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Emergency refugee health care : a chronicle of experience in the Khmer refugee-assistance operation 1979-1980
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    Foreword -- Preface -- PART I. The Setting and the Health Problems -- 1. Historical Background—The Historical Context of the Khmer Refugee-Assistance Effort in Thailand -- 2. Organization of Health-Care Efforts for Khmer Refugees in Thailand -- 3. Organization of Sakaeo Refugee Center, October 1979-January 1980 -- 4. Organization of Khao I-Dang Center, November 1979-January 1980 -- 5. The Border Camps—Health Assistance in Khmer Refugee Camps under Less Stable Conditions -- 6. The Role of the Thai Red Cross Society in Providing Health Care to Khmer Refugees, 1979-1981 -- 7. Patterns of Illness and Death among Khmer Refugees in Thailand, October 1979-April 1980 -- 8. Rapid Assessment of Health Status and Preventive Medicine Needs of Newly Arrived Kampuchean Refugees, Sakaeo, Thailand -- 9. Malaria among Newly Arrived Khmer Refugees in Thailand, 1979-1980 -- 10. Measles Outbreak, Khao I-Dang Refugee Camp, Thailand -- 11. Cholera in Two Kampuchean Refugee Camps -- 12. Tuberculosis Control Program s, Sakaeo and KhaoI-Dang -- 13. Meningococcal Disease among Khmer Refugees in Thailand 65 -- 14. Poliomyelitis in KhaoI-Dang Holding Center, February-March 1980 -- 15. Nutritional Assessment and Feeding Programs in Refugee Centers: The Thailand Experience -- 16. Surgery during Khmer Refugee-Assistance Efforts in Thailand -- -- Part II. Public Health Considerations -- 17. Refugee Public Health Issues -- 18. The Evolution of a Refugee-Assistance Operation: Who is Needed—and When? -- 19. Overall Organization of a Refugee Health-Assistance Program -- 20. The Role of Traditional Medicine in Khmer Refugee Camps -- 21. The Role of Khmer Refugees in Their Own Health Care -- 22. Psychological Needs of Refugees—The Khmer in Thailand -- 23. Environmental Health Issues in Refugee Camps -- 24. Nutritional Aspects of Refugee Assistance -- 25. Donated Foods and Their Use in Refugee-Assistance Operations -- 26. Vaccination Programs for Refugees -- 27. Surveillance of Fertility Patterns in the Khmer Refugee Camps: A Guide for Anticipated Health Services -- 28. Obstetrical Services for Refugees -- 29. Laboratory Services in a Refugee-Assistance Program -- -- Part III. The Role of Epidemiologic Surveillance -- 30. Organizing Epidemiologic Surveillance for a Refugee Population -- 31. Rapid Health Screening as an Epidemiologic Tool in Refugee Camps -- 32. The Role of the Epidemiologist in the Established Refugee Camp -- -- Part IV. Epilogue

    This report is devoted entirely to health aspects of refugee relief. This is a timely topic, since there has been an enormous increase over the last few years in the number of refugees in the world, and relief organizations have had to expand their activities in many areas. In addition to the Khmer and other refugees in Southeast Asia, large numbers of refugees have been associated with other conflicts in Central America, Asia, and Africa. These expanding refugee populations have major public health and medical problems that need to be addressed.

    The 33 contributors to this report are from 11 countries in Asia, Europe, North America, and Australia. All worked in the early days of one of the largest emergency humanitarian relief efforts ever undertaken—the Khmer refugee relief operation of 1979-1980. The authors represent a variety of medical and public health disciplines, including administration, nutrition, epidemiology, laboratory technology, sanitation, and clinical specialties.

    This document is intended to serve as a compendium and chronicle of recent experiences of various health professionals and to extract from these experiences some general principles and lessons that will be of use to health workers in future refugee operations in developing countries. Clearly, the Khmer operation was in m any ways unique—rarely in the history of humanitarian relief has there been such an outpouring of money, personnel, and other resources from a concerned international community. The combination of available resources and a cooperative host country (Thailand) enabled the Khmer operation to pursue and achieve goals often impossible in refugee-assistance programs. Despite this unique aspect of the operation, there are many important lessons to be learned from this experience that can be applied in other refugee-assistance programs.

    Major components of the report include a historical prospective of the area, the organization of the camps, and specific health problems encountered—and the large area covered by public health practice—societal influences, administrative concerns, and logistics of dealing with large groups of displaced persons.

    In the interests of clarity and readability we have tried whenever possible to avoid using medical terminology or the specific jargon of any medical or public health specialty. When technical words or abbreviations are used, an effort has been made to define them or place them in context.

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