1. General
Cut-off values for emergency warning | More than |
Health status | |
· daily crude death rate | 1/10 000 population |
· daily under-5 death rate | 2/10 000 children under 5 |
Nutrition status | |
· acute malnutrition (weight-for-height <- 2Z scores) in under-5s | 10% of children under 5 |
· growth faltering rate in under-5s | 30% of monitored children |
· low weight at birth (less than 2.5 kg) | 7% of live births |
Standard structure of population | Average in the population |
· 0-1 year | 4% |
· 0-5 years | 18% |
· fertile women | 24% |
· pregnant women | 5% |
· expected births | 4.4 per 100 population per year |
2. Vital needs
Water | Indicator | Average requirement |
· quantity | no. of litres/person/day | 20 litres/person/day |
· quality | no. of users/water point | 200 people/water point |
(1 cubic metre = 1 tonne = 1 000 litres) | (not more than 100 metres from housing) |
Food | kcal (MJ) content | Radon, kg/person/month |
· cereals | 350 (1.46)/100g | 10.5 |
· pulses | 335 (1.40)/100g | 1.8 |
· oil | 860 (3.59)/100g | 1.2 |
· sugar | 400 (1.67)/100g | 1.2 |
kcal value of recommended ration, person/day: | 2100 kcal (8.79 MJ) | |
Total kg/person/month for feeding | 14.7 kg |
Sanitation
Latrine: ideally one per family; minimum, one seat per 20 people (6-50 m from housing)
Refuse disposal: one communal pit (2m × 5m × 2m) per 500 people
Household fuel | Average need |
Firewood | 15 kg/household/day |
Note: with one economic stove per family, the needs may be reduced: | 5 kg/stove/day |
Space for accommodation | |
· Individual requirements (shelter only) | 4 m2/person |
· Collective requirements, including shelter, sanitation, services, community activities, warehousing and access | 30 m2/person |
3. Health needs and care
Prevalent health hazards | Expected attack rate in emergency situations |
· Acute respiratory infections in children under 5 | 10%/month in cold weather |
· Diarrhoeal diseases in children under 5 (other than dysentery and cholera) | 50%/month |
· Malaria, in total non-immune population | 50%/month |
Essential primary health care activities | Target | Optimal coverage of target |
· under-5 clinic and growth monitoring | all children of 0-59 months | 100% of under-5s per month |
· antenatal clinic | all pregnancies | 50% of pregnancies per month |
· tetanus toxoid | all pregnancies | 30% of pregnancies per month |
· assisted deliveries | all deliveries | 1/12 of total annual deliveries per month |
· BCG | all new births | 1/12 of total annual births per month |
· DTP1-TT1 | all children 0-1 year | 1/12 of total group per month |
· DTP2-TT2 | all children 0-1 year | 1/12 of total group per month |
· DTP3 | all children 0-1 year | 1/12 of total group per month |
· Measles | all children 9-12 months | 1/12 of total group per month |
· STD/HIV prevention (by condoms) | all sexually active males | 12 condoms per man per month |
Health personnel requirements | Output of one person/hour of work |
Activity | |
· vaccination | 30 vaccinations |
· under-5 clinic and growth monitoring | 10 children |
· antenatal clinic | 6 women |
· assisted delivery | 1 delivery |
· outpatient department consultation | 6 consultations |
· outpatient department treatment (dressings, etc.) | 6 treatments |
Note: one person/day = 7 hours of field work | |
Health workers emergency requirements (e.g. refugee camp) for vaccinations, growth monitoring, antenatal clinic, assisted delivery, outpatient department consultations and treatments, registry and clerical duties | 60 staff × 10 000 population |
Health supplies requirements | Needed |
Essential drugs and medical equipment | |
· The WHO emergency health kit | 1 kit for 10 000 population/3 months |
Nutritional rehabilitation | Needs of each under-5 patient |
· oil | 90g/day |
· milk | 120g/day |
· sugar | 70g/day |
Safe drinking-water | amount |
a) to prepare 1 litre of stock solution 1%: | use 1 litre of water, plus: |
15g calcium hypochlorite 70% | |
or 33 g bleaching powdera 30% | |
or 250 ml sodium hypochlorite 5% | |
or 110 ml sodium hypochlorite 10% | |
b) to disinfect drinking-water with the stock solution: | use 0.6 ml or three drops of solution per litre of water; |
use 60 ml of solution per 100 litres of water. | |
(Note: allow the chlorinated water to stand at least 30 minutes before using) |
a Chlorinated lime or bleaching powder is a white powder which is a mixture of calcium hydroxide, calcium chloride and calcium hypochlorite. It typically contains 20-35% available chlorine.
· Cholera | |
Likely maximum attack rate | 6% over 4 months |
100% cases needing ORS | 6.5 packets/patient |
20% cases needing IV fluids | 3 litres/patient |
20% cases needing antibiotics: doxycycline 300 mg, 1 dose | 1 tab per course |
· Meningococcal meningitis | |
100% cases treated with oily suspension chloramphenicol | 6 amps per course |
100% population to be vaccinated | 1 dose/person |
· Measles | ||
Likely maximum attack rate in non-immunized under-12s | 10% | |
100% non-immunized under-12s to be vaccinated | 1 dose/child | |
100% under-12s to be given vitamin A | · children 6 months to 1 year | 100 000 IU/child |
· children 1 year and over | 200 000 IU/child |
· Typhus | ||
100% population to be deloused | ||
Individual spraying with permethrin 1% | · adult | 30g |
· infant and child | 15g |
5. Essentials of logistics
Weights and volumes | ||
· Food per week | individual ration per month | 14.7 kg |
amount per 10 000 people | 36.8 tonnes | |
(1 tonne of food grains/beans in standard 50kg bags occupies 2m3) | ||
· Drugs and supplies: | 1 WHO emergency health kit | 860 kg, 4m3 |
· Vaccines: | 1000 doses of measles | 3 litres |
1000 doses of DTP | 2.5 litres | |
1000 doses of BCG | 1 litre | |
1000 doses of polio | 1.5 litres | |
1000 doses of tetanus | 2.5 litres | |
· Food for therapeutic feeding: | standard under-5 patient ration | 2 kg/week |
· Family-size tents: | 35-60 kg unit | 1 tonne, 4.5m3 |
· Blankets | compressed | 1 tonne, 4.5m3 |
loose | 1 tonne, 9m3 | |
Warehouse requirements | · approximately 25m2 for 1000 population | |
· 1.2 m2 for 1 tonne of bagged food grains stacked 6m high | ||
Average truck capacity | · 50 tonnes | |
Small aircraft capacity | · 3 tonnes |
Sources: WHO/EHA, UNHCR Emergency Tools Series, draft 1992; UNICEF Assisting in Emergencies, 1986
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