Epidemiology and infection in famine and disasters

Despite advances in health care in the tropics, and the inputs of international and voluntary organisations, famine and disaster continue to cause major devastation in many developing countries. In the aftermath of acute disasters such as earthquakes or cyclones and in chronic post-famine relief camps, mortality rates may be 20–30 times greater than those in ‘normal’ years 1. The interaction of malnutrition, crowding, poor environmental sanitation, and changes in host parasite relationships due to migration or environmental change, result in communicable diseases playing a major role in excess morbidity and mortality.