Helena Legido-Quigley and colleagues examine the barriers that migrants face in accessing healthcare and argue they are counterproductive for host countries

We present a case of an international labour migrant worker from India who acquired multipledrug resistant tuberculosis (MDR-TB) as a result of poor treatment compliance throughout his work and travel history. The travel to Sri Lanka was made under the resident visa scheme. Currently there are no mandatory health assessment requirements for inbound migrants such as resident visa holders to Sri Lanka. The diagnosis of MDR-TB was made at a district level chest clinic and the National Tuberculosis Program (NTP). This is the first documented case of MDR-TB in a foreign born migrant worker in Sri Lanka. The volume of resident visa applicants and foreign migrant workers to Sri Lanka from high TB burden countries has increased dramatically over the past five years. We examine the rationale and public health impact for undertaking a health assessment of the growing numbers inbound migrant workers to Sri Lanka from high TB burden countries.

Limited attention has been made by countries of 'new immigration' to define an immigration medical examination requirement of inbound migrant flows. Importation of TB through inbound migration routes have been a largely neglected strategy in TB control in Sri Lanka despite increasing migrant flows from endemic regions. We contend that establishing a health assessment for those long stay resident visa applicants to Sri Lanka may be useful in mitigating the spread of TB. However the approach should harness a 'rights based' approach to health assessment, and also be linked to the national health system. In this way the assessment becomes a vital mechanism for global public health good rather than be perceived as a tool for discrimination or immigration control. Migrants need to be included in national and global TB control strategies, especially since mobility is a key feature of the post-2015 Millennium Development Goals agenda.

Research into how war-displaced communities value or prioritize aid response is limited. A clearer conceptualization of what affected populations seek from the international humanitarian response to their needs would be valuable in planning for emergencies.AimExploring internally displaced person's (IDP) experiences and perceptions of the humanitarian response, with a focus on health risks, resources, and health services received during their displacement.MethodA mixed-method approach using both quantitative and qualitative methods was used. This study assessed the perceptions of IDPs on provision of health and other services using an interviewer-administered-questionnaire (survey) using a sample frame that included the entire displaced population of 150,000 IDPs living in 97 camps. Findings from the survey were synthesized with the key themes that emerged through the qualitative methodology. In-depth interviews were conducted with health cluster actors. An innovative child-to-child (CTC) based research methodology was used to ascertain the insights and perceptions of displaced children and adolescents.ResultsThe survey revealed community satisfaction with health care services immediately after displacement (within IDP camps) improved considerably from 63% to 80% (6 months after the acute phase). Significant gains also were registered for shelter (54.2% to 81.4%), and sanitation (47.4% to 62%). Satisfaction of services rendered by primary healthcare workers also were high; 81.7% for public health midwife (who provided maternal and child health care), and 76.8% for public health inspectors (who provided environmental health and disease control). However, CTC workshops revealed inequalities in access to food based on ‘caste’ and occupation. Protection issues relating to violence from community and militant groups were reported.ConclusionsDespite IDP satisfaction with healthcare services, there were gaps in food security and violence/protection activities. Recognizing of the role/impact community health volunteers play in health care is an important factor in enhancing primary health care services in IDP camps.

Abstracts -17th World Congress on Disaster and Emergency Medicine Prehospital and Disaster MedicineVol. 26, Supplement 1 and falling out of favour with conflicting literature reviews. Its simplicity of use makes it an effective tool in the treatment of exacerbations of asthma. Aminophylline is one of the earliest bronchodilator that has heaps of adverse effects. This presentations begins with a world tour of major guidelines with a special focus on Magnesium, Aminophylline and Heliox followed by an in depth literature search. Current literature and metanalysis for all the three drugs for pulmonary function test, hospitalisation and adverse effects are graphically illustrated. Based on the evidence so far, a guideline is proposed for the use of the above three drugs for Paediatric asthma. The main trends in the development of the ideology of humanism in disaster medicine can be formulated in the following theses: 1. Responsibility of governmental bodies for providing medical safety of a human being in emergencies; 2. Responsibility of public health in the society; 3. Main tasks in nuclear threats connected as applied to disaster medicine are the responsibility of United Nations; 4. History of humanitarian medicine and the development of the World Health Organization's activities in providing medical humanitarian assistance; 5. Ethics of modern physical investigations in the light of development of nuclear and thermonuclear hazards; 6. Roles and trends of humanitarian medicine in modern society; 7. Philosophical and humanitarian approaches and ethics in the modern scientific investigations in the whole; 8. Ethics in modern medicine, biology, and disaster medicine; 9. Rights of victims to receive humanitarian medical assistance in local military conflicts; and 10. Threat of acts of terrorism with the use of chemical, biological, radiological, or nuclear agents and technologies; The paradox of the modern age is that the "principal basis and aim of disaster medicine are humanitarian by their primordial nature", but the reduction of common human values can lead to a global disaster. On the other hand, emergencies should lead mankind to unity, to the deep understanding of biosocial aspects of survival when the best qualities of human nature are revealed. International disaster medicine problems should be considered as tools for providing an optimal basis for the development of human relations. This presentation explores the nexus between collective violence (in the form of violent civil conflict) and health and human rights in Sri Lanka, focusing specifically on persons displaced during the most recent conflict in Northern Sri Lanka beginning in November 2008. After exploring the normative framework in relation to the right to health, the local legal framework governing internal displacement, and the related component on healthcare access, service provision, and standards will be described. By examining health cluster reports, health surveys, and case-studies, this presentation describes how the health sector responded...