Health considerations for refugees

People living in refugee camps have special health concerns. Overcrowding, poor sanitation, and lack of medicine and food can turn simple problems into more serious ones. Diseases like cholera flourish. So does HIV/AIDS. Mental and emotional health problems such as alcoholism, depression, and violence are other serious concerns. Many refugees suffer from fear, anger and guilt. They may have anxiety about family members at home, and their own future.

Over the next few [programs/days], we will hear about some of the health concerns of people living in refugee camps. Today’s program is about the special needs of women who give birth in the camps. Conditions there can make giving birth more dangerous than giving birth at home. Mothers-to-be and the women helping with the birth should prepare in advance to make sure mother and baby are both healthy. Joining us today is Martha. Martha is a midwife who trains birth attendants. Good morning, Martha.

Good morning.

So tell us, what should be done before the baby comes?

Most women will want to have a relative or friend help with the birth, but it’s important to have at least one trained birth attendant there too. If everything is kept clean and the baby’s cord is tied off properly, chances are much better that the birth will go fine. But if there are problems, mother and baby can get into real trouble if no one knows how to help them. Here in the refugee camp, there aren’t always enough midwives to go around in an emergency. So that’s why it’s important to arrange in advance to have a birth attendant.

Well that makes good sense. What else can you do to prepare for the birth?

I tell all my mothers the same thing: “clean place and clean hands.” The cleaner everything is, the better it will go for both mother and baby. That’s why you need a “clean delivery” kit. If you can’t get one from the clinic, you can make your own.

What goes in a “clean delivery” kit?

You’ll need a sheet of clean plastic to put under mother while she’s in labour, and a bar of soap to wash with. You’ll also need a new or sterilized razor blade to cut the umbilical cord, and a good long piece of string to tie it off afterward.

What about water?

Yes, absolutely. Clean water is very important, and lots of it. If you’re not sure if the water will be clean, then the best thing to do is boil several litres beforehand and put it aside in a closed container. As well, set aside a few clean cloths. As I said, “clean place and clean hands” will make things go much smoother for mother and baby.

Well I’m sure you’ve given all the mothers-to-be out there a lot to think about. Thanks for joining us today Martha.

I thank you. It’s been a pleasure.

MUSIC TO END PROGRAM.

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Part 2: Water safety and storage

Welcome back to our series on the health concerns of people living in refugee camps. As we discussed on our program [yesterday/last week], overcrowding, poor sanitation, and lack of medicine and food can turn simple problems into more serious ones. Diseases flourish. Mental and emotional health problems are other serious concerns.

Today we’re going to talk about keeping water clean for drinking and washing. This can be a big challenge in a refugee camp. But it’s very important. Diseases like cholera and diarrhea pass from person to person in dirty water. The bacteria that cause diseases are so small that you can’t tell from looking at the water if it’s bad. Sometimes even water that looks clean can be dangerous to your health.

Boiling water is the best way to be sure it’s safe. After boiling it for several minutes, cool the water and store it in sealed plastic jugs or closed containers. Never leave your drinking water in a bucket or open container because dirt can fall into it.

Once you’ve got clean water, keep it in clean, sealed containers or jugs. And be sure to use the same cup all the time to scoop out the water. Too many hands in the water will contaminate it.

MUSICAL BREAK.

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Part 3: A sick child

On our last two programs, we talked about two of the health concerns of people living in refugee camps – safe conditions for mothers giving birth in the camps, and the importance of clean water. The story in today’s program shows how important it is that children get enough to drink. Dehydration can cause serious health problems, especially in infants and young children.

MUSICAL BREAK.

After days of travelling, Esther and her two children arrived in the refugee camp late one afternoon. Esther’s older child fell asleep immediately in the corner of the hut, but the baby wouldn’t stop crying. She cried all that night and into the next day. In the morning, Esther’s new neighbour Mary came over to see if she could help.

Oh Mary, the baby won’t stop crying. I think she’s just tired, but I’m worried about her.

Has she eaten anything? She may not be getting enough to drink and might be dehydrated.

She’s only had a little to eat. I’m afraid I don’t have enough milk for her.

One way to tell if a baby is dehydrated is to gently pinch a bit of the baby’s skin between your fingers. If the skin feels dry, and falls back into place very slowly, she’s dehydrated. Look, like this. (pause) Yes, Esther, your baby is dehydrated. You’ve got to watch the little ones here. When we first arrived my little boy had the same problem. Does she have diarrhea?

Not so bad. But it is watery.

Diarrhea is nothing new at home, but I tell you, if you don’t look after it right away here in the camp, children can get very weak before you know it. Or they could be sick with something much worse that is going around the camp, like cholera.

I didn’t realize it was so serious.

Probably what she needs is the sugar-salt drink – you may have heard it called oral re-hydration solution. The local health worker will know about this. And you should keep breastfeeding.

Do you know where I can find a doctor to make sure she’s alright?

Of course. I’ll call my daughter to come watch your boy and we’ll go together.

You’re very kind, Mary.

We all need to help however we can.

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Part 4: Men’s mental health

In our last few programs, we’ve heard about some of the special health needs of women and children who live in refugee camps – safe conditions for mothers giving birth in the camps, the importance of clean water, and making sure young children do not become dehydrated.

But men also face new hardships. With no jobs to go to and little work to do, it can very hard for men to adjust to life in a refugee camp. They may feel their role in the family is gone. And that can lead to emotional anxiety.

Today we’re going to listen in on a conversation between two friends, Salim and Nazim. Salim arrived in the camp a year ago with his wife and their two daughters. His friend Nazim has been living here even longer. Salim and Nazim meet in a shabeen every afternoon to drink and talk.

MUSICAL BREAK.

Ah, the first beer of the day always tastes so good! Cheers!

SOUND EFFECTS: CLINKING GLASSES.

What’s wrong, my friend?

My wife chased me out of the house this morning with her broom.

(laughing) Oh no! What did you do?

She says I’m lazy.

You? Never! What does she want you to do?

I don’t know. She says, “Look at all I do. You must keep busy.”

: But…what can you do here in the camp?

Exactly! There are no jobs here, no work to do. We’ve been here a year. What am I to do?

Can your wife not see that this is hard for you too?

She says I’m not being a man. (To the bartender) Another beer for me please, and one for my friend too.

That’s terrible.

She has the children and our house to keep her busy. But, what is my job?

It can get you down, I tell you.

Yes it can. Some days the only thing that makes me feel good is to come here, talk with you, and have a few drinks. What’s wrong with that? It helps me forget all the trouble I’ve seen.

I’ll drink to that, my friend. (clinking glasses)

I have nightmares too. Sometimes having a beer or two is the only thing that drives them away. So what are you going to do about your wife?

What can I do? This is our life now.

Maybe you could tell her about your troubles. Maybe she will understand.

Salim is not alone. Feelings of sadness and anger, boredom and guilt are all common among men living in a refugee camp. Everyone feels them at some time or another. Try to understand why you have these feelings, and talk to someone about it. You cannot drink your troubles away.

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Part 5: HIV/AIDS prevention
Note: When you translate Auntie Nokie’s drumming slogans, try to find words that rhyme.

Our programs recently have focused on the special health needs of people living in refugee camps. We’ve learned about the importance of clean water, and making sure that children do not become dehydrated, as well as some of the issues for men who live in the camps. Today we’re going to talk about HIV/AIDS. Living in cramped quarters with strangers, and many people without husbands or wives or parents often leads to behaviours that increases the risk of contracting HIV/AIDS. And HIV/AIDS is a very serious health problem …(interrupted by sound of drumming)

(to the drumbeat) Use Protection to Fight Infection!! Use Protection to Fight Infection!!

I’m sorry, but you can’t just come in here like this! Who are you?

Auntie Nokie is my name! And stopping AIDS is my game!

(puzzled) What is that around your neck?

My condoms necklace! Do you like it?

(thoughtful) I never thought condoms could make a pretty necklace, but it’s not bad.

Here, take some. (to the drumbeat) ‘Be wise! Prevent a surprise!!’

Uh, thank you. So what are you doing here, Auntie Nokie.

I have a little song for all the young men who won’t wear condoms because they think AIDS will never happen to them… (to the drumbeat) ‘You wanted to be macho for one night. And now you have a disease to fight! Where were your thoughts? Where was your brain? Now you have a lifetime of worry and pain!!’

(seriously) Yes, as I was going to say before you came in…there is no cure for AIDS.

And you don’t know who is infected! Even yourself! Many people infected with the HIV virus look healthy for many years. And without condoms, all that time they are passing the virus on to others. (to the drumbeat) ‘So be a man-na! Cover your ba-na-na!!’

And Auntie Nokie, you should tell them too that by wearing condoms they will be protecting the whole community from the spread of AIDS.

You said it! Here have some more condoms!! Are you going to sing with me?

Okay! (clears throat)