POST-EMERGENCY EPIDEMIOLOGIC SURVEILLANCE IN IRAQI-KURDISH REFUGEE CAMPS IN IRAN

In 1991 a computerized, comprehensive epidemiological surveillance sys tem was developed to monitor health trends in approximately 25,000 acu tely displaced Kurds in Nowsood and Saryas refugee camps, Bakhtaran re gion, Northwestern Iran. In addition, community-based surveys offered information unobtainable from health facilities. Weekly population mov ements, attack rates, point-prevalence estimates, and case fatality ra tios were calculated, and the data were analysed and compared. The ove rall crude mortality rate (CMR) in the camps under study was still 9 t imes higher than the reported CMR for Iraq. Health problems with very low rates (less than 1.0/1,000 population/week) included the triad of measles, meningitis and tetanus. However, morbidity for the most commo n conditions (acute respiratory infections, diarrhoea, skin infections , eye diseases and, finally, typhoid fever) was shown to increase at t he end of the intervention, highlighting that the pressure of repatria tion on refugees made them progressively worse. This article concludes that epidemiological surveillance systems should be implemented durin g mass-migrations in developing countries also in post-emergency setti ngs. Furthermore, surveillance appears to be indispensable in order fo r the international agencies to keep abreast of events and to safeguar d human rights when international attention subsides.