Evidence-based guidelines for the care of children in emergency situations should be developed and distributed to international relief organizations, according to researchers from the Johns Hopkins Bloomberg School of Public Health and the World Health Organization (WHO).
In a review of published literature, the researchers found that the highest mortality rates following armed conflicts, natural disasters, population displacements or famines are often in children younger than five years. The most common causes of death are diarrhea, acute respiratory infections, measles, malaria and malnutrition; these are also the major causes of death in countries with high child mortality rates. The study is published in the January 2006 issue of the Bulletin of the World Health Organization.
“The major causes of child mortality in complex emergencies are well known and we have learned how to manage these conditions in stable situations. However, conflict or disaster often exacerbates the magnitude and severity of these illnesses, requiring rapid assessment and treatment of large numbers of severely ill children. This was seen with the tsunami disaster and the recent earthquake in Pakistan. What we need are simple, easy-to-use guidelines that are brought together in a single package for the different levels of health workers caring for children in complex emergencies,” said William J. Moss, MD, MPH, senior author of the study and an assistant professor in the Bloomberg School of Public Health's Department of Epidemiology.
The researchers came to their conclusions after reviewing previously published literature and interviewing representatives from international relief organizations. They found that in emergency situations, most relief organizations use WHO, UNICEF and other ministry of health guidelines that are intended for stable environments. Few studies, however, have assessed how effective these interventions are in reducing child mortality in complex emergencies. Moss and his colleagues note that during emergency situations, care is given by multiple organizations and a broad range of health workers with different levels of training and experience.