Other Health Issues
Although these reports focus on the major causes of morbidity and mortality
during the emergency phase of refugee displacements, other health problems
warrant the attention of public health practitioners in these settings.
Injuries
Thus far, injuries related to armed conflict and psychological problems
relating to war, persecution, and the flight of the refugee have been poorly
quantified. In a recent report on Iraqi refugees on the Turkish border, 8% of
the deaths during a 2-month period were attributed to trauma. Sixty percent
of these trauma-related deaths were attributable to shootings by armed
soldiers (CDC. Toole M, trip report, September 1991). Anecdotal reports
support the existence of high rates of physical disabilities caused by war
injuries in some refugee camps, such as those for Afghan refugees in
Pakistan, Cambodian refugees in Thailand, and Mozambican refugees in Malawi.
Maternal health
The problem of morbidity and mortality related to pregnancy and childbirth
has been inadequately documented, although earlier sections of this report
described high anemia rates and high hepatitis-specific mortality rates among
pregnant women (52). Also, studies of scurvy and pellagra among refugees in
Africa have consistently revealed higher incidence rates in women than in
men, and a study in Somalia showed that pregnancy was a risk factor for the
development of clinical scurvy (32,35).
Sexually transmitted diseases and HIV
Few published reports have referred to sexually transmitted diseases (STD) in
refugee populations. However, there is no evidence that the incidence of STDs
in camps is any higher (or lower) than in non-refugee communities. Similarly,
practically no data exist on the prevalence of HIV infection, nor on rates of
transmission in these populations. Many of the large displaced and refugee
populations of the world are either located in, or have fled to, countries
where HIV prevalence rates are high. These include: Mozambican refugees in
Malawi, Zambia, and South Africa; Ethiopian refugees in Sudan; Liberian
refugees in Cote d'Ivoire and Guinea; Ugandan and Rwandan refugees in Zaire;
Cambodian and Laotian refugees in Thailand; and Sudanese refugees in Uganda.
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