings,
at least in the first
weeks. This
may be a crucial
canponent of
UNKR’s leadership role.
176
c
0.
In
a
large-scale
refugee
einergency , the NGO co-ordinating
cannittee
should also be errouraged to create sectoral sub-coumittees ) for example for health and
nutrition.
The ccarmittee, and particularly
such
sub-cannittees,
could play an important
part in
the developrent
of the specific
standards
for
the delivery
of
assistance.
See
for
example,
ch.7.2.18 on guidelines
for health
care.
7.
some experience
has
been
gained in the working of IGO coordinating
curmittees
in refugee
emergencies. Annex 1, “Elements of
a co-ordinating
body”, might be
helpful
to those considering
the
establisbnent
of a ccsrnittee.
8.
A NGO co-ordinating
comnittee
can also be of considerable
value
when new agencies arrive,
both in
integrating
their
assistance
in
the overall programre and with the
practical
administrative
ati general
briefing
arrangements.
If
there is no such caxrni ttee, agencies new to the country are likely
to turn to UNHm for initial
administrative
support,
hotel reservat ions,
transport
This can
etc.
quickly
becane a major preoccupation for UNHCR field staff at the
expense of their own work.
Within UNHCR
9.
Within UNHCR itself,
in addition to the staff meetings already
recorrmcnded, regular
and frequent
meetings of key personnel will be
essential,
both centrally
and at
site level.
In a critical
situation, a daily early morning planning meeting and another in the
evenins. for reoortine.
will
of ten
be us&l.
S&ary
m;inutes and/or
decision
sheets are an important
management tool
in anergencies ,
otherwise
under the pressure
of
events what was decided, and who
was to take what act ion when, may
be forgot ten.
- Field
l2.SBianaeuent attbe
level management -
eitelewl
/7
CQrmon standards
tial.
are
essen-
/7
Proper
inmlvernent
of
furkiamental
refugees
is
success at this level.
and the home visiting
canponent of
health
care,
feeding
progranmes
an;l social services.
the
to
1.
Itlefr amework for the organization
an;t co-ordinating
mechanisms at the site level is likely
to reflect
broadly
that establibut it will
be
shed centrally,
more affected
by the implementing
arrangements.
2.
Clear
under&ding
of
the
aims ard objectives
of the emergency programne and proper co-ordination
are even more important
at the site level than centrnlly ,
for it is here that failures
and
misutrierstandinzs
will
directlv
affect the refi&es . Of articula;
importance will be the---i&TX
a
cormson standards when a number of
orwnizations
are providing
simiPar assistance.
Regular meetings
of those corcerned are essential:
an overall co-ordinating
mechanism
chaired by the operational
partner
may be cunplemented by sectoral
cannittees.
3.
A rapid changeover of outside
sonnel can create [email protected] probsite-level
Wlagement I
f
SEs man% is a swested
minimun
leqgtb of service for staff involin the
ved in running
services
Sane specialists
may
settlement.
obviously be required for shorter
periods.
*
importance of continuity is directly
proportional
to
the closeness of contact with the
refugees. Only sane of the problems can be overc:me by the overall
operational
partner
at the
site having a standard orientation
and briefing
procedure LO ensure
continuity
of action
and policy
despite personnel changes.
4.
Certain
prograume activities
are interdependent
or have a canmon component and wiil need particularly
close co-ordination.
Examples are environmental
sanitation
measures and the health services,
support and enhance the refugees’
own abilities
to provide for themselves. The importance of working
with the refugees and using and
developing
their
own skills
and
organizational
structures
has been
a carmOn theme in the preceding
chapters.
Refugee settlements
are
&pically.
simple replicas
of EL
mer c-unity
life,
as large nunbers of refugees may be living
temporarily
outside
their
traditional
c-unity
leadership
structures.
In leyd9riy every emergency,
refugee
spokesmen,
or
respected elders ‘will,
however, be
present.
It will
be necessary to
the caununity
the
define
with
method of choosing
leaders
to
representation
and
ensure
fair
proper participation
in both the
planning and implementation of the
emergency prograarne. The more the
settlement
differs
from
former
c-unity
life,
the more important
this action is likely
to be to the
success of the prmraume.
7.
To ensure adequate representation and access for the individual refugee,
vas ious levels
of
representatives
arid leaders
are
likely
to be required.
Bear in
mind that there is no reason
should be representative
carmunity simply becausebe
or she has a caxmon languqze with
assist2t se
ance. Arrangements should be based
ontraditional
leadership
systems
it
is
to the extent
possible-.
natural
that other,
p;aF;s
less
traditional,
mY
power
arge
within
the cannunity.
Particular
attention
should be paid
to the sources of such power. A
consideration
is
the
specific
to separate
need,
if
possible,
177
,
- Field level manqement physically
any previously
groups asr3ng the refugees.
hostile
Subject to traditional
social
the basic planning unit
patterns,
is likely
to be the familv.
and
the basic organizational
&it
is
likely
to be groupings of r&ugees
accord&
to livitlg
arrangements.
A good-sized basic- organizational
unit might be 80-100 people: this
is sanetimes referred to as a community unit. Above this ccmes the
section which usually consists of
saile 1,000. Many settlement
serto this
vices are decentralized
level.
Five or so sections might
be grouped together to form a sector for certain organizational
and
For
purposes.
representational
instance in chapter 7 it is suggested that
there should be a
health
clinic
for
every
5,000
Similarly , the particirefugees.
pation of elected sector representatives on a settlement management
would be appropriate.
carmittee,
As to how many sectors might make
a settlement,
there is no hard and
It depends on the
fast
advice.
Rut generally
the
circumstances.
smaller a settlement
the better.
Physical layout of tbe sits will
have a major influerxx
on social
and the irqxxrance
organization,
of preserving
and pranoting
a
sense of ccxrmmity has been stressed in chapter 6. The system of
which may
refugee representation,
be a several-tiered
one with
comnunity-elected
representatives
selecting
from among their number
representatives
who in
sect ion
turn
representachoose sector
tives,
should be consistent
with
these physical divisions.
8.
The social
organization
of
the refugees must also make use of
their
specific
skills
and provide
the personnel to run the caammity
services. Details of what might be
required
ha-ve already been given
in the relevant chapters, but as a
check list:
9.
(1)
178
health
services
(trad i i ional
including
nidpractitioners,
i :alth
wives, home visiting,
public health I-:-3ucacentres,
tion, etc.) ;
(2)
feeding programnes ;
(3)
water
system
(consupply
struction,
maintenance,
protection/treatment
and distribution) ;
(4)
sanitation
(maintenance
and
cleaning
of latrines , drainage, garbage disposal,
vector
control, etc. ) ;
(5)
shelter
construction
ing ccutmmal buildings;
(6)
social
services
(caring
unaccompanied
children
the disabled) ;
(7)
tracing;
03)
education programnes ;
includfor
and
(9) general administration.
12.6
/7
No programne can work proper ly unless the number of beneficiaries
is known: there are
several
ways of determining
this with sufficient
accuracy.
/-i
A fair
distribution
must be established.
system
Registration
1.
Alll planning, as well as fair
distrsution,
will
require
an
accurate census of the population.
This will
be an essential
ccmponent of the needs assessment. It
should be noted that under the
Statute (8(f)) UNHCRobtains “from
Governrents information
concerning
the number and condition
of refuterritories”.
Algees in their
though it
is UNHCX’s statutory
responsibility
to
seek refugee
numbers from the government , it
must be made clear from the start
that it is not possible for UNHCR
to mount a programne of assistance
without
a precise measure of the
nurber of beneficiaries .
While an accurate census is
2.
essent ial, a formal mass registration should not necessarily
be an
- Field
level management -
autcmatic response at the start of
an emergency. The arguments for
and against
initially
going further than establishing
ntiers
and
an indication
of
the
age/sex
breakdown must be weighed carefully,
and the objective and benefits determined.
Ibe main advantage is that
3.
provides
a unique
registration
opportunity
to secure basic inforincluding
on health
and
mation,
nutritional
status,
on which subsequent prograarning can be based.
In addition
registration
allows a
much tighter
system of ration distribution.
A drawback is that a
detailed
registration
may have an
effect on a refugee’s attitude
to
pass ible
durable
solutions.
For
circumstances
example, in certain
a refugee who was aware his identity was officially
recorded might
be reluctant
to repatriate
spontaneously .
registration
Equally,
certain
can,
in
circumstances ,
give a refugee the impression of a
pass ibility
of resettlement
that
does not exist.
4.
In sane emergencies registration may be an important factor in
J;;o tecting
refugees.
Registration
will be an essential
ccxuponent of
tracing
programne
any irrl ividual
and in this
respect
there
are
arguments for registering
as early
as possible.
5.
If a registration
is undertaken, the form used and arrangements made must be carefully
planned. Whatever the purpose of the
registration,
certain
quest ions
are likely
to be c-n.
An inlication of these is given in Part
2. ‘JJry to avoid the need for a
re-registration
because key questions
were
omitted,
a cornnon
error . After
the imnediate emergency is over, there may be a need
for
for
specific
registrations,
example a socioeconomic
survey,
and a phased approach to gathering
the further
information
required
should be adopted.
6.
Registration
cient numbers of
requires
properly
suf f ibriefed
and trained registration
clerks or
social workers who speak the language of the refugees, understand
the purpose of the questions and
can assess answers and eliminate
obvious
distortions.
must
Thy
have a cormKln code for transliteration
between
alphabets
if
necessary, -*r titularly
for proper
n-s.
If time allows,
much will
be learned
from a small pilot
registration.
7.
Ibe most practical
time to
register
refugees is on arrival
at
the site,
for example in conjunction
with
the health
screening.
Much will
depend on the type and
rate of any continuing
influx.
In
any large influx there are advantages in passing arriving
refugees
through
a reception/transit
centre.
This allows their
registration
and the issue
of ration
cards. It can ease later prograume
management problems and help avoid
disputes
about
refugee
numbers.
Transfer of the refugees to a new
site always provides a good opportunity for a mass registration.
8.
Where a card is issued on the
basis of a registration,
a photograph identity
card sealed inside
unbreakable
plastic
is probably
the least
likely
to be forged ,
altered, sold, or exchanged.
Numbers
9.
With time, a discrepagy
-in
nu&ers may arise between 0 icial
figures
and the best estimate of
those working closest to the refugees .
Unless
this
*
swiftly
resolved major problem?nill
follow. Representatives
and particularly
field
officers
must discuss
with
the
any such discrepancies
authorities
as soon as they occur,
informing Headquarters of signif icant differences
that
cannot be
resolved.
Small discrepancies
are
likely,
given
the
difficulties
already discussed.
Large ones can
be avoided by timely action.
10. Where registration
is deemed
inappropriate
and whr u . t has not
been possible to cc *
-ugees as
179
- Field
level management -
they enter through a transit
centre, every effort
shculd still
be
made to arrive
at an accurate
verifiable
estimate of the number
of refugees. If refugees cannot be
counted on arrival,
there are certain
well-establishzd
demographic
techniques which can be used: the
can be
mu&e= of tefijgee dweiiiss
counted, if necessary through the
use of aerial
photography. Assuming there is some conformity
of
a random sample of
house size,
dwelliwill
provide an average
ntier
of inhabitants
per house.
The population
of the settlement
can then be estimated as a multiplication
of the nmber of houses
by the average house size. As settlemnt
services
develop it will
to cross-check
the
be possible
estimate of settlement
population.
R&an
sampliq
can establish
the
demographic make-up of the camp in
terms of age breakdown. Then, for
.
example,
a vaccination
for under fives is carried Et:‘%
its
out-reach
is successful
and
pirrents ’ sqpxt
for it strong, it
should reach nearly
all
0; the
target group. If the proportion
of
under fives in the camp is known,
it
is then possible
to double
check the estimate for Che total
site
population.
Whenever possible, within
each separate comnunity , dwelliss
should ia any case
be individually
numbered.
11. However, withouc a system of
ration cards (whi j:h, if they have
been issued at the start,
should
make this counting exercise redundant) it will be difficult
to keep
abreast of subsequent changes in
the settlement
population.
If new
arrivals
do not have to report
themselves a3 there are no ration
cards to be issued,
the best
rcethod is likely
to be to make the
reporting
of new arrivals
a responsibility
of the refugee leadership.
Alternatives
to be considered are, either good enough control over house lay-out
to ensure
that new arrivals
build on designated spaces ; or if many of the
new arrivals
are actually
joining
family members and not building
houses of their own, sample censu180
ses should be considered
to try
and establish how much the settlement as a whole is growing i.e.
the same comrmnity units
would
have to be surveyed each time. The
rate
of growth
in these utiits
would then be taken to reflect
that of the settlement as a whole,
Sample surveying
is a scientific
procedure and must be done properly if
authoritative
figures
are
required:
seek expert advice from
local demographers if possible.
Distribution
12. An effective
and fair system
for the distribution
of goods and
supplies will he an essential
part
of site- eve
11
critical
importance when supplies
are short. IYonitoring
the distribution to ensure that it 1s fair,
including
to vulnerable
groups,
will
be an important
maneement
responsibility
of IMER. Mnitor.
y%J~:t;;:{gy
;izzieJff
3::
pa
Y
P
contracted specifications.
13. l%e typz of distribution
system will depend on the circumstances. Daily distributions
are generally
to be avoided. At least a
weekly interval
might be appropriate for dry rations.
A decentralized system, initially
in bulk to
community units or groups and then
to families or individuals,
is the
preferred method, In certain situations,
for example where supplies
are short or abuses likely,
centralized
mass distribution
direct
to heads of family or individuals
may be the only way to ensure reasonable equity . Guidance on other
aspects of distribution
is given
in chapters
5 (logistics)
and 8
(food) .
14. There are two principal
means
fair distribution:
a
of ensuring
ration
card system and an honest
refugee
leadership.
In
per Eect
circumstances a ration card system
might be regulated and enforced by
stich a leadership.
However ingeniou3 the distribution
system devito work
sed , it is most unlikely
- Field
level management -
fairly
without
the basic support
of the leadership.
Ration -&ds
are most easily
issued when the
refugees arrive
at the time of
initial
registration.
Done subsequently
it is more likely
there
will be a margin of abuse or, at
simple,
least,
inaccuracy.
A
ef feet ive system is to have colour
cards with the number of family
members the ration
is to serve
marked on the card. The refugee is
for example, issued a
initially,
blue card. When the first
week’s
ration is distributed
that card is
collected
and a yellow card indieating the same number of family
tiers
issued. This card will be
valid
for the distribution
in a
week’s time. Obviously the card
must not be forgeable.
Distribution
has never theless
in =v
cases
been
done
successfully
through an honest refugee carmunity leadership
without
a ration
card sys tern.. Whatever system is
employed, spot-checks and the nutri tional surveys should be used to
ensure that the system is working
fairly.
15. ResponsiXlity
for diatributien is thus i iten delegated
to
lhis
can confer
refugee leaders.
considerable
power arG should be
closely supervised.
&Jess nlanbers
are accurately
iino~,
there will
be wide sccpe for abuses at sever censuses will
need to
al levels:
be repeated as nlanbers change.
12.7
fl
Suf f icier&
information
must
be available
to the decisionmakers so that the operation
can be adjusted
to
meet
needs or
correct
ctwG%
shor t-ca.uixs .
/7
Situation
reports
should
sent as a matter of routine.
be
0
Do not waste energy on [email protected]% information
that is
not acted upon.
1.
In order that the emergency
operation
can be implanented and
monitored,
a reliable
and effective ccfsnunications
system which
allows daily contact between IJIWX
at the site, any regional base, for
example for supplies
and storage,
XI the capital will be essential.
%e requirement
will
be for a
voice and/or
cable
link
and a mail
.
service.
Options are
ZLE%Yn
Part 2.
2.
Repor tins systems provide the
information
necessary for monitor ing an3 evaluation,
as well as the
wider
information
needed
for
donors
and public
info .mation.
[email protected]
should be set up,
specific
informat ion
required
defined
’
stardard
formats which ensure ?hat
itnportant information
is there but avoid
unnecessary detail.
Annex 2 gives
an example of a suggested format
to IX used, adapted as necessary,
for reports
from both the site
level to the capital and the capital to Headquarters.
3.
reports
Specific
will
be
required
for
various
sectors.
Annex 1 to chapter
7, Health,
gives an example of a health surve illance
report , also
c-:ver ing
feeding programnes. Other specific
reports
might
include
those on
social
services,
particularly
unaccvnied
children,
tracing
and
family reunion. Responsibility
for
preparing reports must be defined,
as must those who need to see
them. A report that is not read
and acted upon, at least by evaluating its information,
is a waste
of paper and time.
12.8 Srecial considerations
D
A ntier
of difficult
or sensitive
issues may arise.
A
clear policy
on these, promulgated in advance to those
who need to know, can help
defuse many problems.
1.
In a refugee emergency the
Representative
may be faced with a
number of other carmon management
or policy questions on which guidaIy3e may be helpful.
The question
of what is acceptable administra181
- Field level management tive expenditure by an operational
partner has been discussed briefly
in chapter 4.2.15. The question of
uNI(x -paying for the purchase or
rent of land occupied by the refuarise.
UNHQI’S
also
eees am
&icy
iT; that the provision
of
land is a matching contribution
by
the goverrtnent , though construction on it may be financed by
UNJCR. In certain
extreme circumis to
3tances, a possible solution
find a voluntary
agency which is
able to buy land on UMX’s
beapproval
is
Headquarters’
half.
required
for
such arrangements.
Obviously, donors are reluctant
to
land
purchases
anal when
fund
necessary it should be made clear
from the start
that the internahowever extentional
cansunity,
sive it3 other forms of support,
does expect the govertrrent of asylum to provide land.
2. ‘ibe question of the
-7i&YFE
of refugee3 in cash or
cauuunity services will
inevitably
arise.
Ibe issue of paying refugees can have a crucial
effect on
on the
a settlement’ s character.
one hard, payment can break any
sense of responsibility
the refugees should continue to feel for
their welfare despite their dependence on outside
assistance.
&I
the absence of payment
the other,
may mean tasks. essential
to the
settlanent’s
well-being
are either
not done or have to be done by
paid outside labour.
In the first
days of a settlement’s
existence
it is most unlikely
that the payment of refugees would be appropriate.
In this
start-up
phase
that
sholrld
understand
refugees
they
have a responsibility
to
themselves and their
fellows
to
participate
in the establishment
of their settlement.
Even a foodfor-work
s&sue is probably wrong
at this stage. In addition to the
unfortunate
impression of condonit may
ing a right
to payrznt,
which
ccmnitJnents
also
involve
cannot cant inue to be met, or have
to be met at the expense of the
whole settlement’s
general ration.
Problems with
the supply system
the
inevi table
at
are
almost
182
beginning of a settlement’s
life
and no group should in such circumstances get extra food to the
direct detriment of others.
3. In the longer - term, certain
types of cannunity-wide
work frequently start
to emerge as areas
where standards will drop if sane
form of payment is not given. This
is often the case with key public
health
services
whose importance
is not always correctly
understood
by the refugees. Before any payment scheme is entered into its
full
potential
costs
should be
calculated
and the funds or extra
food assured. The amounts involved
for a large caseload may be very
considerable
once the precedent
has been set. It should be borne
in mind that
after
payment is
introduced
every group of workers
will clamour to be included in the
scheme. It will
be necessary to
have sane very clear but restricted criteria
on inclusion.
Further , UNHCR should look to those
agencies responsible
for different
sectocal services to meet the wage
costs of ref ug.ees working in that
3ec tar . Also no wage system should
be introduced
which will
inhibit
settlement
progress
towards
a
achieving self-sufficiency
.
4.
As important as the level of
renuneration
- which, as the refugees are already supported, should
be well below the national rates fair
application
to all
is its
refugees doing broadly
the same
work. A major cause of discord at
has been the
many refugee sites
payment by different
NGOs of markedly different
rates to refugees
for
the same work. A standard
scale is essential.
Whether or not
there are differentials
recognizing different
levels of skill
will
be a matter to decide in consultation with the refugees.
5.
Another cam-~n question concerns the provision of services to
UNHM does
the local population.
not have a mandate to Drovide
direct assistance to local populations affected by the presence of
refugees . It should be noted that
- Field level management organizations,
both within
other
an3 outside
the UN system, and
bilateral
aid programnes may be
able to_---help affected
nationals.
Rec&Iing
I5.K prirciple
that the
assistance
available
to the refugees should take account of the
in the
conditions
of nationals
area, there may be circumstances
in which a flexible
approach will
be in everyone’s
interest.
For
a large
nunbet of
example, if
refugees are located in a previously sparsely populated area, and
have health services that are not
available
locally,
these could be
offered
to
nationals
on
the
asslnnption they would represent a
small proportion
of the patients.
finansing
the
conConversely ,
struction
of a hospital
in the
local
town, where it was clear
that a substantial
proportion
of
the beds would ‘be reserved
for
nationals,
would not be within
mandate.
Headquar ters ’
IRWR’S
advice should be sought when in
doubt.
The problem of corruption
may
6.
arise in an emergency, whenlarge
sMs of money and quantities
of
relief
are
attractive
supplies
being spent or distributed.
Every
effort must be made to prevent the
d iver s ion or misappropriation
of
funds or goods intended for the
re f ugees . UNHCR has an obligation
to ensure that what is paid for
refugees;
actually
reaches
the
careful
monitoring
and control,
includis
oi quality,
is essential.
As different
attitudes
to
the problem exist,
this task will
be made easier
if all
concerned
with the provision
of assistance
know clearly
UNlCR’s policy
and
principles
with regard to UNMXfunded assistarre.
In other words,
no one should be in doubt as to
what practices
7JNHCR regards
proper and of UNHCR’S intention
have them respected.
as
to
7.
The question
of
political
activities
may also arise. Responsibility
for security
and public
order at the refugee site always
rests
with
the government.
‘ihe
refugees have obligations
to conform to the laws and regulations
of the country as well as to the
measures taken for the maintenance
of public order. UNHCR’s responsibility
is clear: “the work of the
High Ccmrnissioner shall be of an
entirely
non-political
character ;
it
shall
be hunanitarian
and
social
. . .‘I (paragraph 2 of the
Statute).
No general
guidelines
can be given on political
activities within the refugee community.
The matter may be extremely delicate and Headquarters’
advice must
be sought imnediately on any specific problems.
8.
Finally,
mention
should
be
made of religious
activities
among
emergency relief
may also have a
religious
aspect in their
normal
work. Some are traditional
psrtners of UNHClI, with the separation
between these two roles long established
and well understood,
but
for others it may be useful to
recall
the basic principle.
Religious activities
by those outside
the refugee c-unity
, where permitted by the authorities,
must be
clearly dissociated
from the delivery of assistance and services to
refugees.
In particular,
no proselytizing
should take place in
association
with the provision
of
such general carmunity services as
education,
health and social welfare.
183
I
- Field level management -
International
Disaster Institute
(1981)
Disasters Volune 5 No.3
&dical
Care in Refugee Camps
ID1
Oxfam (1980)
Field Directors ’ Handbook
Oxfam
UN (1977)
A Guide to Food and Health Relief
Operations for Disasters.
(Also in French and Spanish)
Protein-Calorie
Advisory croup
of the UN.
de Ville de tiyet C.
!&man J., Geijer U.
(1978)
The Managment of Nutritional
Dnergencies in Large Populations
WHO
(Also in French and Spanish)
All the above cover considerations
emergen: ies .
184
relevant
to the matqpent
of refugee
- Field level management -
Annex 1
(1)
No two relief
efforts
are ident ical.
Nevertheless,
list many of the issues that will require consideration
in
tiatirg
co-ordination
mechanisms. Each of the factors
need to be evaluated against the particular
context and
host government.
I.
it is possible to
the course of inilisted
below would
the policy of the
embership
‘Ihe nature of the co-ordinating
body and its services will be determined by decisions on the composition of the membership.
These decisions
will be based on the degree of agency participation
in the provision of seran appropriate
role for
tices.
Fur thermore, these decisions must identify
organizations
excluded from full membership.
II.
a.
Eligibility
criteria
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
full-time
representation
in country
provision of direct services
minimum size of progranrne
attendance at co-ordination
meetings
compliance with service guidelines
approval of host goverrnnent
regular finmial
contributions
to co-ordination
mechanism
inclusion and considerations
of indigenous agencies
b.
Associate
(1)
(2)
(3)
(4)
external organizations
(UNNR, unless a full manber, etc.)
voluntary agencies which may choose not to become members
funding organizations
public interest groups
status
Services nrwided
for full
membership
for organizations
without
full
membership
bv co-ordination achanism
The following services should be selected according to their ability
to
facilitate
the increased effectiveness
of the collective
services provided by
voluntary
agencies.
Betings
provide the forum for both the formal and
info-1
exchange of information
that results
in complementary program&g,
elimination
of waste, prevention of duplication
and the sharing of technical
information.
Tbis co-ordination
will occur to various degrees depending upon
the needs and on the willingness
of the participating
agencies.
a.
Meetings
(1) coin&tee of the whole
(2) working sub-camnittees
b.
Administrative
services
vis-a-vis
host governrent
off ices
(1)
Abridged from “Associations
and -ittees
Serving Voluntary Agencies
at the Country Level:
A Study of Eight Organizations
in Five Duntries”,
by
Clifford
Olson, March 1981 (prepared for the International
Council of Voluzltary Agencies).
185
- Field level management -
C.
Information
collection
and dissemination
(1) description
of agencies
(2) periodic reporting of services
(3) personnel lists
(4) newsletters
(5) collection
ard dispersal of technical
d.
Conf ererces
e.
Representations
f.
Identification
agencies to
services
of needed services
assure responsibilities
g-
Co-ordination
of emergency responses
h.
.
1.
Allocation
of donated cauaodities
Guidelines
for the provision
5
Orientation
of newly-arrived
k.
Orientation
of incaning voluntary
1.
Research and documentation
to external
m. Support for settlement
III:
n.
Co-ordination
0.
Fund raising.
Relations with
host
information
organizations
and soliciting
of
for the provision
and financial
voluntary
of these
contributions
of services
agencies
agency employees
co-ordination
ccnrnittees
with agencies outside
the country
eroeeroment
Voluntary agencies are guests of the host governnent.
It is important
to build into the co-ordinating
body, mchanisms which encourage co-operation
and ccumumication with appropriate levels of that goverrment.
Consideration
-
should be given to relations
with officials:
at the central level;
at the provincial
levels;
at the local level;
who are technical specialists
(education,
the civil service and academia;
- who are camp administrators,
and
- who are in the military
forces.
public
health,
etc.)
in
Governing procedures will describe the mechanisms through which representatiws
of member agencies choose to cane to decisions.
In some cases
representatives
meet frequently
and are actively
involved in all types of
decision-making.
In other instances,
representatives
delegate Eer tain responsibilities
to a smaller executive ccumittee, sub-casrittee
or staff.
186
- Field
a.
b.
c.
d.
level management -
Voti.ng procedures
Election of Officers
Selection of Executive Comnittee
Vrequexy of stings
v.
g?olirceof fundi-
meter,
The source of futiing
will predict better than any other single parathe beneficiaries
of the services provided hy the co-ordinating
body.
Agencies will make best use of opportunities
provided by the co-ordinating mechanism if they are assured of control over the decision-making
process within
that mechanism. The degree to which that mechanism depends
financially
upon member agencies is a measure of that control.
Secretariats
with independent sources of funding are at times subject to temptations to
develop in directions
independent of the desires of member agencies.
a. Willingness to accept external support
b. Portion of expenditures covered by member contributions
c. Assessment by size of agency involvement in relief
effort
equal contributions
d. Provision of exemptions or partial
exemptions from required
butions I
VI.
versus
contri-
!Staffirq
The ntier
of staff must be both large enough to provide the required
services and small enough to be paid by available funding.
The authority
and
supervision of the staff should be clearly delineated.
Three sets of alternat ives should be considered :
a. Personnel
employed by
b. Expatriates
c. Generalists
seconded from member agencies
versus
the co-ordinating
body
versus host country nationals
(co-ordinators)
versus technical specialists.
Again, the specific
site context is a determining
the co-ordinating
mechanism. Individuals
working at the
irg participating
agencies are best able to determine
structure
will achieve a co-ordination
that will result
tiveness and efficient
use of resources.
professionals
factor in designing
site and representwhich organizational
in increased effec-
187
- Field
level management -
Annex 2
that regular situation
reports reach
1.
In Mgenc ies , it is essential
The frequency of such reports will be determined by the charHeadquarters.
acteristics
of the situation;
more frequent reports will be necessary in the
initial
stage of an emergency. Situation reports should give an overall view
of the situation
with sufficient
factual content and explanation of changes
sinse the last report to answer rather than raise substantive questions.
By
indicating
progress achieved, problems encountered and steps being taken or
planned to overcane these, the reports should give a cumulative picture of
how the needs of the refugees are being met.
2.
A suggested format is given opposite.
Major headings should as a rule
be the same in each report , indicating
‘ho change” if appropriate.
Depending
on the situation,
headings E through K may either be presented as shown, with
locations covered under each sector of assistance,
or alternatively
by locaIn either
tions, with sectors of assistance covered under each location.
case, the information under each sector of assistance and for each location
should cover as applicable:
(1)
Current situation;
problem areas, remedial action planned or necessary, (1)
with time frame;
Any variation from overall implementing arrangements in DDD;
Personnel and facilities
available.
(2) Particular
(3)
(4)
‘Ihe reports should be sequent ially numbered, copied to RO New York and
3.
The report may be used as the
to other IJlWcR field offices as appropriate.
basis for any wider situation
report issued from Headquarters.
4.
A similar format may be useful for situation
tive by field officers at the site level.
reports
to the Representa-
(l)
Specific action requested of Headquarters should be the subject of a
sitrep.
separate cable, which could of course make reference to an earlier
Where relevant, reference should be made to such requests in the sitrep.
L
-
188
,.
.!
_
‘.T;
:’
“_ *.1
‘_
:
I
i
‘>
I”
,
^(
;,
-- Field level
management ..
. HIKMEF GENEVAWED HICXMREF-NEWYORK (and other offices concerned)
SITREP -(nun&r)
COVERINGPERIOD (date)
To
(date)
(Sumnary of major developments including
protection,
assessment
of situation
generally and ~by refugee location,
and field deployment of UNHCf:staff.)
PRIM0
SIXUNDO
etc.
.I
EWUXE SI’ATISIICS AND REGISTRATION
E
I
c
I
GENERALSITUATION
A
* (By location,
country of origin or distinct
groups if
evident, with explanation of changes since last report,
[email protected] source, e.g. government, UIWX, etc.)
not selfand indi-
CO-ORDINATION
(Government departmnts,
UN system, NGOS, both at capital
field levels . Arrangements for briefing diploartatic corps.)
I!
and
OVERALLIMPLEMEWINGARl?AN2FMEhTs
(Role of authorities
Operational role of W-RR (if any)
Role of UNHCR’s operational partners
Other sources of significant
assistance)
I2
SUPPLIESAND LOGISTI’~
(Including
informat ion on internal
transport
arrangements,
arrival of major consignments of multilateral
or bilateral
relief
supplies, outstanding needs, etc.)
E
SHELTER
(Site layout,
I
/
,
housing,
G
HEALTH
J!
FOODAND NUIRITION
.L
I-WATm
2
SANITATIONAND ENVIRONMENTAL
SERVICES
K
SOCIAL SFRVIQ?SAND EDUCATION
(Including disabled
etc. as applicable.)
L
refugees,
unaccompanied children,
and tracing
PUBLIC INFDRMATION
(Significant
I
etc.)
events/media coverage.)
189
If you are seeking general information
on a -subject, you may find
easier to look at the first
DafLe of the relevant chapter, which gives
annotated list of contents.
* A
Covy;;ption
Abbreviations
(viii)
Acknowledg~ts
(ii) (vi) (vii)
Agreements, implementing 27-28
Air, transport 38
Aircraft,
capacities 41
chartering 27
Anerican Convention on mn
Rights l.2
Anaemia 81, 102
Aquaprivies 148-150
Assessment of needs 15-19
health 75-77, nutrition
99-100,
water 119-123
Assistance, standards of 4,17, 19-20
to local population 182-183
Asylun 8-10
Declaration of Territorial
12
Arrangeukznts, implearenting
23-28, 173-174
Co&actual
arrangements 27-28
Convention(s), Geneva 13-14
1951 Refugee 8,12
WI Refugee 8,i2,59
Conversion factors 54
Cooking 98, 103, fuel 99, 135
utensils 47, 99
Corruption 183
Covenant, International
on Civil
and Political
Rights 11-12
CSM (corn-soya+nilk)
104
Customs clearance 44-45
Co-ordination
2-3, 33-34, 175-176
NGO176, 185-187
Co-ordinator,
health 73-74, 76
feeding programne 98
B
Biogas 145
Bilharzia
(schistosomiasis)
59, 133, 142
Blankeb 65, specifications
47
Bored-hole latrine 147
Breast-feoding
82, 108-109
Ruckets, specification
47
Buildings, see shelter 65-67
C
Camps, refugee (vi) 57,60
Centers for Disease Control (vii)
Census 178
Charter of the United Nations 3, 11
Children, feeding 104,108-109
health 83
nutrition
104-109
unaccompanied 160-165, 168-169
Chlorination
127, 129, 135
Cholera 81
Clothing 37
Gold chain 86, 94
mnicable
diseases 79-81
Comnunications 34, 181
Competence ofUIWR9
Composting latrine 148
Oonsigfment procedures 43-44
(family
it
an
planning)
D
Dead, disposal of 153-154
Death, record of 11, 154
Declaration of Territorial
Asylum 12
Dental care 83
Diets 102, 111
Diphtheria 94
Disaster corps 27, 34
International
Institute
(vii)
“Disasters"
journal (v) (vi)
Disease(s), control 79-81
notifiable
77
reporting on 89-91
water-borne/washed I.23
Displaced persons 9
Distribution
180-181, food 103
water 132-133
Drugs 85-86
DSM (dried skimned milk) 109
WI (dried whole milk) 109
E
Education 165-167
health 84, nutrition
98
Rnergency, definition
of 2
Ehvironorental services 137-154
Epidemiology 75
Exclusion clauses 9
Rxcreta disposal 141-150
Executive Ccxrmittee of UIWCR11-12
Experts (v), 30
191
P
Family planning
Family
reunion
71, 84
11. 13-14, 160-5
!?A0 3; 98
Feedi% programne(s) , co-ordinator
98
general 100-103, infants 108 -109
supplementary (!SP) 92, 104-107
therapeutic
(I’FP) 93, 107-108
Filtration,
water 127, 134-135
Fi;;, g;ve&$n
and fighting
Flied 1511152
Food(s) 95-114, distribution
103
nutritional
value of staple 112-113
sources 110, special 104-105, 108
storage 40, 42, 99, 109
weaning 109
Implementing , agency,
see operational partner (ii) 25-28
arrangements 23-28, 173-174
Infant feeding 108-109
Insect control 151-152
Inspection of supplies 43, 103
Insurance 43
International
Covenant on Civi.1 and
Folitical
Rights 11-12
Disaster Institute
(vii)
Instruments 11-14
Inter tect (vi i)
J
Job descriptions
174
G
Garbage disposal 150-151
Geneva Conventions and Protocols
13-14
K-mix II 108
Kit, Emergency Health 85-86
Kwashiorkor 100, 107, 111, 115
H
L
Health 69-94
centres and clinics 76, 83
co-ordinator
(DlWR/WHO) 73-74, 76
education 84
Rnergency Health Kit 85-86
of field staff 175, screening 75, 77
supplies 85-86, surveillance
77, 89-91
Mminths
(worms) 81
Hospitals 84-85
Musing, see shelter 65-67
Human Rigfits, American Convention on 12
International
Covlenants 11-12
Universal Declaration of 3, 9-11
Laboratory servihes 77
testing water 123
Land, purchase 60, 182, rights
Latrines 141-150
Layout of sites 60-65
Law and order 2, 183
Lead entity 3
Local population,
assistance to 182-183
Logistics 31-54
LRCS (vii) 3, 25, 74, 86
60
M
I
IBKD (International
Bank for
Reconstruction and Developnt)
,
see World Bank 57, 166
ICM 27
ICX (vii) 3, 9, 13-14, 74, 85-86
role in armed conflicts
13-14
tracing and family reunion
13-14, 160, 163
ICVA (International
Counsil of
Voluntary Agencies) 185
Identification
of unaccompanied
children 163
Identity cards, refugees 179
1m 34
Immunization 79-81, 94
192
Mail, refugees’ 11, 160
Malaria 59, 80-81, 150-152
Malnutrition
100, 104-108, 111,
115-116
Management, at field level 171-184
Marasmus 100, 107, 111
Markets, local 36, 102
Maasles 79-81, 94
Medical, see health 69-94
supplies 85-86
Meningitis 81
Milk 108-109
Minerals (in food) 102, 110, 112-113
Minors, unaccompanied,
see chi ldren 160-165, 168-169
tisqui toes 80, 150-152
Mother and child health 83, 104-107
1s
NE&S, asses-t
of 15-21
~~1s
3.
co-ordination
176, 185-187
-_--relief
supplies 45
Non-refoulwt
10, l.2
TW~I=S
of refuRe es 179-180
.--meition
[email protected],
education 98
--2id assessment of status 115-1116
tar
surwillance
89-93, 99-100
0
QAURefugee Convention 8, 12, 59
o&ma (Kwashiorkor) 100, 107, 111,
J 25-28
177-178
, 99
P
Paymsnt of refugees 182
PiN (protein-energy
malnutrition)
107-108, 111
Personnel 28-30, 174
for health care 76, vement
174-175
Pertussis (whooping Cough) 94
pharmacist 74, 76, 86
Pit
146-147
--~ latrines
Plague 152-153
Plans or‘ action 172-173
Pl;;;i;+sheeting
47, 66-67
.
J
Political
activities
of refugees 183
mu+flush
latrine 148-149
kocurelllL?nt 36-37
Protection 2, 7-14
Protein 102, 104, lI0, 1X2-113
_ _
energy malnutri tion (PM) 107-108, 111
protocol(s) , 1967 Refugee 8, 12
Geneva 13-14
Pui$? 130-131
Purchase, local 36, abroad 36-37
Purification
of water 123, 126-127,
133-135
R
Rain water 127, 130
Ration. cards 180-181, food 102-103
Ration,
-------,
pre-packed 103, supplementary 106
therapeutic 108
Rats 151-152
Reception centres 19, 58 179
Red cross and Red @esceAt
Societies 3, 25, 74
REDR (Register of Engineers for
Disaster Relief) (vii)
Refoulement 10, 12
Refugees, definition
2, 8-9 12
location of 11, 59, pa&ipation
and representation
(vi),
4, 177-178
payment of 182, rights ad we---sibilities
3, 10-11, 183
Registration
19, 178-180
birtfis, marriages, deaths 11, 154
unaccoolpanied children 163,
168-169
Religious activities
183
Repatriation
5, 11, 59
Reports, standard situation
188-189
Resettlement 5, 27
yes nsibilities,
a 3plocation of 173-175
of UNH(x 2, 24-25
of other organizations
2-3
ofrefugees
3, 10-11, 183
Reunm, family 11, 13-14, 160-165
Rights, hm,
see human rights 9-12
land 60
Roads 40, 63
Rodents 151-152
Ross Institute
(vi i)
Sanitation 137-150
Scabies 81, 152
Schistosmiasis
59, 133, 142
Schools 83, 165-167
Secretary-General,
of UN 2, 3, 9
Security, of refugees 2, 11, 59, 183
Of staff
working for refugees
24-25
Settlement, see Sites 55-67
Sheeting, plastic 47, 66-67
tarpaulin 48
Shelter 65-67
Site(s) selection,
planning ad
layout 55-67
Social services 155-165
Solar, cookers 99, pumps 131
Somalia, Ministry of Health,
Refugee Health Unit (vii)
Space, living 59, 66
Spares, vehicle 39
Specifications,
standard 37, 47-48
StatUte
of UMKR (ii) 8
193
Stock control 42-43, systems 49-53
Storage 40, 42, food 42, 99, 109
vaccine 86, 94, water 131-132
Supplementary feeding programne
(SFP) 92, 104-107
Sq$ies
31-53, medical 85-86
packing and labelling43-44
Surveillaxe,
health 77, 89-91
nutritional
89-93, 99-100
T
Tarpaulins 48
Tents 42, 66
specifications
of 48
'J&tanus 81, 94
Therapeutic feeding progrm
(J'F'P) 93, 107-108
Tracing 11, 14, 160
unaccompanied children 163-164
Transport 37-40, capacities 41
Treatment, water 123, 126-127, 133-135
Trench latrines 142, 146
Triage82
'
Tuberculosis 81, 94
'Qphoid 81, 142
Ty.'y;s3;52-153
U
Unaccompanied children 160-165, 168-169
Whited Nations, Charter of 3, 11
UNDP3, 20, 25, 57
UNDRO(vii) 3, 67
Llmsco 166
UNICEF (vii) 3, 20, 25, 36-37, 47, 57,
86, 108, 121, 165
UNIPAC 37, 47, 86
UN volunteers 29
Universal Declaration of Human
Rights 3, 9-11
v
Vaccines 79, 86, 94
Vector control 151-152
Vegetables 102, 110, 112
Vegetation 59
Vehicles 38-41
Ventilated
improved pit (VIP)
latrine
146-147
Vietnamese c-sting
latrine 148
Vitamins 102, 110, 112-113
A deficiency 81, 102
multivitamin
tablets 102
Voluntary agencies, see NGOs 3
co-ordination
176, 185-187
relief
supplies 45
Volunteers, local 174, UN 29
Warehouses, see storage 40, 42, 109
Waste disposal 150-151
Water 58, 63, 117-136,
basic needs l.22, boiling I.35
distribution
132-133
quality 123, 133, rain 127, 130
rationing
125, sea 130, 143
sources 125-130, storage N-132
treatment 123, 126-127, 133-135
Water seal latrine 148-149
Weaning foods 109
Mzlls 126-129
WFP (vii) 3, 20, 25, 34, 97-98,
109-110
WHO(vii) 3, 20, 25, 57, 71,
73-75, 85-86
Whooping cough 94
Mnen, pregnant and lactating
83. 104-109
un&xompanied young 165
World Bank 57, 166
Worms 81
WSB (wheat-soya-blend)
105
X
Xeroythalmia
I,-
194
81
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