In the shadow of the volcanoes: the impact of intervention on the nutrition and health status of Rwandan refugee children in Zaire two years from the exodus

Objective: To evaluate the public health and nutritional situation of refugee children in Katale camp, Eastern Zaire, after two years of nutritional and health intervention from 1994 to 1996.
Design: Cross-sectional survey using a two-stage cluster sampling method. Anthropometric data were collected from 28 May 1996 to 4 June 1996. Retrospective review of food basket monitoring data over the preceding six months and the United Nations High Commission for Refugees' weekly mortality data was conducted. Measles immunisation coverage data were surveyed simultaneously, using child health records.
Main outcome measures: Nutritional status measured by weight-for-height index (W/H), measles immunisation status, average daily energy content of the general food ration and crude mortality rate.
Setting: Katale refugee camp, Zaire, June 1996.
Analysis: Weight-for-height index and proportion of immunised children were computed using EPINUT, part of EPINFO computer package.
Results: Malnutrition was found to be most prevalent in children aged six to 29 months old (W/H < -2 Z-score and/or oedema: 6.2%; 95% CI: 3.4%, 10.6%), among whom the malnutrition rate was almost double the overall malnutrition prevalence (W/H < -2 Z-score and/or oedema: 3.5% (95% CI: 1.5%, 7.2%). The general food ration, although conforming to the World Food Program minimum standards of adequacy in terms of variety (being composed of cereals, oil, beans, blended cereal and legume mixes and salt), provided only 6240 kJ on average (95% CI: 5040, 7140 kJ) per person per day, thus meeting only 57% to 84% of the minimum energy requirements for an adult, and falling well below the needs for sub groups with higher nutritional requirements such as children, pregnant and breastfeeding women and the sick. Measles immunisation coverage in children nine to 59 months was 88.6%. The crude mortality rate was found to be 0.3 per 10 000 per day. Refugees received 15 litres of clean water per person per day.
Conclusion: Public health interventions in Katale camp 1994 to 1996 had reduced mortality and morbidity rates dramatically. This was not reflected in the malnutrition rates for children under five years, that remained stable after an initial fall despite two years of nutritional intervention. The factors contributed to this were related to an inadequate general food ration (due to food shortages), lack of ability to supplement the diet, (due to economic restrictions that were imposed in the camp) and inequities in the food distribution process (due to food being siphoned off by camp leaders for military purposes).

Fat, rich and beautiful: changing socio-cultural paradigms associated with obesity risk, nutritional status and refugee children from sub-Saharan Africa

There has been an increase in Australia's intake of refugees and migrants from sub-Saharan Africa over the last two decades. These refugees have been exposed to nutritional risks prior to migration, which, together with changes associated with acculturation, impact on their health and nutritional status post-migration. However, there is a paucity of data in Australia that has examined the health and nutritional status of this ethnic minority in Australia. Despite basic research assessing the nutritional status of children, none have specifically concentrated on the health and nutritional situation of sub-Saharan refugee children. In the absence of such studies, this paper explores issues relating to obesity in sub-Saharan African refugee children within a cultural and public health framework. We begin by outlining the history of obesity and its cultural meaning. We then move to a consideration of predisposing factors for obesity and how these factors translate into obesity risk contexts of sub-Saharan refugees post-migration. We argue there are a number of key challenges related to culture and the relationship between socio-economic factors post-migration that require addressing by health professionals, dieticians and health educators to ensure the delivery of successful health outcomes.

Selective feeding centres in refugee settings: evaluation framework protocol

Selective feeding programs are centres for the treatment of persons suffering from acute malnutrition. Unlike chronic malnutrition, acute malnutrition reflects recent problems. In a crisis situation, wasting is preferred above other indicators because it is sensitive to rapid change, indicates present change, can be used to monitor the impact of interventions and is a good predictor of immediate mortality risk. This paper reviews the current approach being used in the field to evaluate the effectiveness of feeding programs. There is no comprehensive evaluation framework in place to assess the impact of feeding programs on mortality due to malnutrition. Some loose outcome measures, such as the number of children enrolled in a feeding centre, are being used to determine if a feeding centre should continue. In addition, malnutrition prevalence and crude mortality rates determined through nutritional and mortality surveys are used to assess the impact of feeding programs. This procedure does not take into account potential confounding factors that impact on malnutrition prevalence, including access to non-relief foods and the general food ration. Therefore, one could not confidently say that the reduction of malnutrition prevalence is a result of feeding programs. This paper presents an alternative approach to evaluating feeding centres.

1948 and 1968 Czech refugee settlers in Australia : a comparison of the settlement and integration processes among two waves of settlers

Nearly eighteen years ago when I first became interested in the history and sociology of Australian immigration, I was particularly attracted by the fact and opportunity to incorporate immigration settlement, experience and accomplishments in my history teaching in secondary school. In particular it was the area of the settlement of Australia that needed a fuller understanding in the teaching of Australian history. By that I mean it was needed to show that there were many other ethnic groups besides the Anglo-Saxon group which had participated in the development of Australia since 1788. Since the end of World War II, the Australian population has doubled, the population structure and characteristics have changed and knowledge about the diverse groups forming the Australian nation is now sought. Sane ethnic groups, mainly the numerically large, have been studied and numerous reports are available. But many of the smaller groups have attracted little interest among Australian scholars. This was one of the reasons that I decided to research the behaviour of one of the smaller groups - the Czechs - to find out about their immigration history to Australia; their immigration processes such as re-settlement and re-establishment; and their community life since World War II. Because of the scarcity of written materials on Czechs in Australia, I had to rely on interviews, personal reminiscenses, letters and documents translated from the Czech language. I should like to express my gratitude to all people and officials of Czech ethnic organisations and clubs in Australia, who agreed to be interviewed and who provided me with documentary material so important for my work. Respecting the wishes of my interviewees their anonymity had to be preserved. In the course of my research, I have received substantial help and the encouragement from the Editor of the now extinct Czech language paper Newspaper Hlas domova, Mr. F.V., whose co-operation is gratefully recognised. I am also grateful to Associate Professor William D. Rubinstein for his help and encouragement in all stages of my work. The introductory part of the study is covered in Chapter One. She reasons for the need to increase Australia's population after World War II and an analysis of the development of settlement in Australia between 1947 and 1984 are discussed. The emigration of Czechs into Australia and their place in the post-war immigration scheme is introduced. To obtain an overview of how Czechs have emigrated around the world, the literature describing their settlement is compared. Also discussed in the literature on Czech settlement in Australia from an historical point of view. The studies on the concept of ethnicity and settlement in Australia are used to document the theoretical issues for an understanding of Australian society. This chapter also contains aspects of sources and research, shewing the processes of documentary research, interviews and related matters. In Chapter Two the history of Czech emigration is discussed, covering the period from the seventeenth to the twentieth century. The first contacts with Australia are highlighted, continuing into the inter-war period and finally the re-settlement of Czechs after World War II. To understand why Czechs left their ancestral country after World War II, the political situation in Czechoslovakia is analysed. The third chapter concentrates mainly in the 1948 wave of settlers, who left Czechoslovakia after the communist take-over in 1948. Their means of departure from their homeland, selection of Australia as a new homeland and their re-settlement and re-establishment are discussed. Their attitudes after their arrival and their later stages of their settlement are analysed. The formation of numerous Czech ethnic organisations which mushroomed between 1950 and 1954 led to an active community life which began to change about five years after their arrival. These charges led to disorganisation of Czech community's life. The causes of these changes which were influential for the failure of the 1948 group to establish a viable community in Australia are analysed. In Chapter Four the wave of 1968 is viewed, their arrival and settling is covered. The study of their group attitudes and formation of group institutions is the main part of this section. A comparison of my data of the two waves, 1948 and 1968, reveals the information that these two groups did not develop the harmonious relationship expected of them as members of the one ethnic group. Chapter Five discusses immigration typologies and concentrates on the differences between legal and illegal emigrants from the Czechoslovak point of view. The integration processes of Czechs and their incorporation into Australian society are discussed. The sixth chapter sums up the findings of this disertation and states the influences which were responsible for the divisions in Czech ethnic life in Australia in the 1980s.

Current situation of practical work in secondary school biology (VCE biology) in Victoria state, Australia

In secondary school biology in Victoria State, Australia, practical work including laboratory exercises, fieldwork and other research activities is carried out more frequently than in Japanese senior high school biology. The authors examined the contents of the practical work and how often such practical work is carried out in some urban and rural secondary schools in Victoria. The topics of biology practical work were based on the VCE Biology Study Design which was published by the Victorian Board of Studies. Some of the activities continued for some weeks. Sometimes students went out from their school for fieldwork for a few days. The average number of practical work per credit was about 4. This number is consider ably larger than the value (2.3 per credit) which was reported on senior high schools in Osaka Prefecture. Why so often can the practical work be carried out? The main reason is that as well as the scores of ordinary paper tests, the evaluation of each practical work is taken into consideration at the entrance examination of universities and other tertiary education institutes in Victoria State.

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.

Refugee law: time for a fundamental re-think: need as the criterion for assistance

Concern that the definition of refugee based on race, religion, nationality, membership of a particular social group or political opinion found in 1951 United Nations Convention relating to the Status of Refugees is unduly narrow and arbitrary and should be replaced by a definition reflecting the concept of deprivation and need.

"Disturbing practices":dehumanizing asylum seekers in the refugee "Crisis" in Australia, 2001-2002

Throughout late 2001 and 2002, the Australian Government, seeking re-election, campaigned on a tough line against so-called "illegal" immigrants. Represented as "queue jumpers," "boat people," and "illegals," most of these asylum seekers came from Middle Eastern countries, and, in the main, from Afghanistan and Iraq. This paper explores the way particular representations of cultural difference were entwined in media and government attacks upon asylum seekers. In particular, it analyzes the way key government figures articulated a negative understanding of asylum seekers' family units--representing these as "foreign" or "other" to contemporary Australian standards of decency and parental responsibility. This representational regime also drew upon post-September 11 representations of Middle Eastern people, and was employed to call into question the validity of asylum-seekers' claims for refugee status. Manufactured primarily through the now notorious "children overboard" incident, these images became a central motif of the 2001 election campaign. This paper concludes by examining the way these representations of refugees as "undeserving" were paralleled by new Temporary Protection Visa regulations in Australia.

Discrimination as the touchstone of persecution in refugee law

The touchstone of refugee law is the concept of persecution. The concept is poorly defined. The courts have suggested that it includes several elements, including discrimination, systematic conduct, motivation and causation. In the context of distinguishing between prosecution and persecution, other criteria that have been employed include the notion of a law of general application’ and the legitimate and appropriate and adapted test. These concepts are often overlapping and some are superfluous. This paper proposes a new test for persecution. The best way forward to unify and inject coherency, consistency and certainty into this area of the law is to make discrimination the sole criterion of persecution. The (exhaustive) test for persecution that is proposed is as follows:  1. Does the law on its face impose an additional burden for a Convention reason? 2. If the answer is no, it is necessary to examine if the practical effect of the law is to impose an additional burden on people for a Convention reason either because the law selectively targets people for a Convention ground or disproportionately applies against people for a Convention ground? 3. If the answer to both questions is ‘no’, the law does not constitute persecution. 4. If the answer to question 1 or 2 is ‘yes’, then the law will constitute persecution unless there is a relevant basis for causing serious harm to people for a Convention reason.

Refugee law: the irrelevance of the framers` intentions

The Convention relating to the Status of Refugees 1951 ("the Convention") is over fifty years old. It is the most comprehensive legally binding international standard for the treatment of refugees.' The Convention governs the rights of refugees and the obligations of ratifying State parties towards refugees. The key aspect of the Convention is article 1A(2), which sets out the Convention definition of a refugee. It provides that a refugee is a person who: Owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his or her nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence, is unable or, owing to such fear, is unwilling to return to it.2 At the international law level the definition has remained (effectively)3 unchanged during this period. However, there has been a considerable amount of uncertainty at the domestic level concerning the precise meaning that should be given to important aspects of the definition, such as "particular social group" and "persecution". Given that the Convention is the principal international instrument dealing with the rights of refugees (since it was ratified by Denmark in 1952, 140 states have acceded to the Convention)4 and the importance of the interests and indeterminate nature of several aspects of the definition of refugee, the interpretive approach adopted in relation to the Convention is of considerable importance.

Obesity and undernutrition in sub-Saharan African immigrant and refugee children in Victoria, Australia

The study assessed the anthropometric status of 337 sub-Saharan African children aged between 3-12 years who migrated to Australia. These children were selected using a snowball sampling method stratified by age, gender and region of origin. The prevalence rates for overweight and obesity were 18.4% (95%CI: 14 - 23%) and 8.6% (95%CI: 6% -12%) respectively. The prevalence rates for the indicators of undernutrition were: wasting 4.3% (95%CI: 1.6%-9.1%), underweight 1.2% (95%CI: 0.3%-3.0%), and stunting 0.3 (95%CI: 0.0%-1.6%). Higher prevalence of overweight/obesity was associated with lower household income level, fewer siblings, lower birth weight, western African background, and single parent households (after controlling for demographic and socio-economic factors). Higher prevalence rates for underweight and wasting were associated with lower household income and shorter lengths of stay in Australia respectively. No effect was found for child's age, gender, parental education and occupation for both obesity and undernutrition indices. In conclusion, obesity and overweight are very prevalent in SSA migrant children and undernutrition, especially wasting, was also not uncommon in this target group.