美国军方在基地管理重新安置或难民营方面已有50年的历史。2021年7月和8月,超过124,000人从阿富汗撤离,在盟军欢迎行动(OAW)的高峰期,有55,000名阿富汗人临时安置在世界各地的美国军事基地。
搜索PubMed在1980年1月1日至2021年2月1日之间以英语发表的论文,使用“阿富汗”和“健康”(包括“公共卫生,\"\"产妇保健,\"和\"儿童健康\"),\"母亲,新生,儿童健康,“”和“健康状况”作为搜索词和感兴趣的特定主题。在没有学术研究的地方,美国国际开发署的报告,执行伙伴,灰色文学,捐赠者报告,阿富汗卫生部文件,国家卫生计划,政策,和战略,国防部事后审查(AAR),搜索中还包括以前难民空运的指导。
尽管AAR可以为这些难民环境提供一些有用的指导,对开源AAR的审查,几乎没有健康指导,主要集中在行政问题上,不遵守人道主义准则。国防部关于难民环境的指导已经过时,需要更新才能有用。有一套完善的国际标准文献,指导方针,和难民环境的最佳做法。使用标准化的难民紧急情况需求评估清单作为指导,这项审查提供了一个标准化的难民健康评估框架,以确保在美国军事基地的阿富汗难民的健康和福祉基于人道主义应急指南和最佳做法,以确保他们的护理符合国际标准.所有团体,尤其是少数民族(例如,Hazaras),性和性别少数群体,老年人,已禁用,或精神病患者,需要平等地获得保护,以确保它们不是目标。水,卫生,卫生必须对性别问题有敏感认识和包容性,其中包括为男性和女性提供光线充足的单独设施,以减少遭受暴力的脆弱性。流离失所者必须通过社区参与和代表参与难民营的管理。应向非统组织的所有提供者简要介绍他们所照顾者的粮食安全和营养情况。如果医疗提供者在难民人口健康方面有丰富的经验,他们是最有效的。了解难民医学,与文盲和未受过教育的人群和翻译一起工作的能力是重要的技能。遵守国际护理标准并与当前的难民护理准则保持最新非常重要。生殖健康必须是降低死亡率的总体健康对策的核心组成部分,发病率,和处于危机状况的育龄妇女的残疾。必须遵守立即和纯母乳喂养以及母乳喂养的国际标准,特别是在OAW的一部分营养危险的阿富汗人中。熟悉难民环境教育的教育实施者是建立正式,非正式,非正式的,加速,和基于本质的教育计划。
参与任何难民环境的合作伙伴和提供者应熟悉最新的指导方针,标准,和最佳做法,并将其应用于任何行动,以确保基于权利的保护方法,care,以及难民的健康和福祉。
The U.S. military has a 50-year history of managing resettlement or refugee camps on bases. In July and August 2021, more than 124,000 persons were evacuated from Afghanistan, with 55,000 Afghans temporarily housed at U.S. military bases around the world during Operation Allies Welcome (OAW) at its peak.
PubMed was searched for papers published in English between January 1, 1980, and February 1, 2021, using \"Afghanistan\" and \"health\" (including \"public health,\" \"maternal health,\" and \"child health\"), \"maternal, newborn, and child health,\" and \"health situation\" as search terms and specific topics of interest. Where scholarly work was unavailable, reports of the United States Agency for International Development, implementing partners, gray literature, donor reports, Afghanistan Ministry of Health documents, national health plans, policies, and strategies, DoD after-action reviews (AARs), and guidance from previous refugee airlifts were also included in the search.
Although AARs may provide some helpful guidance for these refugee settings, a review of open-source AARs and had little to no health guidance, focused primarily on administrative issues, and do not follow humanitarian guidelines. DoD guidance for refugee settings is dated and requires updating to be useful. There is a well-developed body of literature of international standards,
guidelines, and best practices for refugee settings. Using the standardized Needs Assessment for Refugee Emergencies checklist as a guide, this review provides a standardized refugee health assessment framework for ensuring the health and well-being of Afghan
refugees on U.S. military bases is based on humanitarian response
guidelines and best practices to ensure their care meets international standards. All groups, especially minority ethnic groups (e.g., Hazaras), sexual and gender minorities, elderly, disabled, or mentally ill persons, need equal access to protection to ensure they are not targeted. Water, sanitation, and hygiene must be gender-sensitive and inclusive which includes well-lit separate facilities for males and females to decrease vulnerability to violence. The displaced population must be involved in the management of the camp through community participation and representation. All providers in OAW should be briefed on the food security and nutrition context of those in their care. Medical providers are most effective if they have significant experience with the refugee population health context. Understanding refugee medicine, the ability to work with illiterate and uneducated populations and translators are important skills. Abiding by international standards of care and being up-to-date with current
guidelines for refugee care is important. Reproductive health must be a core component of the overall health response to decrease mortality, morbidity, and disability among reproductive-age women in crisis situations. Immediate and exclusive breastfeeding and international standards for breastfeeding must be adhered to, especially among nutritionally at-risk Afghans who are part of OAW. Education implementors familiar with education in refugee settings are an important contributor to establish formal, informal, non-formal, accelerated, and essence-based education programs.
Partners and providers involved in any refugee setting should become familiar with updated guidelines, standards, and best practices and apply them to any operation to ensure a rights-based approach to protection, care, and the health and well-being of
refugees.