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[Comment] Where is the science in humanitarian health?

In 1948, in the aftermath of the partition of India and Pakistan, a journal article on the health situation of refugees and internally displaced persons stated that “this report is based entirely on impressions”.1 Another of the earliest articles about a humanitarian emergency, the East Bengal cyclone in 1970, stated that “relief supplies and volunteers poured in, but no one knew the magnitude or geographic distribution of losses and needs.”2 How did these volunteers know what skills were needed? What supplies and commodities to distribute? How did they know where to go or who to help? Impressions, best intentions, and customary practices were the rule at the time, and health interventions were rarely supported by epidemiological or clinical studies that provided evidence of effectiveness.