Since the Cambodian refugee emergency of 1979, refugee emergencies continue to be a global problem. Health care workers returning from the Cambodian emergency relief presented the need for improved predeparture training and orientation to the Second World Congress on Emergency and Disaster Medicine in Pittsburgh and elsewhere (1,2). The special training needs of health professionals working in such emergencies have come to the attention of the National Council for International Health in the US (NCIH) whose role is to increase US effectiveness in international health in developing countries (3,4,5). NCIH, established in 1971, is a private non-profit organization. Membership includes individuals, private and voluntary organizations, health and medical associations, universities, governmental agencies, foundations, corporations and consulting firms.

Worldwide today, more than 10 mill. refugees have been forced to leave their homelands because of political and civil disturbances, war, famine, earthquakes, floods and other disasters. Host governments are often unable to deal with these situations and rely on international relief to provide for the various physical, humanitarian and other needs of these victims.

Providing health care is a complex process that takes place in phases within political, economic, social and cultural constraints that are unfamiliar to health care workers without prior experience or special training. Unfortunately training to meet these emergencies is either non-existent or consists of brief predeparture sessions. Only a fraction of those with prior experience are available at short notice. In Thailand, for example, organizations were forced to recruit medical professionals who were inexperienced in refugee relief.