Intended for healthcare professionals

Clinical Review ABC of conflict and disaster

Displaced populations and long term humanitarian assistance

BMJ 2005; 331 doi: (Published 07 July 2005) Cite this as: BMJ 2005;331:98
  1. Maria Kett, research fellow
  1. Leonard Cheshire Centre of Conflict Recovery, University College London, London.


    Conflicts and disasters—whether manufactured or natural—often result in the wide scale displacement of people. This may be as a result of destruction of homes and environment, religious or political persecution, or simply economic necessity. Some remain internally displaced within the borders of their own country, if not their own region or homeland. Others will cross international borders as refugees. (A refugee is legally defined as someone who has crossed an international border to escape actual or potential persecution.)

    Whatever the reason for displacement, the resulting mass of vulnerable people, most of whom may be women and children, must be accommodated somewhere, be it in tented camps, semipermanent or permanent collective centres or settlements, or even private residences.

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    Camp for refugees and internally displaced people

    For healthcare professionals contributing to humanitarian missions and projects in the acute phase of population displacement, an awareness of some of the factors that can influence the long term outcomes can be of great benefit for understanding project implications and sustainability.

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    Potential causes of displacement

    Issues in humanitarian responses

    Humanitarian responses can be considered under the phases of early or emergency, post-emergency or intermediate, and resettlement or long term (these phases overlap and are not necessarily sequential). This article focuses on continued responses in the long term resettlement phase.

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    Changes in humanitarian response and responsibility over time


    While the United Nations High Commission for Refugees (UNHCR) is legally bound by international statute to assist and protect refugees, this is not so for internally displaced people—though the commission often does take responsibility for them, as set out in its Guiding Principles on Internal Displacement.

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    Statistics for internally displaced people

    Other agencies that share responsibility for refugees and internally displaced people include the International Committee of the Red Cross (although its mandate ceases when conflict ends), the UN children's fund Unicef, …

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