Only people displaced as a result of drought or famine are under consideration here. It is generally beyond the power of communities to manage displacements of population. It is for governments to plan the settlement of displaced persons by distributing them in areas best suited to receive them (with water, cultivable land, pasturage, possibilities of development, favourable sociocultural conditions, etc.).
But when no planned action is undertaken, displaced persons end by settling down on the outskirts of towns on sites with no facilities. If there are large numbers of them, an emergency situation arises characterized by considerable problems of health and survival. It is essential to begin to act as soon as possible while waiting for government intervention and international assistance. The local authority should set up a community committee for dealing with emergencies. When international bodies intervene, they should work in collaboration with that committee. Essential steps are:
A. Appraisal of the site. If on the site of spontaneous settlement there is no possibility of water supply or if there are considerable risks (floods, subsidence, etc.), another site must be chosen and equipped with the participation of the displaced persons. The features of an acceptable site were described in the preceding section.
B. Organization of the displaced persons into family groupings1 and the selection of persons to be in charge. This implies taking a census of the displaced persons already settled on the site and of new arrivals.
C. The tackling by the community and the displaced persons’ organization of the most urgent problems:
· installation of water-supply points,1
· digging of latrines, ¹
· organization of waste collection and disposal.1
D. The local health personnel should establish a system to monitor:
· communicable diseases, giving priority to endemic diseases, including those of the area of origin of the displaced persons.¹
· the nutritional and health status of the children.1
The advisability of setting up a provisional health post near the displaced persons should be considered. An attempt should be made to provide them with:
· routine care,
· vaccinations in accordance with the national plan,
· health education,1
· community activities.
1 See the paragraph dealing specifically with this question.
The local health personnel will be assisted by volunteers from the community and by the displaced persons’ organization.