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Geneva, Switzerland, UNHCR, 2013 Jun 19.  p.UNHCR's annual Global Trends report, released today, covers displacement that occurred during 2012 based on data from governments, NGO partners, and the UN refugee agency itself. The report shows that as of the end of 2012, more than 45.2 million people were in situations of displacement compared to 42.5 million at the end of 2011. This includes 15.4 million refugees, 937,000 asylum seekers, and 28.8 million people forced to flee within the borders of their own countries. The report does not include the rise in those forced from their homes in Syria during the current year. War remains the dominant cause. A full 55 percent of all refugees listed in UNHCR's report come from just five war-affected countries: Afghanistan, Somalia, Iraq, Syria and Sudan. The report also charts major new displacement from Mali, in the Democratic Republic of the Congo, and from Sudan into South Sudan and Ethiopia.
Reproductive Health Matters. 2008 May; 16(31):10-21.Continued political and civil unrest in low-resource countries underscores the ongoing need for specialised reproductive health services for displaced people. Displaced women particularly face high maternal mortality, unmet need for family planning, complications following unsafe abortion, and gender-based violence, as well as sexually transmitted diseases, including HIV. Relief and development agencies and UN bodies have developed technical materials, made positive policy changes specific to crisis settings and are working to provide better reproductive health care. Substantial gaps remain, however. The collaboration within the field of reproductive health in crises is notable, with many agencies working in one or more networks. The five-year RAISE Initiative brings together major UN and NGO agencies from the fields of relief and development, and builds on their experience to support reproductive health service delivery, advocacy, clinical training and research. The readiness to use common guidance documents, develop priorities jointly and share resources has led to smoother operations and less overlap than if each agency worked independently. Trends in the field, including greater focus on internally displaced persons and those living in non-camp settings, as well as refugees in camps, the protracted nature of emergencies, and an increasing need for empirical evidence, will influence future progress. (author's)
Reproductive Health Matters. 2008 May; 16(31):22-32.This paper surveys the international legal frameworks, including the many guidelines, handbooks, resolutions, toolkits, conclusions and manuals produced by various United Nations bodies, that confirm an awareness of the protection issues specific to women and girls displaced by conflict. It explores the extent to which these documents address the gendered impacts of conflict-induced migration, and the role of United Nations bodies as international governmental organisations in implementing these norms. The main focus is upon internally displaced women and women refugees. In addition to problems of enforcing compliance with existing guidelines, the paper concludes that two areas - developing strategies to accommodate the realities of long-term, even permanent displacement and enhancing women's literal and legal literacy - require much greater attention on the part of governmental and non-governmental international organisations. (author's)
New York, New York, Human Rights Watch, 2008 Apr. 44 p. (1-56432-302-1)Five years into the armed conflict in Sudan's Darfur region, women and girls living in displaced persons camps, towns, and rural areas remain extremely vulnerable to sexual violence. Sexual violence continues to occur throughout the region, both in the context of continuing attacks on civilians, and during periods of relative calm. Those responsible are usually men from the Sudanese security forces, militias, rebel groups, and former rebel groups, who target women and girls predominantly (but not exclusively) from Fur, Zaghawa, Masalit, Berti, Tunjur, and other non-Arab ethnicities. Survivors of sexual violence in Darfur have no meaningful access to redress. They fear the consequences of reporting their cases to the authorities and lack the resources needed to prosecute their attackers. Police are physically present only in principal towns and government outposts, and they lack the basic tools and political will for responding to sexual violence crimes and conducting investigations. Police frequently fail to register complaints or conduct proper investigations. While some police seem genuinely committed to service, many exhibit an antagonistic and dismissive attitude toward women and girls. These difficulties are exacerbated by the reluctance-and limited ability-of police to investigate crimes committed by soldiers or militia, who often gain effective immunity under laws that protect them from civilian prosecution. (excerpt)
Integration of the human rights of women and the gender perspective: Violence against women. Violence against women, its causes and consequences. Report of the Special Rapporteur, Yakin Erturk. Addendum. Visit to the Darfur region of the Sudan.
[Geneva, Switzerland], United Nations, Commission on Human Rights, 2004 Dec 23. 6 p. (E/CN.4/2005/72/Add.5)From 25 to 26 September I participated in the first Africa Regional Consultation on violence against women with the Special Rapporteur of the African Commission on Human and People's Rights on women's rights in Africa, Angela Melo. The consultation was held in Khartoum and organized by the Geneva Institute for Human Rights, the African Women's Development and Communications Network (FEMNET) and the Babiker Badri Scientific Association for Women's Studies (BBSAWS). I took the opportunity whilst in the Sudan to undertake a short visit to the Darfur region, following allegations that women were being targeted for rape as part of the conflict, to assess the situation. (excerpt)
Development. 2006 Sep; 49(3):82-86.Although a natural disaster does not differentiate between people, societal norms do. According to a study carried out by Oxfam International, the number of women who died in the tsunami of December 2004 considerably outnumbered men. In many places, the ratio between female and male deaths was 3:1.This difference can be directly attributed to gender roles. In many fishing villages, most of the men were not at home when the wave reached the coast. They were out with their boats and were not hit with the same brute force as the people who were staying on the coast. Or they were working in the fields and could escape climbing up trees. In contrast, women mostly stayed inside or around their houses and the first thing they did when the wave reached was to try to save the lives of children and old people. Life-saving skills such as swimming or climbing up a tree are not deemed seemly for girls. Traditional clothing such as the 'Kain Sarong' worn in Aceh limits the freedom of movement of women and girls. (excerpt)
Operational implications of using 2006 World Health Organization growth standards in nutrition programmes: Secondary data analysis.
BMJ. British Medical Journal. 2007 Feb 23; 334(7596):733-738.The objective was to assess the implications of adopting the World Health Organization 2006 growth standards in combination with current diagnostic criteria in emergency and non-emergency child feeding programmes. Secondary analysis of data from three standardised nutrition surveys (n=2555) for prevalence of acute malnutrition, using weight for height z score (<-2 and <-3) and percentage of the median (<80% and <70%) cut-offs for moderate and severe acute malnutrition from the National Center for Health Statistics/WHO growth reference (NCHS reference) and the new WHO 2006 growth standards (WHO standards). Setting: Refugee camps in Algeria, Kenya, and Bangladesh. Population: Children aged 6-59 months. Important differences exist in the weight for height cut-offs used for defining acute malnutrition obtained from the WHO standards and NCHS reference data. These vary according to a child's height and according to whether z score or percentage of the median cut-offs are used. If applied and used according to current practice in nutrition programmes, the WHO standards will result in a higher measured prevalence of severe acute malnutrition during surveys but, paradoxically, a decrease in the admission of children to emergency feeding programmes and earlier discharge of recovering patients. The expected impact on case fatality rates of applying the new standards in conjunction with current diagnostic criteria is unknown. A full assessment of the appropriate use of the new WHO standards in the diagnosis of acute malnutrition is urgently needed. This should be completed before the standards are adopted by organisations that run nutrition programmes targeting acute malnutrition. (author's)
From camp to community: Liberia study on exploitation of children. Discussion paper on children's vulnerability to exploitation and abuse during the delivery of assistance in Liberia based on field studies carried out by Save the Children UK in Liberia.
Monrovia, Liberia, Save the Children UK, 2006. 20 p.The people of Liberia have experienced ongoing suffering over the past two decades as a result of war and displacement. Children have been drawn into this in many ways, such as recruitment into armed forces, separation from their families, witnessing atrocities, rape and torture. Thousands have been driven from their homes into exile into neighbouring countries or camps for internally displaced people (IDPs) within Liberia. This study focuses on children remaining in those camps and those who have recently been repatriated to their towns and villages of origin after the end of the war. Save the Children, along with many other non-governmental organisations, has been working alongside the Liberian government in the IDP camps. During the course of our work with children, Save the Children staff became aware that many children were agreeing to have sex with older men for money, food and other goods and favours. In order to document more closely the circumstances surrounding this issue, and to look at ways to improve Save the Children's delivery of assistance to better protect children against such exploitation, we instigated a study in four IDP camps and four communities with a high population of people returning from the camps. (excerpt)
Annals of Tropical Medicine and Parasitology. 2001 Dec; 95(8):741-754.Owing to the breakdown of health systems, mass population displacements, and resettlement of vulnerable refugees in camps or locations prone to vector breeding, malaria is often a major health problem during war and the aftermath of war. During the initial acute phase of the emergency, before health services become properly established, mortality rates may rise to alarming levels. Establishing good case management and effective malaria prevention are important priorities for international agencies responsible for emergency health services. The operational strategies and control methods used in peacetime must be adapted to emergency conditions, and should be regularly re-assessed as social, political and epidemiological conditions evolve. During the last decade, research on malaria in refugee camps on the Pakistan± Afghanistan and Thailand± Burma borders has led to new methods and strategies for malaria prevention and case management, and these are now being taken up by international health agencies. This experience has shown that integration of research within control programmes is an efficient and dynamic mode of working that can lead to innovation and hopefully sustainable malaria control. United Nations' humanitarian and non-governmental agencies can play a significant part in resolving the outstanding research issues in malaria control. (author's)
GBV communication skills manual. Communication Skills in Working with Survivors of Gender-based Violence: a five-day training of trainers workshop.
[New York, New York], Reproductive Health Response in Conflict Consortium, .  p.This curriculum represents collaboration between FHI, the RHRC Consortium, and the IRC. The original curriculum used in Peja, Kosovo, has been supplemented and refined in subsequent trainings by FHI, as well as by the work of IRC's Sophie Read-Hamilton in Tanzania and Sierra Leone. The curriculum presented here has been finalized by Jeanne Ward of the RHRC Consortium, with feedback from FHI and IRC. What follows is an outline of the overall goals of the training, a training outline, and a list of materials needed, as well as a list of transparencies, handouts, and activity sheets used in the training, an indepth training curriculum, and all transparencies, handouts, and activity sheets necessary to conduct a training. The training is designed so that all the materials used in the training can be shared with participants at the end of the workshop (preferably in a binder), and they can conduct subsequent trainings on topics with which they feel comfortable. Participants are not expected to be able to train on the entire contents of the manual unless they have extensive training and psychosocial experience. (excerpt)
Suffering in silence: a study of sexual and gender based violence (SGBV) in Pabbo camp, Gulu district, northern Uganda.
Gulu, Uganda, Gulu District Sub Working Group on SGBV, 2005 Jan.  p.The study looks at the nature, causes and effects as well as the current interventions related to SGBV in Pabbo IDP camp. The purpose of the study was to generate information to enable the Sub Committee on Sexual and Gender-Based Violence to identify needs of the people in Pabbo camp and inform future interventions. The Gulu District Sub-Committee on Sexual and Gender Based Violence (SGBV) Group chaired by the District Community Service Department and co-chaired by UNICEF, commissioned the study. The research was conducted in Pabbo IDP camp between the 6th and 25th September 2004. (excerpt)
African Affairs. 2004; 103:227-247.In most academic literature refugees are portrayed either as those who lack what national citizens have or as a threat to the national order of things. This article explores the effects of being excluded in such a way, and argues that Burundian refugees in a camp in northwest Tanzania find themselves in an ambiguous position, being excluded from the national order of things — secluded in the Tanzanian bush — while simultaneously being subject to state-of-the-art humanitarian interventions — apparently bringing them closer to the international community. The article explores the ways in which refugees in the camp relate to the international community. Ambiguous perceptions of the international community are expressed in rumours and conspiracy theories. These conspiracy theories create a kind of ontological surety by presenting the Hutu refugees as the victims of a grand Tutsi plot supported by ‘the big nations’. Finally, the article argues that refugees — being excluded from the nationstate and being subject to the government of international NGOs — seek recognition from the international community rather than any nationstate. This does not, however, destabilize the hegemony of the nation-state, as refugees perceive their own position as temporary and the international community as the guarantor of a more just international order in the long run. (author's)
New York, New York, Human Rights Watch, 2004 Aug 11. 35 p. (Human Rights Watch Briefing Paper)The government of Sudan is hardly a credible actor when it comes to protecting its citizens given its record of human rights abuses against Sudanese civilians in other areas of Sudan and its responsibility for the campaign of terror in Darfur. Khartoum seeks to have it both ways—it claims it cannot control or disarm the Janjaweed militias but at the same time refuses to permit international forces to be deployed to protect civilians and bring the situation under control. If the Sudanese government were serious about protecting civilians, it would welcome an increased international presence to help it stop the violence and put in place the conditions necessary for the voluntary and safe return of civilians to their home villages. This report documents and analyzes the ongoing violence and the government’s claims of progress to address the human rights crisis in Darfur in more detail based on recent Human Rights Watch research in Chad and Darfur. In some cases, the precise locations of incidents and other identifying details have been withheld to protect the security of the victims and witnesses. (excerpt)
Testing the effectiveness of integrating community-based approaches for encouraging abandonment of female genital cutting into CARE's reproductive health programs in Ethiopia and Kenya.
Washington, D.C., Population Council, Frontiers in Reproductive Health, 2004 Dec.  p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00; USAID Cooperative Agreement No. HRN-A-00-98-00023-00)Between 2000 and 2002, CARE International, with technical support from the Frontiers in Reproductive Health Program of the Population Council, implemented an operations research (OR) project among the Afar people of Ethiopia and Somali refugees in Daadab camps in Kenya. The OR project aimed to assess the effectiveness of community-based female genital cutting (FGC) strategies in increasing the knowledge of harmful FGC effects and positive FGC related attitudes and intended behaviour among the intervention communities. Both communities are predominantly of Islamic faith and practice infibulation, the most severe form of FGC. In both Ethiopia and Kenya, CARE integrated FGC interventions into existing community-based reproductive and primary health care information and service delivery activities. The study in Ethiopia was designed to test the effectiveness of education activities using behaviour change communication (BCC) approaches and advocacy activities by religious and other key leaders in the intervention site. No interventions occurred in the control sites. In Kenya, both the intervention and comparison sites had education/BCC activities. The intervention site had advocacy activities in addition to education/BCC activities. The OR study assessed the effectiveness of BCC and advocacy activities versus no interventions in Ethiopia, while in Kenya the comparison was between BCC strategies alone and the combination of BCC and advocacy activities. (excerpt)
Science. 2005 Jan 21; 307:345.At least one early-warning system in Indonesia is in place and working. On the morning of 8 January, World Health Organization (WHO) officials in Banda Aceh received a call from a relief worker reporting a case of measles—one of the biggest potential killers of children during humanitarian disasters. The team confirmed it within hours; by afternoon, health officials and aid workers were able to vaccinate more than 1000 people in the sick child’s village. The danger is far from over: WHO estimates that only a quarter of the children in the Aceh area have received a measles vaccination. But the quick and effective response to this case—and another a few days later—is one example of the kind of science-based approaches that relief organizations are bringing to the region devastated by the tsunami, says Ronald Waldman of Columbia University, who helped coordinate WHO’s team in Banda Aceh. (excerpt)
Lancet. 2004 Nov 27; 364:1974-1983.Communicable diseases, alone or in combination with malnutrition, account for most deaths in complex emergencies. Factors promoting disease transmission interact synergistically leading to high incidence rates of diarrhoea, respiratory infection, malaria, and measles. This excess morbidity and mortality is avoidable as effective interventions are available. Adequate shelter, water, food, and sanitation linked to effective case management, immunisation, health education, and disease surveillance are crucial. However, delivery mechanisms are often compromised by loss of health staff, damage to infrastructure, insecurity, and poor co-ordination. Although progress has been made in the control of specific communicable diseases in camp settings, complex emergencies affecting large geographical areas or entire countries pose a greater challenge. Available interventions need to be implemented more systematically in complex emergencies with higher levels of coordination between governments, UN agencies, and non-governmental organisations. In addition, further research is needed to adapt and simplify interventions, and to explore novel diagnostics, vaccines, and therapies. (author's)
Lancet. 2004; 364:1801-1813.Major advances have been made during the past decade in the way the international community responds to the health and nutrition consequences of complex emergencies. The public health and clinical response to diseases of acute epidemic potential has improved, especially in camps. Case-fatality rates for severely malnourished children have plummeted because of better protocols and products. Renewed focus is required on the major causes of death in conflict-affected societies—particularly acute respiratory infections, diarrhoea, malaria, measles, neonatal causes, and malnutrition—outside camps and often across regions and even political boundaries. In emergencies in sub- Saharan Africa, particularly southern Africa, HIV/AIDS is also an important cause of morbidity and mortality. Stronger coordination, increased accountability, and a more strategic positioning of non-governmental organisations and UN agencies are crucial to achieving lower maternal and child morbidity and mortality rates in complex emergencies and therefore for reaching the UN’s Millennium Development Goals. (author's)
Global HealthLink. 2001 Nov-Dec; (112):6-7.Humanitarian workers and displaced people are racing against time to build an estimated 6,000 mud brick shelters in Maslakh camp for the displaced just outside Herat, while across the country others are bracing themselves for the consequences of both the attack on Ahmed Shah Massoud, military leader of the anti-Taliban Alliance, and the tragic events in the United States. They have less than eight weeks before winter takes serious hold bringing snow and freezing winds to rake the valley. Another 4,000 shacks need repairs, and neither of these figures take into account accommodation for new displaced who continue to arrive at a rate of around 300 people a day - more than 8,500 in the month of August. However, all international UN staff are now being evacuated and many NGOs are doing the same. (excerpt)
BMJ. British Medical Journal. 2004;  p..Médecins Sans Frontières (MSF) has found "alarming nutritional needs" in war torn Darfur, western Sudan. "MSF is extremely concerned about the food security of the population of Darfur and fears that continued violence and insecurity, coupled with an insufficient international response, means that the situation can only deteriorate," warned the organisation. During a two day vaccination drive among 4900 children in the town of Garsila, western Darfur, MSF staff identified 111 severely malnourished children and 387 moderately malnourished children. In February, MSF reported "catastrophic mortality rates" and "newly displaced people living in extremely precarious conditions." In early March it reported a "marked increase in the degree of malnutrition in just the past two months," insisting that a massive aid effort be undertaken urgently. The UN Office for Coordination of Humanitarian Affairs (OCHA) has also reported that half of Darfur's six million population are affected by the conflict. (excerpt)
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2003 Mar. 28 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/03.16E)Until recently, relatively little attention had been paid to HIV/AIDS care and prevention in the context of a humanitarian response. Traditional priorities in emergencies included the provision of food, water, sanitation, shelter and basic health services. Because of the long incubation period of HIV, the disease was not considered an immediate threat to life and was therefore not thought of as a ‘relief issue’. Factors (such as poverty, social instability and powerlessness), typically associated with conflicts and the forced displacement of people, were already known to exacerbate HIV transmission. Until the catastrophic Rwandan refugee crisis of 1994, however, there was little appreciation of how very significant these factors were. Before that date, no major specific interventions for HIV infection or for other sexually transmitted infections (STIs) had been designed for refugees. This monograph documents the first large-scale AIDS and STI intervention programme to be implemented during a refugee crisis. It describes the operational aspects of the intervention, the observed impact and the effect this experience had on policies and practices in other refugee situations, among both international and nongovernmental organizations. It provides insights into the elements and approaches for STI services that will be useful for reproductive health programme managers from government and international organizations as well as nongovernmental organizations involved in relief operations. It will also be useful for district or regional health managers in identifying needed support systems for STI service delivery. (excerpt)
Lancet. 2003 Jul 5; 362(9377):72-74.The wars in Afghanistan in 2002 and Iraq in 2003 have focused the world’s attention and siphoned much funding away from other humanitarian crises. Emergencies such as those in Colombia, the Democratic Republic of Congo (DRC), Guinea, Ivory Coast, Liberia, Sierra Leone, and southern Sudan are equally or more serious in respect of human suffering and lives lost. Governments’ provision of aid to Afghanistan and Iraq, irrespective of the motives underlying it, is laudable and indicates that with sufficient political will there are enough resources to assist in refugee situations. However, in 2002, many refugee programmes, especially in Africa, were forced to cut up to a third of their budgets, with serious consequences in their capacity to provide basic lifesaving services. Further cuts are likely for 2003. These tragedies are on a second- tier in terms of political or media attention and funding. However, a third tier of protracted refugee and internally displaced person (IDP) situations receives even less attention. Consequently, such situations are chronically underfunded and often have little hope of resolution in the near future. It is difficult to quantify the health, human rights, and economic consequences for these forgotten refugees. In this report, we consider a few of these populations and call on the international community to address them properly and equitably. (excerpt)
Tanzania. Report on the nutrition situation of refugees and displaced populations. [Tanzanie : Rapport sur l'état de nutrition des réfugiés et des populations déplacées]
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):35-36.The nutrition situation of the refugees in western Tanzania is under control (category IV). Adequate relief aid supply has to be continued. (excerpt)
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):12-14.The current nutrition situation of the refugees in Kenya can not be considered acceptable (category II/III). Refugees, especially the poorest, are highly dependent on external aid. The funding shortfall UNHCR is currently facing, as well as the food shortfall WFP is expecting from February, may worsen the situation. (excerpt)
Liberia. Report on the nutrition situation of refugees and displaced populations. [Libéria : Rapport sur l'état de nutrition des réfugiés et des populations déplacées]
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):27-28.The situation of IDPs, returnees and newly-created refugees in Liberia is of concern (category II). The large new influx of vulnerable people, adding further to the already high number of IDPs and refugees, will be a difficult challenge for humanitarian agencies to respond to. (excerpt)
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):31-32.The Current food security situation in Burundi seems to be very precarious. Close monitoring and food aid should be provided in order to prevent any significant deterioration of the nutrition status. (excerpt)