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Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.00,0:00:04.00,Default,,0000,0000,0000,,(English captions by Trisha Paul, University of Michigan.)
Dialogue: 0,0:00:05.00,0:00:11.00,Default,,0000,0000,0000,,In this session, we are going to look at complex\Nemergencies, a major form of public health
Dialogue: 0,0:00:11.00,0:00:15.00,Default,,0000,0000,0000,,disasters in the Eastern Africa region.
Dialogue: 0,0:00:21.00,0:00:25.00,Default,,0000,0000,0000,,Let us start by looking at this scenario.
Dialogue: 0,0:00:25.00,0:00:34.00,Default,,0000,0000,0000,,A certain district Y has been affected by\Na 10 year conflict in which over 200,000 people
Dialogue: 0,0:00:34.00,0:00:38.00,Default,,0000,0000,0000,,have been internally displaced and they live\Nin camps.
Dialogue: 0,0:00:38.00,0:00:42.00,Default,,0000,0000,0000,,They cannot return to their homes for fear\Nof the rebels.
Dialogue: 0,0:00:42.00,0:00:47.00,Default,,0000,0000,0000,,The living conditions and health status of\Npeople in these camps is very poor.
Dialogue: 0,0:00:47.00,0:00:52.00,Default,,0000,0000,0000,,This is an example of a complex emergency.
Dialogue: 0,0:00:52.00,0:00:56.00,Default,,0000,0000,0000,,What then is a complex emergency?
Dialogue: 0,0:00:56.00,0:01:05.00,Default,,0000,0000,0000,,A complex emergency is a deep social crisis\Nin which large numbers of people die from
Dialogue: 0,0:01:05.00,0:01:11.00,Default,,0000,0000,0000,,war, displacement and hunger owing to man\Nmade disasters.
Dialogue: 0,0:01:11.00,0:01:15.00,Default,,0000,0000,0000,,This is a definition by Klugman.
Dialogue: 0,0:01:15.00,0:01:23.00,Default,,0000,0000,0000,,It is also defined as a humanitarian crisis\Nwith a breakdown in authority due to internal
Dialogue: 0,0:01:23.00,0:01:30.00,Default,,0000,0000,0000,,or external conflicts that requires international\Nresponse. This definition is by the UN Office
Dialogue: 0,0:01:30.00,0:01:39.00,Default,,0000,0000,0000,,for Coordination of Humanitarian Affairs,\NOCHA.
Dialogue: 0,0:01:39.00,0:01:46.00,Default,,0000,0000,0000,,Characteristics of a complex emergency include\Nviolence and massive displacement of people and,
Dialogue: 0,0:01:46.00,0:01:50.00,Default,,0000,0000,0000,,administrative, economic, and political collapse.
Dialogue: 0,0:01:50.00,0:01:55.00,Default,,0000,0000,0000,,It is long lasting and widespread.
Dialogue: 0,0:01:55.00,0:01:57.00,Default,,0000,0000,0000,,That means it affects a large number of people.
Dialogue: 0,0:01:57.00,0:02:07.00,Default,,0000,0000,0000,,There is usually exploitation and worsening\Nof existing differences in civil society like
Dialogue: 0,0:02:07.00,0:02:14.00,Default,,0000,0000,0000,,economic differences, social differences,\Npolitical differences, religious differences,
Dialogue: 0,0:02:14.00,0:02:18.00,Default,,0000,0000,0000,,and others.
Dialogue: 0,0:02:18.00,0:02:27.00,Default,,0000,0000,0000,,These often dispute over legitimacy of authority,\Nusually between government and other formal
Dialogue: 0,0:02:27.00,0:02:33.00,Default,,0000,0000,0000,,or informal groups like rebels, insurgents,\Netc.
Dialogue: 0,0:02:33.00,0:02:38.00,Default,,0000,0000,0000,,Vulnerable population is at greatest risk.
Dialogue: 0,0:02:38.00,0:02:41.00,Default,,0000,0000,0000,,Large scale humanitarian assistance is often\Nneeded.
Dialogue: 0,0:02:41.00,0:02:49.00,Default,,0000,0000,0000,,There is usually hindrance of assistance by\Npolitical or military forces, meaning that
Dialogue: 0,0:02:49.00,0:02:56.00,Default,,0000,0000,0000,,some groups that have power may prevent others\Nfrom receiving assistance.
Dialogue: 0,0:02:56.00,0:03:00.00,Default,,0000,0000,0000,,Complex emergencies are usually political.
Dialogue: 0,0:03:00.00,0:03:10.00,Default,,0000,0000,0000,,They often result in catastrophic public health\Nproblems.
Dialogue: 0,0:03:10.00,0:03:18.00,Default,,0000,0000,0000,,Complex emergencies often include wars and\Ncivil strife, armed aggression, insurgency
Dialogue: 0,0:03:18.00,0:03:23.00,Default,,0000,0000,0000,,and other actions resulting in displaced persons\Nand refugees.
Dialogue: 0,0:03:23.00,0:03:26.00,Default,,0000,0000,0000,,They usually have a political undertone.
Dialogue: 0,0:03:26.00,0:03:32.00,Default,,0000,0000,0000,,Can you name some in your region?
Dialogue: 0,0:03:32.00,0:03:42.00,Default,,0000,0000,0000,,Look at these pictures and try to understand\Nsome of the effects of complex emergencies.
Dialogue: 0,0:03:42.00,0:03:49.00,Default,,0000,0000,0000,,Priority interventions in refugee or mass\Ndisplacement of people situations.
Dialogue: 0,0:03:49.00,0:03:51.00,Default,,0000,0000,0000,,There is need for Rapid Needs Assessment.
Dialogue: 0,0:03:51.00,0:03:56.00,Default,,0000,0000,0000,,There is need to provide water and sanitation\Nfor affected people.
Dialogue: 0,0:03:56.00,0:04:02.00,Default,,0000,0000,0000,,There is need to provide food and nutrition\Nfor affected people, need to provide shelter
Dialogue: 0,0:04:02.00,0:04:09.00,Default,,0000,0000,0000,,and site planning, health care, control of\Ncommunicable diseases, and coordination of
Dialogue: 0,0:04:09.00,0:04:16.00,Default,,0000,0000,0000,,the humanitarian response.
Dialogue: 0,0:04:16.00,0:04:20.00,Default,,0000,0000,0000,,What is important in Rapid Needs Assessment?
Dialogue: 0,0:04:20.00,0:04:27.00,Default,,0000,0000,0000,,Health priorities are identified on the basis\Nof rapid collection and analysis of data.
Dialogue: 0,0:04:27.00,0:04:34.00,Default,,0000,0000,0000,,Information is collected on background of\Ndisplacement, risk factors, resources required
Dialogue: 0,0:04:34.00,0:04:36.00,Default,,0000,0000,0000,,etc.
Dialogue: 0,0:04:36.00,0:04:40.00,Default,,0000,0000,0000,,It is important to use a guideline based on\Nstandards.
Dialogue: 0,0:04:40.00,0:04:47.00,Default,,0000,0000,0000,,For instance, the SPHERE Standards.
Dialogue: 0,0:04:47.00,0:04:50.00,Default,,0000,0000,0000,,Water and Sanitation.
Dialogue: 0,0:04:50.00,0:04:55.00,Default,,0000,0000,0000,,Drinking water is top priority in complex\Nemergencies.
Dialogue: 0,0:04:55.00,0:04:59.00,Default,,0000,0000,0000,,Both quality and quantity are important.
Dialogue: 0,0:04:59.00,0:05:07.00,Default,,0000,0000,0000,,During first days 20 litres of water \Nper person per day should be the target.
Dialogue: 0,0:05:07.00,0:05:19.00,Default,,0000,0000,0000,,Poor and inadequate water supply is associated \Nwith sanitation related diseases.
Dialogue: 0,0:05:19.00,0:05:22.00,Default,,0000,0000,0000,,Sanitation.
Dialogue: 0,0:05:22.00,0:05:30.00,Default,,0000,0000,0000,,In the first days of the displacement, emergency\Nlatrines for every 50-100 persons.
Dialogue: 0,0:05:30.00,0:05:37.00,Default,,0000,0000,0000,,But these should be improved to 1 latrine\Nfor 20 persons, and ideally 1 latrine per
Dialogue: 0,0:05:37.00,0:05:47.00,Default,,0000,0000,0000,,family when the situation improves,\Nor the humanitarian situation
Dialogue: 0,0:05:47.00,0:05:50.00,Default,,0000,0000,0000,,is addressed.
Dialogue: 0,0:05:50.00,0:05:53.00,Default,,0000,0000,0000,,Food and Nutrition.
Dialogue: 0,0:05:53.00,0:06:02.00,Default,,0000,0000,0000,,Population movement is both a cause and consequence\Nof food shortage.
Dialogue: 0,0:06:02.00,0:06:08.00,Default,,0000,0000,0000,,Malnutrition is an important contributory\Ncause of death during complex emergencies.
Dialogue: 0,0:06:08.00,0:06:17.00,Default,,0000,0000,0000,,Food distribution should be planned, effective\Nand equitable
Dialogue: 0,0:06:17.00,0:06:22.00,Default,,0000,0000,0000,,Shelter and site planning is an important\Naspect of complex emergencies, especially
Dialogue: 0,0:06:22.00,0:06:26.00,Default,,0000,0000,0000,,when large numbers of people are displaced.
Dialogue: 0,0:06:26.00,0:06:33.00,Default,,0000,0000,0000,,Shelter is important for protection, security\Nand privacy.
Dialogue: 0,0:06:33.00,0:06:43.00,Default,,0000,0000,0000,,It is recommended that each person has 3.5 square\Nmetres of available space for their personal use.
Dialogue: 0,0:06:43.00,0:06:46.00,Default,,0000,0000,0000,,Appropriate shelter sites should be selected.
Dialogue: 0,0:06:46.00,0:06:53.00,Default,,0000,0000,0000,,It should be in a secure location away from\Nborder, availability of land and access to
Dialogue: 0,0:06:53.00,0:07:02.00,Default,,0000,0000,0000,,water, and the location should be socially\Nand culturally agreeable to the affected persons.
Dialogue: 0,0:07:02.00,0:07:09.00,Default,,0000,0000,0000,,Health care aims to reduce mortality\Nin the emergency phase of displacement.
Dialogue: 0,0:07:09.00,0:07:14.00,Default,,0000,0000,0000,,Curative, preventive and rehabilitative care\Nis crucial.
Dialogue: 0,0:07:14.00,0:07:19.00,Default,,0000,0000,0000,,Manuals and guidelines should be available\Nfor standardization of treatment.
Dialogue: 0,0:07:19.00,0:07:28.00,Default,,0000,0000,0000,,A Tier system of health care, that is hospital,\Nhealth centre and outreach services.
Dialogue: 0,0:07:28.00,0:07:35.00,Default,,0000,0000,0000,,Determine human resource needs, recruit and\Ntrain health workers and place them where
Dialogue: 0,0:07:35.00,0:07:41.00,Default,,0000,0000,0000,,they are needed.
Dialogue: 0,0:07:41.00,0:07:47.00,Default,,0000,0000,0000,,Control of communicable diseases is very important\Nduring complex emergencies.
Dialogue: 0,0:07:47.00,0:07:53.00,Default,,0000,0000,0000,,Intervention strategies include attacking\Nthe sources of infection like curative care,
Dialogue: 0,0:07:53.00,0:07:58.00,Default,,0000,0000,0000,,isolation of highly infectious patients.
Dialogue: 0,0:07:58.00,0:08:07.00,Default,,0000,0000,0000,,Prevent transmission of illness through environment \Nsanitation, personal hygiene, and health education.
Dialogue: 0,0:08:07.00,0:08:16.00,Default,,0000,0000,0000,,Protect the susceptible patients like measles\Nimmunisation, chemoprophylaxis, and provision
Dialogue: 0,0:08:16.00,0:08:19.00,Default,,0000,0000,0000,,of bed nets etc).
Dialogue: 0,0:08:19.00,0:08:26.00,Default,,0000,0000,0000,,There is need for continuous surveillance\Nto detect epidemics and to assess the effectiveness
Dialogue: 0,0:08:26.00,0:08:31.00,Default,,0000,0000,0000,,of interventions.
Dialogue: 0,0:08:31.00,0:08:37.00,Default,,0000,0000,0000,,Coordination is another vital part of management\Nof complex emergencies.
Dialogue: 0,0:08:37.00,0:08:42.00,Default,,0000,0000,0000,,The rationale is that there are usually many\Nactors involved in the response.
Dialogue: 0,0:08:42.00,0:08:49.00,Default,,0000,0000,0000,,The goal is to achieve the greatest impact\Nthrough integration of activities, establish
Dialogue: 0,0:08:49.00,0:08:55.00,Default,,0000,0000,0000,,clear leadership and co-ordination, ensure\Npriorities are shared between the intervening
Dialogue: 0,0:08:55.00,0:09:02.00,Default,,0000,0000,0000,,partners, rationalise services by establishing\Ncommon standards, and ensure good communication
Dialogue: 0,0:09:02.00,0:09:06.00,Default,,0000,0000,0000,,among stakeholders.