Destroyed hospitals and health facilities, collapsed health systems and increased morbidity and mortality can represent a common occurrence during conflict. Breakdowns in the supply of clean water and lack of sanitation make populations more vulnerable to waterborne and communicable diseases. The healthcare workforce can become scarce due to the direct or indirect effect of the conflict. The provision of medical supplies is often interrupted, hampering the delivery of preventive and curative health services. The health status of populations affected by conflict can henceforth be deeply affected and the lives of groups of individuals threatened.
DDR programmes carried out in post-conflict environments usually generate large movements of populations including combatants and their dependents within and across borders. These movements may bring diseases into areas where they do not usually occur and may speed up the spread of outbreaks of diseases that can easily turn into epidemics. DDR practitioners therefore have an important responsibility to prevent or minimize the risk that diseases will spread by detecting and containing them early on in the process.
In each country where a DDR process is being implemented, even without considering the different features of the process itself, a unique set of health needs will have to be met. The United Nations role in DDR and health may range from norms and standards-setting to direct operational responsibilities including the health screening of demobilized ex-combatants and their dependants and improving their access to healthcare services. Where initial assessments reveal that large movements of ex-combatants and their dependents are likely to occur and where special groups are likely to be among DDR participants, DDR programmes should call upon specialized health agencies to provide technical support in the planning and implementation stages.
Where health actions are judged necessary during the DDR process, DDR practitioners should
Identify the most appropriate coordination mechanism to respond to the health-related aspects of the integrated DDR approach; this requires that planning and implementation be undertaken in cooperation with national authorities and other key stakeholders from the earliest stages of the process. Early involvement will help create necessary linkages between international and national health staff, with a goal of building capacity and connecting to longer-term national health strategies.
Encourage the health sector to be represented in the national commission on DDR (NCDDR) or any other steering committee.
Identify the health focal point within each armed force or group participating in the DDR process.
Once health actors have been identified, they should be brought together to plan and design health interventions. While every DDR programme is unique and will bring specific health implications, the following are actions that should usually be considered:
Setting standards for health screening and the delivery of health care and health-related services to DDR participants by non-governmental organizations (NGOs) and other implementing partners during demobilization, whether in cantonment, interim care centres (ICCs), mobile sites or a network of DDR offices.
Supporting the provision of health equipment and services during demobilization.
Strengthening the health care system in expected areas of return and reintegration.