4020.0: Tuesday, October 23, 2001 - 9:00 AM

Abstract #24341

A cross sectional study of the Health Experience of Rwandese refugees repatriated from refugee camps in Tanzania during mass repatriation back to Rwanda in 1996

Johnmark O Opondo, MD, MPH, International Health, Emory University, 2971 Cedar Brook Drive, Decatur, GA 30033, (404) 251-9277, jopondo@sph.emory.edu, James Setzer, MPH, Department of International Health, Emory University, Rollins School of Public Health, 1518 Clifton Road, N.E., Atlanta, GA 30322, and Brent Burkholder, MD, MPH, International Emergency and Refugee Health Branch, CDC, National Center for Environmental Health, 4770 Buford Hwy, N.E. Mail stop F-48, Atlanta, GA 30341.

Background: From Dec 14, 1996 to Jan 2, 1997 473,000 Rwandan refugees returned home from refugee camps in Tanzania. Mass repatriations over such a short time frame are uncommon and international humanitarian organizations had few standards to guide their interventions. Methods: The methodology used in this case study is a descriptive analysis of secondary data collected by the epidemiologic surveillance system set up during mass repatriation, and field reports on the health of this group of returnees. Daily epidemiological reports from 34 health facilities in Kibungo Prefecture were examined and the morbidity and mortality data of the 473,000 returnees were compared with similar data on 414,000 members of the local population. Findings: The morbidity patterns experienced by both the local and returnee populations were similar. An outbreak of bloody diarrhea was seen in Kibungo Prefecture, the returnees accounted for 65% of the cases. The major causes of mortality were related to obstetric causes (7), trauma (5), diarrhea (1), malaria (1), and pneumonia (1). Recommendations: Mass repatriation in poor resource environments needs good inter-sectoral collaboration with host national governments. Experienced field personnel should be involved in the triage of the vulnerable populations at the start of the mass repatriation so as to be able to provide transport for all the pregnant women. All vehicles should be equipped with an emergency delivery kits. A system to control the movement of motor vehicles in densely crowded situations is important. Health education should be provided for the truck drivers on pedestrian traffic safety.

Learning Objectives: An increased incidence of mortality and morbidity is not uncommon during forced mass migration as the conditions which facilitate disease transmission such as inadequate clean water, poor personal hygiene, and fecal contamination of both food and water often occur in these situations. This study proposes to examine the health experience of a group of Rwandese refugees as they repatriated back to their home country en-mass as the host country Tanzania had become increasingly hostile following military unrest in Rwandese refugee camps based in Goma, Zaire.

Keywords: Access, Birth Outcomes

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: African Education Fund Belgian Corp. CINS African Health Action, World Vision MSF MEMISA
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA