1. Health Care Professional
HEALTHCARE SERVICES FOR DISPLACED AND VULNERABLE PEOPLE IN PRECARIOUS ENVIRONMENT
Case study: Borgop Site
Doret Rose NCHANG
Health Care Professional
International Medical Corps Cameroon (IMC)
National Advanced School of Posts and Telecommunications (NASPT) Cameroon

2. CONTENTS Introduction
Illiteracy and vulnerability in precarious environment
Language barrier in the refugee camp
Cultural, religious and social norms in the camp
Bad roads in the precarious environment
Acknowledgement

3. INTRODUCTION
Healthcare environment for displaced and vulnerable people is a precarious situation in which quality health care services cannot be guaranteed.
Refugees and displaced people being the most vulnerable groups in society have specific health care needs which arise from the adverse effects of conflict and forced exile with experiences of persecution, psychological trauma, deprivation, unhealthy environmental conditions, and disrupted access to health care.

4. This work identifies the challenges experiences in refugee’s camps through personal observation, focus group discussions and key person’s interviews. Among the major challenges observed are:
lack of water
poor hygiene
population density
bad roads
poor transportation making it difficult to access settlements

5. Refugees and displaced people in the society face major difficulties as per their environment (demand side) and health care service delivery (supply side).
These difficulties that have lead to the gap creation between the health personnel providing healthcare services, and the vulnerable persons accessing these services with these, a way forward or strategies have to be put in place to eliminate this difficulties and promote accessible and proper health care service delivery.

6. Difficulties and constraints faced
Illiteracy and lack of education;
Language barriers;
Cost and limited finances;
High population density;
Cultural, religious and social norms.

7. Illiteracy and lack of education
Illiteracy is the inability to read and write, being uneducated, ignorant or uncultured. It is seen that illiteracy result from the interaction of a number of factors:
Malnutrition
Health problems
Child labour
Migration
Lack of access to continuous teaching and learning environment

8. Disinformation is one of the most significant problems of illiteracy
Disinformation is one of the most significant problems of illiteracy. Amongst other things illiteracy increases the likelihood of high risk of sexual behaviour, lack of awareness which may lead to contracting viruses like HIV.
In short, illiterate persons are more vulnerable, in both senses. They are also at greater risk, and less able to face adversity.

9. Language barrier
Language barriers result in miscommunication, misdiagnosis, and lack of appropriate follow up. Miscommunication in the sense that since the doctor and the patient do not speak the same language, the doctor or health personnel will not be able to understand what the patient is saying and in turn not be able to explain to the patient what he or she is suffering from. Also because of this miscommunication they will be misdiagnosis and lack of proper follow up.

10. Cultural, religious and social norms
Most refugees take their culture and religions very seriously making it difficult for the health personnel to do their job.
These norms are deep rooted attitudes that reflect the low demand for health care services by the displaced or vulnerable persons.
A great number of refugees prefer traditional treatment which follows their tradition over modern therapies.
Therefore access to health care for some refugees is hindered by a lack of familiarity and acceptability with available services

11. Bad roads
In this environment, the roads are not the best which causes transportation difficulties. Due to the bad condition of the road, much time is taken to cover short distances which can be fatal to the refugees or health official in case of any complication. Sometimes pregnant women have complication at child birth and because of these bad roads they are not able to go to the hospital on time and this may cause the death of the mother or child and sometimes both. Sometimes when the child is not properly taken care of at birth he or she may contract diseases.

12. The table below illustrates how the increase in population over these periods in the precarious environment has affected the difficulties faced. Tables: Increase in difficulties in the precarious environment as the population increases.

13. Acces to healthcare observe services in Borgop population, September 2014 - April 2015

14. Access to healthcare services observed in Ngam, from September 2014 - April 2015

15. Results and discussions
The table shows that over the periods there has been an increase in population in the precarious environment of Borgop with no increase in facilities like provision of water, good roads, and education and healthcare services. We see that as the population increases, there is an increase in difficulties faced. This population increase makes it difficult for health personnel to provide healthcare to the displaced and vulnerable people. So to make provision of health care in that environment, it will be necessary that most if not all of the difficulties be addressed.

16. Conclusively, effective health care is underutilized in environment areas with refugee habitats. So the way forward is to call on the government, NGO’s to see in to the situation: providing good roads, potable water and schools. Thus solutions, at a general level, must address one or more of these causes be it social, economic, cultural, religious or political. Out of sensitizing all stakeholders, it will be necessary to conceive tools using innovative technologies. Facing a situation of injuries like the one in this photograph we are thinking about an automatic tourniquet.

17. (Sensitive abstain)

18. Thank you for your kind attention.