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Vol. 6, No. 2 April-June 2000
| Editor's Corner... | 
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From the grassroots . . .
CARE-Bangladesh's Disaster Management Project, under the Integrated Food Security Program, works to minimize the impacts of disasters on livelihood security. During the 1998 flood, CARE-Bangladesh spent US$16 million for emergency response activities throughout the country, setting up 15 camps in urban areas and providing health services in rural areas. This brief article highlights some lessons learned in managing flood shelters. Although relief management deals primarily with shelter and food for distressed people, health interventions should also be central to the planning and organization of disaster management activities. Health risk factors in disaster shelters, and diseases that may result, are shown in the diagram.
Some guidelines for providing health services to disaster victims in flood shelters include:
An Operational Strategy in Disaster Camp Health Centers
One public health physician should supervise the overall activity of the camp health center, with a logistics manager responsible for support to all center personnel. Two or three paramedics should be employed to help the physician with clinical services. They would visit the whole camp (every individual) every day and prescribe drugs for minor ailments. Critical or complicated patients would be referred to the physician for further evaluation. A number of volunteers should be selected as "health educators". Each of the volunteers would receive an orientation prior to starting work. "Health informers" should be another group of volunteers who report outbreaks of infectious disease in the camp and also provide necessary health information to others.
No complicated cases should be treated at the camp center. Any deaths might have a negative impact and the best way to avoid such a situation is to establish referral linkages with clinics and hospitals beforehand. Complicated cases that need hospital admission and more clinical intervention which is not available at the camp, should be referred to the clinics and hospitals. Only common cases treatable with drugs, and minor injury or accidents, should be treated at the camp health center.
-- Monzu Morshed and Dr. Rasheduzzaman Shah, CARE Bangladesh
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