University of Eastern Africa Baraton, Kenya HUMANITARIAN AID WORKER IN KAKUMA REFUGEE CAMP

Transcription

1 University of Eastern Africa Baraton, Kenya Student assignment Master s Degree in Global Health Care HUMANITARIAN AID WORKER IN KAKUMA REFUGEE CAMP Student: Name of Study Unit: Assignment name and/or number: Tuula J. Marshalls Master s Degree in Global Health Care Master s Degree in Global Health Assignment for basic epidemiology and health situation in globalization Date: Reference guidance: When referring to this document, please indicate the name of the author, publishing year, title of the document and the text: This document is originally published and available at: repository.ueab.ac.ke Accessed: Date.

2 Document synopsis: The assignment handles the topic of humanitarian work in refugee camp. It goes through the needed immunization and essential preparedness of the worker to reduce the risk of communicable diseases.

3 Table of contents 1 Background of Kakuma Refugee Camp Health risks and prevention Aid worker`s personal preparedness... 6 List of references... 8

4 1 BACKGROUND OF KAKUMA REFUGEE CAMP Since 1992 the Kakuma refugee camp has been located in northwestern deserted Turkana County, Kenya. It has served vulnerable people fleeingfrom famine, civil war, slavery/ child soldiery, genocide and other conflicts among denominations, clans or ethnic groups. The majority of refugees seeking sanctuary in Kakuma has entered from Somalia, South-Sudan and Northern Sudan. Other minorities are originated from Ethiopia, Eritrea, Uganda, Congo, Burundi and Rwanda. (Feyisse & Horn 2008) The Kakuma refugee camp is operated by The United Nations High Commission of Refugees (UNHCR). The camp area is protected by fences also residents leaving the area only by permission of the Kenyan government. The cooperation with international relief agencies and nongovernmental organizations (NGOs) is essential for running the camp. Displaced people have often experienced multiple traumas such as loss of home or family, violence and injury, but most of all the loss of hope is most crucial. The anticipation for the refugee camp being a stepping stone for resettlement in other countries is often prolonged or silenced. According to the Health Information System`s (HIS) year 2012 Kakuma refugee camp had inhabitants which of about (18 %) were under 5 years old children. Feyissa & Horn (2008) suggest some minor ethnic communities having settled their lives in the camp into rather normal routines despite the fact of standing on a strange soil. 2 HEALTH RISKS AND PREVENTION Kenya has high risk of major infectious diseases. When focusing on the risk of communicable diseases, based on the WHO health determinants such as socioeconomic environment and physical environment, the risk of getting infected in concentrated refugee camp environment 4

5 is radically increased. (Labonte & Schrecker ) People`s individual characteristics and behaviour in uprooted circumstances are also vulnerable for any unexpected changes as distress, violent behaviour and mental illnesses. Based on the fact of ethnic and behavioural diversity of the people located into the Kakuma refugee camp, the health promotion and prevention intervention sought to be based on systematic, multisectoral and quickly respond to root-level risk assessment. The efforts put into the health care in Kakuma, especially the infant care and vaccination programmes has been emphasized with outstanding results as dropping infant and under 5 years mortality rates (IMR/ U5MR) and reducing the prevalence of childhood infectious diseases such as measles, pox infections and polio. Though 25 % of U5MR is yet related to neonatal deaths, the number is still lower than for example the rates of rest of Kenya. The major challenge of communicational diseases in Kakuma refugee camp environment relates to respiratory system diseases as upper and lower respiratory infections and water-/ foodborne disease as diarrhoea, schistosomiasis and intestinal worms. The main vectorborne diseases and infections such as malaria, skin and eye infections occurs often, but are fairly treatable. The acute malnutrition - though not counted as communicable disease, has often a link to the food- or waterborne diseases as intestinal worms causing stunting and is one of the major mortality cause of children in the camp. (Lindstrand et.al 2014.) Other major communicable diseases in the camp among older population are STDs, UTIs and ear infections. Despite the incidences of HIV/AIDS, Tb and meningitis are recorded being rather few (HIS 2012), the risk of these causing widely spread epidemic is noteworthy. For example outbreaks of epidemics such as Ebola in Western Africa this year or Cholera in Zimbabwe year 2008, would have devastating results in refugee camp context. That is a reason why structuring, up keeping and even protecting the functional clean water and sanitary system besides of systematic immunization are key elements of refugee camp health care and risk prevention. The basic education and practical level of knowledge provided for residents on nutrition, food and personal hygiene and environmental issues has long term outcomes among the present or future communities. (WHO, 2014; 2012; 2011). 5

6 3 AID WORKER`S PERSONAL PREPAREDNESS Finland is renowned for executing the one of most systematic and long term vaccination programme in the world. It covers infanthood, childhood and military service as well if needed the elderly immunization. The author of this paper was born in 1970 and being part of the system was privileged to receive then the life time immunization against meningitis, pertussis, measles, chickenpox, rubella, whooping cough and mumps. According to Finnish National Institute for Health Care and Welfare (THL), beside of mentioned comprehensive childhood vaccination programme, the polio immunity is suggested to be boosted every after 5 years and tetanus/ diphtheria every 10 years if located to the risk areas. Due to the previous expatriate work experience in East Africa between years 1994 and 1999, yellow fever vaccination was required to enter the Eastern African Community. Based on fact of yellow fever risk being very low, if any in East Africa, the vaccination card was stamped without actual immunization by request. According to the WHO (2013) the 10 years booster vaccination is no longer demanded for yellow fever, though yet required for example by Kenya officials. Also the author game to find out, that the typhoid fever vaccination did not prevent from the bacteria, nor will sickness provide any immunity against the same or a different strain of S. typhi bacteria. The oral booster is suggested to be taken every 5th year while staying in infected area. Working in refugee camp environment as a health care personnel, both Hepatitis A and B are crucial. Hepatitis A vaccination combined with booster is expected to cover at least 30 years and Hepatitis B with booster vaccinations gives life time immunity. Both vaccinations are valid and accordingly recorded into the international vaccination document. (Rokote.fi.) As the first and most important measure of personal preparedness in actual working situation in refugee camp condition is proper hand and food hygiene. While most of the infections passes through food or water (Lindstrand et.al 2014), fully cooked and boiled/ filtered water reduces the stocking infectious diseases. Other means are keeping yourself from vector contacts as mosquito or fly bits by using repellents, net and long sleeves as well avoiding touching animals or soil. A good skincare reduces rash, cuts and so possible infections besides keeping wet laundry inside avoiding insect egg hatching in the skin. Also when treating risk assessed patients, 6

7 the protection gear use as breathing protection and cloves is crucial. Other measures of protection has to be taken seriously when infections as cholera occurs. According to the UN High Commissioner for Refugees Mr Antònio Guterres (2012), the faith is central of hope and resilience. It forms a personal and collective support recovering from conflict being one of the most powerful thing in helping uprooted people to cope with fear, loss, separation and destitution. In due to accomplishing the challenging goals of improving refugees` multidimensional well-being, the aid workers own mental and physical strength and balance is a key to success in stressful and uncertain circumstances. (Leininger & McFairland ) The value of proper training and peer-support could never be overemphasized. The awareness of safety measures and preparedness plan of hostile situations, especially when violence risk is obvious, should neither be neglected while several studies shows that the immunity of international peace support actors is no longer respected in humanitarian crises (edit. Ådahl, 2013; 7-11,). 7

8 LIST OF REFERENCES Feyissa, Abebe & Horn, Rebecca, The camp a report from Limbo. Boston College Magazine. Spring bcm.bc.edu (accessed ) Finnish Defence Forces International Centre Expecting the Unexpected, Edited by Susanne Ådahl. Tuusula: Fincent Publication Series 1:2013 Guterres, Antònio, High Comissioner`s Dialogue on Protection Challenges. Theme: Faith and Protection. UNHCR. unhcr.org (accessed ) (HIS) The Health Information System, Kenya Summary Report, Labonte, R. & Schrecker, T Globalization and social determinants of health: Promoting health equity in global governance (part 3 of 3). Globalization and Health 2007 (3) 7. Leininger Madeleine & McFairland Marilyn R. 2002, Transcultural nursing concepts, theories, research & practice. New York: McGraw-Hill Medical Publishing Division. 3rd edition. ISSN/ISBN Lindstrand A. Bergström S. Rosling H. Rubenson B. Stenson B. & Tylleskär T. 2014, Global Health an introductory textbook. Lund: StudentlitteraturAB. ISSN/ISBN ; WHO, Rokote.fi Travellers vaccinations THL - Child and youth vaccination. WHO, Progress on Sanitation and Drinking-water 2014 update. apps.who.int. (accessed )

9 WHO, Weekly epidemiological record. 2013, 88, p.11 WHO, facts on food safety (accessed ) WHO, Valuing Water, Valuing Livelihoods. Guidelines on Social Costbenefit Analysis of Drinking-water Interventions, with special reference to small Community Water Supplies. Edited by John Cameron, Paul Hunter, Paul Jagals and Katherine Pond. WHO, IWA Publishing. whglibdoc-who-int (accessed )