IDPs Report

8/14/2019 IDPs Report

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Jazan University

Faculty of Medicine

Department of Family and Community Medicine

4 th year 1430-31

Module : Research Methodology and Field Training

Internally Displaced Persons ( IDPs ) Needs Assessment Health Survey Report.

WORK TEAM

Mohammed Ali Al-HamziMohammed Ahmed Al-TherwiMohammed Ali DahasEmad Hussein Al-AqsamAbdul Arrhamn Abul QassemAli Ebrahim WasliAbdul Majeed Hakami



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INTRODUCTION

At least 25 million people are uprooted with-in the borders of their own countries by armedconflict, generalized violence, persecution, and natural and human-caused disasters. The

plight of these internally displaced persons (IDPs) in some 52 countries is a pressing

humanitarian, human rights, development, and political challenge for the global community.

Internally displaced persons are "persons or groups of persons who have been forced or obliged to flee or to leave their homes or places of habitual residence, in particular as aresult of or in order to avoid the effects of armed conflict, situations of generalised violence,violations of human rights or natural or human-made disasters, and who have not crossed aninternationally recognised State border."

“IDPs are among the world’s most vulnerable population groups.”

· Internally displaced persons may be in transit from one place to another, may be inhiding, may be forced toward unhealthy or inhospitable environments, or face other circumstances that make them especially vulnerable.

· The social organization of displaced communities may have been destroyed or damaged by the act of physical displacement; family groups may be separated or disrupted; women may be forced to assume non-traditional roles or face particular vulnerabilities.

· Internally displaced populations, and especially groups like children, the elderly, or pregnant women, may experience profound psychosocial distress related todisplacement.

· Removal from sources of income and livelihood may add to physical and psychosocial vulnerability for displaced people.

· Schooling for children and adolescents may be disrupted.

· Internal displacement to areas where local inhabitants are of different groups or inhospitable may increase risk to internally displaced communities; internallydisplaced persons may face language barriers during displacement.

· The condition of internal displacement may raise the suspicions of or lead to abuse byarmed combatants, or other parties to conflict.

· Internally displaced persons may lack identity documents essential to receiving benefits or legal recognition; in some cases, fearing persecution, displaced personshave sometimes got rid of such documents.

Health need assessment is the process of determining the health and health care needs of anygiven population or sub-group in an area. Health care needs is changing a now challengesarising from chronic diseases , unfavorable human condition human condition such asdisplacement should be faced. Better coverage of preventive and essential health care servicehas lead to greater emphasis on improving the quality of health care to ensure the efficientand judicious use of scarce resources.



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Literature review

The Northern Uganda IDP Profiling Study has been carried out under theauspices of the Office of the Prime Minister, Department of DisasterPreparedness and Refugees.

The level of human suffering for the 1.3 million internally displaced persons (IDPs) in Gulu,Kitgum and Pader is high, but even within Acholiland there is a clear hierarchy of suffering:across almost all indicators used in this study the situation for the IDP population in Pader isthe worst, followed by the one in Kitgum. The overall situation in Gulu is only slightly better.The IDPs in Northern Uganda are constantly afraid, both outside of the camps and insidethem as well. They are extremely poor, with limited possibilities for cash income, almost nocredit available, and very few receive remittances from relatives. They depend onhumanitarian aid. A minority believe that their situation will improve. Most believe it willdeteriorate. Our research shows that, in their experience, the situation can almost alwaysbecome worse, and if the war continues very much longer this is precisely what will happen.The IDP popula on is young, more than 50 percent are under the age of een. As many as25 percent of the children have lost one, or both of their parents, and a huge number of thewomen are widows.The role of men in the camps has been noted in other studies and, while to a certain degreeit appears that their traditional role is vanishing, the present study indicates that that menare just as involved as women in economic activities.There are few positive aspects about the IDP situation. One of the very few, is the schoolsystem in the camps. The report indicates that there is an educational system in the campsthat is working. This should be taken into consideration while planning for return.The IDPs are effectively displaced from their homes, but their displacement is only a shortgeographical distance. If a peace comes to Northern Uganda, as many as one third of the IDPpopula on, or approximately 400,000 people, may start moving out of the campsspontaneously. Another third will move if some assistance is given, while a final third will

remain in the camps, at least for a while. The implications are that assistance providers willhave to plan for at least three scenarios that may take place at more or less the same timeand place.

Bøås M , Hatløy A , Fafo. The Northern Uganda IDP Profiling Study. United NationsDevelopment Programme. September 2005 ; Volume 1 : 5.



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Internally displaced persons in El Geneina, western Darfur.

A nutritional, mortality and general household status survey was conducted between 26 and29 June 2004 among internally displaced persons (IDPs) living in twelve camps in or aroundthe city of El Geneina, capital of West Darfur State, Sudan.

The IDP population in question had begun arriving in El Geneina in November‐December2003, but li le humanitarian assistance had been made available to them as of June 2004,aside from food distribu ons based on a single registra on in March 2004 (arrivalscontinued up to May).The IDP population in each of the camps (Abu Zahr, Ardamata, Durti, Kirinding, Medinat elHujjaj,al Mustaqbal, Riad, Sultan House, el Tadamon, al Thura, al Zahra, and Zalingei University)was estimated through a combination of hand tally counts and area sampling. A classic two‐stage cluster survey was then performed, with a sample size of 900 children 6‐59 months oldfor the nutritionalassessment, 900 households for the mortality assessment, and 210 households for thegeneral household status assessment.

An es mate of 80 277 IDPs was obtained for the twelve camps in and around El Geneina.Thisestimates exceeds the previous World Food Programme working figure, but isconsiderably lower than counts provided by camp chiefs. Serious overcrowding was apattern in almost all camps.

· Main findings of the survey included: A 5.5% (95%CI 4.1‐7.3) prevalence of severe acute malnutri on expressed as Z‐score

devia on from the reference mean. The global malnutri on prevalence was 25.8%(95%CI 22.9‐28.8).A crude mortality rate of 5.6/10 000/day (95%CI 4.1‐7.6) in a retrospective recall period

of 39 days from the rst yearly rainfall (20 May 2004).o Under 5 mortality rate was 14.1/10 000/day (95%CI 9.7‐20.1).

o Diarrhoea was the leading cause of death.o Only 17.4% of dead persons received care in hospital.A diarrhoeal morbidity rate of 50.2 cases/1000/week among under 5 children, of whichonly 26.3% received treatment.59.5% of households had access to pump or tap water, but only 40.0% owned a

jerrycan.Only 36% of households used a latrine, and 5% owned soap.

Only 40% of shelters had a roof protec ng against the rain.Only 35% of households stated that they owned a food distribu on card

Checchi F. A survey of internally displaced persons in El Geneina, western Darfur. WHOCollaborating Centre for Epidemiology Research and Response to Emerging Diseases. July2004 ; Final Report.



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Objectives

1. To investigate the health situation of displaced people in the displacement camps.2. To determine the most common cause of morbidity in the studied camps.3. To identify the basic health needs of displaced people in Jazan camps.

4. To come out with recommendation that help in improving the health status of displaced people.

Research methodology

§ Study area. The study has been conduct in internally displaced persons campaign in Al‐Ahadcity.

§ Study population.

Internally displaced person ( IDP ) : a person not living in his/her permanentresidence.

§ Study design. The study based on cross‐sectional study.

§ Sample design. The field work conducted in Jazan region in internally displaced persons campaign inAl‐Ahad city and the samples were divide into 4 groups in each group 6 members ,and each group approximately met 120 families.

§ Data collection. The data collected by interview . The questionnaire was designed to collect a set of information related to health needs of displaced people.The questions were designed to collect information on demographic characteristicsincluding sex , age , literacy , marital status , general health , child health , andcommunicable diseases.

§ Data analysis. we use frequencies ,tables , charts and association by SPSS and EXCEL.

§

Ethical consideration. The study had been follow the following principles :

i. A duty to show respect to persons.ii. A duty be sensitive to culture and traditions.iii. A duty not to exploit the vulnerable.iv. A duty of confidentiality.



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Sex

Male

Female

Result

Most respondents are young

In the study we met 120 families and the total of the individuals in these families is 943persons . including 125persons below 5 years which represents 13.3 % , and 275 persons

between 5 and 14 years which represents 29.2 % and 331 persons between 15 and 29 years

which represents 35 % , and 166 persons between 30 and 59 years which represents 17.6 % .and 29 persons between 60 and 70 years which represents 3.1 % . and 17 persons above 70years .

The mean age for all individuals is 21 year .

Men more than women.

In our sample study we found there is 943 respondents , 498 of them were males which

represents 51.9 % , and 454 were females which represents 48.1 % .

Sex of respondents

Frequency Percent

Male 489 51.9

Female 454 48.1

Total 943 100.0

13.3

29.2

35

17.6

3.1 1.8 Age Group Percent

0 – 4

5 – 14

15 – 2930 – 59

60 – 70

70 and above

Age Group Frequency Percent

0 – 4 125 13.3

5 – 14 275 29.2

15 – 29 331 35.0

30 – 59 166 17.6

60 – 70 29 3.1

70 and above 17 1.8

Total 943 100.0



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Big families

We found 6 families of the 120 families with no present head of the family for many reasonslike death , divorce ,or travelling .

And we found the mean of family members is 7.85 .

also the mean of sons & daughters in each family is 5.22 .

Relation with the head of the family Frequency Percent

Head of the Family 114 12.1

Son 336 35.4Daughter 291 30.9

Wife 100 10.6

Father 2 .2

Mother 10 1.1

Other 90 9.5Total 943 100.0

Marital Status

We found the most common marital status is single in number equals 666 but 400 personsof them were below the age of marriage ( 15 years ), so we consider only persons above 15years which was 266 persons equaling 48.98 % .

Also there 238 married persons which represents 43.83 % .

Marital Status Frequency Percent

Single +15 266 48.98

Married 238 43.83

Divorced 9 1.0

Widowed 30 5.52Total 543 100.0



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Educational level below than expected

We found the most common educational status is illiterate in number equals 467 but 175

persons of them below the educational age ( 7 years ) . so we consider only personsabove 7 years which was 292 persons equaling 38.02 % .

And there were only 11 persons in university which represents 1.43 %

Educational Status

Frequency Percent

Illiterate +7 292 38.02

Read and write 73 9.50

Basic 245 31.90

Intermediate 98 12.76

Secondary 49 6.38

University 11 1.43

Total 768 100.0

Another Frustrating Fact

In the all families there are 409 individuals in the work age (18 -59) , 82 of them were

head of their families

that the most majority of people ( 81.90 % ) there have no work . 50 % of the head of family are not working.

Occupation of respondents

Frequency Percent Head of Family

Government Employee 29 3.2 12

Private Employee 13 1.5 3

Working for his own 11 1.2 10

Laborer 7 .7 4

Farmer 8 1.2 7

Not working 335 90.3 41

Other 6 1.9 5

Total 409 100.0 82



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Individuals in work age Head of Family

Government Employee

Private Employee

Working for his own

Laborer

Farmer

Not working

Other

Prevalence of HP ,DM

We found that the most frequent disease is hypertension which represents 2.8 % of allindividuals and in the same me it represents 25.50 % in the risk group ( +45)

Also we found the prevalence of diabetes 1.8 % in all individuals and 16.66 % in thesame risk group .

Chronic Diseases

Frequency Percent

High Blood Pressure 26 2.8

Diabetics 17 1.8asthma 13 1.1

Heart Disease 3 0.3

epilepsy 2 0.2

Stomach Disease 4 0.4

Psychiatric 6 0.6

More than 2 diseases 25 2.6

More than 3 diseases 4 0.4

Other 80 8.5

No Disease 760 80.6

Total 943 100



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Taking care of handicapped

We found 11 handicapped person and none of them resulted from the war .and all of themreceive social and health care .

Frequency Percent

deafness 1 0.8paralysis 3 2.5other 7 5.8

Smoking & Gat

48 families have at least one smoker member , also 38 families have at least onemember who used to chew gat .

Is there any person in the family smokes

Yes No Total

Smoking 48 72120

Chewing Gat 38 82

Safe place

We found only 8 injuries and all of them for natural reasons .Is there any injuries

Frequency Percent

Yes 8 0.9

No 935 99.1

Total 943 100.0

Types of injuries Frequency

Fractions 3

Injuries 3Burns 1Other 1Total 8



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Diarrhea , Malaria and PI

We found about 8.5 % were had diarrhea , most probably causes are low level of sanitationand low level of education .

TotalAbove 5 yearsBelow 5 yearsDisease

633malaria793643diarrhea30921Pulmonary infection25241other

Deaths

We found 8 death cases in all interviewed families , one of the deaths was maternalmortality .

Environmental health

All of respondents are using the same source of water drinking which is the bottleddrinking water

All of them using general ( public ) water cycle

All of them eliminate the garbage into the garbage box.



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678

45Lactation Yes

Lactation No

Lactation NA

Lactation state is good

We found 75 families which has children below 5 years and those of 67 of thefamilies had got natural breast feeding .

The mean for natural breastfeeding period is 13.45 month

Children of 38 families s ll breas eeding .

Absolute breastfeeding

44 families had got use absolute breas eeding .

The mean for the total of absolute breas eeding period in these 44 families is 5.81

We found 42 of the 120 families using bo le in lactation .

The mean for age of starting using bottle is 3.45 month

The Past two weeks

We found 35 children who had got diarrhea within the past two weeks

One of them has not treated yet ,and most of them was treated with A.S + Anti Biotic

Family with diarrhea Frequency PercentYes 35 29.2No 40 33.3NA 45 37.5

Total 120 100

During the past two weeks there are 36 families with children were having cough ordyspnea .

Family with Children havingCough

Frequency Percent

Yes 36 30.0No 39 32.5NA 45 37.5

Total 120 100

Type of treatment FrequencyNothing 1

A.S 10Anti Biotic 9

Other 1A.S + Anti Biotic 14

Total 35



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Among all families there were 61 families with at least one diseased child ,52 families took care of their children in PHC that represents 85.24 % of all diseasedchildren .

Child Care Facility Frequency Percent

Home 3 4.91PHC 52 85.24

Hospital 2 3.27two places 4 6.55

Total 61 100

In the all 75 families which have children , 60 of them answered that they haveavailable Vaccination card , 8 of them said that they were having it but it is notavailable now , and the rest seven said that they did not have one .

Vaccination card Frequency PercentYes and available 60 80.0

Yes but not available 8 10.66No 7 9.33Total 75 100

In the past two weeks there were 12 children having fever , 11 of them visited PHCand 3 of them had screened for malaria10 of 12 had been treated for fever or malaria , 6 of them were giving Panadol as atreatment .

Yes No Total

Visit PHC 11 1

12Screen for Malaria 3 9

Treated for fever or malaria 10 2

Type of the treatment FrequencyPanadol 6

Other 2They don't know 2

Total 10

There is no family at all use bed net to sleep under .



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Conclusion

· Most respondents are young.· Men more than women.· Educational level below than expected .· Most of them are not working.· High prevalence for Hypertension and Diabetes.· Camps are considered to be a safe place.· Few number of deaths in the last year , one of them was maternal mortality.· Lactation state is good .· There is no family at all use bed net to sleep under .

Recommendation

1. Improving sanitation in Water cycles.2. The camps so far from the main entrance , so many of elderly move a long distance

which may hurt them.

References

· Bøås M , Hatløy A , Fafo. The Northern Uganda IDP Profiling Study. UnitedNations Development Programme. September 2005 ; Volume 1 : 5.

·

Checchi F. A survey of internally displaced persons in El Geneina, western Darfur. WHOCollaborating Centre for Epidemiology Research and Response to Emerging Diseases.July 2004 ; Final Report.

Done

IDPs Report

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