Refugee-Related Emergencies: Lessons Learned from the Emergency Management of Hunger Strikers

qualified for international assistance as official refugees steadily escalated from 2.5 million in 1975 to more than 15 million in 1989 [1]. The United Nations Convention of 1951 defines a refugee as “a person who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is...unwilling to return to it” [2]. In the post-Cold War period, those crossing international borders (refugees) and those migrating within their country of origin (internally displaced populations) primarily originate from source-country populations embroiled in politically-driven internal conflicts, popularly referred to as complex emergencies (CEs) [3,4]. Examples of CEs include the ethnic-based conflicts in Northern Iraq, Somalia, Rwanda, the former Yugoslavia, and, most recently, in Kosovo [1,5]. Migrant populations, which now exceed 22 million, flee from violence erupting from myriad complex social, economic, religious, and political causes. Civilian deaths, which accounted for half of all Cold War-related deaths in the 1950s, now constitute more than 90% of such deaths [1]. Over the past decade more children than soldiers--some 2 million-have died as a result of civil strife associated with CEs [1]. Refugees from Cold War persecution were most often welcomed in asylum countries as a first step to eventual immigration or emigration to a second country. They were integrated into existing health and human services by both governmental and non-gov-