Measuring refugee malnutrition in the under-fives: pitfalls in practice

This article reviews the merit of using the World Health Organization (WHO) / National Center for Health Statistics (NCHS) references to evaluate the nutritional status of refugees and famine-affected populations and the implication of the findings for further development of Public Health Nutrition programs. Public health nutrition interventions, in order to change the nutritional status of refugees and famine affected-populations, need to be based on accurate and appropriate reference criteria in order to satisfy demands for cost-effectiveness and preserve the human right to adequate food. However, many are confused by the current practice of estimating malnutrition in complex emergencies and it appears that the use of WHO/NCHS references may not be appropriate for use under these conditions in particular, and in the third world in general. To verify this claim, we conducted a literature review. Factors to be reviewed were selected a priori. Computer-assisted searches for English-language publications in the MEDLINE database were conducted and references cited in related publications were reviewed. The literature was restricted to published papers from 1975 to 2000, which focused on malnutrition and its measurement. Findings from the literature review indicate that there is a need to develop more appropriate references that are reflective of the field of intervention. In the absence of more appropriate references, this paper presents the advantages and disadvantages of using these references and some policy recommendations.

The legacy of Australia's treatment of onshore asylum seekers

The Australian government's response to the 'unlawful' arrival of asylum seekers has been characterised by a host of draconian measures - most notably mandatory detention and a punitive 'temporary protection visa' with severely limited access to settlement services. This hard stance was seen as important in stemming the tide of 'illegal' asylum seekers - most of whom seek protection in Australia from their war-torn countries in the Middle East. However, the government's own statistics suggest that this strategy is not working, as the number of asylum seekers has not decreased since these tough measures were adopted in October 1999. Moreover, as this study [2] argues, the restricted access to social services and income support imposed on TPV holders is causing significant economic hardships and unnecessarily traumatic settlement experiences. Many non-government agencies (most notably community organizations and ethnic associations) are left with the daunting challenge of meeting both practical and special needs of traumatized refugees.