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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by a grant to the National Academy of Sciences by the Andrew W. Mellon Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the organizations or agencies that provided support for the project.
Suggested citation: National Research Council (2001) Forced Migration and Mortality. Roundtable on the Demography of Forced Migration. Committee on Population. Holly E. Reed and Charles B. Keely, eds. Commission on Behavioral and Social Sciences and Education. Washington, D.C.: National Academy Press.
Library of Congress Cataloging-in-Publication Data
Forced migration and mortality / Roundtable on the Demography of Forced Migration, Committee on Population ; Holly E. Reed and Charles B. Keely, editors ; Commission on Behavioral and Social Sciences and Education, National Research Council.
p. cm.
Chiefly papers presented at a workshop organized by the Roundtable on the Demography of Forced Migration, held in Nov. 1999 in Washington, D.C.
Includes bibliographical references and index.
ISBN 0-309-07334-0 (pbk.)
1. Refugees—Mortality—Congresses. 2. Forced migration—Congresses.
I. Reed, Holly. II. Keely, Charles B. III. Roundtable on the Demography of Forced Migration. IV. National Research Council (U.S.). Committee on Population. V. National Research Council (U.S.). Commission on Behavioral and Social Sciences and Education
HV640 .F57 2001
304.6′4—dc21
2001000942
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Copyright 2001 by the National Academy of Sciences . All rights reserved.
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ROUNDTABLE ON THE DEMOGRAPHY OF FORCED MIGRATION
CHARLES B. KEELY (Chair),
Walsh School of Foreign Service, Georgetown University
RICHARD BLACK,
School of African and Asian Studies, University of Sussex
BRENT BURKHOLDER, *
South East Asia Regional Office, World Health Organization, and International Emergency and Refugee Health Program, Centers for Disease Control and Prevention, Atlanta, Georgia
GILBERT BURNHAM,
Center for Refugee and Disaster Studies, School of Public Health, Johns Hopkins University
WILLIAM GARVELINK,
U.S. Agency for International Development, Eritrea
STEVEN HANSCH,
Center for Disaster and Humanitarian Assistance Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
KENNETH HILL,
Center for Refugee and Disaster Studies, School of Public Health, Johns Hopkins University
BELA HOVY,
Division of Operational Support, United Nations High Commissioner for Refugees, Geneva
ALLAN JURY,
Bureau of Population, Refugees, and Migration, U.S. Department of State
JENNIFER LEANING,
François-Xavier Bagnoud Center for Health and Human Rights, School of Public Health, Harvard University
STEPHEN LUBKEMANN,
Watson Institute for International Studies, Brown University
CAROLYN MAKINSON,
The Andrew W. Mellon Foundation, New York
SUSAN FORBES MARTIN,
Institute for the Study of International Migration, Georgetown University
ERIC NOJI,
National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
W. COURTLAND ROBINSON,
Center for Refugee and Disaster Studies, School of Public Health, Johns Hopkins University
SHARON STANTON RUSSELL,
Center for International Studies, Massachusetts Institute for Technology
PAUL SPIEGEL, **
International Emergency and Refugee Health Program, Centers for Disease Control and Prevention, Atlanta, Georgia
BARRY STEIN,
Department of Political Science, Michigan State University
COMMITTEE ON POPULATION
JANE MENKEN (Chair),
Institute of Behavioral Sciences, University of Colorado, Boulder
CAROLINE H. BLEDSOE, *
Department of Anthropology, Northwestern University
JOHN BONGAARTS, **
The Population Council, New York
ELLEN BRENNAN-GALVIN,
Population Division, United Nations, New York
JOHN N. HOBCRAFT,
Population Investigation Committee, London School of Economics
F. THOMAS JUSTER,
Institute for Social Research, University of Michigan, Ann Arbor
CHARLES B. KEELY,
Walsh School of Foreign Service, Georgetown University
DAVID I. KERTZER,
Department of Anthropology, Brown University
DAVID A. LAM,
Population Studies Center, University of Michigan, Ann Arbor
LINDA G. MARTIN, *
The Population Council, New York
MARK R. MONTGOMERY, *
The Population Council, New York, and Department of Economics, State University of New York, Stony Brook
W. HENRY MOSLEY,
Department of Population and Family Health Sciences, Johns Hopkins University
ALBERTO PALLONI,
Center for Demography and Ecology, University of Wisconsin, Madison
JAMES P. SMITH, ** RAND,
Santa Monica, California
BETH J. SOLDO, *
Population Studies Center, University of Pennsylvania
JAMES W. VAUPEL,
Max Planck Institute for Demographic Research, Rostock, Germany
KENNETH W. WACHTER,
Department of Demography, University of California, Berkeley
LINDA J. WAITE,
Population Research Center, University of Chicago
BARNEY COHEN, Director
HOLLY E. REED, Research Associate
BRIAN TOBACHNICK, Project Administrative Coordinator
ELIZABETH WALLACE, ** Committee Administrative Coordinator
* Through October 1999. |
** Through October 2000. |
CONTRIBUTORS
BRENT BURKHOLDER, South-East Asia Regional Office, World Health Organization, and International Emergency and Refugee Health Program, Centers for Disease Control and Prevention, Atlanta, Georgia
GILBERT BURNHAM, Center for Refugee and Disaster Studies, School of Public Health, Johns Hopkins University
MANUEL CARBALLO, International Centre for Migration and Health, Geneva, and Mailman School of Public Health, Columbia University
STEVEN HANSCH, Center for Disaster and Humanitarian Assistance Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
PATRICK HEUVELINE, Population Research Center, National Opinion Research Center, and University of Chicago
KENNETH HILL, Center for Refugee and Disaster Studies, School of Public Health, Johns Hopkins University
CHARLES B. KEELY, Walsh School of Foreign Service, Georgetown University
MYUNG KEN LEE, School of Public Health, Johns Hopkins University
DOMINIQUE LEGROS, Epicentre/Médecins Sans Frontières, Paris
PIERRE NABETH, Epicentre/Médecins Sans Frontières, Paris
CHRISTOPHE PAQUET, Institut de Veille Sanitaire, Paris
HOLLY E. REED, Committee on Population, Division on Behavioral and Social Sciences and Education, National Research Council
W. COURTLAND ROBINSON, Center for Refugee and Disaster Studies, School of Public Health, Johns Hopkins University
PETER SALAMA, International Emergency and Refugee Health Program, Centers for Disease Control and Prevention, Atlanta, Georgia
PAUL SPIEGEL, International Emergency and Refugee Health Program, Centers for Disease Control and Prevention, Atlanta, Georgia
RONALD J. WALDMAN, Mailman School of Public Health, Columbia University
Preface
Over the last few years, there has been a growing appreciation of the need for more information about complex humanitarian emergencies in order to develop understanding about and more effective reactions to such events. The number, frequency, magnitude, and sheer difficulty of forced migrations in recent history have contributed to the need for more data. In addition, operational personnel realize that cumulative knowledge does not simply emerge from repetitions of prior experience. Insight, better protocols, and more effective reactions require analysis, comparison, and testing new approaches. To accomplish this, the field needs systematic data collection to assess behaviors, to ask questions, and to formulate alternatives.
Demographers and epidemiologists can provide some of these services. These population-related disciplines have long histories of applied work, based on the mathematical and statistical methods they have developed. They have not built up a cumulative body of knowledge, however, about complex emergencies.
In response to the need for more information about the measurement and estimation of displaced populations and their vital rates, the Committee on Population held a workshop on the demography of forced migration in 1998. The report of this workshop, published in 1999, summarized the field and suggested some potential directions for further research, as identified by participants.
As there was an obvious need for a vehicle for further exploration of these topics and others, the Committee on Population, with support from
the Andrew W. Mellon Foundation, developed the Roundtable on the Demography of Forced Migration. The Roundtable provides a forum in which a diverse group of experts can discuss the state of knowledge about demographic structures and processes among people who are forced to move, whether to escape war and political violence, to flee famine and other natural disasters, or by government projects or programs that destroy their homes and communities. The Roundtable's task is often confounded by definitional problems (e.g., what is “forced migration”), and by a lack of data or data whose representativeness is unknown.
The Roundtable includes representatives from operational agencies, with long field and administrative experience. It includes researchers and scientists with both applied and scholarly experience in medicine, demography, and epidemiology. The group also includes representatives from government, international organizations, donors, universities, and non-governmental organizations. The Roundtable is organized to be as inclusive as possible of relevant expertise and to provide occasions for substantive sharing to increase knowledge for all participants with a view toward developing cumulative facts to inform policy and programs in complex humanitarian emergencies. The accomplishment of this goal will necessarily advance our knowledge about demographic structures and processes during and following high levels of social stress. This cannot help but enlighten demography as a field regarding comparative situations, such as famine, as well as provide contrasts to more “normal” social histories and the lives of people.
The first workshop organized by the Roundtable was on “Mortality Patterns in Complex Emergencies.” Held in Washington, D.C., in November 1999, it was the first of a planned series of meetings attempting to survey what is known in the literature, what needs to be illuminated, and what current situations may tell us about the demography of current and future complex humanitarian emergencies. The objectives of the workshop were to explore patterns of mortality in recent crises and consider how these patterns resemble or differ from mortality in previous emergencies.
This volume emerges from the papers that were first presented at the workshop as well as the discussion at the workshop. It provides a basic overview of the state of knowledge about mortality in past complex humanitarian emergencies. Case studies on Rwanda, North Korea, and Kosovo, commissioned for the workshop, and on Cambodia, added after the workshop, provide focused reflection on complex emergencies as they have been in the past, as they are today, and as they appear to be for the near future.
The papers in this volume have been reviewed by individuals chosen for their diverse perspectives and technical expertise in accordance with
procedures approved by the Report Review Committee of the National Research Council (NRC). The purpose of this independent review was to provide candid and critical comments that would assist the institution in making the published volume as accurate and as sound as possible and to ensure that it meets institutional standards for objectivity and evidence. The review comments and draft manuscripts remain confidential.
We thank the following individuals for their participation in the review of this volume: Richard Black, School of African and Asian Studies, University of Sussex; Allan G. Hill, Center for Population and Development Studies, School of Public Health, Harvard University; Jennifer Leaning, François-Xavier Bagnoud Center for Health and Human Rights, School of Public Health, Harvard University; Stephen Lubkemann, Watson Institute for International Studies, Brown University; M. Giovanna Merli, Department of Sociology, University of Wisconsin, Madison; Kathleen Newland, International Migration Policy Program, Carnegie Endowment for International Peace; Eric Noji, National Center for Infectious Diseases, Centers for Disease Control and Prevention; Susanne Schmeidl, Institute for Conflict Resolution, Swiss Peace Foundation; William Seltzer, Department of Sociology and Anthropology, Fordham University; and David Turton, Refugee Studies Centre, University of Oxford.
Although the individuals listed above have provided many constructive comments and suggestions, they were not asked to endorse the papers nor did they see the final drafts before publication. The review process was overseen by David Kertzer, Departments of Anthropology and History, Brown University. Appointed by the National Research Council, he was responsible for making certain that an independent examination of these papers was carried out in accordance with insitutional procedures and that all review comments were carefully considered. Responsibility for the final content of this volume rests entirely with the authors and editors of this volume.
We are also grateful to the staff and associates of the National Research Council. In particular, Holly Reed, who was instrumental in the organization of the workshop, coordinated the contributions of the authors, co-authored the overview chapter, and coordinated the review process. Brian Tobachnick and Elizabeth Wallace expertly coordinated the logistical and travel arrangements for the workshop. Randi M. Blank edited the volume. Christine McShane guided the manuscript through the publication process and skillfully assisted with the editing. Sally Stanfield and the Audubon team at the National Academy Press handled the technical preparation of the report. Development and execution of this project occurred under the general guidance of the director of the Committee on Population, Barney Cohen.
We thank the Andrew W. Mellon Foundation, for its continual sup-
port of the work of the Roundtable as well as many others working in this field. A special thanks is due to Carolyn Makinson, Program Officer for Population and Forced Migration at the Mellon Foundation, for her enthusiasm and significant expertise in the field of forced migration. She has been an intellectual driving force behind the Roundtable's work.
We also wish to thank Charles Keely, of Georgetown University, a member of the Committee on Population and chair of the Roundtable, for his excellent work on the workshop and this volume, and his continued intellectual guidance for the Roundtable. Finally, we wish to recognize Ronald Waldman, of Columbia University, for his important substantive contributions in helping to organize the workshop.
Most of all, of course, we are grateful to the authors and other participants in the workshop, whose ideas have been captured in this volume. We hope that this publication helps to ensure the continuation of study about topics related to forced migration and ultimately contributes to both better policy and practice in the field.
Jane Menken
Chair, Committee on Population