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<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><FONT
size=3>About one third of the patients in the camp clinics demonstrate somatic
complaints that are aggravated by psychological and social stress. Since medical
NGOs mainly have the mandate to treat emergency medical cases and acute
infectious diseases, chronic diseases can only be addressed symptomatically.
Although the World Health Organisation and Ministry of Health are pushing for
strategies to address diseases like HIV, TB and mental disorders, the lack of
financial and political will to address diseases that are rooted in social
disruption leave these programs on standby for the moment. In humanitarian
emergencies, funds are allocated for a period of one year and rapid progress
must be made. Hence vertical programs addressing health issues are in the
majority. Malaria, diarrhoea and malnutrition are reduced by providing
antimalarials, ORS and enriched food. Health messages are given to the
population about the necessity of using impregnated bednets, proper hygiene and
breastfeeding the infants. To be fair, all these programs are <I>necessary</I>
in the humanitarian work, but all too often they are not embedded in a broader
strategy that addresses root causes of disease. The displacement and
impossibility to economically maintain a family’s livelihood <I>itself</I>
increases by tenfold the relative risk on poor health status and
mortality.</FONT><A title="" style="mso-endnote-id: edn1"
href="mhtml:mid://00000549/#_edn1" name=_ednref1><SPAN
class=MsoEndnoteReference><SPAN style="mso-special-character: footnote"><SPAN
class=MsoEndnoteReference><SPAN lang=EN-GB
style="FONT-SIZE: 12pt; FONT-FAMILY: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-GB; mso-fareast-language: NL; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA">[1]</SPAN></SPAN></SPAN></SPAN></A><?xml:namespace
prefix = o ns = "urn:schemas-microsoft-com:office:office"
/><o:p></o:p></SPAN></P></DIV><SPAN lang=EN-GB
style="FONT-SIZE: 12pt; FONT-FAMILY: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-GB; mso-fareast-language: NL; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA"><BR
style="PAGE-BREAK-BEFORE: always; mso-break-type: section-break"
clear=all></SPAN>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><FONT
size=3>Is it surprising that IDPs sell the bednets they were given on the
market? What about health messages about hygiene when people are crowded into a
camp? From a clinical and public health approach we treat symptomatically. We
cannot cure, but alleviate symptoms. Many lives have been saved, but the
community and social nucleus itself is destroyed. <o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><FONT
size=3>What is the alternative? In medicine, diseases can be prevented, and if
they occur can be prevented from worsening. In public health, the goal is to
prevent outbreaks of communicable diseases such as meningitis and cholera. To
prevent a humanitarian emergency may be more difficult, but possible. In
<?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags"
/><st1:place w:st="on">Eastern Africa</st1:place>, fragile balances exist (or
have already been disrupted) between communities and interests groups about
natural and political resources. The Democratic Republic of Congo, with all its
mineral resources, has suffered gravely in recent years. The <st1:country-region
w:st="on">Central African Republic</st1:country-region> and <st1:country-region
w:st="on"><st1:place w:st="on">Chad</st1:place></st1:country-region> face crises
as governments might topple. <st1:country-region
w:st="on">Ethiopia</st1:country-region> and <st1:country-region
w:st="on"><st1:place w:st="on">Kenya</st1:place></st1:country-region>, with
their varied ethnic tribes, are constantly at risk of famine.
<st1:country-region w:st="on"><st1:place
w:st="on">Somalia</st1:place></st1:country-region> is still inflamed and
devastated by an ethno-religious conflict. And <st1:country-region
w:st="on"><st1:place w:st="on">Sudan</st1:place></st1:country-region>, with its
20 years of war in the South, continues to be the country with the largest
internal displaced population on Earth. Because major political and economic
structures can be analysed, but are almost impossible to alter, international
assistance must focus on individual communities. This assistance must be humble
in character and rely on the knowledge and character of the community. In
general <I>they </I>are the ones who know best how to organise the resources.
Communities must be supported in claiming their right to health as part of a
larger human rights approach, holding the duty bearers accountable for the
violated and neglected health determinants</FONT><A title=""
style="mso-endnote-id: edn2" href="mhtml:mid://00000549/#_edn2"
name=_ednref2><SPAN class=MsoEndnoteReference><SPAN
style="mso-special-character: footnote"><SPAN class=MsoEndnoteReference><SPAN
lang=EN-GB
style="FONT-SIZE: 12pt; FONT-FAMILY: Garamond; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-GB; mso-fareast-language: NL; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA">[ii]</SPAN></SPAN></SPAN></SPAN></A><FONT
size=3> <o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><FONT
size=3>In the meantime, the international community must keep analysing,
discussing and lobbying on the effects that WTO agreements, oil, mineral and
water exploitation, weapons trade have on regions and environments. A widening
gap will grow between the globalised haves and the have-nots who are left
behind. More and more people risk tumbling over into this last group. Will we
let it happen on our watch?<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><o:p><FONT
size=3> Dr Remco van de Pas</FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: justify"><SPAN
lang=EN-GB
style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><o:p></o:p></SPAN><FONT
size=3><SPAN lang=EN-GB
style="FONT-FAMILY: Garamond; mso-ansi-language: EN-GB"><SPAN
style="mso-tab-count: 2"> </SPAN><SPAN
style="mso-tab-count: 5"> </SPAN><SPAN
style="mso-spacerun: yes"> </SPAN>Darfur
& The <st1:country-region w:st="on"><st1:place
w:st="on">Netherlands</st1:place></st1:country-region>, July
2006</SPAN></FONT></P></FONT></DIV></BODY></HTML>