Enclosure (4) to COMDTINST 6220.9A
HEALTH ISSUES OF ALIEN MIGRANTS
A. Background. Persons displaced by war, natural disaster, famine and other factors are frequently
dependent on others for their basic human needs. Large numbers of migrants can rapidly overwhelm
the resources of those providing assistance, unless there has been careful planning and adequate
preparations. A systematic and organized response will greatly assist in making structure out of
apparent chaos. Issues associated with AMIO cover a spectrum of concerns ranging from
international law, security, and humanitarian needs. Planning will help ensure that AMIO will be
conducted in an appropriately safe and efficient manner. The content of this chapter focuses on the
public health and humanitarian needs of displaced populations (e.g., those related to AMIO).
B. Planning. Public health and communicable disease issues of alien migrants are primarily focused on
or injured. Planning for probable contingencies involves awareness of the factors and circumstances
pertinent to AMIO, such as:
1. The country of migrant origin;
2. Estimated numbers of persons;
3. Population characteristics of alien migrants (race, gender and age distributions);
4. Presenting symptoms of health and mental status;
5. General environmental conditions;
6. Length of stay; and
7. Unique issues (e.g., security concerns, etc).
C. Specific Issues.
1. Assessment of Health Status. Upon arrival, the migrants health status shall be rapidly assessed.
This shall be done by an HS; or if none are available, this role should be filled by the next most
medically-qualified person (e.g.; EMT, First Responder). Standard triage techniques will
differentiate those who require immediate, urgent or delayed medical attention. Persons who
have life or limb threatening conditions should receive immediate care and be referred for more
definitive care, if needed. Health care problems of a less threatening nature should be addressed
secondarily, dependent on available resources and health care expertise. Resources should not
be diverted for chronic conditions which are generally best remedied in more stable
circumstances. If possible:
a) Record information on the Chronological Record of Medical Care (SF-600) for health care
assessment and interventions for individual persons. A sample form has been provided in
enclosure (3) and also on the CG-1121 website.
b) Summarize health information on the Chronological Record of Medical Care (SF-600) for
the entire population treated. Summary information should include total number of persons
treated, distribution of patients by gender and age, number and types of diseases encountered
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