ties that “(t)he crude mortality rate (CMR) most accurately represents [in a single measure] the health status of emergency-affected populations ” (Toole and Waldman, 1997). Mortality is indeed a valuable event to measure in emergencies; although it refers to only one dimension, it is a useful summary measure of the scale of the crisis and its impact, as well as the performance of those working to provide aid. Mortality estimates can be highly inaccurate, but they are often better and more easily captured than other health indicators, which may be subject to different definitions and cultural interpretations. There are many other potential outcomes of complex humanitarian emergencies, including morbidity, a possible change in fertility, migration, changes in family and household structures, broader societal changes, psychological effects, and potential cultural shifts. Mortality, however, has so far been one of the most easily and accurately measured indicators in an emergency setting. Since the mid-1980s, therefore, mortality rates have become a basic indicator in complex humanitarian emergencies (Hansch, 1999).

Concern for human life raises many questions about the causes, consequences, correlates, and measurement of mortality in complex humanitarian emergencies:

  • How do mortality patterns differ in different kinds of complex humanitarian emergencies?

  • How do mortality rates differ between refugee and internally displaced populations?

  • How do mortality patterns differ in various types of geographic settings?

  • How do mortality patterns differ by gender, age, or other groupings?

  • How do mortality patterns in complex humanitarian emergencies differ from (or are similar to) “normal” mortality patterns?

  • How does the distance traveled by refugees affect mortality?

  • How does the length of a crisis affect mortality?

  • How does food insecurity affect mortality? and

  • What are the effects of various humanitarian interventions on mortality?

The case studies in this volume and the collected wisdom based on several decades of relief aid in emergencies provide a good starting point for understanding mortality patterns in complex humanitarian emergencies. However, much of this knowledge is based on data collected in camp settings and must be adapted for different situations. There are still many issues that remain unresolved and many new issues that must be examined. It is also important to realize the potential policy and program



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement