Enclosure (4) to COMDTINST 6220.9A
and so forth. Disease Non-Battle Injury (DNBI) forms may be used as a summarized
information sheet. This form is located in reference (d).
2. Nutrition. Health status assessment provides an initial idea of the nutritional state of alien
migrants. Persons who appear emaciated or gaunt or who have a distended abdomen or swollen
ankles may be in severe nutritional deficiency and require rapid and specialized intervention.
Separate these people from the other migrants and contact a Flight Surgeon for further guidence.
Food best suited for migrants are those which are part of their normal diet. Caution must be
taken to prevent issuing food to alien migrants when there is a known physical intolerance.
Meals served twice a day, in generous quantities, are usually sufficient to meet the nutritional
needs of most persons. Individuals who are ill, suffer chronic nutritional deficiencies, are under
6 years of age or are pregnant, have nutritional needs that require more frequent and specialized
meals. Additional basic principles of alien migrant nutrition include:
a) Rule-of-thumb on daily caloric need is a minimum 1,900 calories per person per day. At
least 10 percent of the calories should be from fats and 12 percent from proteins;
b) Food distribution should be controlled to ensure that all personnel are fed;
c) Avoid use of dried milk or other milk products unless these foods are normally consumed;
d) Generally safest are simple foods (e.g., rice, beans and cooked vegetables); and
e) Encourage breast feeding infants when such situations exist.
3. Space. Operational and environmental circumstances are important determinants in space needs.
Space requirements for alien migrants include those needed for sleeping, eating, personal
hygiene and medical care. Additional factors are the numbers of persons involved and
anticipated length of stay. Large numbers of migrants can quickly crowd available holding
areas. What may be acceptable for short term stays may be unacceptable for long term stays.
4. Communicable Disease Control. Crowding, over-tasked resources, nutritional deficiencies, poor
sanitation and apparent chaos are common circumstances affecting displaced populations. Acute
communicable diseases frequently accompany alien migrants, the most common of which are
diarrhea and respiratory infection. Prevention and control measures should be implemented
among migrants to minimize communicable disease occurrence. Some measures and safeguards
are:
a) Attain and maintain safe food and potable water sources (if available Meals Ready to Eat
(MREs) may be provided);
b) Install and ensure the availability of sanitary disposal systems for human wastes;
c) Eradicate or control insects and animal vectors;
d) Decontaminate or otherwise effectively process eating utensils, clothing, bedding and
personal effects which serve as sources of disease transmission;
e) Appropriately handle alien migrants identified with communicable diseases to control
transmission, as discussed in this instruction; and
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