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Food-Security-small

Shelter & Non-Food Items

The importance of food security and nutrition in disasters

Access to food and the maintenance of an adequate nutritional status are critical determinants of people’s survival in a disaster. The people affected are often already chronically undernourished when the disaster hits. Undernutrition is a serious public health problem and among the lead causes of death, whether directly or indirectly.

The causes of undernutrition are complex. The conceptual framework below is an analytical tool that shows the interaction between contributing factors to undernutrition. The immediate causes of undernutrition are disease and/or inadequate food intake, which result from underlying poverty, household food insecurity, inadequate care practices at household or community levels, poor water, hygiene and sanitation, and insufficient access to healthcare. Disasters such as cyclones, earthquakes, floods, conflict and drought all directly affect the underlying causes of undernutrition. The vulnerability of a household or community determines its ability to cope with exposure to these shocks. The ability to manage the associated risks is determined largely by the characteristics of a household or community, particularly its assets and the coping and livelihood strategies it pursues.

For this chapter the following definitions are used:

Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. Within this definition of food security, there are three components:

Availability refers to the quantity, quality and seasonality of the food supply in the disaster-affected area. It includes local sources of production (agriculture, livestock, fisheries, wild foods) and foods imported by traders (government and agencies’ interventions can affect availability). Local markets able to deliver food to people are major determinants of availability.

Access refers to the capacity of a household to safely procure sufficient food to satisfy the nutritional needs of all its members. It measures the household’s ability to acquire available food through a combination of home production and stocks, purchases, barter, gifts, borrowing or food, cash and/or voucher transfers.

Utilisation refers to a household’s use of the food to which it has access, including storage, processing and preparation, and distribution within the household. It is also an individual’s ability to absorb and metabolise nutrients, which can be affected by disease and malnutrition.

Livelihoods comprise the capabilities, assets (including natural, material and social resources) and activities used by a household for survival and future well-being. Livelihood strategies are the practical means or activities through which people use their assets to earn income and achieve other livelihood goals. Coping strategies are defined as temporary responses forced by food insecurity. A household’s livelihood is secure when it can cope with and recover from shocks, and maintain or enhance its capabilities and productive assets.

Nutrition is a broad term referring to processes involved in eating, digestion and utilisation of food by the body for growth and development, reproduction, physical activity and maintenance of health. The term ‘malnutrition’ technically includes undernutrition and over-nutrition. Undernutrition encompasses a range of conditions, including acute malnutrition, chronic malnutrition and micronutrient deficiencies. Acute malnutrition refers to wasting (thinness) and/or nutritional oedema, while chronic malnutrition refers to stunting (shortness). Stunting and wasting are two forms of growth failure. In this chapter, we refer to undernutrition and revert to malnutrition specifically for acute malnutrition.

The framework shows that exposure to risk is determined by the frequency and severity of natural and man-made shocks and by their socio-economic and geographical scope. The determinants of coping capacity include the levels of a household’s financial, human, physical, social, natural and political assets; the levels of its production, income and consumption; and its ability to diversify its income sources and consumption to mitigate the effects of the risks.

 

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The vulnerability of infants and young children means that addressing their nutrition should be a priority. Prevention of undernutrition is as important as treatment of acute malnutrition. Food security interventions may determine nutrition and health in the short term and their survival and well-being in the long term.

Women often play a greater role in planning and preparation of food for their households. Following a disaster, household livelihood strategies may change. Recognising distinct roles in family nutrition is key to improving food security at the household level. Understanding the unique nutritional needs of pregnant and lactating women, young children, older people and persons with disabilities is also important in developing appropriate food responses.

Better food security and nutrition disaster response is achieved through better preparedness. It is the capacities, relationships and knowledge developed by governments, humanitarian agencies, local civil society organisations, communities and individuals to anticipate and respond effectively to the impact of likely, imminent or current hazards. Preparedness is based on an analysis of risks and is well linked to early warning systems. It includes contingency planning, stockpiling of equipment and supplies, emergency services and stand-by arrangements, communications, information management and coordination arrangements, personnel training and community-level planning, drills and exercises.

The main areas of intervention for food security and nutrition in disasters covered in this Handbook are infant and young child feeding; the management of acute malnutrition and micronutrient deficiencies; food transfers; cash and voucher transfers; and livelihoods.

Food State Nutrition:

IMAT is working with DR ERIC LWELLYN, a noted expert on NUTRITION & HOLISTIC HEALTH. Dr. Llewellyn has also studied the crucial role of soil vitality in health and nutrition.

DR. LWELLYN has made pioneering contributions to nutrition through what he calls “RE-NATURED” NUTRIENTS, which are distinguished from isolated chemicals such as vitamins and minerals.  According to Dr. Llewellyn, nutrients are complexes of vitamins or minerals and associated food factors.  Without the delivering mechanism of food factors, what is believed to be nutrition merely consists of pure, isolated chemicals in their free state.  This is FOOD STATE NUTRITION.

Utilisation refers to a household’s use of the food to which it has access, including storage, processing and preparation, and distribution within the household. It is also an individual’s ability to absorb and metabolise nutrients, which can be affected by disease and malnutrition.

Livelihoods comprise the capabilities, assets (including natural, material and social resources) and activities used by a household for survival and future well-being. Livelihood strategies are the practical means or activities through which people use their assets to earn income and achieve other livelihood goals. Coping strategies are defined as temporary responses forced by food insecurity. A household’s livelihood is secure when it can cope with and recover from shocks, and maintain or enhance its capabilities and productive assets.

Nutrition is a broad term referring to processes involved in eating, digestion and utilisation of food by the body for growth and development, reproduction, physical activity and maintenance of health. The term ‘malnutrition’ technically includes undernutrition and over-nutrition. Undernutrition encompasses a range of conditions, including acute malnutrition, chronic malnutrition and micronutrient deficiencies. Acute malnutrition refers to wasting (thinness) and/or nutritional oedema, while chronic malnutrition refers to stunting (shortness). Stunting and wasting are two forms of growth failure. In this chapter, we refer to undernutrition and revert to malnutrition specifically for acute malnutrition.

The framework shows that exposure to risk is determined by the frequency and severity of natural and man-made shocks and by their socio-economic and geographical scope. The determinants of coping capacity include the levels of a household’s financial, human, physical, social, natural and political assets; the levels of its production, income and consumption; and its ability to diversify its income sources and consumption to mitigate the effects of the risks.

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Shelter & Non-Food Items

The importance of shelter, settlement and non-food items in disasters

Shelter is a critical determinant for survival in the initial stages of a disaster. Beyond survival, shelter is necessary to provide security, personal safety and protection from the climate and to promote resistance to ill health and disease. It is also important for human dignity, to sustain family and community life and to enable affected populations to recover from the impact of disaster. Thermal comfort, protection from the effects of the climate and personal safety and dignity are achieved by meeting a combination of needs at the level of the individuals themselves, the covered space they inhabit and the location in which their covered area is situated. Similarly, meeting these needs requires an appropriate combination of the means to prepare, cook and eat food; clothing and bedding; an adequate covered area or shelter; a means of space heating and ventilation as required; and access to essential services.

Shelter is a critical determinant for survival in the initial stages of a disaster. Beyond survival, shelter is necessary to provide security, personal safety and protection from the climate and to promote resistance to ill health and disease. It is also important for human dignity, to sustain family and community life and to enable affected populations to recover from the impact of disaster. Shelter and associated settlement and non-food item responses should support existing coping strategies and promote self-sufficiency and self-management by those affected by the disaster. Local skills and resources should be maximised where this does not result in adverse effects on the affected population or local economy. Any response should take into account known disaster risks and minimise the long-term adverse impact on the natural environment, while maximising opportunities for the affected population to maintain or establish livelihood support activities.

Thermal comfort, protection from the effects of the climate and personal safety and dignity are achieved by meeting a combination of needs at the level of the individuals themselves, the covered space they inhabit and the location in which their covered area is situated. Similarly, meeting these needs requires an appropriate combination of the means to prepare, cook and eat food; clothing and bedding; an adequate covered area or shelter; a means of space heating and ventilation as required; and access to essential services.

The shelter, settlement and non-food item needs of populations affected by a disaster are determined by the type and scale of the disaster and the extent to which the population is displaced. The response will also be informed by the ability and desire of displaced populations to return to the site of their original dwelling and to start the recovery process: where they are unable or unwilling to return, they will require temporary or transitional shelter and settlement solutions (see the diagram below). The local context of the disaster will inform the response, including whether the affected area is rural or urban; the local climatic and environmental conditions; the political and security situation; and the ability of the affected population to contribute to meeting their shelter needs. In extreme weather conditions, where shelter may be critical to survival or, as a result of displacement, the affected population may be unable to construct appropriate shelter, rapidly deployable shelter solutions, such as tents or similar, will be required or temporary accommodation provided in existing public buildings. Displaced populations may arrange shelter with host families, settle as individual households or in groups of households within existing settlements or may need to be temporarily accommodated in planned and managed camps or collective centres.

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Water Sanitation

The importance of WASH in disasters

Water & sanitation are critical determinants for survival in the initial stages of a disaster. People affected by disasters are generally much more susceptible to illness and death from disease, which to a large extent are related to inadequate sanitation, inadequate water supplies and inability to maintain good hygiene. The most significant of these diseases are diarrhea and infectious diseases transmitted by the faeco-oral route. The term ‘sanitation’, refers to excreta disposal, vector control, solid waste disposal and drainage. The main objective of WASH programmes in disasters is to reduce the transmission of faeco-oral diseases and exposure to disease-bearing vectors through the promotion of:

  1. Good hygiene practices
  2. The provision of safe drinking water
  3. The reduction of environmental health risks
  4. The conditions that allow people to live with good health, dignity, comfort and security.

Simply providing sufficient water and sanitation facilities will not, on its own, ensure their optimal use or impact on public health. In order to achieve the maximum benefit from a response, it is imperative that disaster-affected people have the necessary information, knowledge and understanding to prevent water- and sanitation-related diseases and to mobilize their involvement in the design and maintenance of those facilities.

Water and sanitation are critical determinants for survival in the initial stages of a disaster. People affected by disasters are generally much more susceptible to illness and death from disease, which to a large extent are related to inadequate sanitation, inadequate water supplies and inability to maintain good hygiene. The most significant of these diseases are diarrhoeal and infectious diseases transmitted by the faeco-oral route (see Appendix 4: Water- and excreta-related diseases and transmission mechanisms). Other water- and sanitation-related diseases include those carried by vectors associated with solid waste and water. The term ‘sanitation’, throughout the Sphere Handbook, refers to excreta disposal, vector control, solid waste disposal and drainage.

The main objective of WASH programmes in disasters is to reduce the transmission of faeco-oral diseases and exposure to disease-bearing vectors through the promotion of:

  • good hygiene practices
  • the provision of safe drinking water
  • the reduction of environmental health risks
  • the conditions that allow people to live with good health, dignity, comfort and security.

Simply providing sufficient water and sanitation facilities will not, on its own, ensure their optimal use or impact on public health. In order to achieve the maximum benefit from a response, it is imperative that disaster-affected people have the necessary information, knowledge and understanding to prevent water- and sanitation-related diseases and to mobilise their involvement in the design and maintenance of those facilities.

The use of communal water and sanitation facilities, for example in refugee or displaced situations, can increase women’s and girls’ vulnerability to sexual and other forms of gender-based violence. In order to minimise these risks, and to provide a better quality of response, it is important to ensure women’s participation in water supply and sanitation programmes. An equitable participation of women and men in planning, decision-making and local management will help to ensure that the entire affected population has safe and easy access to water supply and sanitation services, and that services are appropriate.

Better disaster response in public health is achieved through better preparedness. Such preparedness is the result of capacities, relationships and knowledge developed by governments, humanitarian agencies, local civil society organizations, communities and individuals to anticipate and respond effectively to the impact of likely, imminent hazards. It is based on an analysis of risks and is well linked to early warning systems. Preparedness includes contingency planning, stockpiling of equipment and supplies, emergency services and stand-by arrangements, personnel training and community-level planning training and drills.

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Medical Care

The importance of health action in disasters

Access to healthcare is a critical determinant for survival in the initial stages of disaster. Disasters almost always have significant impacts on the public health and well-being of affected populations. The public health impacts may be described as direct (e.g. death from violence and injury) or indirect (e.g. increased rates of infectious diseases and/or malnutrition). These indirect health impacts are usually related to factors such as inadequate quantity and quality of water, breakdowns in sanitation, disruption of or reduced access to health services and deterioration of food security. Lack of security, movement constraints, population displacement and worsened living conditions (overcrowding and inadequate shelter) can also pose public health threats. Climate change is potentially increasing vulnerability and risk.

The primary goals of humanitarian response to humanitarian crises are to prevent and reduce excess mortality and morbidity. The main aim is to maintain the crude mortality rate (CMR) and under-5 mortality rate (U5MR) at, or reduce to, less than double the baseline rate documented for the population prior to the disaster (see table on baseline reference mortality data by region). Different types of disaster are associated with differing scales and patterns of mortality and morbidity (see table on public health impact of selected disasters), and the health needs of an affected population will therefore vary according to the type and extent of the disaster.

The contribution from the health sector is to provide essential health services, including preventive and promotive interventions that are effective in reducing health risks. Essential health services are priority health interventions that are effective in addressing the major causes of excess mortality and morbidity. The implementation of essential health services must be supported by actions to strengthen the health system. The way health interventions are planned, organised and delivered in response to a disaster can either enhance or undermine the existing health systems and their future recovery and development.

An analysis of the existing health system is needed to determine the system’s level of performance and to identify the major constraints to the delivery of, and access to, health services. In the early stages of a disaster, information may be incomplete and important public health decisions may have to be made without all of the relevant data being available. A multi-sectoral assessment should be conducted as soon as possible (see Core Standard 3).

Better response is achieved through better preparedness. Preparedness is based on an analysis of risks and is well linked to early warning systems. Preparedness includes contingency planning, stockpiling of equipment and supplies, establishment and/or maintenance of emergency services and stand-by arrangements, communications, information management and coordination arrangements, personnel training, community-level planning, drills and exercises. The enforcement of building codes can dramatically reduce the number of deaths and serious injuries associated with earthquakes and/or ensure that health facilities remain functional after disasters.

Public health impact of selected disasters

NB: Even for specific types of disaster, the patterns of morbidity and mortality vary significantly from context to context.

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Pathfinders

Reflective of IMAT itself

The Pathfinder skill set is a synergistic constellation of specialties that provide support to the overall mitigation of an instance. Pathfinder Teams are made up of durable, experienced and supremely flexible individuals with specific expertise and the ability to interface effectively with indigenous and international resources.

You may rely upon their resourcefulness and other unique qualities to accomplish imperative tasks under the most arduous circumstances in order to facilitate maximum effectiveness of arriving resources and the overall mitigation of a disaster or crisis.

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