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Surveillance is an essential component of health and nutrition information management during humanitarian situations. Changes in the nature and scope of humanitarian assistance activities have created new challenges in health surveillance, particularly outside of camp-based settings.
The primary aim of the Humanitarian Health Information Management Working Group was to identify challenges and areas that need further elucidation in a range of non-camp settings, including urban and rural as well as low-and middle-income countries.
Three major themes emerged: (1) standardization of measures and methodologies; (2) context in data collection and management; and (3) hidden populations and the purpose of surveillance in urban settings. Innovative examples of data collection and management in community-based surveillance were discussed, including task-shifting, health worker to community member ratio, and literacy needs.
Surveillance in non-camp settings can be informed by surveillance activities in camp-based settings, but requires additional consideration of new methods and population needs to achieve its objectives.
This chapter summarizes the complex ways in which people experience disasters. These experiences are organized into categories of traumatic stressors, loss, ongoing adversities, and community effects and meanings. The chapter explores the most acutely severe and personally traumatic aspects of disaster exposure: loss of life and traumatic bereavement; threat to life, injury, and fear; and witnessing of horror. Damage to home and property, often accompanied by financial loss, may be the prototypical stressor associated with natural disasters. The acutely stressful experiences of trauma and loss are followed by a host of challenges associated with poor housing conditions, rebuilding, and other stressors in the postdisaster environment. Postdisaster stressors are typically captured in disaster research by measures of stressful life events or chronic stress. Development and validation of quantitative measures that encompass both universal and culture-specific responses to trauma could help address current cross-cultural and transnational assessment challenges.