Larrance Ryan, Anastario Michael, Lawry Lynn
International Medical Corps, Department of Evidence-Based Research, Washington, DC 20006, USA.
Ann Emerg Med. 2007 May;49(5):590-601, 601.e1-12. doi: 10.1016/j.annemergmed.2006.12.004. Epub 2007 Mar 30.
We used a global humanitarian aid perspective to assess basic needs, women's health, mental health, and opinions about the status of internally displaced persons living in travel trailer parks to inform recovery efforts for this population.
This was a systematic randomized survey of 366 internally displaced persons, conducted with structured questionnaires. The study setting was commercial and group travel trailer parks in Louisiana and Mississippi. Information was gathered about respondent demographics, food security, basic needs, domestic and sexual violence, security concerns, reproductive health, mental health, morbidity, mortality, health care assessment, substance use, and opinions about internally displaced persons and social status.
Respondents were 45.9 (standard deviation 0.8) years of age on average and were mostly white (62%) in Mississippi and mostly black (65%) in Louisiana. Shelter, transportation, security, and lack of financial means were listed as the worst problems since displacement. Sixteen percent of respondents reported not having enough drinking water, and only 13% of those living in counties and parishes under boil orders were doing so. More than half of households reported an ill adult or child in the previous 2 months. The number of parents reporting problems getting children to school more than tripled after displacement. Intimate partner violence rates postdisplacement were 3 times higher than US baseline rates. Fifty percent of respondents met criteria for major depression. Suicide completion rates after displacement were more than 14 times the baseline rates, and attempt rates were more than 78 times baseline.
The health burdens identified present a formidable challenge for the health infrastructures in Louisiana and Mississippi without outside assistance. Those planning and leading recovery efforts must understand internally displaced persons in a more global context and tailor programming that follows well-developed international models of rights-based care.
我们从全球人道主义援助的角度评估了基本需求、妇女健康、心理健康以及居住在旅行拖车公园的境内流离失所者对自身状况的看法，以为该人群的恢复工作提供信息。
这是一项对366名境内流离失所者进行的系统随机调查，采用结构化问卷。研究地点是路易斯安那州和密西西比州的商业和集体旅行拖车公园。收集了有关受访者人口统计学、食品安全、基本需求、家庭暴力和性暴力、安全问题、生殖健康、心理健康、发病率、死亡率、医疗保健评估、物质使用以及对境内流离失所者和社会地位的看法等信息。
受访者平均年龄为45.9岁（标准差0.8），在密西西比州大多为白人（62%），在路易斯安那州大多为黑人（65%）。住房、交通、安全和缺乏经济手段被列为流离失所以来最严重的问题。16%的受访者报告没有足够的饮用水，而在实行煮沸水令的县和教区，只有13%的居民遵守该规定。超过一半的家庭报告在前两个月有成年或儿童生病。流离失所后，报告孩子上学困难的家长数量增加了两倍多。流离失所后的亲密伴侣暴力发生率是美国基线发生率的3倍。50%的受访者符合重度抑郁症的标准。流离失所后的自杀完成率是基线率的14倍多，自杀未遂率是基线率的78倍多。
在没有外部援助的情况下，所确定健康负担给路易斯安那州和密西西比州的卫生基础设施带来了巨大挑战。那些规划和领导恢复工作的人员必须在更广泛的全球背景下了解境内流离失所者，并根据完善的基于权利的国际护理模式调整方案。
