A Human Rights Violation: Malnourished Refugee Children in Camps and After US Resettlement Open Access
Lutfy, Caitlyn Leigh (2012)
Abstract
Abstract
Background: Identifying and addressing nutrition issues
among US-resettling refugee children are a human rights issue.
Methods: The target population is children from Burma,
Bhutan, Somalia, Liberia, Eritrea, Sudan, Burundi, and the
Democratic Republic of Congo 6-59 months of age who live in
secondary country camps prior to US-resettlement. Analysis of camp
child nutrition data informs pre-arrival nutrition conditions. A
survey of Refugee Health Coordinators provides information on
nutritional assessment, reporting and referrals in domestic refugee
medical screening. Results: Half of the camps had global
acute malnutrition prevalence rates over 15% at least once from
2004-2010. Camps collecting anemia data had greater than 40%
prevalence. The majority of State-regulated refugee health exams
include height and weight measurements but few use National Center
for Health Statistics or WHO standards. Recommendations:
Improve overseas monitoring and data linkages of nutrition
information to US-resettlement services. Domestically, adopt
standards for nutrition assessment and referral protocols.
Length: 149 words
Table of Contents
Definitions 10
ACRONYMS. 11
INDICATORS. 11
Chapter I Introduction. 13
Introduction and Rationale. 13
Problem Statement 14
Figure 1. The Journey of the Refugee from fleeing persecution to establishing a new life in the US: Barriers to nutrition and opportunities for surveillance and intervention. 15
Research Objectives 16
Significance. 16
CHAPTER II Background and History. 20
Who are Refugees?. 20
A Brief History of Refugee Protections 22
The United Nations High Commissioner for Refugees 22
Operation and Services 24
Nutrition Services in Refugee Camps Served by UNHCR. 26
Food Assistance Programs Systems and Regulations 28
General and Selective Feeding Programs: 30
Nutritional Assessments and Surveillance in Refugee Settlements 31
Macro and Micro-Nutrient Deficiencies in Refugee Camps 32
Long-Term Consequences of Childhood Malnutrition. 35
The Barker Hypothesis 35
Malnourishment and Obesity. 36
Micronutrient Deficiencies 36
Micronutrient Deficiencies Overseas 38
Domestic Micronutrient Deficiencies 38
Pre- and Post-Resettlement Health Screenings 39
Overseas Medical Examination. 39
Domestic Medical Screenings 40
Nutrition Guidelines 41
CHAPTER III Nutrition in the US: Literature Review.. 42
Acculturation. 43
Economic Barriers and Governmental Assistance. 45
Analyses of US-Refugee Nutrition indicators and Related Chronic Health Conditions 47
Relating Camp and Post-Resettlement Nutrition. 49
Chapter IV Methodology. 51
Introduction. 51
Overseas Nutrition. 51
Population. 51
Data Source. 54
US Nutrition assessments and services 56
Population. 56
Measurement 57
Chapter V Manuscript and Results. 58
Background. 60
Methods 60
Results 61
Results Tables 62
Figures 64
Global Acute Mortality (GAM)*. 64
Global Anemia Prevalence* 68
Discussion. 72
Recommendations 73
Contribution to the Literature. 74
Chapter VI Conclusion and Recommendations. 75
Limitations 77
Recommendations 78
References. 81
Appendix I: Summary of Overseas Medical Exam.. 85
APPENDIX II CDC Recommended Protocol for Domestic Refugee Screenings that is pertinent to nutritional status 88
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