Internal+Displacement

= Internal Displacement = toc

Overview
Internally displaced persons (IDP), as defined by the United Nations Secretary-General in 1992 refers to "persons or groups who have been forced to flee their homes suddenly or unexpectedly in large numbers” but have not had to cross international borders and thus do not qualify for refugee status. Displacement is historically associated with lack of basic needs, a change in livelihood and a general lack of support networks. Even when basic needs are essentially met, IDPs are still vulnerable to sexual violence and victimization. Among those most affected are women and children, who lacking supporting social structures, have little ways to defend themselves from perpetrators.



Health Impact
In the Sierra Leone, female IDPs suffered high amounts of sexual violence from armed groups. Similarly, Haitian IDPs after the 2010 earthquake experienced high levels of rape, both within and outside established IDP camps by either males charged with maintaining order or gangs of young men that emerged after the disaster. Within the context of an industrialized nation, female evacuees of Hurricane Katrina in Houston were at times targets of rapes and sexual assaults immediately after the storm. Displacement itself often puts women at a higher risk for HIV by placing them in more frequent contact with at-risk populations. The physical traumas and stresses that IDPs often encounter in turn have significant implications for their mental health. In one study of IDP and refugee health, IDPs reported more traumatic events than refugees or non-displaced women and over time were shown to suffer more continued negative mental health outcomes. In situations in which violence was observed or experienced, there were long lasting effects consistent with post traumatic stress disorder. This is especially true with women, who as noted, often suffer from increased levels of sexual violence and exploitation. Bosnia serves as an effective example of an emerging industrial country that experienced conflict and displaced populations. As Bosnia and Herzegovina waged war, residents fled areas of conflict. One study assessing the health of women showed that fear and lack of control were factors that were closely associated with the emergence of symptoms associated with post traumatic stress syndrome. Another study, focusing on displaced children's health, found that issues related to wartime displacement including leaving home, being separated from loved ones and seeing death was related to high levels of depression, anxiety and symptoms of PTSD. Colombia also faced intense violence. Conflicts associated with drug trafficking organizations and a two-pronged war against leftist armies and right wing paramilitaries have led to continued displacement over the last four decades of almost 4 million people. An assessment of displaced populations in Cartagena found extensive health issues including 80 percent of children with respiratory problems, 30 percent with diarrhea and 30 percent with pus infected lesions on the skin Colombia continues to have the highest number of IDPs in the Western Hemisphere. The health issues associated with displacement can be cyclical. While physical trauma can be related to stressful environments that affect mental health, mental health in itself often has implications for the physical health of displaced populations.. Research in biological anthropology and public health have shown examples of long term stress found in marginalized populations to be related to high levels of blood pressure and elevated hormone levels. The study of allostatic loads has shed light on the embodiment of social mechanisms of displacement, uncertainty, poverty and structural violence. Often, long term elevated levels contribute to the emergence of long term chronic diseases like hypertension, diabetes and heart problems. This is particularly salient as internally displaced populations can be displaced for extended periods of time as seen with Dominicans that continue to be displaced by the damage from Hurricane David in 1979.

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Medical Anthropology Research
Medical anthropological literature has primarily examined internal displacement in light of natural disasters. Linda Whiteford has examined the effects of volcanic activity on Ecuadorian residents living in the shadow of Mount Tungurahua. In the fall of 1999, Mount Tungurahua in central Ecuador entered a phase of continuous activity punctuated by major eruptions in 1999, 2001, 2002, 2006, 2008, 2010 and 2011. As a result of the volcanic activity, communities that were especially vulnerable to danger were evacuated to safer areas. The Penipe canton, in the Chimborazo province of Ecuador, was especially affected by heavy ash fall and devastating lava flows that led to mass evacuations from the area. Whiteford's research has documented the chronic health needs associated with long-term exposure to ash fall. Her research has also examined the social consequences of evacuation and how these can affect the enforcement of official evacuations from at-risk communities. She has done research on community resilience and the role of women in post disasters community health.

Applied Work
It can be difficult to avoid the internal displacement of people. Still, the health risks that are associated with it can be mitigated through careful planning and a better understanding of social stressors. Applied anthropology has explored the health conditions of persons living in shelters to find that unsanitary conditions, uncertainty in new environments, and stresses to survive all made them more prone to sickness. There are difficulties in convincing a populace to evacuate their homes and sources of income when required. Whiteford and Tobin were able to make recommendations based on interviews with locals to create a more effective evacuation process.

Online Resources
Internal Displacement Monitoring Centre 

Office of the United Nations High Commisioner for Refugees (UNHCR)-Internally Displaced People http://www.unhcr.org/pages/49c3646c146.html