Godfrey N, Kalache A
Evaluation and Planning Centre for Health Care, London School of Hygiene and Tropical Medicine, England.
Soc Sci Med. 1989;28(7):707-13. doi: 10.1016/0277-9536(89)90218-9.
The high rates of death, disability and illness and the scarcity of resources associated with relief operations for victims of oppression, war and famine have led to some support systems of triage for health and nutritional care in relief. Two vulnerable groups have often been given priority for targeting in health relief--young children and their mothers. This paper reports the findings of a study of the health needs of another vulnerable group, older adults, among those who had been recently displaced to Sudan in 1984-1985 by the war and famine in Tigray region of Ethiopia. The study attempted to determine the extent to which morbidity events and migration affected the life-style of older adults and the socio-economic support mechanisms which were available to them. The findings indicate that older adults (those over 45 years of age) were a very small proportion of the population and that over half of those aged 60 years and over (defined as 'elderly' in this paper) had been left behind in Tigray. This may well indicate that disability, illness or both, forced many older adults, particularly those most in need, to remain in Tigray. Among older adults living in Sudan, high levels of minor disability, social isolation and total economic dependency indicated vulnerability, but older adults had not been specifically considered in health policies and plans. Their primary needs were basic--for cloth, food, shelter, transport, seeds, oxen and farming tools. We conclude that priority in relief should be to support individuals, families and entire communities by adequately providing for basic needs. Furthermore, international relief agencies should give equal consideration to those who remain in their homes and those who migrate for assistance. This approach would take into consideration quality of life, not just the number of lives saved among those who reach the camps and shelters, and would assume responsibility for 'Health for All', not just for selected 'vulnerable groups'.
与压迫、战争和饥荒受害者救援行动相关的高死亡率、高致残率和高发病率以及资源匮乏，促使人们在救援中建立了一些健康和营养护理的分诊支持系统。在健康救援中，有两个弱势群体常常被列为优先照顾对象——幼儿及其母亲。本文报告了一项针对另一弱势群体——老年人——健康需求的研究结果，这些老年人是1984 - 1985年因埃塞俄比亚提格雷地区的战争和饥荒而新近流离到苏丹的人群。该研究试图确定发病事件和迁移对老年人生活方式的影响程度以及他们可获得的社会经济支持机制。研究结果表明，老年人（45岁以上）在人口中所占比例非常小，60岁及以上的人群（本文定义为“老年人”）中有一半以上留在了提格雷。这很可能表明残疾、疾病或两者兼而有之，迫使许多老年人，尤其是那些最需要帮助的老年人，留在了提格雷。在生活在苏丹的老年人中，轻微残疾、社会孤立和完全经济依赖程度较高，表明他们处于脆弱状态，但健康政策和计划中并未特别考虑老年人。他们的基本需求很简单——衣服、食物、住所、交通、种子、耕牛和农具。我们得出结论，救援的重点应该是通过充分满足基本需求来支持个人、家庭和整个社区。此外，国际救援机构应该平等考虑留在家里的人和为寻求援助而迁移的人。这种方法将考虑生活质量，而不仅仅是到达营地和避难所的人中获救的人数，并将承担起“全民健康”的责任，而不仅仅是为选定的“弱势群体”负责。
