Humanitarian crises: what determines the level of emergency assistance? Media coverage, donor interests and the aid business.

PubMed

Olsen, Gorm Rye; Carstensen, Nils; Høyen, Kristian

2003-06-01

This paper proposes a basic hypothesis that the volume of emergency assistance any humanitarian crisis attracts is determined by three main factors working either in conjunction or individually. First, it depends on the intensity of media coverage. Second, it depends on the degree of political interest, particularly related to security, that donor governments have in a particular region. Third, the volume of emergency aid depends on strength of humanitarian NGOs and international organisations present in a specific country experiencing a humanitarian emergency. The empirical analysis of a number of emergency situations is carried out based on material that has never been published before. The paper concludes that only occasionally do the media play a decisive role in influencing donors. Rather, the security interests of Western donors are important together with the presence and strength of humanitarian stakeholders, such as NGOs and international organisations lobbying donor governments.

The co-construction of medical humanitarianism: analysis of personal, organizationally condoned narratives from an agency website.

PubMed

Ager, Alastair; Iacovou, Melina

2014-11-01

Recent years have seen significant growth in both the size and profile of the humanitarian sector. However, little research has focused upon the constructions of humanitarian practice negotiated by agencies and their workers that serve to sustain engagement in the face personal challenges and critique of the humanitarian enterprise. This study used the public narrative of 129 website postings by humanitarian workers deployed with the health-focused international humanitarian organization Médecins Sans Frontières (MSF) to identify recurrent themes in personal, organizationally-condoned, public discourse regarding humanitarian practice. Data represented all eligible postings from a feature on the agency's UK website from May 2002 to April 2012. The text of postings was analysed with respect to emergent themes on an iterative basis. Comprehensive coding of material was achieved through a thematic structure that reflected the core domains of project details, the working environment, characteristics of beneficiaries and recurrent motivational sub-texts. Features of the co-construction of narratives include language serving to neutralize complex political contexts; the specification of barriers as substantive but surmountable; the dominance of the construct of national-international in understanding the operation of teams; intense personal identification with organization values; and the use of resilience as a framing of beneficiary adaptation and perseverance in conditions that--from an external perspective--warrant despair and withdrawal. Recurrent motivational sub-texts include 'making a difference' and contrasts with 'past professional constraints' and 'ordinary life back home.' The prominence of these sub-texts not only highlights key personal agendas but also suggests--notwithstanding policy initiatives regarding stronger contextual rooting and professionalism--continuing organizational emphasis on externality and volunteerism. Overall, postings illustrate a complex co-construction of medical humanitarianism that reflects a negotiated script of personal and organizational understandings adapted to evolving demands of humanitarian engagement. Copyright © 2014 Elsevier Ltd. All rights reserved.

Non-Communicable Diseases in Emergencies: A Call to Action

PubMed Central

Demaio, Alessandro; Jamieson, Jennifer; Horn, Rebecca; de Courten, Maximilian; Tellier, Siri

2013-01-01

Recent years have demonstrated the devastating health consequences of complex emergencies and natural disasters and thereby highlighted the importance of comprehensive and collaborative approaches to humanitarian responses and risk reduction. Simultaneously, noncommunicable diseases are now recognised as a real and growing threat to population health and development; a threat that is magnified by and during emergencies. Noncommunicable diseases, however, continue to receive little attention from humanitarian organisations in the acute phase of disaster and emergency response. This paper calls on all sectors to recognise and address the specific health challenges posed by noncommunicable diseases in emergencies and disaster situations. This publication aims to highlight the need for: • Increased research on morbidity and mortality patterns due to noncommunicable diseases during and following emergencies; • Raised awareness through greater advocacy for the issue and challenges of noncommunicable diseases during and following emergencies; • Incorporation of noncommunicable diseases into existing emergency-related policies, standards, and resources; • Development of technical guidelines on the clinical management of noncommunicable diseases in emergencies; • Greater integration and coordination in health service provision during and following emergencies; • Integrating noncommunicable diseases into practical and academic training of emergency workers and emergency-response coordinators. PMID:24056956

The 2018 Inter-agency field manual on reproductive health in humanitarian settings: revising the global standards.

PubMed

Foster, Angel M; Evans, Dabney P; Garcia, Melissa; Knaster, Sarah; Krause, Sandra; McGinn, Therese; Rich, Sarah; Shah, Meera; Tappis, Hannah; Wheeler, Erin

2017-11-01

Since the 1990s, the Inter-agency field manual on reproductive health in humanitarian settings (IAFM) has provided authoritative guidance on reproductive health service provision during different phases of complex humanitarian emergencies. In 2018, the Inter-Agency Working Group on Reproductive Health in Crises will release a new edition of this global resource. In this article, we describe the collaborative and inter-sectoral revision process and highlight major changes in the 2018 IAFM. Key revisions to the manual include repositioning unintended pregnancy prevention within and explicitly incorporating safe abortion care into the Minimum Initial Service Package (MISP) chapter, which outlines a set of priority activities to be implemented at the outset of a humanitarian crisis; stronger guidance on the transition from the MISP to comprehensive sexual and reproductive health services; and the addition of a logistics chapter. In addition, the IAFM now places greater and more consistent emphasis on human rights principles and obligations, gender-based violence, and the linkages between maternal and newborn health, and incorporates a diverse range of field examples. We conclude this article with an outline of plans for releasing the 2018 IAFM and facilitating uptake by those working in refugee, crisis, conflict, and emergency settings.

Cracking the humanitarian logistic coordination challenge: lessons from the urban search and rescue community.

PubMed

Tatham, Peter; Spens, Karen

2016-04-01

The challenges of achieving successful inter-agency logistic coordination in preparing for and responding to natural disasters and complex emergencies are both well understood and well documented. However, although many of these challenges remain unresolved, the literature reveals that the organisations that form the urban search and rescue (USAR) community have attained a high level of coherence and interoperability that results in a highly efficient and effective response. Therefore, this paper uses the idea of 'borrowing' from other fields as it explores how the processes and procedures used by the USAR community might be applied to improve humanitarian logistic operations. The paper analyses the USAR model and explores how the resultant challenges might be addressed in a humanitarian logistic context. The paper recommends that further research be undertaken in order to develop a modified USAR model that could be operationalised by the international community of humanitarian logisticians. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

An account of co-ordination mechanisms for humanitarian assistance during the international response to the 1994 crisis in Rwanda.

PubMed

Borton, J

1996-12-01

This paper examines the co-ordination strategies developed to respond to the Great Lakes crisis following the events of April 1994. It analyses the different functions and mechanisms which sought to achieve a co-ordinated response--ranging from facilitation at one extreme to management and direction at the other. The different regimes developed to facilitate co-ordination within Rwanda and neighbouring countries, focusing on both inter-agency and inter-country co-ordination issues, are then analysed. Finally, the paper highlights the absence of mechanisms to achieve coherence between the humanitarian, political and security domains. It concludes that effective co-ordination is critical not only to achieve programme efficiency, but to ensure that the appropriate instruments and strategies to respond to complex political emergencies are in place. It proposes a radical re-shaping of international humanitarian, political and security institutions, particularly the United Nations, to improve the effectiveness of humanitarian and political responses to crises such as that in the Great Lakes.

Humanitarianism and local service institutions in Angola.

PubMed

Christoplos, I

1998-03-01

The role of local service institutions is not a major focus of current discourse on humanitarianism and complex emergencies. These institutions, in the few places where they are mentioned, are usually presented as either the seed of civil society and future democracy, or as pawns and components of the predatory economic, political and military élites. Few would deny that examples can be found which conform to both of these stereotypes. This simplistic representation of local institutions ignores the perspectives of the actors themselves--the nurses, extension agents, school teachers and others who actually staff most NGO-supported projects. The debate has focused on what 'we' should do; the moral dilemmas of aid agencies and their expatriate staff, inevitably leading to the question of whether or not humanitarian workers should stay or leave situations in which aid may be causing more harm than good. Without denying the fundamental importance of these issues, it is important to consider also how the discourse has unfortunately moved away from those humanitarian workers who have no such choice, since they live there. Current concerns about keeping humanitarian aid from feeding local political and military struggles may inadvertently and paradoxically serve to constrain room for maneuver in the field, particularly among those individuals with the greatest tacit understanding of the predatory environment. There is a need to understand how actors in local service institutions make sense of their own situations, including the factors which frame their moral dilemmas and their day-to-day choices. By analysing the organisational processes within local service institutions, this study is intended to provoke consideration of how these individuals and their institutions may be effectively supported in complex emergencies through a focus on how they themselves deal with danger and complexity. It is suggested that there is a value in considering the lessons learnt in recent years about how service organisations in the North function in turbulent environments. This experience points to the importance of allowing workers the discretion to develop a relationship with their clients, and in so doing make sense of a confusing and ambivalent environment.

An Analysis of the Use of Medical Applications Required for Complex Humanitarian Disasters and Emergencies via Hastily Formed Networks (HFN) in the Field

DTIC Science & Technology

2005-09-01

define criteria for deployment in cooperation with HFN and explore concepts of operations. The end product of this research will serve as a baseline...When choosing an EMR for a humanitarian mission, the user must be careful not only to choose a product for its ease of use or its functionality as it...January 2000, SSL was not allowed to be shipped outside of the U.S. with 128-bit encryption due to the fact that any software product that contained strong

Improving menstrual hygiene management in emergency contexts: literature review of current perspectives.

PubMed

VanLeeuwen, Crystal; Torondel, Belen

2018-01-01

Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM) among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations' menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material) and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body's biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be included in an effective menstrual hygiene intervention, there is insufficient empirical evidence to establish which interventions are most effective in humanitarian emergencies and which sectors should be responsible for the coordination and implementation of such. Increased monitoring and evaluation studies of interventions should be completed and publicly shared, in order to feed evidence-based guidelines in the humanitarian sector.

Improving menstrual hygiene management in emergency contexts: literature review of current perspectives

PubMed Central

VanLeeuwen, Crystal; Torondel, Belen

2018-01-01

Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM) among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations’ menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material) and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body’s biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be included in an effective menstrual hygiene intervention, there is insufficient empirical evidence to establish which interventions are most effective in humanitarian emergencies and which sectors should be responsible for the coordination and implementation of such. Increased monitoring and evaluation studies of interventions should be completed and publicly shared, in order to feed evidence-based guidelines in the humanitarian sector. PMID:29692636

Data collection tools for maternal and child health in humanitarian emergencies: a systematic review

PubMed Central

Dickinson, Fiona; Kerr, Robbie; Boschi-Pinto, Cynthia; Mathai, Matthews; van den Broek, Nynke

2015-01-01

Abstract Objective To describe tools used for the assessment of maternal and child health issues in humanitarian emergency settings. Methods We systematically searched MEDLINE, Web of Knowledge and POPLINE databases for studies published between January 2000 and June 2014. We also searched the websites of organizations active in humanitarian emergencies. We included studies reporting the development or use of data collection tools concerning the health of women and children in humanitarian emergencies. We used narrative synthesis to summarize the studies. Findings We identified 100 studies: 80 reported on conflict situations and 20 followed natural disasters. Most studies (76/100) focused on the health status of the affected population while 24 focused on the availability and coverage of health services. Of 17 different data collection tools identified, 14 focused on sexual and reproductive health, nine concerned maternal, newborn and child health and four were used to collect information on sexual or gender-based violence. Sixty-nine studies were done for monitoring and evaluation purposes, 18 for advocacy, seven for operational research and six for needs assessment. Conclusion Practical and effective means of data collection are needed to inform life-saving actions in humanitarian emergencies. There are a wide variety of tools available, not all of which have been used in the field. A simplified, standardized tool should be developed for assessment of health issues in the early stages of humanitarian emergencies. A cluster approach is recommended, in partnership with operational researchers and humanitarian agencies, coordinated by the World Health Organization. PMID:26478629

Ethics beyond borders: how health professionals experience ethics in humanitarian assistance and development work.

PubMed

Hunt, Matthew R

2008-08-01

Health professionals are involved in humanitarian assistance and development work in many regions of the world. They participate in primary health care, immunization campaigns, clinic- and hospital-based care, rehabilitation and feeding programs. In the course of this work, clinicians are frequently exposed to complex ethical issues. This paper examines how health workers experience ethics in the course of humanitarian assistance and development work. A qualitative study was conducted to consider this question. Five core themes emerged from the data, including: tension between respecting local customs and imposing values; obstacles to providing adequate care; differing understandings of health and illness; questions of identity for health workers; and issues of trust and distrust. Recommendations are made for organizational strategies that could help aid agencies support and equip their staff as they respond to ethical issues.

Exploring the Role of Ad Hoc Grassroots Organizations Providing Humanitarian Aid on Lesvos, Greece.

PubMed

Kitching, George Tjensvoll; J Haavik, Hanne; Tandstad, Birgit J; Zaman, Muhammad; Darj, Elisabeth

2016-11-17

Syrian refugees displaced into Turkey have attempted high-risk sea migrations to reach safer destinations in Europe, most often initially arriving on the Greek island of Lesvos. These refugees were often in need of basic humanitarian assistance that has been provided in part by a new category of ad hoc grassroots organizations (AHGOs). The aim of this study was to understand the internal and external operations of these AHGOs and their role on Lesvos. The experiences of AHGOs were investigated through a qualitative research design utilizing semi-structured interviews with organization leaders and spokespersons. AHGOs identified through media and social media sources as new Lesvos-specific organizations were purposively invited to complete an interview over phone, Skype or email. Data analysis of the transcribed interviews was performed by Systematic Text Condensation. Forty-one organizations were contacted and 13 interviews were conducted. Most organizations were formed in autumn 2015 responding to the greater influx of refugees and migrants at that time and reported an absence of professional humanitarian agencies providing aid on Lesvos. Three categories emerged from the material. Features of organizations; Features of volunteers and; Evolution of AHGOs. The organizations perceived themselves capable of evaluating needs, mobilizing resources, funding and providing quick response. The volunteers came with limited humanitarian experience and from a wide variety of nationalities and professional backgrounds, and the organizations developed while on Lesvos. Knowledge from our findings of AHGOs response to this complex disaster on Lesvos could be utilized in future catastrophes. We conclude that AHGOs may prove effective at providing humanitarian aid in a surge response when international non-governmental organizations are unable to respond quickly. In future complex disasters AHGOs should be recognized as new humanitarian actors and conditions should be made favourable for their operations.

77 FR 25180 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-27

... announced below concerns Conducting Research on Moderate Acute Malnutrition in Humanitarian Emergencies... to ``Conducting Research on Moderate Acute Malnutrition in Humanitarian Emergencies, FOA GH12-006...

Coming together to document mortality in conflict situations: proceedings of a symposium

PubMed Central

Ratnayake, Ruwan; Degomme, Olivier; Guha-Sapir, Debarati

2009-01-01

The use of epidemiology in documenting the mortality experience in complex emergencies has become pervasive in humanitarian practice. Recent assessments in Iraq and Darfur have provoked much discussion on the assessment of mortality in scientific and policy spheres. In this context, the Centre for Research on the Epidemiology of Disasters and the Harvard Humanitarian Initiative held an inter-disciplinary symposium to examine the topic among epidemiologists, demographers, forensic scientists and legal and human rights investigators. We aimed to strengthen the scientific understanding of mortality estimation by reviewing progress across fields and building inter-disciplinary bridges. We report on the presentations and discussions here. PMID:19243612

[Civilian-military coordination].

PubMed

de Montravel, G

2002-01-01

Current humanitarian emergencies create complex, mutidimensional situations that stimulate simultaneous responses from a wide variety of sources including governments, non-governmental organizations (NGO), United Nations agencies, and private individuals. As a result, it has become essential to establish a coherent framework in which each actor can contribute promptly and effectively to the overall effort. This is the role of the United Nations Office for the Coordination of Humanitarian Affairs. Regardless of the circumstances and level of coordination, cooperation and collaboration between humanitarian and military personnel, it is necessary to bear in mind their objectives. The purpose of humanitarian action is to reduce human suffering. The purpose of military intervention is to stop warfare. The author of this article will discuss the three major obstacles to civilian-military coordination (strategic, tactical, and operational). Operations cannot be conducted smoothly and differences cannot be ironed out without mutual respect between the two parties, an explicit definition of their respective duties and responsibilities, a clear understanding of their cultural differences, and the presence of an organization and facilities for coordination and arbitrage by a neutral referee.

Health equity in humanitarian emergencies: a role for evidence aid.

PubMed

Pottie, Kevin

2015-02-01

Humanitarian emergencies require a range of planned and coordinated actions: security, healthcare, and, as this article highlights, health equity responses. Health equity is an evidence-based science that aims to address unfair and unjust health inequality outcomes. New approaches are using health equity to guide the development of community programs, equity methods are being used to identify disadvantaged groups that may face health inequities in a humanitarian emergency, and equity is being used to prevent unintended harms and consequences in interventions. Limitations to health equity approaches include acquiring sufficient data to make equity interpretations, integrating disadvantage populations in to the equity approach, and ensuring buy-in from decision-makers. This article uses examples from World Health Organization, Refugee Health Guidelines and Health Impact Assessment to demonstrate the emerging role for health equity in humanitarian emergencies. It is based on a presentation at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Ethical considerations for vaccination programmes in acute humanitarian emergencies

PubMed Central

Hardie, Kate; Selgelid, Michael J; Waldman, Ronald J; Strebel, Peter; Rees, Helen; Durrheim, David N

2013-01-01

Abstract Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice. PMID:23599553

Health information systems in humanitarian emergencies.

PubMed Central

Thieren, Michel

2005-01-01

Health information systems (HIS) in emergencies face a double dilemma: the information necessary to understand and respond to humanitarian crises must be timely and detailed, whereas the circumstances of these crises makes it challenging to collect it. Building on the technical work of the Health Metrics Network on HIS and starting with a systemic definition of HIS in emergencies, this paper reviews the various data-collection platforms in these contexts, looking at their respective contributions to providing what humanitarian actors need to know to target their intervention to where the needs really are. Although reporting or sampling errors are unavoidable, it is important to identify them and acknowledge the limitations inherent in generalizing data that were collected in highly heterogeneous environments. To perform well in emergencies, HIS require integration and participation. In spite of notable efforts to coordinate data collection and dissemination practices among humanitarian agencies, it is noted that coordination on the ground depends on the strengths and presence of a lead agency, often WHO, and on the commitment of humanitarian agencies to investing resources in data production. Poorly integrated HIS generate fragmented, incomplete and often contradictory statistics, a situation that leads to a misuse of numbers with negative consequences on humanitarian interventions. As a means to avoid confusion regarding humanitarian health statistics, this paper stresses the importance of submitting statistics to a rigorous and coordinated auditing process prior to their publication. The audit trail should describe the various steps of the data production chains both technically and operationally, and indicate the limits and assumptions under which each number can be used. Finally emphasis is placed on the ethical obligation for humanitarian agencies to ensure that the necessary safeguards on data are in place to protect the confidentiality of victims and minority groups in politically sensitive contexts. PMID:16184277

Impact of nutrition interventions on pediatric mortality and nutrition outcomes in humanitarian emergencies: A systematic review.

PubMed

Balhara, Kamna S; Silvestri, David M; Tyler Winders, W; Selvam, Anand; Kivlehan, Sean M; Becker, Torben K; Levine, Adam C

2017-12-01

Malnutrition contributes to paediatric morbidity and mortality in disasters and complex emergencies, but summary data describing specific nutritional interventions in these settings are lacking. This systematic review aimed to characterise such interventions and their effects on paediatric mortality, anthropometric measures and serum markers of nutrition. A systematic search of OVID MEDLINE, Cochrane Library and relevant grey literature was conducted. We included all randomised controlled trials and observational controlled studies evaluating effectiveness of nutritional intervention(s) on defined health outcomes in children and adolescents (0-18 years) within a disaster or complex emergency. We extracted study characteristics, interventions and outcomes data. Study quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. A total of 31 studies met inclusion criteria. Most were conducted in Africa (17), during periods of conflict or hunger gaps (14), and evaluated micronutrient supplementation (14) or selective feeding (10). Overall study quality was low, with only two high and four moderate quality studies. High- and medium-quality studies demonstrated positive impact of fortified spreads, ready-to-use therapeutic foods, micronutrient supplementation, and food and cash transfers. In disasters and complex emergencies, high variability and low quality of controlled studies on paediatric malnutrition limit meaningful data aggregation. If existing research gaps are to be addressed, the inherent unpredictability of humanitarian emergencies and ethical considerations regarding controls may warrant a paradigm shift in what constitutes adequate methods. Periodic hunger gaps may offer a generalisable opportunity for robust trials, but consensus on meaningful nutritional endpoints is needed. © 2017 John Wiley & Sons Ltd.

Using Grass Roots Community Programs as an Anti-Extremism Strategy

ERIC Educational Resources Information Center

Broadbent, Robyn

2013-01-01

In recent times the Australian Government has become increasingly concerned with the challenge to the dominant culture by humanitarian immigrants entering the country. As a part of a complex strategy, emerging from the events of 9/11 and the perceived changing face of multiculturalism in Australia, the Attorney-General Robert McClelland announced…

Increase urban resilience by planning the public spaces uses for humanitarian interventions.

NASA Astrophysics Data System (ADS)

Delaitre, Maxime; Barroca, Bruno; Vargas, Jorge; Cornejo, Christian; Sierra, Alexis

2017-04-01

Challenges in post-disaster crisis of natural origin seem to have a strong relation with territory characteristics (location, habitat, propagation, etc.). Moreover, they determine those requirements needed for humanitarian interventions. Decision-making at response and recuperation stages are supported or limited depending on the availability of public spaces to be used for victims' accommodation, field hospitals and rubble deposits. In the case of Lima and Callao (Peru), the presence and superposition of multiple governmental levels - national, regional (1), provincial (2) and district (50) - result in a highly-complex local Disaster Risk Management system for response coordination. The diversity of actors, their responsibilities and individual initiative suggest competition for the resources available in an emergency situation. Resource location determines if humanitarian operations can be run in an effective and efficient way. In this context, public space is a fundamental resource; if it is well-selected, it will provide access to accumulated resources such as water, electricity and telecommunications for the affected population. To increase urban resilience, it requires previous planning and coordination for emergency response, where institutional and territorial configurations are decisive factors for the recuperation and rehabilitation processes performance. This communication will present the institutional and territorial dimensions of the Peruvian capital which condition emergency management performances to consider the crisis management opportunities, offered by territorial analysis and estimations of actors' needs. It would be a starting point for decision-making on emergence activities locations and for establishing coordination frameworks concerning territorial issues and challenges.

Child Protection Assessment in Humanitarian Emergencies: Case Studies from Georgia, Gaza, Haiti and Yemen

ERIC Educational Resources Information Center

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-01-01

Objectives: The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of…

Hunger strikers: historical perspectives from the emergency management of refugee camp asylum seekers.

PubMed

Burkle, Frederick M; Chan, Jimmy T S; Yeung, Richard D S

2013-12-01

The treatment of hunger strikers is always contentious, chaotic and complex. The management is particularly difficult for health professionals as it raises unprecedented clinical, ethical, moral, humanitarian, and legal questions. There are never any easy answers. The current situation of prisoners from the Iraq and Afghanistan Wars currently at the Guantanamo Bay Detention Center in Cuba demands unprecedented transparency, accountability and multilevel coordination to ensure that the rights of the strikers are properly met. There are scant references available in the scientific literature on the emergency management of these tragedies. This historical perspective documents the complex issues faced by emergency physicians in Hong Kong surrounding refugee camp asylum seekers from Vietnam in 1994 and is offered as a useful adjunct in understanding the complex issues faced by emergency health providers and managers.

Exploring the Role of Ad Hoc Grassroots Organizations Providing Humanitarian Aid on Lesvos, Greece

PubMed Central

Kitching, George Tjensvoll; J. Haavik, Hanne; Tandstad, Birgit J.; Zaman, Muhammad; Darj, Elisabeth

2016-01-01

Introduction: Syrian refugees displaced into Turkey have attempted high-risk sea migrations to reach safer destinations in Europe, most often initially arriving on the Greek island of Lesvos. These refugees were often in need of basic humanitarian assistance that has been provided in part by a new category of ad hoc grassroots organizations (AHGOs). The aim of this study was to understand the internal and external operations of these AHGOs and their role on Lesvos. Methods: The experiences of AHGOs were investigated through a qualitative research design utilizing semi-structured interviews with organization leaders and spokespersons. AHGOs identified through media and social media sources as new Lesvos-specific organizations were purposively invited to complete an interview over phone, Skype or email. Data analysis of the transcribed interviews was performed by Systematic Text Condensation. Results: Forty-one organizations were contacted and 13 interviews were conducted. Most organizations were formed in autumn 2015 responding to the greater influx of refugees and migrants at that time and reported an absence of professional humanitarian agencies providing aid on Lesvos. Three categories emerged from the material. Features of organizations; Features of volunteers and; Evolution of AHGOs. The organizations perceived themselves capable of evaluating needs, mobilizing resources, funding and providing quick response. The volunteers came with limited humanitarian experience and from a wide variety of nationalities and professional backgrounds, and the organizations developed while on Lesvos. Discussion: Knowledge from our findings of AHGOs response to this complex disaster on Lesvos could be utilized in future catastrophes. We conclude that AHGOs may prove effective at providing humanitarian aid in a surge response when international non-governmental organizations are unable to respond quickly. In future complex disasters AHGOs should be recognized as new humanitarian actors and conditions should be made favourable for their operations. PMID:28018747

Who should be undertaking population-based surveys in humanitarian emergencies?

PubMed Central

Spiegel, Paul B

2007-01-01

Background Timely and accurate data are necessary to prioritise and effectively respond to humanitarian emergencies. 30-by-30 cluster surveys are commonly used in humanitarian emergencies because of their purported simplicity and reasonable validity and precision. Agencies have increasingly used 30-by-30 cluster surveys to undertake measurements beyond immunisation coverage and nutritional status. Methodological errors in cluster surveys have likely occurred for decades in humanitarian emergencies, often with unknown or unevaluated consequences. Discussion Most surveys in humanitarian emergencies are done by non-governmental organisations (NGOs). Some undertake good quality surveys while others have an already overburdened staff with limited epidemiological skills. Manuals explaining cluster survey methodology are available and in use. However, it is debatable as to whether using standardised, 'cookbook' survey methodologies are appropriate. Coordination of surveys is often lacking. If a coordinating body is established, as recommended, it is questionable whether it should have sole authority to release surveys due to insufficient independence. Donors should provide sufficient funding for personnel, training, and survey implementation, and not solely for direct programme implementation. Summary A dedicated corps of trained epidemiologists needs to be identified and made available to undertake surveys in humanitarian emergencies. NGOs in the field may need to form an alliance with certain specialised agencies or pool technically capable personnel. If NGOs continue to do surveys by themselves, a simple training manual with sample survey questionnaires, methodology, standardised files for data entry and analysis, and manual for interpretation should be developed and modified locally for each situation. At the beginning of an emergency, a central coordinating body should be established that has sufficient authority to set survey standards, coordinate when and where surveys should be undertaken and act as a survey repository. Technical expertise is expensive and donors must pay for it. As donors increasingly demand evidence-based programming, they have an obligation to ensure that sufficient funds are provided so organisations have adequate technical staff. PMID:17543107

Are Commercial Complementary Food Distributions to Refugees and Migrants in Europe Conforming to International Policies and Guidelines on Infant and Young Child Feeding in Emergencies?

PubMed

Theurich, Melissa Ann; Grote, Veit

2017-08-01

In 2015, more than one million migrants and refugees arrived in Europe. Commercial complementary foods, processed foods marketed for infants and young children 6-23 months of age, were distributed by various humanitarian actors along migrant routes and in European refugee camps. Unsolicited donations and distributions of commercial complementary food products were problematic and divergent from international policies on infant and young child feeding during humanitarian emergencies. Interim guidance regarding commercial complementary foods was published during the peak of the emergency but implemented differently by various humanitarian actors. Clearer and more technical specifications on commercial complementary foods are needed in order to objectively determine their suitability for operational contexts in Europe and emergency nutrition assistance in the future.

75 FR 51749 - Bureau for Democracy, Conflict and Humanitarian Assistance Office of Food for Peace Announcement...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... AGENCY FOR INTERNATIONAL DEVELOPMENT Bureau for Democracy, Conflict and Humanitarian Assistance Office of Food for Peace Announcement of Draft Request for Applications for Title II Non-Emergency Food... Democracy, Conflict and Humanitarian Assistance. [FR Doc. 2010-20874 Filed 8-20-10; 8:45 am] BILLING CODE P ...

75 FR 4526 - Bureau for Democracy, Conflict and Humanitarian Assistance; Office of Food for Peace...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-28

... AGENCY FOR INTERNATIONAL DEVELOPMENT Bureau for Democracy, Conflict and Humanitarian Assistance; Office of Food for Peace; Announcement of FFP Guidance for FY2010 Title II Proposals for Emergency Relief... Peace, Bureau for Democracy, Conflict and Humanitarian Assistance. [FR Doc. 2010-1776 Filed 1-27-10; 8...

From war on terror to war on weather? Rethinking humanitarianism in a new era of chronic emergencies.

PubMed

Munslow, Barry; O'Dempsey, Tim

2010-01-01

This special issue of Third World Quarterly makes a case for redirecting attention and resources away from the 'war on terror' and focussing as a matter of urgency on the causes and consequences of global climate change. Global climate change must be recognised as an issue of national and international security. Increased competition for scarce resources and migration are key factors in the propagation of many of today's chronic complex humanitarian emergencies. The relentless growth of megacities in natural disaster hotspots places unprecedented numbers of vulnerable people at risk of disease and death. The Earth's fragile ecosystem has reached a critical tipping point. Today's most urgent need is for a collective endeavour on the part of the international community to redirect resources, enterprise and creativity away from the war on terror and to earnestly redeploy these in seeking solutions to the far greater and increasingly imminent threats that confront us as a consequence of global climate change.

'Mind the gap!' rethinking the role of health in the emergency and development divide.

PubMed

O'Dempsey, Tim; Munslow, Barry

2009-10-01

The 'Emergency Relief-Rehabilitation-Development' model is highly problematic, especially in fragile states which fluctuate in and out of crisis. Lack of definition as to what constitutes a humanitarian emergency and the absence of rules of engagement of NGOs and donors further complicates the problem. Restricted mandates and budgets of institutions and funding bodies lead to gaps in the provision of health services for affected populations. Reducing the gap between emergency and developmental healthcare requires approaching the issue from both sides, recognizing that the emergency-development gap is not a single uniform entity but a complex dynamic of heterogeneous gaps. Copyright (c) 2009 John Wiley & Sons, Ltd.

Evaluating the co-production of a near real time Earthquake Aftershock forecasting tool for humanitarian risk assessment and emergency planning

NASA Astrophysics Data System (ADS)

Quinn, Keira; Hope, Max; McCloskey, John; NicBhloscaidh, Mairead; Jimenez, Abigail; Dunlop, Paul

2015-04-01

Concern Worldwide and the University of Ulster Geophysics Research Group are engaged in a project to co-produce a suite of software and mapping tools to assess aftershock hazard in near real-time during the emergency response phase of earthquake disaster, and inform humanitarian emergency planning and response activities. This paper uses a social learning approach to evaluate this co-production process. Following Wenger (1999) we differentiate between the earthquake science and humanitarian communities of practice (CoP) along three dimensions: enterprise (the purpose of CoPs and the problems participants are working to address), repertoire (knowledge, skills, language), and identity (values and boundaries). We examine the effectiveness of learning between CoP, focusing on boundary work and objects, and various organisational structures and aspects of the wider political economy of learning that enable and hinder the co-production process. We conclude by identifying a number of ways to more effectively integrate earthquake science into humanitarian decision-making, policy development and programme design.

The humanitarian common logistic operating picture: a solution to the inter-agency coordination challenge.

PubMed

Tatham, Peter; Spens, Karen; Kovács, Gyöngyi

2017-01-01

Although significant progress has been made in developing the practice of humanitarian logistics, further improvements in efficiency and effectiveness have the potential to save lives and reduce suffering. This paper explores how the military/emergency services' concept of a common operating picture (COP) can be adapted to the humanitarian logistics context, and analyses a practical and proven approach to addressing the key challenge of inter-agency coordination and decision-making. Successful adaptation could provide the mechanism through which predicted and actual demands, together with the location and status of material in transit, are captured, evaluated, and presented in real time as the basis for enhanced decision-making between actors in the humanitarian supply network. Through the introduction of a humanitarian logistics COP and its linkages to national disaster management systems, local communities and countries affected by disasters and emergencies will be better placed to oversee and manage their response activities. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Emergency Response and Humanitarian Assistance Operations

DTIC Science & Technology

2010-12-01

Humanitarian Assistance Operations Op Food DSTr I Support food distribution with U.S. ARMY / WFP - 03 to 18Fev2010 15 Dias 637,5 Ton de alimentos ...distribution by WFP – 10 a 18Mar2010 – 21 a 28Mar2010 1.723 Ton de Alimentos em 30 Dias Humanitarian Assistance Operations Op Food DSTr II Supporting food...distribution by WFP – 10 a 18Mar2010 8 Dias 420 Ton de alimentos Humanitarian Assistance Operations Op Food DSTr III Supporting food distribution by

Addressing culture and context in humanitarian response: preparing desk reviews to inform mental health and psychosocial support.

PubMed

Greene, M Claire; Jordans, Mark J D; Kohrt, Brandon A; Ventevogel, Peter; Kirmayer, Laurence J; Hassan, Ghayda; Chiumento, Anna; van Ommeren, Mark; Tol, Wietse A

2017-01-01

Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners with crucial background information to improve their capacity to work efficiently and with maximum benefit. In this paper, we draw on experience implementing desk review guidance from the World Health Organization (WHO) and UNHCR, the United Nations Refugee Agency (2012) in four diverse humanitarian crises (earthquakes in Haiti and Nepal; forced displacement among Syrians and Congolese). We discuss critical parameters for the design and implementation of desk reviews, and discuss current challenges and future directions to improve mental health care and psychosocial support in humanitarian emergencies.

Mental health treatment outcomes in a humanitarian emergency: a pilot model for the integration of mental health into primary care in Habilla, Darfur.

PubMed

Souza, Renato; Yasuda, Silvia; Cristofani, Susanna

2009-07-21

There is no description of outcomes for patients receiving treatment for mental illnesses in humanitarian emergencies. MSF has developed a model for integration of mental health into primary care in a humanitarian emergency setting based on the capacity of community health workers, clinical officers and health counsellors under the supervision of a psychiatrist trainer. Our study aims to describe the characteristics of patients first attending mental health services and their outcomes on functionality after treatment. A total of 114 patients received mental health care and 81 adult patients were evaluated with a simplified functionality assessment instrument at baseline, one month and 3 months after initiation of treatment. Most patients were diagnosed with epilepsy (47%) and psychosis (31%) and had never received treatment. In terms of follow up, 58% came for consultations at 1 month and 48% at 3 months. When comparing disability levels at baseline versus 1 month, mean disability score decreased from 9.1 (95%CI 8.1-10.2) to 7.1 (95%CI 5.9-8.2) p = 0.0001. At 1 month versus 3 months, mean score further decreased to 5.8 (95%CI 4.6-7.0) p < 0.0001. The findings suggest that there is potential to integrate mental health into primary care in humanitarian emergency contexts. Patients with severe mental illness and epilepsy are in particular need of mental health care. Different strategies for integration of mental health into primary care in humanitarian emergency settings need to be compared in terms of simplicity and feasibility.

The academic health center in complex humanitarian emergencies: lessons learned from the 2010 Haiti earthquake.

PubMed

Babcock, Christine; Theodosis, Christian; Bills, Corey; Kim, Jimin; Kinet, Melodie; Turner, Madeleine; Millis, Michael; Olopade, Olufunmilayo; Olopade, Christopher

2012-11-01

On January 12, 2010, a 7.0-magnitude earthquake struck Haiti. The event disrupted infrastructure and was marked by extreme morbidity and mortality. The global response to the disaster was rapid and immense, comprising multiple actors-including academic health centers (AHCs)-that provided assistance in the field and from home. The authors retrospectively examine the multidisciplinary approach that the University of Chicago Medicine (UCM) applied to postearthquake Haiti, which included the application of institutional structure and strategy, systematic deployment of teams tailored to evolving needs, and the actual response and recovery. The university mobilized significant human and material resources for deployment within 48 hours and sustained the effort for over four months. In partnership with international and local nongovernmental organizations as well as other AHCs, the UCM operated one of the largest and more efficient acute field hospitals in the country. The UCM's efforts in postearthquake Haiti provide insight into the role AHCs can play, including their strengths and limitations, in complex disasters. AHCs can provide necessary intellectual and material resources as well as technical expertise, but the cost and speed required for responding to an emergency, and ongoing domestic responsibilities, may limit the response of a large university and hospital system. The authors describe the strong institutional backing, the detailed predeployment planning and logistical support UCM provided, the engagement of faculty and staff who had previous experience in complex humanitarian emergencies, and the help of volunteers fluent in the local language which, together, made UCM's mission in postearthquake Haiti successful.

Trends in malnutrition and mortality in Darfur, Sudan, between 2004 and 2008: a meta-analysis of publicly available surveys.

PubMed

Nielsen, Jens; Prudhon, Claudine; de Radigues, Xavier

2011-08-01

The humanitarian response to the crisis in Darfur is the largest humanitarian operation in the world. To investigate the evolution of the conditions of the affected population, we analysed trends in malnutrition and mortality, the most widely accepted indicators for assessing the degree of severity of a crisis. We did a meta-analysis of 164 publicly available surveys taking into account changes in the contextual situation and humanitarian aid; type of population [residents and internally displaced persons (IDPs)]; and seasonal variations. Data on global acute malnutrition (GAM), severe acute malnutrition (SAM), crude death rate (CDR) and under-five death rate (U5DR) were analysed using a random effect model. GAM and SAM decreased by 16% and 28%, respectively, in 2004-05, whereas CDR dropped by 44-75% per year depending on state and type of population and U5DR decreased by an overall 50% yearly. Both security and the humanitarian contexts became increasingly complex after 2005, but levels of malnutrition stabilized in North and South Darfur. In West Darfur, GAM remained stable but SAM tended to increase for IDPs, although mortality rates remained constant. Mortality increased slightly for residents in South Darfur after 2005, even though nutritional status was stable. GAM, SAM, CDR and U5DR fluctuated markedly with seasons. A meta-analysis of myriads of surveys permitted us to draw an overall picture of the situation in Darfur and to identify some of its influencing factors. The large humanitarian operation, which gained momentum through 2004-05, was able to contain the crisis despite huge difficulties, but did not compensate for seasonal variations. The situation has remained fragile with some negative patterns tending to emerge. It is crucial that the humanitarian situation continues to be closely monitored.

Evaluation of health, nutrition and food security programmes in a complex emergency: the case of Congo as an example of a chronic post-conflict situation.

PubMed

Rossi, Laura; Hoerz, Thomas; Thouvenot, Veronique; Pastore, Gianni; Michael, Markus

2006-08-01

To describe the case of Congo as an example of the assessment and appropriateness of donor operational and sectoral strategies in a complex emergency. The paper reports the findings of an external evaluation of operations financed by the European Commission Humanitarian Office in the Democratic Republic of Congo (DRC). The Congolese health system is suffering from severe deterioration. What is functioning in the public health context is donor-dependent with high costs and limited coverage. Despite a relatively favourable agro-climatic situation, food shortage and famine severely affect the nutritional status of large population groups. In this context, humanitarian programmes have generally improved access to health care and the nutritional status of beneficiaries. The reduction of malnutrition in project areas is often demonstrated even though the context did not permit consolidation of these results. Malnutrition continues to claim a massive cost of lives owing to the effect of widespread food insecurity that follows a circular cause-and-effect pattern of very low food production and extreme poverty. The current context in DRC does not correspond yet to 'post-crisis': neither at population level with regard to indicators of poverty, malnutrition, disease and death, nor at institutional level, with regard to state support to institutions. In these situations, the international community is often called upon to replace the state as service provider. Integrated humanitarian actions should be the future of relief projects in DRC. Health, nutrition and food security components should be considered a standard public health intervention strategy representing the most sensible approach to address the needs of the affected population.

The far side: the meta functions of humanitarianism in a globalised world.

PubMed

Donini, Antonio

2010-04-01

This paper explores the meta functions of humanitarianism--that is, the functions that, as an ideology, a movement and a profession, it performs, wittingly or unwittingly, in the early twenty-first century. The term humanitarianism is used as shorthand to encompass a complex set of currents of thought, actions and institutions of which the boundaries are unclear. The focus is on mainstream humanitarianism, the dominant Northern/Western enterprise. The paper first discusses the relationship between humanitarianism and globalised power. It goes on to examine three types of functions that humanitarianism and humanitarian action perform: 'macro' functions--the deep undercurrents, power relations and values that humanitarianism articulates and transmits; 'meso' functions--those that relate to the political economy of humanitarian action and to the mechanics (rather than to the ideology) of globalisation; and 'micro' functions that relate to the motivations of the individuals who devote their energies to humanitarianism.

Ethics of emergent information and communication technology applications in humanitarian medical assistance.

PubMed

Hunt, Matthew; Pringle, John; Christen, Markus; Eckenwiler, Lisa; Schwartz, Lisa; Davé, Anushree

2016-07-01

New applications of information and communication technology (ICT) are shaping the way we understand and provide humanitarian medical assistance in situations of disaster, disease outbreak or conflict. Each new crisis appears to be accompanied by advancements in humanitarian technology, leading to significant improvements in the humanitarian aid sector. However, ICTs raise ethical questions that warrant attention. Focusing on the context of humanitarian medical assistance, we review key domains of ICT innovation. We then discuss ethical challenges and uncertainties associated with the development and application of new ICTs in humanitarian medical assistance, including avoiding harm, ensuring privacy and security, responding to inequalities, demonstrating respect, protecting relationships, and addressing expectations. In doing so, we emphasize the centrality of ethics in humanitarian ICT design, application and evaluation. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Tackling the Global Challenge: Humanitarian Catastrophes

PubMed Central

Iserson, Kenneth V.

2014-01-01

“Humanitarian catastrophes,” conflicts and calamities generating both widespread human suffering and destructive events, require a wide range of emergency resources. This paper answers a number of questions that humanitarian catastrophes generate: Why and how do the most-developed countries—those with the resources, capabilities, and willingness to help—intervene in specific types of disasters? What ethical and legal guidelines shape our interventions? How well do we achieve our goals? It then suggests a number of changes to improve humanitarian responses, including better NGO-government cooperation, increased research on the best disaster response methods, clarification of the criteria and roles for humanitarian (military) interventions, and development of post-2015 Millennium Development Goals with more accurate progress measures. PMID:24672618

Mental health treatment outcomes in a humanitarian emergency: a pilot model for the integration of mental health into primary care in Habilla, Darfur

PubMed Central

Souza, Renato; Yasuda, Silvia; Cristofani, Susanna

2009-01-01

Background There is no description of outcomes for patients receiving treatment for mental illnesses in humanitarian emergencies. MSF has developed a model for integration of mental health into primary care in a humanitarian emergency setting based on the capacity of community health workers, clinical officers and health counsellors under the supervision of a psychiatrist trainer. Our study aims to describe the characteristics of patients first attending mental health services and their outcomes on functionality after treatment. Methods A total of 114 patients received mental health care and 81 adult patients were evaluated with a simplified functionality assessment instrument at baseline, one month and 3 months after initiation of treatment. Results Most patients were diagnosed with epilepsy (47%) and psychosis (31%) and had never received treatment. In terms of follow up, 58% came for consultations at 1 month and 48% at 3 months. When comparing disability levels at baseline versus 1 month, mean disability score decreased from 9.1 (95%CI 8.1–10.2) to 7.1 (95%CI 5.9–8.2) p = 0.0001. At 1 month versus 3 months, mean score further decreased to 5.8 (95%CI 4.6–7.0) p < 0.0001. Conclusion The findings suggest that there is potential to integrate mental health into primary care in humanitarian emergency contexts. Patients with severe mental illness and epilepsy are in particular need of mental health care. Different strategies for integration of mental health into primary care in humanitarian emergency settings need to be compared in terms of simplicity and feasibility. PMID:19622151

Model describing the effect of employment of the United States military in a complex emergency.

PubMed

MacMillan, Donald S

2005-01-01

The end of the Cold War vastly altered the worldwide political landscape. With the loss of a main competitor, the United States (US) military has had to adapt its strategic, operational, and tactical doctrines to an ever-increasing variety of non-traditional missions, including humanitarian operations. Complex emergencies (CEs) are defined in this paper from a political and military perspective, various factors that contribute to their development are described, and issues resulting from the employment of US military forces are discussed. A model was developed to illustrate the course of a humanitarian emergency and the potential impact of a military response. The US intervention in Haiti, Northern Iraq, Kosovo, Somalia, Bosnia, and Rwanda serve as examples. A CE develops when there is civil conflict, loss of national governmental authority, a mass population movement, and massive economic failure, each leading to a general decline in food security. The military can alleviate a CE in four ways: (1) provide security for relief efforts; (2) enforce negotiated settlements; (3) provide security for non-combatants; and/or (4) employ logistical capabilities. The model incorporates Norton and Miskel's taxonomy of identifying failing states and helps illustrate the factors that lead to a CE. The model can be used to determine if and when military intervention will have the greatest impact. The model demonstrates that early military intervention and mission assignment within the core competencies of the forces can reverse the course of a CE. Further study will be needed to verify the model.

The symphony of the damned: racial discourse, complex political emergencies and humanitarian aid.

PubMed

Duffield, M

1996-09-01

This paper concerns the manner in which the West is responding to protracted political crises beyond its borders. It examines the conceptual world-view that aid agencies bring to complex emergencies and which shapes action. The paper provides an analysis of developmentalism. That is, the currently dominant idea of development which is an adapted form of multiculturalism. It is based on the empowerment of cultural differences and the relativisation of progress. As a variant of multiculturalism, developmentalism is part of Western racial discourse. In terms of understanding conflict, it establishes a mirror-image relationship with new rascist ideas premised on cultural pluralism inevitably leading to social breakdown, violence and anarchy. To the contrary, with its functional view of social harmony, libertine developmentalism claims that even unresolved political crisis constitutes a development opportunity. Developmentalism, like culturalism generally, is incapable of analysing power. It therefore cannot understand the effects and significance of its own organisational forms. Moreover, since the absence of power translates into operational neutrality in a war zone, it is also unable to analyse the nature of new political formations emerging in the global periphery. That is, the so-called weak or failed states, warlords and so on. This functional ignorance has allowed a widespread incorporation of humanitarian aid into the fabric of political violence. Developmentalism is an essential underpinning for the growing organisational accommodation to ongoing conflict and eroding standards of justice and accountability.

Improving National Capacity to Respond to Complex Emergencies, The U.S. Experience

DTIC Science & Technology

1998-04-01

effort. As one who was responsible for operations in Africa , Europe, and the Middle East, I can attest to the lack of a systematic process for de...social, and economic. 7 Humanitarian assistance aims to meet the basic subsistence needs of the population: food, water , shelter, and health care...organization could specialize in reforming civilian police, while another develops a capability for water purification. Specifying roles can lead to

Improving the performance of community health workers in humanitarian emergencies: a realist evaluation protocol for the PIECES programme

PubMed Central

Gilmore, Brynne; Adams, Ben Jack; Bartoloni, Alex; Alhaydar, Bana; McAuliffe, Eilish; Raven, Joanna; Taegtmeyer, Miriam; Vallières, Frédérique

2016-01-01

Introduction Understanding what enhances the motivation and performance of community health workers (CHWs) in humanitarian emergencies represents a key research gap within the field of human resources for health. This paper presents the research protocol for the Performance ImprovEment of CHWs in Emergency Settings (PIECES) research programme. Enhancing Learning and Research in Humanitarian Action (ELRHA) funded the development of this protocol as part of their Health in Humanitarian Crises (R2HC) call (No.19839). PIECES aims to understand what factors improve the performance of CHWs in level III humanitarian emergencies. Methods and analysis The suggested protocol uses a realist evaluation with multiple cases across the 3 country sites: Turkey, Iraq and Lebanon. Working with International Medical Corps (IMC), an initial programme theory was elicited through literature and document reviews, semistructured interviews and focus groups with IMC programme managers and CHWs. Based on this initial theory, this protocol proposes a combination of semistructured interviews, life histories and critical incident narratives, surveys and latent variable modelling of key constructs to explain how contextual factors work to trigger mechanisms for specific outcomes relating to IMC's 300+ CHWs' performance. Participants will also include programme staff, CHWs and programme beneficiaries. Realist approaches will be used to better understand ‘what works, for whom and under what conditions’ for improving CHW performance within humanitarian contexts. Ethics and dissemination Trinity College Dublin's Health Policy and Management/Centre for Global Health Research Ethics Committee gave ethical approval for the protocol development phase. For the full research project, additional ethical approval will be sought from: Université St. Joseph (Lebanon), the Ethics Committee of the Ministry of Health in Baghdad (Iraq) and the Middle East Technical University (Turkey). Dissemination activities will involve a mixture of research feedback, policy briefs, guidelines and recommendations, as well as open source academic articles. PMID:27531730

Improving the performance of community health workers in humanitarian emergencies: a realist evaluation protocol for the PIECES programme.

PubMed

Gilmore, Brynne; Adams, Ben Jack; Bartoloni, Alex; Alhaydar, Bana; McAuliffe, Eilish; Raven, Joanna; Taegtmeyer, Miriam; Vallières, Frédérique

2016-08-16

Understanding what enhances the motivation and performance of community health workers (CHWs) in humanitarian emergencies represents a key research gap within the field of human resources for health. This paper presents the research protocol for the Performance ImprovEment of CHWs in Emergency Settings (PIECES) research programme. Enhancing Learning and Research in Humanitarian Action (ELRHA) funded the development of this protocol as part of their Health in Humanitarian Crises (R2HC) call (No.19839). PIECES aims to understand what factors improve the performance of CHWs in level III humanitarian emergencies. The suggested protocol uses a realist evaluation with multiple cases across the 3 country sites: Turkey, Iraq and Lebanon. Working with International Medical Corps (IMC), an initial programme theory was elicited through literature and document reviews, semistructured interviews and focus groups with IMC programme managers and CHWs. Based on this initial theory, this protocol proposes a combination of semistructured interviews, life histories and critical incident narratives, surveys and latent variable modelling of key constructs to explain how contextual factors work to trigger mechanisms for specific outcomes relating to IMC's 300+ CHWs' performance. Participants will also include programme staff, CHWs and programme beneficiaries. Realist approaches will be used to better understand 'what works, for whom and under what conditions' for improving CHW performance within humanitarian contexts. Trinity College Dublin's Health Policy and Management/Centre for Global Health Research Ethics Committee gave ethical approval for the protocol development phase. For the full research project, additional ethical approval will be sought from: Université St. Joseph (Lebanon), the Ethics Committee of the Ministry of Health in Baghdad (Iraq) and the Middle East Technical University (Turkey). Dissemination activities will involve a mixture of research feedback, policy briefs, guidelines and recommendations, as well as open source academic articles. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Preventing corruption in humanitarian assistance: perceptions, gaps and challenges.

PubMed

Maxwell, Daniel; Bailey, Sarah; Harvey, Paul; Walker, Peter; Sharbatke-Church, Cheyanne; Savage, Kevin

2012-01-01

Corruption is a threat to the purpose of humanitarian assistance. Until fairly recently, humanitarian assistance has not been considered an important arena in broader efforts aimed at curbing corruption, and corruption has not always been considered a particularly important concern for humanitarian assistance despite the obviously challenging nature of the context of humanitarian emergencies. Corruption, though, is a threat to humanitarian action because it can prevent assistance from getting to the people who most need it, and because it can potentially undermine public support for such assistance. This paper examines perceptions of corruption and its affects, documents best practices, and outlines gaps in understanding. It suggests recommendations for improving the capacity of humanitarian agencies to prevent and manage the risk of corruption. Agencies have taken steps to combat corruption and improve accountability--downwards and upwards--but scope remains for improvement and for greater sharing of learning and good practice. © 2012 The Author(s). Disasters © Overseas Development Institute, 2012.

Effective monitoring and evaluation of military humanitarian medical operations.

PubMed

Waller, Stephen G; Powell, Clydette; Ward, Jane B; Riley, Kevin

2011-01-01

Non-military government agencies and non-governmental organizations (NGOs) have made great strides in the evaluation of humanitarian medical work, and have learned valuable lessons regarding monitoring and evaluation (M&E) that may be equally as valuable to military medical personnel. We reviewed the recent literature by the worldwide humanitarian community regarding the art and science of M&E, with focus toward military applications. The successes and failures of past humanitarian efforts have resulted in prolific analyses. Alliances of NGOs set the standard for humanitarian quality and M&E standards. Military medical personnel can apply some of these standards to military humanitarian M&E in complex and stability operations. The authors believe that the NGO community?s M&E standards should be applied to improve evaluation of U.S. military medical humanitarian operations. 2011.

An Analysis of Cesarean Section and Emergency Hernia Ratios as Markers of Surgical Capacity in Low-Income Countries Affected by Humanitarian Emergencies from 2008 - 2014 at Médecins sans Frontières Operations Centre Brussels Projects.

PubMed

Stewart, Barclay; Wong, Evan; Papillon-Smith, Jessica; Trelles Centurion, Miguel Antonio; Dominguez, Lynette; Ao, Supongmeren; Jean-Paul, Basimuoneye Kahutsi; Kamal, Mustafa; Helmand, Rahmatullah; Naseer, Aamer; Kushner, Adam L

2015-03-27

Surgical capacity assessments in low-income countries have demonstrated critical deficiencies. Though vital for planning capacity improvements, these assessments are resource intensive and impractical during the planning phase of a humanitarian crisis. This study aimed to determine cesarean sections to total operations performed (CSR) and emergency herniorrhaphies to all herniorrhaphies performed (EHR) ratios from Médecins Sans Frontières Operations Centre Brussels (MSF-OCB) projects and examine if these established metrics are useful proxies for surgical capacity in low-income countries affected by crisis. All procedures performed in MSF-OCB operating theatres from July 2008 through June 2014 were reviewed. Projects providing only specialty care, not fully operational or not offering elective surgeries were excluded. Annual CSRs and EHRs were calculated for each project. Their relationship was assessed with linear regression. After applying the exclusion criteria, there were 47,472 cases performed at 13 sites in 8 countries. There were 13,939 CS performed (29% of total cases). Of the 4,632 herniorrhaphies performed (10% of total cases), 30% were emergency procedures. CSRs ranged from 0.06 to 0.65 and EHRs ranged from 0.03 to 1.0. Linear regression of annual ratios at each project did not demonstrate statistical evidence for the CSR to predict EHR [F(2,30)=2.34, p=0.11, R2=0.11]. The regression equation was: EHR = 0.25 + 0.52(CSR) + 0.10(reason for MSF-OCB assistance). Surgical humanitarian assistance projects operate in areas with critical surgical capacity deficiencies that are further disrupted by crisis. Rapid, accurate assessments of surgical capacity are necessary to plan cost- and clinically-effective humanitarian responses to baseline and acute unmet surgical needs in LICs affected by crisis. Though CSR and EHR may meet these criteria in 'steady-state' healthcare systems, they may not be useful during humanitarian emergencies. Further study of the relationship between direct surgical capacity improvements and these ratios is necessary to document their role in humanitarian settings.

An Analysis of Cesarean Section and Emergency Hernia Ratios as Markers of Surgical Capacity in Low-Income Countries Affected by Humanitarian Emergencies from 2008 – 2014 at Médecins sans Frontières Operations Centre Brussels Projects

PubMed Central

Stewart, Barclay; Wong, Evan; Papillon-Smith, Jessica; Trelles Centurion, Miguel Antonio; Dominguez, Lynette; Ao, Supongmeren; Jean-Paul, Basimuoneye Kahutsi; Kamal, Mustafa; Helmand, Rahmatullah; Naseer, Aamer; Kushner, Adam L.

2015-01-01

Background: Surgical capacity assessments in low-income countries have demonstrated critical deficiencies. Though vital for planning capacity improvements, these assessments are resource intensive and impractical during the planning phase of a humanitarian crisis. This study aimed to determine cesarean sections to total operations performed (CSR) and emergency herniorrhaphies to all herniorrhaphies performed (EHR) ratios from Médecins Sans Frontières Operations Centre Brussels (MSF-OCB) projects and examine if these established metrics are useful proxies for surgical capacity in low-income countries affected by crisis. Methods: All procedures performed in MSF-OCB operating theatres from July 2008 through June 2014 were reviewed. Projects providing only specialty care, not fully operational or not offering elective surgeries were excluded. Annual CSRs and EHRs were calculated for each project. Their relationship was assessed with linear regression. Results: After applying the exclusion criteria, there were 47,472 cases performed at 13 sites in 8 countries. There were 13,939 CS performed (29% of total cases). Of the 4,632 herniorrhaphies performed (10% of total cases), 30% were emergency procedures. CSRs ranged from 0.06 to 0.65 and EHRs ranged from 0.03 to 1.0. Linear regression of annual ratios at each project did not demonstrate statistical evidence for the CSR to predict EHR [F(2,30)=2.34, p=0.11, R2=0.11]. The regression equation was: EHR = 0.25 + 0.52(CSR) + 0.10(reason for MSF-OCB assistance). Conclusion: Surgical humanitarian assistance projects operate in areas with critical surgical capacity deficiencies that are further disrupted by crisis. Rapid, accurate assessments of surgical capacity are necessary to plan cost- and clinically-effective humanitarian responses to baseline and acute unmet surgical needs in LICs affected by crisis. Though CSR and EHR may meet these criteria in ‘steady-state’ healthcare systems, they may not be useful during humanitarian emergencies. Further study of the relationship between direct surgical capacity improvements and these ratios is necessary to document their role in humanitarian settings. PMID:25905025

Gnawing Pains, Festering Ulcers, and Nightmare Suffering: Selling Leprosy as a Humanitarian Cause in the British Empire, c. 1890-1960

PubMed Central

Vongsathorn, Kathleen

2014-01-01

When British attention was drawn to the issue of leprosy in the Empire, humanitarian organisations rose to take on responsibility for the ‘fight against leprosy’. In an effort to fundraise for a distant cause at a time when hundreds of charities competed for the financial support of British citizens, fundraisers developed propaganda to set leprosy apart from all other humanitarian causes. They drew on leprosy’s relationship with Christianity, its debilitating symptoms, and the supposed vulnerability of leprosy sufferers in order to mobilise Britain’s sense of humanitarian, Christian, and patriotic duty. This article traces the emergence of leprosy as a popular imperial humanitarian cause in modern Britain and analyses the narratives of religion, suffering, and disease that they created and employed in order to fuel their growth and sell leprosy as a British humanitarian cause. PMID:24932060

Relevance or Excellence? Setting Research Priorities for Mental Health and Psychosocial Support in Humanitarian Settings

PubMed Central

Tol, Wietse A; Patel, Vikram; Tomlinson, Mark; Baingana, Florence; Galappatti, Ananda; Silove, Derrick; Sondorp, Egbert; van Ommeren, Mark; Wessells, Michael G; Catherine, Panter-Brick

2012-01-01

Background: Humanitarian crises are associated with an increase in mental disorders and psychological distress. Despite the emerging consensus on intervention strategies in humanitarian settings, the field of mental health and psychosocial support (MHPSS) in humanitarian settings lacks a consensus-based research agenda. Methods: From August 2009 to February 2010, we contacted policymakers, academic researchers, and humanitarian aid workers, and conducted nine semistructured focus group discussions with 114 participants in three locations (Peru, Uganda, and Nepal), in both the capitals and remote humanitarian settings. Local stakeholders representing a range of academic expertise (psychiatry, psychology, social work, child protection, and medical anthropology) and organizations (governments, universities, nongovernmental organizations, and UN agencies) were asked to identify priority questions for MHPSS research in humanitarian settings, and to discuss factors that hamper and facilitate research. Results: Thematic analyses of transcripts show that participants broadly agreed on prioritized research themes in the following order: (1) the prevalence and burden of mental health and psychosocial difficulties in humanitarian settings, (2) how MHPSS implementation can be improved, (3) evaluation of specific MHPSS interventions, (4) the determinants of mental health and psychological distress, and (5) improved research methods and processes. Rather than differences in research themes across countries, what emerged was a disconnect between different groups of stakeholders regarding research processes: the perceived lack of translation of research findings into actual policy and programs; misunderstanding of research methods by aid workers; different appreciation of the time needed to conduct research; and disputed universality of research constructs. Conclusions: To advance a collaborative research agenda, actors in this field need to bridge the perceived disconnect between the goals of “relevance” and “excellence.” Research needs to be more sensitive to questions and concerns arising from humanitarian interventions, and practitioners need to take research findings into account in designing interventions. (Harv Rev Psychiatry 2012;20:25–36.) PMID:22335180

Mental well-being in settings of 'complex emergency': an overview.

PubMed

Almedom, Astier M; Summerfield, Derek

2004-07-01

The mental state of people affected by war and other disasters has been a subject of special interest to academic researchers and practitioners in humanitarian assistance and public health for over two decades. The last decade in particular has seen a rise in the number of papers published in scholarly journals around the Post-Traumatic Stress Disorder (PTSD) debate. Anthropologists have rarely engaged in this debate. Nevertheless, some of the most illuminating contributions have come from socio-medical anthropology (Last, 2000). This volume brings together a wide range of disciplines in the human sciences to address some of the key questions that bear upon the mental health and well-being of populations affected by war and displacement, with contributions from applied biosocial and medical anthropology (Almedom; Lewando-Hundt et al.); applied psychology/public health and social psychiatry (Carballo et al.; Snider et al.; Fullilove et al.); social work (Ahearn & Noble); and political sciences (Pupavac). The four themes that run through this set of papers (outlined below) remain topical areas of contention in contemporary humanitarianism. Scholars and practitioners in the biosocial sciences may wish to engage in the empirical study of human (if not humanitarian) responses to disaster focusing on questions as yet unanswered.

[New global challenges: the role of international organizations].

PubMed

Nardi, L; Scaroni, E; Riccardo, F; De Rosa, A G; Pacini, A; Russo, G; Pacifici, L E

2007-01-01

Facing the numerous humanitarian emergencies that upset the international balances, the International Organisations (IO) who intervene are: the Agencies of the United Nations (UN), the International Federation of the Red Cross (IFRC) and NGOs. In the sector of international health cooperation, the World Health Organization (WHO) has elaborated a document, the International Health Regulations (IHR), that regulates the health workers' activity during a health emergency. In this paper different International Organizations employed in international humanitarian crisis are described.

Complex emergencies in Indonesia.

PubMed

Bradt, D A; Drummond, C M; Richman, M

2001-01-01

Recently, Indonesia has experienced six major provincial, civil, armed conflicts. Underlying causes include the transmigration policy, sectarian disputes, the Asian economic crisis, fall of authoritarian rule, and a backlash against civil and military abuses. The public health impact involves the displacement nationwide of > 1.2 million persons. Violence in the Malukus, Timor, and Kalimantan has sparked the greatest population movements such that five provinces in Indonesia each now harbor > 100,000 internally displaced persons. With a background of government instability, hyperinflation, macroeconomic collapse, and elusive political solutions, these civil armed conflicts are ripe for persistence as complex emergencies. Indonesia has made substantial progress in domestic disaster management with the establishment of central administrative authority, strategic planning, and training programs. Nevertheless, the Indonesian experience reveals recurrent issues in international humanitarian health assistance. Clinical care remains complicated by absences of treatment protocols, inappropriate drug use, high procedural complication rates, and variable referral practices. Epidemiological surveillance remains complicated by unsettled clinical case definitions, non-standardized case management of diseases with epidemic potential, variable outbreak management protocols, and inadequate epidemiological analytic capacity. International donor support has been semi-selective, insufficient, and late. The militia murders of three UN staff in West Timor prompted the withdrawal of UN international staff from West Timor for nearly a year to date. Re-establishing rules of engagement for humanitarian health workers must address security, public health, and clinical threats.

Surgical Outreach for Children by International Humanitarian Organizations: A Review.

PubMed

Kynes, J Matthew; Zeigler, Laura; McQueen, Kelly

2017-06-28

Low- and middle-income countries carry a disproportionate share of the global burden of pediatric surgical disease and have limited local healthcare infrastructure and human resources to address this burden. Humanitarian efforts that have improved or provided access to necessary basic or emergency surgery for children in these settings have included humanitarian assistance and disaster relief, short-term surgical missions, and long-term projects such as building pediatric specialty hospitals and provider networks. Each of these efforts may also include educational initiatives designed to increase local capacity. This article will provide an overview of pediatric humanitarian surgical outreach including reference to available evidence-based analyses of these platforms and make recommendations for surgical outreach initiatives for children.

Work-related stress in a humanitarian context: a qualitative investigation.

PubMed

Jachens, Liza; Houdmont, Jonathan; Thomas, Roslyn

2018-03-13

There is a paucity of research on the subjective stress-related experiences of humanitarian aid workers. Most evaluations of stress among these individuals focus on trauma and related conditions or adopt a quantitative approach. This interview-based study explored how 58 humanitarian aid workers employed by a United Nations-aligned organisation perceived the transactional stress process. The thematic analysis revealed eight main topics of interest: an emergency culture was found where most employees felt compelled to offer an immediate response to humanitarian needs; employees identified strongly with humanitarian goals and reported a high level of engagement; the rewards of humanitarian work were perceived as motivating and meaningful; constant change and urgent demands resulted in work overload; and managing work-life boundaries and receiving positive support from colleagues and managers helped to buffer perceived stress, work overload, and negative health outcomes. The practical implications of the results are discussed and suggestions made in the light of current research and stress theory. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

The new WHO decision-making framework on vaccine use in acute humanitarian emergencies: MSF experience in Minkaman, South Sudan.

PubMed

Rull, Monica; Masson, Sophie; Peyraud, Nicolas; Simonelli, Marco; Ventura, Alexandre; Dorion, Claire; Luquero, Francisco J; Uzzeni, Florent; Cigleneki, Iza

2018-01-01

The main causes of death during population movements can be prevented by addressing the population's basic needs. In 2013, the World Health Organization (WHO) issued a framework for decision making to help prioritize vaccinations in acute humanitarian emergencies. This article describes MSF's experience of applying this framework in addition to addressing key population needs in a displacement setting in Minkaman, South Sudan. Military clashes broke out in South Sudan in December 2013. By May 2014, Minkaman, a village in the Lakes State, hosted some 85,000 displaced people. MSF arrived in Minkaman on 28 December 2013 and immediately provided interventions to address the key humanitarian needs (health care, access to drinking water, measles vaccination). The WHO framework was used to identify priority vaccines: those preventing outbreaks (measles, polio, oral cholera vaccine, and vaccine against meningococcal meningitis A (MenAfrivac®)) and those reducing childhood morbidity and mortality (pentavalent vaccine that combines diphtheria, tetanus, whooping cough, hepatitis B, and Haemophilus influenzae type B; pneumococcal vaccine; and rotavirus vaccine). By mid-March, access to primary and secondary health care was ensured, including community health activities and the provision of safe water. Mass vaccination campaigns against measles, polio, cholera, and meningitis had been organized. Vaccination campaigns against the main deadly childhood diseases, however, were not in place owing to lack of authorization by the Ministry of Health (MoH). The first field use of the new WHO framework for prioritizing vaccines in acute emergencies is described. Although MSF was unable to implement the full package of priority vaccines because authorization could not be obtained from the MoH, a series of mass vaccination campaigns against key epidemic-prone diseases was successfully implemented within a complex emergency context. Together with covering the population's basic needs, this might have contributed to reducing mortality levels below the emergency threshold and to the absence of epidemics. For the WHO framework to be used to its full potential it must not only be adapted for field use but, most importantly, national decision makers should be briefed on the framework and its practical implementation.

Designing for Multiple Stakeholder Interests within the Humanitarian Market: The Case of Off-Grid Energy Devices

ERIC Educational Resources Information Center

Nielsen, Brita Fladvad; Rodrigues Santos, Ana Laura

2013-01-01

A "humanitarian market" for off-grid renewable energy technologies for displaced populations in remote areas has emerged. Within this market, there are multiple stakeholder agendas. End-user needs and sustainable development goals are currently not considered through the customer-enterprise relationship and the applied product and…

Resilience in Pre-Columbian Caribbean House-Building: Dialogue Between Archaeology and Humanitarian Shelter.

PubMed

Samson, A V M; Crawford, C A; Hoogland, M L P; Hofman, C L

This paper responds to questions posed by archaeologists and engineers in the humanitarian sector about relationships between shelter, disasters and resilience. Enabled by an increase in horizontal excavations combined with high-resolution settlement data from excavations in the Dominican Republic, the paper presents a synthesis of Caribbean house data spanning a millennium (1400 BP- 450 BP). An analysis of architectural traits identify the house as an institution that constitutes and catalyses change in an emergent and resilient pathway. The "Caribbean architectural mode" emerged in a period of demographic expansion and cultural transition, was geographically widespread, different from earlier and mainland traditions and endured the hazards of island and coastal ecologies. We use archaeological analysis at the house level to consider the historical, ecological and regional dimensions of resilience in humanitarian action.

Emergency surgery data and documentation reporting forms for sudden-onset humanitarian crises, natural disasters and the existing burden of surgical disease.

PubMed

Burkle, Frederick M; Nickerson, Jason W; von Schreeb, Johan; Redmond, Anthony D; McQueen, Kelly A; Norton, Ian; Roy, Nobhojit

2012-12-01

Following large-scale disasters and major complex emergencies, especially in resource-poor settings, emergency surgery is practiced by Foreign Medical Teams (FMTs) sent by governmental and non-governmental organizations (NGOs). These surgical experiences have not yielded an appropriate standardized collection of data and reporting to meet standards required by national authorities, the World Health Organization, and the Inter-Agency Standing Committee's Global Health Cluster. Utilizing the 2011 International Data Collection guidelines for surgery initiated by Médecins Sans Frontières, the authors of this paper developed an individual patient-centric form and an International Standard Reporting Template for Surgical Care to record data for victims of a disaster as well as the co-existing burden of surgical disease within the affected community. The data includes surgical patient outcomes and perioperative mortality, along with referrals for rehabilitation, mental health and psychosocial care. The purpose of the standard data format is fourfold: (1) to ensure that all surgical providers, especially from indigenous first responder teams and others performing emergency surgery, from national and international (Foreign) medical teams, contribute relevant and purposeful reporting; (2) to provide universally acceptable forms that meet the minimal needs of both national authorities and the Health Cluster; (3) to increase transparency and accountability, contributing to improved humanitarian coordination; and (4) to facilitate a comprehensive review of services provided to those affected by the crisis.

Relevant in times of turmoil: WHO and public health in unstable situations.

PubMed

Loretti, A; Leus, X; Van Holsteijn, B

2001-01-01

For millions of people world-wide, surviving the pressure of extreme events is the predominant objective in daily existence. The distinction between natural and human-induced disasters is becoming more and more blurred. Some countries have known only armed conflict for the last 25 years, and their number is increasing. Recently, humanitarian sources reported 24 ongoing emergencies, each of them involving at least 300,000 people "requiring international assistance to avoid malnutrition or death". All together, including the countries still only at risk and those emerging from armed conflicts, 73 countries, i.e., almost 1.8 trillion people, were undergoing differing degrees of instability. Instability must be envisioned as a spectrum extending between "Utopia" and "Chaos". As emergencies bring forward extreme challenges to human life, medical and public health ethics make it imperative for the World Health Organisation (WHO) to be involved. As such, WHO must enhance its presence and effectiveness in its capacity as a universally accepted advocate for public health. Furthermore, as crises become more enmeshed with the legitimacy of the State, and armed conflicts become more directed against countries' social capital, they impinge more on WHO's work, and WHO must reconcile its unique responsibility in the health sector, the humanitarian imperative and the mandate to assist its primary constituents. Health can be viewed as a bridge to peace. The Organization specifically has recognised that disasters can and do affect the achievement of health and health system objectives. Within WHO, the Department of Emergency and Humanitarian Action (EHA) is the instrument for intervention in such situations. The scope of EHA is defined in terms of humanitarian action, emergency preparedness, national capacity building, and advocacy for humanitarian principles. The WHO's role is changing from ensuring a two-way flow of information on new scientific developments in public health in the ideal all-stable, all-equitable, well-resourced state, to dealing with sheer survival when the state is shattered or is part of the problem. The WHO poses itself the explicit goals to reduce avoidable loss of life, burden of disease and disability in emergencies and post-crisis transitions, and to ensure that the Humanitarian Health Assistance is in-line with international standards and local priorities and does not compromise future health development. A planning tree is presented. The World Health Organization must improve its own performance. This requires three key pre-conditions: 1) presence; 2) surge capacity; and 3) institutional support, knowledge, and competencies. Thus, in order to be effective, WHO's presence and surge capacity in emergencies must integrate the institutional knowledge, the competencies, and the managerial set-up of the Organization.

[The Humanitarian Charter and minimum standards in humanitarian response are applicable in German refugee facilities].

PubMed

Gardemann, Joachim; Wilp, Thomas

2016-05-01

In recent refugee migration into Germany the responsibilities and reactions of health authorities are still lacking general co-ordination. Can the ethical and technical standards of international humanitarian assistance serve as an appropriate and even a compulsory guideline for relief agencies, public health and regulatory authorities in Germany? Documents from the field of medical ethics, medical law, international humanitarian law and disaster medicine will be examined and checked for practicability by consulting experiences during the 1990s Balkan wars refugee movement and international missions of relief agencies. Ethical and technical standards of international humanitarian assistance have been developed, improved and evaluated for 20 years, and are valuable tools for emergency management. Victims of disaster or conflict have a right to live in dignity and therefore have a right to receive health care according to international standards. International ethical and technical standards for refugees should be considered in the Federal Republic of Germany like in any other country.

Child protection assessment in humanitarian emergencies: case studies from Georgia, Gaza, Haiti and Yemen.

PubMed

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-12-01

The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of assessments that effectively identify, and suggest means of response to, threats to children's rights and well-being in emergency settings. In the context of a field evaluation of an inter-agency resource kit, crisis settings where an inter-agency assessment of child protection had been considered in the period August 2008 to July 2010 were identified. Email correspondence, telephone-based structured interviews and documentary review collated information from child protection coordinating agencies from a total of twenty sites, the minority of which had proceeded to complete an assessment. This paper presents case studies of the experience in Georgia (following the conflict between Russian and Georgian forces in August 2008), Gaza (following the Israeli military incursion beginning in December 2008), Haiti (following the earthquake of January 2010), and Yemen (following the ceasefire agreement between the government and rebel forces in early 2010). CASE STUDY FINDINGS: In each setting the context of the humanitarian emergency is outlined. The processes of the planning (and, where appropriate, implementation) of the child protection assessment is described. Where available, the findings of the child protection assessment and their use in shaping interventions are summarized. Case studies document experience across humanitarian settings widely divergent in terms of the nature of the emergency, social-political context, and institutional capacity. Despite such differences, analysis suggests securing inter-agency coordination, preparation and capacity building, and means of ensuring timeliness of findings to be recurrent themes in the effective mobilization of an effective assessment able to inform programming. Copyright © 2011 Elsevier Ltd. All rights reserved.

The UK medical response to the Sichuan earthquake.

PubMed

Redmond, A D; Li, J

2011-06-01

At 14:48 on 12 May 2008 an earthquake of magnitude 8.0 struck the Wenchuan area of Sichuan province, China. A decision to offer/receive UK medical assistance was agreed at a Sino/British political level and a medical team was despatched to the earthquake area. This study describes the team's experience during the immediate aftermath of the earthquake and the following 18 months, during which there have been joint developments in emergency medicine, disaster planning/preparedness and the management of spinal cord injury. The long-term disability following sudden onset natural disaster and the wider impact on healthcare delivery may prove to be a greater burden to the country than the immediate medical needs, and, accordingly, emergency international aid may need to widen its focus. Although international teams usually arrive too late to support resuscitative measures, they can respond to specific requests for specialised assistance, for example plastic and reconstructive surgery to assist with the ongoing management of complex injury, relieve those who have worked continuously through the disaster, and when required maintain routine day-to-day services while local staff continue to manage the disaster. The timing of this does not necessarily need to be immediate. To maximise its impact, the team planned from the outset to build a relationship with Chinese colleagues that would lead to a sharing of knowledge and experience that would benefit major incident responses in both countries in the future. This has been established, and the linkage of emergency humanitarian assistance to longer term development should be considered by others the next time international emergency humanitarian assistance is contemplated.

A Bayesian hierarchical model for mortality data from cluster-sampling household surveys in humanitarian crises.

PubMed

Heudtlass, Peter; Guha-Sapir, Debarati; Speybroeck, Niko

2018-05-31

The crude death rate (CDR) is one of the defining indicators of humanitarian emergencies. When data from vital registration systems are not available, it is common practice to estimate the CDR from household surveys with cluster-sampling design. However, sample sizes are often too small to compare mortality estimates to emergency thresholds, at least in a frequentist framework. Several authors have proposed Bayesian methods for health surveys in humanitarian crises. Here, we develop an approach specifically for mortality data and cluster-sampling surveys. We describe a Bayesian hierarchical Poisson-Gamma mixture model with generic (weakly informative) priors that could be used as default in absence of any specific prior knowledge, and compare Bayesian and frequentist CDR estimates using five different mortality datasets. We provide an interpretation of the Bayesian estimates in the context of an emergency threshold and demonstrate how to interpret parameters at the cluster level and ways in which informative priors can be introduced. With the same set of weakly informative priors, Bayesian CDR estimates are equivalent to frequentist estimates, for all practical purposes. The probability that the CDR surpasses the emergency threshold can be derived directly from the posterior of the mean of the mixing distribution. All observation in the datasets contribute to the estimation of cluster-level estimates, through the hierarchical structure of the model. In a context of sparse data, Bayesian mortality assessments have advantages over frequentist ones already when using only weakly informative priors. More informative priors offer a formal and transparent way of combining new data with existing data and expert knowledge and can help to improve decision-making in humanitarian crises by complementing frequentist estimates.

Who Is Worst Off? Developing a Severity-scoring Model of Complex Emergency Affected Countries in Order to Ensure Needs Based Funding.

PubMed

Eriksson, Anneli; Ohlsén, Ylva Kristina; Garfield, Richard; von Schreeb, Johan

2015-11-03

Disasters affect close to 400 million people each year. Complex Emergencies (CE) are a category of disaster that affects nearly half of the 400 million and often last for several years. To support the people affected by CE, humanitarian assistance is provided with the aim of saving lives and alleviating suffering. It is widely agreed that funding for this assistance should be needs-based. However, to date, there is no model or set of indicators that quantify and compare needs from one CE to another. In an effort to support needs-based and transparent funding of humanitarian assistance, the aim of this study is to develop a model that distinguishes between levels of severity among countries affected by CE. In this study, severity serves as a predictor for level of need. The study focuses on two components of severity: vulnerability and exposure. In a literature and Internet search we identified indicators that characterize vulnerability and exposure to CE. Among the more than 100 indicators identified, a core set of six was selected in an expert ratings exercise. Selection was made based on indicator availability and their ability to characterize preexisting or underlying vulnerabilities (four indicators) or to quantify exposure to a CE (two indicators). CE from 50 countries were then scored using a 3-tiered score (Low-Moderate, High, Critical).  The developed model builds on the logic of the Utstein template. It scores severity based on the readily available value of four vulnerability and four exposure indicators. These are 1) GNI per capita, PPP, 2) Under-five mortality rate, per 1 000 live births, 3) Adult literacy rate, % of people ages 15 and above, 4) Underweight, % of population under 5 years, and 5) number of persons and proportion of population affected, and 6) number of uprooted persons and proportion of population uprooted. The model can be used to derive support for transparent, needs-based funding of humanitarian assistance. Further research is needed to determine its validity, the robustness of indicators and to what extent levels of scoring relate to CE outcome.

Community-Based Noncommunicable Disease Care for Syrian Refugees in Lebanon

PubMed Central

Sethi, Stephen; Jonsson, Rebecka; Skaff, Rony; Tyler, Frank

2017-01-01

ABSTRACT In the sixth year of the Syrian conflict, 11 million people have been displaced, including more than 1.1 million seeking refuge in Lebanon. Prior to the crisis, noncommunicable diseases (NCDs) accounted for 80% of all deaths in Syria, and the underlying health behaviors such as tobacco use, obesity, and physical inactivity are still prevalent among Syrian refugees in Lebanon. Humanitarian agencies initially responded to the acute health care needs of refugees by delivering services to informal settlements via mobile medical clinics. As the crisis has become more protracted, humanitarian response plans have shifted their focus to strengthening local health systems in order to better address the needs of both the host and refugee populations. To that end, we identified gaps in care for NCDs and launched a program to deliver chronic disease care for refugees. Based on a participatory needs assessment and community surveys, and building on the success of community health programs in other contexts, we developed a network of 500 refugee outreach volunteers who are supported with training, supervision, and materials to facilitate health promotion and disease control for community members, target NCDs and other priority conditions, and make referrals to a primary health care center for subsidized care. This model demonstrates that volunteer refugee health workers can implement community-based primary health activities in a complex humanitarian emergency. PMID:28928227

Community-Based Noncommunicable Disease Care for Syrian Refugees in Lebanon.

PubMed

Sethi, Stephen; Jonsson, Rebecka; Skaff, Rony; Tyler, Frank

2017-09-27

In the sixth year of the Syrian conflict, 11 million people have been displaced, including more than 1.1 million seeking refuge in Lebanon. Prior to the crisis, noncommunicable diseases (NCDs) accounted for 80% of all deaths in Syria, and the underlying health behaviors such as tobacco use, obesity, and physical inactivity are still prevalent among Syrian refugees in Lebanon. Humanitarian agencies initially responded to the acute health care needs of refugees by delivering services to informal settlements via mobile medical clinics. As the crisis has become more protracted, humanitarian response plans have shifted their focus to strengthening local health systems in order to better address the needs of both the host and refugee populations. To that end, we identified gaps in care for NCDs and launched a program to deliver chronic disease care for refugees. Based on a participatory needs assessment and community surveys, and building on the success of community health programs in other contexts, we developed a network of 500 refugee outreach volunteers who are supported with training, supervision, and materials to facilitate health promotion and disease control for community members, target NCDs and other priority conditions, and make referrals to a primary health care center for subsidized care. This model demonstrates that volunteer refugee health workers can implement community-based primary health activities in a complex humanitarian emergency. © Sethi et al.

Humanitarian response: improving logistics to save lives.

PubMed

McCoy, Jessica

2008-01-01

Each year, millions of people worldwide are affected by disasters, underscoring the importance of effective relief efforts. Many highly visible disaster responses have been inefficient and ineffective. Humanitarian agencies typically play a key role in disaster response (eg, procuring and distributing relief items to an affected population, assisting with evacuation, providing healthcare, assisting in the development of long-term shelter), and thus their efficiency is critical for a successful disaster response. The field of disaster and emergency response modeling is well established, but the application of such techniques to humanitarian logistics is relatively recent. This article surveys models of humanitarian response logistics and identifies promising opportunities for future work. Existing models analyze a variety of preparation and response decisions (eg, warehouse location and the distribution of relief supplies), consider both natural and manmade disasters, and typically seek to minimize cost or unmet demand. Opportunities to enhance the logistics of humanitarian response include the adaptation of models developed for general disaster response; the use of existing models, techniques, and insights from the literature on commercial supply chain management; the development of working partnerships between humanitarian aid organizations and private companies with expertise in logistics; and the consideration of behavioral factors relevant to a response. Implementable, realistic models that support the logistics of humanitarian relief can improve the preparation for and the response to disasters, which in turn can save lives.

Geoengineering: A humanitarian concern

NASA Astrophysics Data System (ADS)

Suarez, Pablo; van Aalst, Maarten K.

2017-02-01

The humanitarian sector is active at the global frontline of climate impacts, and has a track record in influencing the climate change policy agenda. Geoengineering is a humanitarian concern: the potential for deliberate large-scale intervention in the Earth's climate system has major implications in terms of impacts on the most vulnerable. Yet, so far the humanitarian community has largely been absent from geoengineering deliberations. Geoengineering may be perceived as too theoretical, too complex, and not imminent enough to merit attention. However, early engagement by the sector is imperative to ensure that humanitarian considerations are integrated into policy decisions. Those who can suffer the worst outcomes need to be involved; especially given the plausibility of "predatory geoengineering" where recklessly self-concerned actions may result in harmful consequences to others. This paper explores the humanitarian dimensions of geoengineering, specifically relating to solar radiation management (SRM). Drawing from the engagement of the Red Cross Red Crescent Climate Centre in SRM discussions, we discuss how to improve linkages between science, policy and humanitarian practice. We further propose the creation of a geoengineering risk management framework to ensure that the interests of the most vulnerable are considered and addressed - including the voices of all stakeholders.

38 CFR 17.165 - Emergency outpatient dental treatment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...

38 CFR 17.165 - Emergency outpatient dental treatment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...

38 CFR 17.165 - Emergency outpatient dental treatment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...

38 CFR 17.165 - Emergency outpatient dental treatment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...

38 CFR 17.165 - Emergency outpatient dental treatment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...

Simulation tools for developing policies for complex systems: modeling the health and safety of refugee communities.

PubMed

Anderson, James; Chaturvedi, Alok; Cibulskis, Mike

2007-12-01

The U.S. Committee for Refugees and Immigrants estimated that there were over 33 million refugees and internally displaced persons (IDPs) in the world at the beginning of 2005. IDP/Refugee communities behave in complex ways making it difficult to make policy decisions regarding the provision of humanitarian aid and health and safety. This paper reports the construction of an agent-based model that has been used to study humanitarian assistance policies executed by governments and NGOs that provide for the health and safety of refugee communities. Agent-based modeling (ABM) was chosen because the more widely used alternatives impose unrealistic restrictions and assumptions on the system being modeled and primarily apply to aggregate data. We created intelligent agents representing institutions, organizations, individuals, infrastructure, and governments and analyzed the resulting interactions and emergent behavior using a Central Composite Design of Experiments with five factors. The resulting model allows policy makers and analysts to create scenarios, to make rapid changes in parameters, and provides a test bed for concepts and strategies. Policies can be examined to see how refugee communities might respond to alternative courses of action and how these actions are likely to affect the health and well-being of the community.

Aid in the midst of plenty: oil wealth, misery and advocacy in Angola.

PubMed

Le Billon, Philippe

2005-03-01

This paper examines advocacy initiatives by humanitarian and human rights organisations to address problems of governance in resource-rich and conflict-affected countries, focussing on the case of Angola. Humanitarian principles preclude the use of indiscriminate conditionality and point towards a cautious approach to advocacy aimed at assisting vulnerable populations. Furthermore, the relatively insignificant amount of aid supplied to resource-rich local authorities means that individual agencies have precious little leverage, especially when commercial interests rather than humanitarian or 'good governance' principles influence the priorities of bilateral donors. A context of resource wealth calls for: high levels of coordination and cooperation between human rights groups, aid agencies and donors; balanced use of conditionality, based on the drawing, by donors, of a clear distinction between emergency and development-oriented assistance; and a sustained effort to highlight the responsibilities of local authorities, foreign governments and businesses in meeting humanitarian and development objectives.

Privatisation and outsourcing in wartime: the humanitarian challenges.

PubMed

Carbonnier, Gilles

2006-12-01

The tendency today to privatise many activities hitherto considered the exclusive preserve of the state has given rise to sharp debate. The specific nature of humanitarian emergencies elucidates in particularly stark contrast some of the main challenges connected to the privatisation and outsourcing of essential public services, such as the provision of drinking water and health care. Privatising the realms of defence and security, which are at the very core of state prerogative, raises several legal and humanitarian concerns. This article focuses on the roles and responsibilities of the various parties involved in armed conflicts, especially those of private companies engaged in security, intelligence and interrogation work, and in the provision of water supply and health services. It highlights the need for humanitarian and development actors to grasp better the potential risks and opportunities related to privatisation and outsourcing with a view to supplying effective protection and assistance to communities affected by war.

A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises.

PubMed

Singh, Neha S; Aryasinghe, Sarindi; Smith, James; Khosla, Rajat; Say, Lale; Blanchet, Karl

2018-01-01

Women and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries. We searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach. Of the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers. Despite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations.

A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises

PubMed Central

Aryasinghe, Sarindi; Smith, James; Khosla, Rajat; Say, Lale; Blanchet, Karl

2018-01-01

Introduction Women and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries. Methods We searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach. Results Of the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers. Conclusions Despite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations. PMID:29736272

[Questions concerning humanitarian action].

PubMed

Simonnot, C

2002-01-01

Although development of humanitarian action is rooted historical events, the dynamics behind today's international relief organizations can only be understood within the context of the modern world. Relief organizations are currently confronted with major challenges and paradoxes. The challenges include the need to enhance professionalization and standardization of assistance operations and exposure to greater risks. The paradoxes involve the need to implement complex, highly publicized programs in a simplistic manner and problems involved in managing the complex relationship between relief workers and victims, tainted with the almighty powers of the actors.

Real-Time Surveillance in Emergencies Using the Early Warning Alert and Response Network.

PubMed

Cordes, Kristina M; Cookson, Susan T; Boyd, Andrew T; Hardy, Colleen; Malik, Mamunur Rahman; Mala, Peter; El Tahir, Khalid; Everard, Marthe; Jasiem, Mohamad; Husain, Farah

2017-11-01

Humanitarian emergencies often result in population displacement and increase the risk for transmission of communicable diseases. To address the increased risk for outbreaks during humanitarian emergencies, the World Health Organization developed the Early Warning Alert and Response Network (EWARN) for early detection of epidemic-prone diseases. The US Centers for Disease Control and Prevention has worked with the World Health Organization, ministries of health, and other partners to support EWARN through the implementation and evaluation of these systems and the development of standardized guidance. Although protocols have been developed for the implementation and evaluation of EWARN, a need persists for standardized training and additional guidance on supporting these systems remotely when access to affected areas is restricted. Continued collaboration between partners and the Centers for Disease Control and Prevention for surveillance during emergencies is necessary to strengthen capacity and support global health security.

Real-Time Surveillance in Emergencies Using the Early Warning Alert and Response Network

PubMed Central

Cordes, Kristina M.; Cookson, Susan T.; Boyd, Andrew T.; Hardy, Colleen; Malik, Mamunur Rahman; Mala, Peter; El Tahir, Khalid; Everard, Marthe; Jasiem, Mohamad

2017-01-01

Humanitarian emergencies often result in population displacement and increase the risk for transmission of communicable diseases. To address the increased risk for outbreaks during humanitarian emergencies, the World Health Organization developed the Early Warning Alert and Response Network (EWARN) for early detection of epidemic-prone diseases. The US Centers for Disease Control and Prevention has worked with the World Health Organization, ministries of health, and other partners to support EWARN through the implementation and evaluation of these systems and the development of standardized guidance. Although protocols have been developed for the implementation and evaluation of EWARN, a need persists for standardized training and additional guidance on supporting these systems remotely when access to affected areas is restricted. Continued collaboration between partners and the Centers for Disease Control and Prevention for surveillance during emergencies is necessary to strengthen capacity and support global health security. PMID:29155660

A review of factors affecting the transfer of sexual and reproductive health training into practice in low and lower-middle income country humanitarian settings.

PubMed

Beek, Kristen; Dawson, Angela; Whelan, Anna

2017-01-01

A lack of access to sexual and reproductive health (SRH) care is the leading cause of morbidity and mortality among displaced women and girls of reproductive age. Efforts to address this public health emergency in humanitarian settings have included the widespread delivery of training programmes to address gaps in health worker capacity for SRH. There remains a lack of data on the factors which may affect the ability of health workers to apply SRH knowledge and skills gained through training programmes in humanitarian contexts. We searched four electronic databases and ten key organizations' websites to locate literature on SRH training for humanitarian settings in low and lower-middle income countries. Papers were examined using content analysis to identify factors which contribute to health workers' capacity to transfer SRH knowledge, skills and attitudes learned in training into practice in humanitarian settings. Seven studies were included in this review. Six research papers focused on the response stage of humanitarian crises and five papers featured the disaster context of conflict. A range of SRH components were addressed including maternal, newborn health and sexual violence. The review identified factors, including appropriate resourcing, organisational support and confidence in health care workers that were found to facilitate the transfer of learning. The findings suggest the presence of factors that moderate the transfer of training at the individual, training, organisational, socio-cultural, political and health system levels. Supportive strategies are necessary to best assist trainees to apply newly acquired knowledge and skills in their work settings. These interventions must address factors that moderate the success of learning transfer. Findings from this review suggest that these are related to the individual trainee, the training program itself and the workplace as well as the broader environmental context. Organisations which provide SRH training for humanitarian emergencies should work to identify the system of moderating factors that affect training transfer in their setting and employ evidence-based strategies to ameliorate these.

Norm Emergence and Humanitarian Intervention

DTIC Science & Technology

2008-12-01

individual or collective self -defense if an armed attack occurs against a Member of the United Nations.”15 Humanitarian intervention such as in the case of...far from ideal as a legitimate body to determine the legal use of force apart from self defense. Shue argues that the UN Security Council is...LIFE CYCLE, AND ARTICULATION A. GETTING TO CONSTRUCTIVISM Three S’s—statism, survival and self -help—represent three facets at the heart of the

Childhood disability in Turkana, Kenya: Understanding how carers cope in a complex humanitarian setting

PubMed Central

Nyapera, Velma; Mwenda, Victoria; Kisia, James; Rono, Hilary; Palmer, Jennifer

2016-01-01

Background Although the consequences of disability are magnified in humanitarian contexts, research into the difficulties of caring for children with a disability in such settings has received limited attention. Methods Based on in-depth interviews with 31 families, key informants and focus group discussions in Turkana, Kenya, this article explores the lives of families caring for children with a range of impairments (hearing, vision, physical and intellectual) in a complex humanitarian context characterised by drought, flooding, armed conflict, poverty and historical marginalisation. Results The challenging environmental and social conditions of Turkana magnified not only the impact of impairment on children, but also the burden of caregiving. The remoteness of Turkana, along with the paucity and fragmentation of health, rehabilitation and social services, posed major challenges and created opportunity costs for families. Disability-related stigma isolated mothers of children with disabilities, especially, increasing their burden of care and further limiting their access to services and humanitarian programmes. In a context where social systems are already stressed, the combination of these factors compounded the vulnerabilities faced by children with disabilities and their families. Conclusion The needs of children with disabilities and their carers in Turkana are not being met by either community social support systems or humanitarian aid programmes. There is an urgent need to mainstream disability into Turkana services and programmes. PMID:28730061

Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group.

PubMed

Allden, K; Jones, L; Weissbecker, I; Wessells, M; Bolton, P; Betancourt, T S; Hijazi, Z; Galappatti, A; Yamout, R; Patel, P; Sumathipala, A

2009-01-01

The Working Group on Mental Health and Psychosocial Support was convened as part of the 2009 Harvard Humanitarian Action Summit. The Working Group chose to focus on ethical issues in mental health and psychosocial research and programming in humanitarian settings. The Working Group built on previous work and recommendations, such as the Inter-Agency Standing Committee's Guidelines on Mental Health and Psychosocial Support in Emergency Settings. The objective of this working group was to address one of the factors contributing to the deficiency of research and the need to develop the evidence base on mental health and psychosocial support interventions during complex emergencies by proposing ethical research guidelines. Outcomes research is vital for effective program development in emergency settings, but to date, no comprehensive ethical guidelines exist for guiding such research efforts. Working Group members conducted literature reviews which included peer-reviewed publications, agency reports, and relevant guidelines on the following topics: general ethical principles in research, cross-cultural issues, research in resource-poor countries, and specific populations such as trauma and torture survivors, refugees, minorities, children and youth, and the mentally ill. Working Group members also shared key points regarding ethical issues encountered in their own research and fieldwork. The group adapted a broad definition of the term "research", which encompasses needs assessments and data gathering, as well as monitoring and evaluation. The guidelines are conceptualized as applying to formal and informal processes of assessment and evaluation in which researchers as well as most service providers engage. The group reached consensus that it would be unethical not to conduct research and evaluate outcomes of mental health and psychosocial interventions in emergency settings, given that there currently is very little good evidence base for such interventions. Overarching themes and issues generated by the group for further study and articulation included: purpose and benefits of research, issues of validity, neutrality, risk, subject selection and participation, confidentiality, consent, and dissemination of results. The group outlined several key topics and recommendations that address ethical issues in conducting mental health and psychosocial research in humanitarian settings. The group views this set of recommendations as a living document to be further developed and refined based on input from colleagues representing different regions of the globe with an emphasis on input from colleagues from low-resource countries.

The 7th French Airborne Forward Surgical Team experience of surgical support to the population of a low-income country: a prospective study on 341 patients with short-term follow-up.

PubMed

Goudard, Yvain; Butin, C; Carfantan, C; Pauleau, G; Soucanye de Landevoisin, E; Goin, G; Clement, D; Bordes, J; Balandraud, P

2018-06-09

The 7th Airborne Forward Surgical Team (FST) has deployed to Chad in 2015 and 2016, in support of French military forces. Humanitarian surgical care is known to represent a significant part of the surgical activity in such missions, but to date limited data have been published on the subject. All surgical patients from a civilian host population treated by the FST during these missions have been prospectively included. Indications, operative outcomes and postoperative outcomes were evaluated. During this period, the FST operated on 358 patients. Humanitarian surgical care represented 95% of the activity. Most patients (92.7%) were operated for elective surgery. Emergencies and infectious diseases represented, respectively, 7.3% and 9.1% of cases. The mean length of stay (LOS) was three days (2-4), and the median follow-up was 30 days (22-34). Mortality rate was 0.6% and morbidity was 5.6%. Parietal surgery had no significant complication and had shorter LOS (p<0.001). Emergent surgeries were more complicated (p<0.01) and required more reoperations (p<0.05). Surgical infectious cases had longer LOS (p<0.01). Humanitarian surgical care can be provided without compromising the primary mission of the medical forces. Close surveillance and follow-up allowed favourable outcomes with low morbidity and mortality rates. Humanitarian care is responsible for a considerable portion of the workload in such deployed surgical teams. Accounting for humanitarian care is essential in the planning and training for such future medical operations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Factors affecting the United Nations' response to natural disasters: what determines the allocation of the Central Emergency Response Fund?

PubMed

Robinson, Tyler D; Oliveira, Thiago M; Kayden, Stephanie

2017-10-01

Natural disasters can overwhelm the domestic response of a country, leaving it dependent on external humanitarian relief. The Central Emergency Response Fund (CERF) of the United Nations centralises humanitarian funding and thus allows for a rapid response. This study combined data to analyse the factors that affected the allocation of CERF funding to countries that suffered a natural disaster between 2007 and 2013. It generated descriptive statistics and information on relative risks, and performed regressions of CERF funding across countries. There were 4,346 disasters in total in 188 countries between 2007 and 2013. CERF provided USD 2.98 billion to 87 countries, comprising 3.3 per cent of their total humanitarian funding. CERF more frequently supplied aid to countries in North Africa and the Middle East, and to those that had suffered geophysical disasters. Appropriately, it funds vulnerable countries experiencing severe natural disasters, yet its funding may be affected by variables beyond severity and vulnerability. Further investigation is warranted, therefore. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Gender, sexuality, and violence in humanitarian crises.

PubMed

Hilhorst, Dorothea; Porter, Holly; Gordon, Rachel

2018-01-01

Gender, sexuality, and violence have attracted significant attention in the sphere of humanitarianism in recent years. While this shift builds on the earlier 'Gender and Development' approach and the 'Women, Peace, and Security Agenda', analytical depth is lacking in practice. Notably, 'gender' often means a singular concern for women, neglecting questions of agency and the dynamic and changing realities of gendered power relations. This introductory paper examines why this neglect occurs and proposes a more relational approach to gender. It explores how the contributions to this special issue of Disasters revisit classic gender issues pertaining to violence, livelihoods, and institutions in different settings of humanitarian emergencies, while expanding one's vision beyond them. It draws from the seven papers a number of lessons for humanitarianism, concerning the entangled nature of gender relations, the risks of the unintended effects of gender programming, and the importance of paying sustained attention to how gender relations unfold in a time of crisis. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Community-based assessment of human rights in a complex humanitarian emergency: the Emergency Assistance Teams-Burma and Cyclone Nargis

PubMed Central

2010-01-01

Introduction Cyclone Nargis hit Burma on May 2, 2008, killing over 138,000 and affecting at least 2.4 million people. The Burmese military junta, the State Peace and Development Council (SPDC), initially blocked international aid to storm victims, forcing community-based organizations such as the Emergency Assistance Teams-Burma (EAT) to fill the void, helping with cyclone relief and long-term reconstruction. Recognizing the need for independent monitoring of the human rights situation in cyclone-affected areas, particularly given censorship over storm relief coverage, EAT initiated such documentation efforts. Methods A human rights investigation was conducted to document selected human rights abuses that had initially been reported to volunteers providing relief services in cyclone affected areas. Using participatory research methods and qualitative, semi-structured interviews, EAT volunteers collected 103 testimonies from August 2008 to June 2009; 42 from relief workers and 61 from storm survivors. Results One year after the storm, basic necessities such as food, potable water, and shelter remained insufficient for many, a situation exacerbated by lack of support to help rebuild livelihoods and worsening household debt. This precluded many survivors from being able to access healthcare services, which were inadequate even before Cyclone Nargis. Aid efforts continued to be met with government restrictions and harassment, and relief workers continued to face threats and fear of arrest. Abuses, including land confiscation and misappropriation of aid, were reported during reconstruction, and tight government control over communication and information exchange continued. Conclusions Basic needs of many cyclone survivors in the Irrawaddy Delta remained unmet over a year following Cyclone Nargis. Official impediments to delivery of aid to storm survivors continued, including human rights abrogations experienced by civilians during reconstruction efforts. Such issues remain unaddressed in official assessments conducted in partnership with the SPDC. Private, community-based relief organizations like EAT are well positioned and able to independently assess human rights conditions in response to complex humanitarian emergencies such as Cyclone Nargis; efforts of this nature must be encouraged, particularly in settings where human rights abuses have been documented and censorship is widespread. PMID:20403200

Community-based assessment of human rights in a complex humanitarian emergency: the Emergency Assistance Teams-Burma and Cyclone Nargis.

PubMed

Suwanvanichkij, Voravit; Murakami, Noriyuki; Lee, Catherine I; Leigh, Jen; Wirtz, Andrea L; Daniels, Brock; Mahn, Mahn; Maung, Cynthia; Beyrer, Chris

2010-04-19

Cyclone Nargis hit Burma on May 2, 2008, killing over 138,000 and affecting at least 2.4 million people. The Burmese military junta, the State Peace and Development Council (SPDC), initially blocked international aid to storm victims, forcing community-based organizations such as the Emergency Assistance Teams-Burma (EAT) to fill the void, helping with cyclone relief and long-term reconstruction. Recognizing the need for independent monitoring of the human rights situation in cyclone-affected areas, particularly given censorship over storm relief coverage, EAT initiated such documentation efforts. A human rights investigation was conducted to document selected human rights abuses that had initially been reported to volunteers providing relief services in cyclone affected areas. Using participatory research methods and qualitative, semi-structured interviews, EAT volunteers collected 103 testimonies from August 2008 to June 2009; 42 from relief workers and 61 from storm survivors. One year after the storm, basic necessities such as food, potable water, and shelter remained insufficient for many, a situation exacerbated by lack of support to help rebuild livelihoods and worsening household debt. This precluded many survivors from being able to access healthcare services, which were inadequate even before Cyclone Nargis. Aid efforts continued to be met with government restrictions and harassment, and relief workers continued to face threats and fear of arrest. Abuses, including land confiscation and misappropriation of aid, were reported during reconstruction, and tight government control over communication and information exchange continued. Basic needs of many cyclone survivors in the Irrawaddy Delta remained unmet over a year following Cyclone Nargis. Official impediments to delivery of aid to storm survivors continued, including human rights abrogations experienced by civilians during reconstruction efforts. Such issues remain unaddressed in official assessments conducted in partnership with the SPDC. Private, community-based relief organizations like EAT are well positioned and able to independently assess human rights conditions in response to complex humanitarian emergencies such as Cyclone Nargis; efforts of this nature must be encouraged, particularly in settings where human rights abuses have been documented and censorship is widespread.

The public health aspects of complex emergencies and refugee situations.

PubMed

Toole, M J; Waldman, R J

1997-01-01

Populations affected by armed conflict have experienced severe public health consequences mediated by population displacement, food scarcity, and the collapse of basic health services, giving rise to the term complex humanitarian emergencies. These public health effects have been most severe in underdeveloped countries in Africa, Asia, and Latin America. Refugees and internally displaced persons have experienced high mortality rates during the period immediately following their migration. In Africa, crude mortality rates have been as high as 80 times baseline rates. The most common causes of death have been diarrheal diseases, measles, acute respiratory infections, and malaria. High prevalences of acute malnutrition have contributed to high case fatality rates. In conflict-affected European countries, such as the former Yugoslavia, Georgia, Azerbaijan, and Chechnya, war-related injuries have been the most common cause of death among civilian populations; however, increased incidence of communicable diseases, neonatal health problems, and nutritional deficiencies (especially among the elderly) have been documented. The most effective measures to prevent mortality and morbidity in complex emergencies include protection from violence; the provision of adequate food rations, clean water and sanitation; diarrheal disease control; measles immunization; maternal and child health care, including the case management of common endemic communicable diseases; and selective feeding programs, when indicated.

The rationality of resistance: alternatives for engagement in complex emergencies.

PubMed

Gilgan, M

2001-03-01

The different conceptualisations of conflict in the complex emergency literature have profound implications on the perception of the agency of different groups and the prospects for conflict management. While much recent analysis has focused on the rational political and economic functions of violence, relatively little analysis has focused on why the majority of people chose not to resort to violence. Using Foucault's analysis of power relations, a new framework for conflict analysis is proposed which includes non-violent resistance as well as violence as a means of domination. Non-violent resistance is explored as a rational, highly adaptable response to acts of domination. A comprehensive understanding of conflict must recognise local forms of resistance and identify the barriers and opportunities for the engagement of the international humanitarian community with these groups. This engagement can be used to foster capacities for the creation of legitimate, inclusive, non-violent political and economic processes in the attempt to provide alternatives for everyone in the conflict. If the purpose of the study of complex emergencies is to understand the nature of various conflicts and, based on that understanding, make recommendations for possible routes to conflict management, the analysis of local resistance and efforts to foster it must become a major aspect of the research agenda.

Malnutrition in emergencies: the framing of nutrition concerns in the humanitarian appeals process, 1992 to 2009.

PubMed

Webb, Patrick

2009-12-01

This paper examines how nutrition has been used to raise humanitarian relief resources through the United Nations appeals process, from 1992 to early 2009. Recent calls for "nutrition safety nets" as a response to the world food price crisis reflect a growing recognition of nutrition as a key element in crisis management, not simply as a metric of how bad things have become. The evolution in thinking about the role of nutrition in emergency programming is reflected in changes in how nutrition has been conceptualized and presented in the consolidated appeals process. Based on a desk review, supported by key informant interviews, the paper highlights important changes that include an increasing distinction that separates nutrition from food, water, and health; the importance of synergies across sectors; increased emphasis on "essential packages" of inputs and services versus stand-alone activities; the importance of technical rigor in food and nutrition assessment and surveys; the need for technical competency and capacity in the design and management of nutrition interventions; and the importance of planning for long-term change even in delivering a short-term response. There has also been growing emphasis on specificity in objectives--a trend linked to demand for more accountability across the humanitarian system. Enhanced emergency preparedness will require further capacity building and improved systems for surveillance and data management. Without more systematic, targeted attention to pre-crisis malnutrition, the resources needed to tackle nutrition problems during emergencies will continue to grow.

Engendering care: HIV, humanitarian assistance in Africa, and the reproduction of gender stereotypes

PubMed Central

Mindry, Deborah

2012-01-01

This paper takes as starting point research conducted in Durban, South Africa to unravel the complexities of care ethics in the context of humanitarian aid. It investigates how the gendering of care shapes humanitarian aid in the context of the HIV/AIDS epidemics in Africa constructing an image of “virile” and “violent” African masculinity. Humanitarian organizations construct imagined relations of caring invoking notions of a shared humanity as informing the imperative to facilitate change. This paper draws on varied examples of research and NGO activity to illustrate how these relations of care are gendered. Humanitarian interventions which invoke universalizing conceptions of need could instead draw on feminist care ethics that seeks to balance rights, justice and care in ways that attend to the webs of relationships through which specific lived realities are shaped. Essentialising, feminized discourses on care result in a skewed analysis of international crises that invariably invoke women (and children) as victims in need of care and, at best, ignore the lived experiences of men, and at worst, cast men as virile and violent vectors of disease and social disorder. PMID:20432080

Between international donors and local faith communities: Intermediaries in humanitarian assistance to Syrian refugees in Jordan and Lebanon.

PubMed

Kraft, Kathryn; Smith, Jonathan D

2018-06-12

This paper explores the crucial part that faith-based organisations (FBOs) play in acting as intermediaries between international donors and local faith communities (LFCs) implementing humanitarian relief projects for Syrian refugees. Humanitarian responses to the mounting Syrian refugee crisis have coincided with greater collaboration between international donors and LFCs. This cooperation often is facilitated by a complex web of non-state intermediaries at the international, national, and local level. This study probes the breadth of roles of these intermediaries, drawing on primary data from case studies of two Christian intermediaries supporting Christian LFCs as they deliver aid primarily to Muslim Syrian refugees in Jordan and Lebanon. The results of the study are connected to the wider literature on LFCs in humanitarian response, revealing how intermediaries address issues of accountability, capacity-building, impartiality, neutrality, and professionalism. The paper concludes by offering suggestions for further research on intermediaries as key actors in the localisation of humanitarian assistance. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Surgical skills needed for humanitarian missions in resource-limited settings: common operative procedures performed at Médecins Sans Frontières facilities.

PubMed

Wong, Evan G; Trelles, Miguel; Dominguez, Lynette; Gupta, Shailvi; Burnham, Gilbert; Kushner, Adam L

2014-09-01

Surgeons in high-income countries increasingly are expressing interest in global surgery and participating in humanitarian missions. Knowledge of the surgical skills required to adequately respond to humanitarian emergencies is essential to prepare such surgeons and plan for interventions. A retrospective review of all surgical procedures performed at Médecins Sans Frontières Brussels facilities from June 2008 to December 2012 was performed. Individual data points included country of project; patient age and sex; and surgical indication and surgical procedure. Between June 2008 and December 2012, a total of 93,385 procedures were performed on 83,911 patients in 21 different countries. The most common surgical indication was for fetal-maternal pathologies, accounting for 25,548 of 65,373 (39.1%) of all cases. The most common procedure was a Cesarean delivery, accounting for a total of 24,182 or 25.9% of all procedures. Herniorrhaphies (9,873/93,385, 10.6%) and minor surgeries (11,332/93,385, 12.1%), including wound debridement, abscess drainage and circumcision, were also common. A basic skill set that includes the ability to provide surgical care for a wide variety of surgical morbidities is urgently needed to cope with the surgical need of humanitarian emergencies. This review of Médecins Sans Frontières's operative procedures provides valuable insight into the types of operations with which an aspiring volunteer surgeon should be familiar. Copyright © 2014 Mosby, Inc. All rights reserved.

Cash grants in humanitarian assistance: a nongovernmental organization experience in Aceh, Indonesia, following the 2004 Indian Ocean Tsunami.

PubMed

Doocy, Shannon; Johnson, Diane; Robinson, Courtland

2008-06-01

Historically, cash interventions, as opposed to material or in-kind aid, have been relatively uncommon in the humanitarian response to emergencies. The widespread implementation of cash-based programs following the 2004 Indian Ocean tsunami provided an opportunity to examine cash distributions following disasters. The Mercy Corps cash grant program in Aceh, Indonesia, was a short-term intervention intended to assist in recompensing losses from the December 2004 tsunami. An evaluation of the Mercy Corps cash grant program was conducted for the 12-month period following the tsunami using program monitoring data and a systematic survey of cash grant beneficiaries. in 2005, the cash grant program disbursed more than US$3.3 million to more than 53,000 beneficiaries; the average cash grant award was US$6390, which was shared by an average of 108 beneficiaries. In a beneficiary survey, more than 95% of respondents reported the grant allocation processes were fair and transparent and that grant funds were received. The Mercy Corps experience with cash programs suggests that cash interventions in the emergency context, when properly administered, can have an immediate impact and serve as an efficient mechanism for providing assistance. Organizations involved in humanitarian relief, particularly donors and nongovernmental organizations, should consider incorporating cash-based interventions as an element of their response in future emergencies.

Measuring the benefits of using market based approaches to provide water and sanitation in humanitarian contexts.

PubMed

Martin-Simpson, S; Parkinson, J; Katsou, E

2018-06-15

The use of cash transfers and market based programming (CT/MBP) to increase the efficiency and effectiveness of emergency responses is gaining prominence in the humanitarian sector. However, there is a lack of existing indicators and methodologies to monitor activities designed to strengthen water and sanitation (WaSH) markets. Gender and vulnerability markers to measure the impact of such activities on different stakeholders is also missing. This study identifies parameters to monitor, evaluate and determine the added value of utilising CT/MBP to achieve WaSH objectives in humanitarian response. The results of the work revealed that CT/MBP can be used to support household, community and market level interventions to effectively reduce transmission of faeco-oral diseases. Efficiency, effectiveness, sustainability, appropriateness and equity were identified as useful parameters which correlated to widely accepted frameworks against which to evaluate humanitarian action. The parameters were found to be directly applicable to the case of increasing demand and supply of point of use water treatment technology for a) disaster resilience activities, and b) post-crisis response. The need for peer review of the parameters and indicators and pilot measurement in humanitarian contexts was recognised. Copyright © 2017 Elsevier Ltd. All rights reserved.

Partnerships in global health and collaborative governance: lessons learnt from the Division of Tropical and Humanitarian Medicine at the Geneva University Hospitals.

PubMed

Beran, David; Aebischer Perone, Sigiriya; Alcoba, Gabriel; Bischoff, Alexandre; Bussien, Claire-Lise; Eperon, Gilles; Hagon, Olivier; Heller, Olivia; Jacquerioz Bausch, Frédérique; Perone, Nicolas; Vogel, Thomas; Chappuis, François

2016-04-29

In 2007 the "Crisp Report" on international partnerships increased interest in Northern countries on the way their links with Southern partners operated. Since its establishment in 2007 the Division of Tropical and Humanitarian Medicine at the Geneva University Hospitals has developed a variety of partnerships. Frameworks to assess these partnerships are needed and recent attention in the field of public management on collaborative governance may provide a useful approach for analyzing international collaborations. Projects of the Division of Tropical and Humanitarian Medicine were analyzed by collaborators within the Division using the model proposed by Emerson and colleagues for collaborative governance, which comprises different components that assess the collaborative process. International projects within the Division of Tropical and Humanitarian Medicine can be divided into four categories: Human resource development; Humanitarian response; Neglected Tropical Diseases and Noncommunicable diseases. For each of these projects there was a clear leader from the Division of Tropical and Humanitarian Medicine as well as a local counterpart. These individuals were seen as leaders both due to their role in establishing the collaboration as well as their technical expertise. Across these projects the actual partners vary greatly. This diversity means a wide range of contributions to the collaboration, but also complexity in managing different interests. A common definition of the collaborative aims in each of the projects is both a formal and informal process. Legal, financial and administrative aspects of the collaboration are the formal elements. These can be a challenge based on different administrative requirements. Friendship is part of the informal aspects and helps contribute to a relationship that is not exclusively professional. Using collaborative governance allows the complexity of managing partnerships to be presented. The framework used highlights the process of establishing collaborations, which is an element often negated by other more traditional models used in international partnerships. Applying the framework to the projects of the Division of Tropical and Humanitarian Medicine highlights the importance of shared values and interests, credibility of partners, formal and informal methods of management as well as friendship.

Overview of overseas humanitarian, disaster, and civic aid programs.

PubMed

Drifmeyer, Jeff; Llewellyn, Craig

2003-12-01

The U.S. Department of Defense (DoD) conducts humanitarian assistance missions under the Overseas Humanitarian Disaster and Civic Aid program for the statutory purposes of training military personnel, serving the political interests of the host nation and United States, and providing humanitarian relief to foreign civilians. These purposes are undertaken via the humanitarian assistance (HA), humanitarian and civic assistance, and excess property donation programs. DoD conducts over 200 such projects annually at a direct cost of approximately 27 million dollars in fiscal year 2001. Although varying by year and command, as many as one-half of these projects involve aspects of health care. These range from short-term patient care to donation of medical supplies and equipment excess to the needs of the DoD. Despite the considerable resources invested and importance of international actions, there is presently no formal evaluation system for these HA projects. Current administrative staffing of these programs by military personnel is often by individuals with many other duties and responsibilities. As a result, humanitarian projects are often inadequately coordinated with nongovernmental organizations, private volunteer organizations, or host-nation officials. Nonmedical military personnel sometimes plan health-related projects with little or no coordination with medical experts, military or civilian. After action reports (AARs) on these humanitarian projects are often subjective, lack quantitative details, and are devoid of measures of effectiveness. AARs are sometimes inconsistently completed, and there is no central repository of information for analysis of lessons learned. (The approximate 100 AARs used in the conduct of these studies are available for official use in the Learning Resources Center, Uniformed Services University of Health Sciences.) Feedback from past humanitarian projects is rare and with few exceptions; DoD-centric projects of a similar design are often repeated. Critical reviews to determine whether other kinds of projects might be more effective are rarely conducted. Recommendations for improving the effectiveness of DoD HA under Overseas Humanitarian Disaster and Civic Aid programs include: ensuring adequate staffing to meet the complex, dynamic nature of humanitarian missions and measuring the effectiveness of each project in mandatory, standardized AARs. For medical HA projects, application of public health strategies would compliment the patient care approach of the majority of medical projects to date. This offers possibilities for enhancing host nation infrastructure, allowing improvements beyond the short period of most military humanitarian projects.

The role of public health information in assistance to populations living in opposition and contested areas of Syria, 2012-2014.

PubMed

Diggle, Emma; Welsch, Wilhelmina; Sullivan, Richard; Alkema, Gerbrand; Warsame, Abdihamid; Wafai, Mais; Jasem, Mohammed; Ekzayez, Abdulkarim; Cummings, Rachael; Patel, Preeti

2017-01-01

The Syrian armed conflict is the worst humanitarian tragedy this century. With approximately 470,000 deaths and more than 13 million people displaced, the conflict continues to have a devastating impact on the health system and health outcomes within the country. Hundreds of international and national non-governmental organisations, as well as United Nations agencies have responded to the humanitarian crisis in Syria. While there has been significant attention on the challenges of meeting health needs of Syrian refugees in neighbouring countries such as Jordan, Lebanon and Turkey, very little has been documented about the humanitarian challenges within Syria, between 2013 and 2014 when non-governmental organisations operated in Syria with very little United Nations support or leadership, particularly around obtaining information to guide health responses in Syria. In this study, we draw on our operational experience in Syria and analyse data collected for the humanitarian health response in contested and opposition-held areas of Syria in 2013-4 from Turkey, where the largest humanitarian operation for Syria was based. This is combined with academic literature and material from open-access reports. Humanitarian needs have consistently been most acute in contested and opposition-held areas of Syria due to break-down of Government of Syria services and intense warfare. Humanitarian organisations had to establish de novo data collection systems independent of the Government of Syria to provide essential services in opposition-held and contested areas of Syria. The use of technology such as social media was vital to facilitating remote data collection in Syria as many humanitarian agencies operated with a limited operational visibility given chronic levels of insecurity. Mortality data have been highly politicized and extremely difficult to verify, particularly in areas highly affected by the conflict, with shifting frontlines, populations, and allegiances. More investment in data collection and use, technological investment in the use of M- and E-health, capacity building and strong technical and independent leadership should be a key priority for the humanitarian health response in Syria and other emergencies. Much more attention should be also given for the treatment gap for non-communicable diseases including mental disorders.

Primary care in an unstable security, humanitarian, economic and political context: the Kurdistan Region of Iraq.

PubMed

Shukor, Ali R; Klazinga, Niek S; Kringos, Dionne S

2017-08-23

This study presents a descriptive synthesis of Kurdistan Region of Iraq's (KRI) primary care system, which is undergoing comprehensive primary care reforms within the context of a cross-cutting structural economic adjustment program and protracted security, humanitarian, economic and political crises. The descriptive analysis used a framework operationalizing Starfield's classic primary care model for health services research. A scoping review was performed using relevant sources, and expert consultations were conducted for completing and validating data. The descriptive analysis presents a complex narrative of a primary care system undergoing classical developmental processes of transitioning middle-income countries. The system is simultaneously under tremendous pressure to adapt to the continuously changing, complex and resource-intensive needs of sub-populations exhibiting varying morbidity patterns, within the context of protracted security, humanitarian, economic, and political crises. Despite exhibiting significant resilience in the face of the ongoing crises, the continued influx of IDPs and Syrian refugees, coupled with extremely limited resources and weak governance at policy, organizational and clinical levels threaten the sustainability of KRI's public primary care system. Diverse trajectories to the strengthening and development of primary care are underway by local and international actors, notably the World Bank, RAND Corporation, UN organizations and USAID, focusing on varying imperatives related to the protracted humanitarian and economic crises. The convergence, interaction and outcomes of the diverse initiatives and policy approaches in relation to the development of KRI's primary care system are complex and highly uncertain. A common vision of primary care is required to align resources, initiatives and policies, and to enable synergy between all local and international actors involved in the developmental and humanitarian response. Further research that integrates the knowledge synthesized in this article, and enables actors in KRI to learn from their own experiences and efforts, along with those of other jurisdictions, would be invaluable towards the ongoing development of primary care.

Select clinical recommendations for military medical practitioners conducting humanitarian and civic assistance activities.

PubMed

Hollon, Justin R; Hickey, Patrick W

2010-09-01

Training and planning for stability, security, transition, and reconstruction, to include humanitarian and civic assistance activities, has taken on new importance for today's military forces. Deployed medical forces providing medical care to local populations are presented with the challenge of limited resources, complex public health needs, and complex cultural and linguistic barriers to care. In this article, we review some of the clinical situations commonly encountered during these operations and provide an evidence-based rationale for proposed courses of action. This report is timely given expanding operations in Afghanistan and the stand-up of the U.S. African Command (AFRICOM).

Standardizing Chaos: A Neo-Institutional Analysis of the INEE Minimum Standards for Education in Emergencies, Chronic Crises and Early Reconstruction

ERIC Educational Resources Information Center

Bromley, Patricia; Andina, Marina

2010-01-01

Violent conflict and humanitarian disasters such as floods, famines, or tsunamis, have existed since the start of human history. However, it is only recently that education in these emergency situations has emerged as a visible organizational field. We aim to use a unique theoretical application of sociological neo-institutionalism to explain the…

Surgical support of Operation Sea Signal: adaptability of the 59th Air Transportable Hospital in Cuba.

PubMed

Pelton, Jeffrey J; Buehrer, Jeffrey L; Cull, David L

2003-12-01

The attempted migration of approximately 50,000 Cubans in the summer of 1994 created a large patient population detained at Guantanamo Bay, Cuba. This study examined the roles and results of the 59th Air Transportable Hospital (ATH) in treating surgical problems within that population during Operation Sea Signal. The surgical case log of the 59th ATH was used to identify all patients operated on at the 59th ATH during the interval of August 1994 to April 1995. These case records and the individual records of the three 59th ATH surgeons were used to determine the types of cases performed, complications, and outcomes. A total of 333 operations were performed at the 59th ATH in three types of surgery: (1) elective (267); (2) emergency for nonself-inflicted conditions (46); and (3) emergency for self-inflicted conditions (20). The total perioperative complication rate was 2.4% (8/333), and the wound infection rate for clean surgical cases was 0.87% (2/229). Elective surgery may be performed in a field environment with acceptable complication and wound infection rates. Humanitarian missions will be faced with considerable pathology from pre-existing conditions within the population cared for. The humanitarian mission may be complicated by political situations that may encourage malingering and self-injurious behavior within the population cared for. The latter events have not been previously encountered in humanitarian missions involving the U.S. military and must be considered by policy makers and mission planners in planning future humanitarian missions.

Changing tracks as situations change: humanitarian and health response along the Liberia-Côte d'Ivoire border.

PubMed

Derderian, Katharine

2014-10-01

In recent years, protracted crises and fragile post-conflict settings have challenged the co-existence, and even the linear continuum, of relief and development aid. Forced migration has tested humanitarian and development paradigms where sudden-onset emergencies, violence and displacement arise alongside ongoing development work. Drawing on Médecins Sans Frontières interventions in the region from December 2010 to May 2011, this paper examines aid and healthcare responses to displacement in Côte d'Ivoire and Liberia; it focuses on challenges to the maintenance of preparedness for such foreseeable emergencies and to adaptation in response to changing situations of displacement and insecurity. This 'backsliding' from development to emergency remains a substantial challenge to aid; yet, in exactly such cases, it also presents the opportunity to ensure access to medical care that is much more urgently needed in times of crisis, including the suspension of user fees for medical care. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

A Rights-based Approach to Information in Humanitarian Assistance.

PubMed

Scarnecchia, Daniel P; Raymond, Nathaniel A; Greenwood, Faine; Howarth, Caitlin; Poole, Danielle N

2017-09-20

Crisis-affected populations and humanitarian aid providers are both becoming increasingly reliant on information and communications technology (ICTs) for finding and provisioning aid. This is exposing critical, unaddressed gaps in the legal and ethical frameworks that traditionally defined and governed the professional conduct of humanitarian action. The most acute of these gaps is a lack of clarity about what human rights people have regarding information in disaster, and the corresponding obligations incumbent upon governments and aid providers.  This need is lent urgency by emerging evidence demonstrating that the use of these technologies in crisis response may be, in some cases, causing harm to the very populations they intend to serve.  Preventing and mitigating these harms, while also working to responsibly ensure access to the benefits of information during crises, requires a rights-based framework to guide humanitarian operations. In this brief report, we provide a commentary that accompanies our report, the Signal Code: A Human Rights Approach to Information During Crisis, where we have identified five rights pertaining to the use of information and data during crisis which are grounded in current international human rights and customary law. It is our belief that the continued relevance of the humanitarian project, as it grows increasingly dependent on the use of data and ICTs, urgently requires a discussion of these rights and corresponding obligations.

Strengthening the evidence base for health programming in humanitarian crises.

PubMed

Ager, A; Burnham, G; Checchi, F; Gayer, M; Grais, R F; Henkens, M; Massaquoi, M B F; Nandy, R; Navarro-Colorado, C; Spiegel, P

2014-09-12

Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial. Copyright © 2014, American Association for the Advancement of Science.

Introduction: evidence-based action in humanitarian crises.

PubMed

Dijkzeul, Dennis; Hilhorst, Dorothea; Walker, Peter

2013-07-01

This introductory paper sets the stage for this special issue of Disasters on evidence-based action in humanitarian crises. It reviews definition(s) of evidence and it examines the different disciplinary and methodological approaches to collecting and analysing evidence. In humanitarian action, the need for evidence-based approaches sometimes is viewed in tension with a principled approach, often unnecessarily. Choosing appropriate research methods depends on the objectives of the researcher, in particular whether the research focuses on the intervention and/or the context and the length and complexity of the causal chains involved. The paper concludes by defining some trends in evidence-based approaches in crises: the move away from inputs and outputs of humanitarian action towards outcomes and impacts; the shift towards a higher degree of partnerships in research, and the participation of users and target groups; and the acceptance of a broad array of approaches to establish evidence. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Meeting the needs of people in emergencies: a review of UK experiences and capability

PubMed Central

Eyre, A

2008-01-01

This article summarises the key findings of two research studies conducted for the UK Government in 2006–2007. The first was a literature review of evidence about provisions and interventions to meet the needs of people affected by ‘emergencies’ as defined within the Civil Contingencies Act (2004). Drawing on both historical and contemporary research and practice, the literature review presented an assessment of people's psychosocial needs after events such as natural disasters, terrorism, and other major incidents. Although some reference was made about the needs of and consequences on disaster workers responding to these events, the main emphasis was on those directly affected as bereaved people and/or injured survivors. The review offered best practice guidelines based on the most effective methods of humanitarian assistance in the immediate, short-term, and long-term aftermath of major emergencies. The second report was a follow-up study conducted in 2007. This was a piece of primary research focusing on the UK's current capability in humanitarian assistance in terms of the extent of planning, training, exercising, and experience relating to meeting people's needs in emergencies. A variety of methods were used to gather quantitative and qualitative evidence of the nature and status of such activity across the UK, including questionnaires, focus groups, and a review of literature and documentary evidence. The report included a number of good practice case studies and made recommendations for the development of best practice in humanitarian assistance within the UK. PMID:22460218

Crisis-Affected Populations and Tuberculosis.

PubMed

Zenner, Dominik

2017-01-01

By definition, humanitarian crises can severely affect human health, directly through violence or indirectly through breakdown of infrastructure or lack of provision for basic human needs, such as safe shelter, food, clean water, and suitable clothing. After the initial phase, these indirect effects are the most important determinants of morbidity and mortality in humanitarian emergencies, and infectious diseases are among the most significant causes of ill health. Tuberculosis (TB) incidence in humanitarian emergencies varies depending on a number of factors, including the country background epidemiology, but will be elevated compared with precrisis levels. TB morbidity and mortality are associated with access to appropriate care and medications, and will also be elevated due to barriers to access to diagnosis and appropriate treatment, including robust TB drug supplies. While reestablishment of TB control is challenging in the early phases, successful treatment programs have been previously established, and the WHO has issued guidance on establishing such successful programs. Such programs should be closely linked to other health programs and established in close collaboration with the country's national treatment program. Individuals who flee the emergency also have a higher TB risk and can face difficulties accessing care en route to or upon arrival in host countries. These barriers, often associated with treatment delays and worse outcomes, can be the result of uncertainties around legal status, other practical challenges, or lack of health care worker awareness. It is important to recognize and mitigate these barriers with an increasing number of tools now available and described.

Books vs bombs? Humanitarian development and the narrative of terror in Northern Pakistan.

PubMed

Ali, Nosheen

2010-01-01

This article examines the role of humanitarian discourse and development in reconfiguring the contemporary culture of empire and its war on terror. It takes as its point of entry the immensely popular biographical tale, Three Cups of Tea, which details how the American mountaineer Greg Mortenson has struggled to counter terrorism in Northern Pakistan through the creation of schools. Even as this text appears to provide a self-critical and humane perspective on terrorism, the article argues that it constructs a misleading narrative of terror in which the realities of Northern Pakistan and Muslim life-worlds are distorted through simplistic tropes of ignorance, backwardness and extremism, while histories of US geopolitics and violence are erased. The text has further facilitated the emergence of a participatory militarism, whereby humanitarian work helps to reinvent the military as a culturally sensitive and caring institution in order to justify and service the project of empire.

The role of the military in post-conflict situations.

PubMed

Court, Bruce V

2004-11-01

This article considers the possible role of the military in relation to 'post-conflict situations' and helping to improve the health of affected civilian populations. The opinions expressed are personal reflections which draw upon the author's recent military medical experience in southern Iraq in 2004. The perspective of humanitarian aid agencies that have strong reservations about any involvement with the military is recognised, as they seek to maintain neutrality and the safety of their staff. The environment itself, however, may represent an unacceptable level of threat to humanitarian aid agencies, if their personnel are at risk of serious intimidation, e.g. kidnap or murder. Where terrorist and insurgent para-military groups emerge in a post-war fighting phase, it may be that the military is best placed to help co-ordinate efforts to ensure public health and health care provision until a satisfactory level of security is attained and humanitarian aid agencies are able to operate with confidence.

Users' guides to the medical literature: how to use an article about mortality in a humanitarian emergency

PubMed Central

Mills, Edward J; Checchi, Francesco; Orbinski, James J; Schull, Michael J; Burkle, Frederick M; Beyrer, Chris; Cooper, Curtis; Hardy, Colleen; Singh, Sonal; Garfield, Richard; Woodruff, Bradley A; Guyatt, Gordon H

2008-01-01

The accurate interpretation of mortality surveys in humanitarian crises is useful for both public health responses and security responses. Recent examples suggest that few medical personnel and researchers can accurately interpret the validity of a mortality survey in these settings. Using an example of a mortality survey from the Democratic Republic of Congo (DRC), we demonstrate important methodological considerations that readers should keep in mind when reading a mortality survey to determine the validity of the study and the applicability of the findings to their settings. PMID:18826636

Medical Humanitarianism Under Atmospheric Violence: Health Professionals in the 2013 Gezi Protests in Turkey.

PubMed

Aciksoz, Salih Can

2016-06-01

During the 2013 Gezi protests in Turkey, volunteering health professionals provided on-site medical assistance to protesters faced with police violence characterized by the extensive use of riot control agents. This led to a government crackdown on the medical community and the criminalization of "unauthorized" first aid amidst international criticisms over violations of medical neutrality. Drawing from ethnographic observations, in-depth interviews with health care professionals, and archival research, this article ethnographically analyzes the polarized encounter between the Turkish government and medical professionals aligned with social protest. I demonstrate how the context of "atmospheric violence"-the extensive use of riot control agents like tear gas-brings about new politico-ethical spaces and dilemmas for healthcare professionals. I then analyze how Turkish health professionals framed their provision of health services to protestors in the language of medical humanitarianism, and how the state dismissed their claims to humanitarian neutrality by criminalizing emergency care. Exploring the vexed role that health workers and medical organizations played in the Gezi protests and the consequent political contestations over doctors' ethical, professional, and political responsibilities, this article examines challenges to medical humanitarianism and neutrality at times of social protest in and beyond the Middle East.

Health in the service of state-building in fragile and conflict affected contexts: an additional challenge in the medical-humanitarian environment.

PubMed

Philips, Mit; Derderian, Katharine

2015-01-01

Global health policy and development aid trends also affect humanitarian health work. Reconstruction, rehabilitation and development initiatives start increasingly earlier after crisis, unleashing tensions between development and humanitarian paradigms. Recently, development aid shows specific interest in contexts affected by conflict and fragility, with increasing expectations for health interventions to demonstrate transformative potential, including towards more resilient health systems as a contribution to state-building agendas. Current drives towards state-building opportunities in health interventions is mainly based on political aspirations, with little conclusive evidence on linking state-building efforts to conflict prevention, neither on transformative effects of health systems support. Moreover, negative consequences are possible in such volatile environments. We explore how to anticipate, discuss and monitor potential negative effects of current state-building approaches on health interventions, including on humanitarian aid. Overriding health systems approaches might increase tension in fragile and conflict affected contexts, because at odds with goals typically associated with immediate emergency response to populations' needs. Especially in protracted crisis, quality and timeliness of humanitarian response can be compromised, with strain on impartiality, targeting the most vulnerable, prioritising direct health benefits and most effective strategies. State-building focus could shift health aid priorities away from sick people and disease. Precedence of state institutions support over immediate, effective health service delivery can reduce population level results. As consequence people might question health workers' intention to privilege health above political, ethnic or other alliances, altering health and humanitarian workers' perception. Particularly in conflict, neither health system nor state are impartial bystanders. In spite of scarce evidence on benefits of health systems support for state-building, current dominant line of thought among donors might influence aid strategies and modalities in settings of crisis, conflict and longer-term health system fragility. Negative consequences may arise from dominance of political agendas over health needs, with risk for effectiveness, nature and perception of health interventions. Potential effects in at least three key health areas merit critical review: quality of humanitarian health interventions, tangible contributions to population level health benefits, perception of health and humanitarian workers. To keep health needs as yardstick to determine effective health and humanitarian priority investments, is challenging.

Integration of Surgical Residency Training With US Military Humanitarian Missions.

PubMed

Jensen, Shane; Tadlock, Matthew D; Douglas, Trent; Provencher, Matthew; Ignacio, Romeo C

2015-01-01

To describe how the US Navy integrates surgical resident training during hospital ship-based humanitarian activities and discuss the potential operative and educational benefits during these missions. Retrospective review of predeployment surgical plans, operative case logs, and after-action reports from United States Naval Ship (USNS) Mercy humanitarian deployments from 2006 to 2012. The USNS Mercy hospital ship. We enrolled 24 surgical residents from different surgical specialties including general surgery, obstetrics and gynecology, urology, otolaryngology, and ophthalmology. During 4 planned deployments (2006-2012), 2887 surgical procedures were performed during 20 humanitarian missions conducted by the USNS Mercy in 9 different Southeast Asian countries. Of all the general surgery eligible procedures performed, 1483 (79%) were defined categories under the current general surgery Accreditation Council for Graduate Medical Education guidelines, including abdominal (31%); skin, soft tissue, and breast (21%); ear, nose, and throat (20.5%); plastic surgery (15.5%); and pediatric (12%) cases. The number of surgical cases completed by each resident ranged from 30 to 67 cases over a period of 4 to 6 weeks during the overseas humanitarian rotation. The US Navy's humanitarian experience provides a unique educational opportunity for young military surgeons to experience various global health systems, diverse cultures, and complex logistical planning without sacrificing the breadth and depth of surgical training. This model may provide a framework to develop future international electives for other general surgery training programs. Copyright © 2015. Published by Elsevier Inc.

Women's oral and dental health aspects in humanitarian missions and disasters: Jordanian experience.

PubMed

Smadi, Leena; Sumadi, Aiman Al

2016-01-01

The study aimed to review oral and dental health aspects in female patients presented to Jordanian Royal Medical Services (RMS) international humanitarian missions over a 3-year period. Analysis of humanitarian missions of RMS data and records over a 3-year period (2011-2013) in regard to women's oral and dental health issues was done. The data were analyzed in regard to the number of women seen, the presenting conditions, and the prevalence of oral and dental diseases and procedures in these cases. During the 3-year period, 72 missions were deployed in four locations (Gaza, Ram Allah-West Bank, Jeneen-West Bank, and Iraq). The total number of females seen in this period was 86,436 women, accounting for 56 percent of adult patients seen by RMS humanitarian missions. Dental Clinics were deployed to only two missions (Iraq and Gaza), during which they received 13,629 visits; of these, 41 percent were females (5,588 patients), 29 percent were males, and 30 percent were in the pediatric age group. Trauma accounts for only 7 percent of the cases, while nonacute dental problems (caries and gingivitis) were responsible for the majority of cases (31.6 and 28.7 percent, respectively). RMS dental services during humanitarian mission deployment are a vital part of comprehensive healthcare. Women usually seek more dental care than men, with the majority of treatments for nonacute conditions. RMS experiences demonstrate the tremendous need for a well-defined preparedness plan for deployment of humanitarian missions that considers the contributions of all types of health professionals, the appropriate mobile technology to respond to emergent health risks, and a competent workforce ready and able to respond. Such preparation will require our dental education programs to develop disaster preparedness competencies to achieve the desired level of understanding.

Coincident polio and Ebola crises expose similar fault lines in the current global health regime.

PubMed

Calain, Philippe; Abu Sa'Da, Caroline

2015-01-01

In 2014, the World Health Organization (WHO) declared two "public health emergencies of international concern", in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. Both emergencies can be seen as testing moments, challenging the current model of epidemic governance, where two worldviews co-exist: global health security and humanitarian biomedicine. The resurgence of polio and the spread of Ebola in 2014 have not only exposed the weaknesses of national health systems, but also the shortcomings of the current global health regime in dealing with transnational epidemic threats. These shortcomings are of three sorts. Firstly, the global health regime is fragmented and dominated by the domestic security priorities of industrialised nations. Secondly, the WHO has been constrained by constitutional country allegiances, crippling reforms and the limited impact of the (2005) International Health Regulations (IHR) framework. Thirdly, the securitization of infectious diseases and the militarization of humanitarian aid undermine the establishment of credible public health surveillance networks and the capacity to control epidemic threats. The securitization of communicable diseases has so far led foreign aid policies to sideline health systems. It has also been the source of ongoing misperceptions over the aims of global health initiatives. With its strict allegiance to Member States, the WHO mandate is problematic, particularly when it comes to controlling epidemic diseases. In this context, humanitarian medical organizations are expected to palliate the absence of public health services in the most destitute areas, particularly in conflict zones. The militarization of humanitarian aid itself threatens this fragile and imperfect equilibrium. None of the reforms announced by the WHO in the wake of the 68(th) World Health Assembly address these fundamental issues.

Vulnerability of Internally Displaced Children in Disaster Relief Camps of Pakistan: Issues, Challenges, and Way Forward

ERIC Educational Resources Information Center

Hirani, Shela Akbar Ali

2014-01-01

Pakistan is a developing country with the second highest infant and child mortality rates in South Asia. During the past years this region has undergone several humanitarian emergencies that have negatively affected all the aspects of health and development of young children. During these emergencies relief camps are set up by governmental and…

Do no harm: toward contextually appropriate psychosocial support in international emergencies.

PubMed

Wessells, Michael G

2009-11-01

In the aftermath of international emergencies caused by natural disasters or armed conflicts, strong needs exist for psychosocial support on a large scale. Psychologists have developed and applied frameworks and tools that have helped to alleviate suffering and promote well-being in emergency settings. Unfortunately, psychological tools and approaches are sometimes used in ways that cause unintended harm. In a spirit of prevention and wanting to support critical self-reflection, the author outlines key issues and widespread violations of the do no harm imperative in emergency contexts. Prominent issues include contextual insensitivity to issues such as security, humanitarian coordination, and the inappropriate use of various methods; the use of an individualistic orientation that does not fit the context and culture; an excessive focus on deficits and victimhood that can undermine empowerment and resilience; the use of unsustainable, short-term approaches that breed dependency, create poorly trained psychosocial workers, and lack appropriate emphasis on prevention; and the imposition of outsider approaches. These and related problems can be avoided by the use of critical self-reflection, greater specificity in ethical guidance, a stronger evidence base for intervention, and improved methods of preparing international humanitarian psychologists. Copyright 2009 by the American Psychological Association

Philippine Academy of Rehabilitation Medicine emergency basic relief and medical aid mission project (November 2013-February 2014): the role of physiatrists in Super Typhoon Haiyan.

PubMed

Ganchoon, Filipinas; Bugho, Rommel; Calina, Liezel; Dy, Rochelle; Gosney, James

2017-06-09

Physiatrists have provided humanitarian assistance in recent large-scale global natural disasters. Super Typhoon Haiyan, the deadliest and most costly typhoon in modern Philippine history, made landfall on 8 November 2013 resulting in significant humanitarian needs. Philippine Academy of Rehabilitation Medicine physiatrists conducted a project of 23 emergency basic relief and medical aid missions in response to Super Typhoon Haiyan from November 2013 to February 2014. The final mission was a medical aid mission to the inland rural community of Burauen, Leyte. Summary data were collected, collated, and tabulated; project and mission evaluation was performed. During the humanitarian assistance project, 31,254 basic relief kits containing a variety of food and non-food items were distributed and medical services including consultation, treatment, and medicines were provided to 7255 patients. Of the 344 conditions evaluated in the medical aid mission to Burauen, Leyte 85 (59%) were physical and rehabilitation medicine conditions comprised of musculoskeletal (62 [73%]), neurological (17 [20%]), and dermatological (6 [7%]) diagnoses. Post-mission and project analysis resulted in recommendations and programmatic changes to strengthen response in future disasters. Physiatrists functioned as medical providers, mission team leaders, community advocates, and in other roles. This physiatrist-led humanitarian assistance project met critical basic relief and medical aid needs of persons impacted by Super Typhoon Haiyan, demonstrating significant roles performed by physiatrists in response to a large-scale natural disaster. Resulting disaster programing changes and recommendations may inform a more effective response by PARM mission teams in the Philippines as well as by other South-Eastern Asia teams comprising rehabilitation professionals to large-scale, regional natural disasters. Implications for rehabilitation Large-scale natural disasters including tropical cyclones can have a catastrophic impact on the affected population. In response to Super Typhoon Haiyan, physiatrists representing the Philippine Academy of Rehabilitation Medicine conducted a project of 23 emergency basic relief and medical aid missions from November 2013 to February 2014. Project analysis indicates that medical mission teams responding in similar settings may expect to evaluate a significant number of physical medicine and rehabilitation conditions. Medical rehabilitation with participation by rehabilitation professionals including rehabilitation doctors is essential to the emergency medical response in large-scale natural disasters.

Minimum initial service package (MISP) for sexual and reproductive health in disasters.

PubMed

Lisam, Suchitra

2014-12-01

This paper is based on a presentation given at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. The paper provides background about how the sexual and reproductive health (SRH) got conceived as a humanitarian health response that adopts human right approach, based on core principles driven by needs of adolescent girls and women, and having respect for their values, ethics and morals. Good practices across nations documented by Inter-Agency Working Groups (IAWGs) on Reproductive Health in Humanitarian Crisis has supported the provision of essential SRH care services to adolescent girls and women in humanitarian crisis and in disasters. Secondary desk review is used to document the lessons learnt and good practices followed and documents for SRH. These essential SRH care services are to be provided as "Minimum Initial Service Package (MISP)" for implementation at the outset of disaster. The Sphere Humanitarian Charter and Minimum Standards in Disaster Response incorporated the MISP for SRH as a minimum standard of care in disaster response with a goal to reduce mortality, morbidity and disability among populations affected by crises, particularly women and girls. Disaster prone countries are expected to roll out MISP to improve humanitarian response and emergency preparedness systems. The East Europe and Central Asia (EECA) region including India have rolled out MISP starting from 2011 (EECA) and from 2013-2014 onwards in India across cities such as Chennai, Patna, Bhubaneshwar, Kolkata, Faridabad and Calcutta. Across India, through these national and state level trainings, nearly 600 people from NGOs, institutions, and government agencies were developed as national level trainers and resource persons for MISP who could advocate for RH in emergencies, apply core techniques provided in the MISP, apply coordination skills for the implementation of MISP and develop an action plan to integrate RH and Gender Based Violence (GBV) into Disaster Management Plans of respective agencies. The way forward includes focusing on MISP distance learning module, integration of MISP in Health action plans, and integration into national disaster preparedness and contingency planning of respective agencies and departments and building capacity at various levels. © 2014 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

The nature of international health security.

PubMed

Chiu, Ya-Wen; Weng, Yi-Hao; Su, Yi-Yuan; Huang, Ching-Yi; Chang, Ya-Chen; Kuo, Ken N

2009-01-01

Health issues occasionally intersect security issues. Health security has been viewed as an essential part of human security. Policymakers and health professionals, however, do not share a common definition of health security. This article aims to characterize the notions of health security in order to clarify what constitutes the nexus of health and security. The concept of health security has evolved over time so that it encompasses many entities. Analyzing the health reports of four multilateral organizations (the United Nations, World Health Organization, Asia-Pacific Economic Cooperation, and the European Union) produced eight categories of most significant relevance to contemporary health security, allowing comparison of the definitions. The four categories are: emerging diseases; global infectious disease; deliberate release of chemical and biological materials; violence, conflict, and humanitarian emergencies. Two other categories of common concern are natural disasters and environmental change, as well as chemical and radioactive accidents. The final two categories, food insecurity and poverty, are discussed less frequently. Nevertheless, food security is emerging as an increasingly important issue in public health. Health security is the first line of defence against health emergencies. As globalization brings more complexities, dealing with the increased scale and extent of health security will require greater international effort and political support.

Optimizing the Use of a Precious Resource: The Role of Emergency Physicians in a Humanitarian Crisis.

PubMed

Parmar, Parveen K; Greenough, P Gregg

2017-06-01

Emergency physicians (EP) are uniquely suited to provide care in crises as a result of their broad training, ability to work quickly and effectively in high-pressure, austere settings, and their inherent flexibility. While emergency medicine training is helpful to support the needs of crisis-affected and displaced populations, it is not in itself sufficient. In this article we review what an EP should carefully consider prior to deployment.

Commentary: Advancing an implementation science agenda on mental health and psychosocial responses in war-affected settings: comment on trials of a psychosocial intervention for youth affected by the Syrian crisis - by Panter-Brick et al. (2018).

PubMed

Betancourt, Theresa S; Fazel, Mina

2018-05-01

Syria's civil conflict has created the largest humanitarian disaster of our time, causing massive population displacement, tremendous exposure to trauma, and loss. Advancing the mental health and psychosocial responses of war-affected populations both during acute humanitarian emergencies and in post-conflict transition is imperative in forging a constructive implementation agenda. This study makes an important contribution in building evidence toward effective interventions to advance the mental health and well-being of those affected by the Syrian crisis. Using an innovative approach, this work demonstrates that a thoughtful, ethical, and scientifically valid trial can be carried out in the midst of mass displacement. Further research is urgently needed on the effectiveness of interventions for vulnerable populations, with a growing need to embed studies of evidence-based mental health interventions within humanitarian responses. © 2018 Association for Child and Adolescent Mental Health.

Remotely Piloted Life-Saving Effort vehicles and emergency management: An analysis on revolutionizing humanitarian assistance in Pakistan.

PubMed

Nadeem, Ali Bin; Chandna, Ysa

The majority of the Pakistani public has known little of the unmanned aerial vehicles, also known for their onomatopoeically inspired name "drones," except the fact that it regularly rains Hellfire missiles in Pakistan, claiming the lives of many innocent Pakistanis settled in the western provinces. In actuality, in addition to their destructive capacities, these remotely piloted vehicles have been used since the turn of the century in a variety of live-saving and risk-reducing roles. This research article primarily addresses the third stage of Emergency management-response, with Pakistan being the primary region of research. This research article will first begin by diagnosing and accurately delineating the types of humanitarian crisis that grip Pakistan, devastating its land, exhausting its limited resources in its weak, and now almost archaic, disaster response strategy that results in the prolongation of its citizens' plight. Subsequently, this article will describe the history of the usage of unmanned vehicles, its multi-functional capacities, and its relevance in aiding humanitarian response efforts in disaster-stricken areas. Finally, this article will propose the introduction of Remotely Piloted Life-Saving Effort (RELIEF) vehicles in performing analysis and surveillance roles in Pakistan's disaster-prone and disaster-struck areas and its capacity to dramatically improve and expedite the existing relief supply delivery systems in place.

Implications and Constraints of Fiscal Laws in Contingency Contracting

DTIC Science & Technology

2013-08-30

earthquakes, and floods and are supported by U.S. military forces providing cleanup and humanitarian assistance (for example, after Hurricanes Hugo , Andrew...included operations in New Orleans in the aftermath of Hurricane Katrina and in New York after storm damage in 2012. The military has also supported...Emergency Relief Operations Domestic disaster and emergency relief operations focus on natural disasters such as hurricanes , weather storms

Disaster preparedness in a complex urban system: the case of Kathmandu Valley, Nepal.

PubMed

Carpenter, Samuel; Grünewald, François

2016-07-01

The city is a growing centre of humanitarian concern. Yet, aid agencies, governments and donors are only beginning to comprehend the scale and, importantly, the complexity of the humanitarian challenge in urban areas. Using the case study of the Kathmandu Valley, Nepal, this paper examines the analytical utility of recent research on complex urban systems in strengthening scholarly understanding of urban disaster risk management, and outlines its operational relevance to disaster preparedness. Drawing on a literature review and 26 interviews with actors from across the Government of Nepal, the International Red Cross and Red Crescent Movement, non-governmental organisations, United Nations agencies, and at-risk communities, the study argues that complexity can be seen as a defining feature of urban systems and the risks that confront them. To manage risk in these systems effectively, preparedness efforts must be based on adaptive and agile approaches, incorporating the use of network analysis, partnerships, and new technologies. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Humanitarian health computing using artificial intelligence and social media: A narrative literature review.

PubMed

Fernandez-Luque, Luis; Imran, Muhammad

2018-06-01

According to the World Health Organization (WHO), over 130 million people are in constant need of humanitarian assistance due to natural disasters, disease outbreaks, and conflicts, among other factors. These health crises can compromise the resilience of healthcare systems, which are essential for achieving the health objectives of the sustainable development goals (SDGs) of the United Nations (UN). During a humanitarian health crisis, rapid and informed decision making is required. This is often challenging due to information scarcity, limited resources, and strict time constraints. Moreover, the traditional approach to digital health development, which involves a substantial requirement analysis, a feasibility study, and deployment of technology, is ill-suited for many crisis contexts. The emergence of Web 2.0 technologies and social media platforms in the past decade, such as Twitter, has created a new paradigm of massive information and misinformation, in which new technologies need to be developed to aid rapid decision making during humanitarian health crises. Humanitarian health crises increasingly require the analysis of massive amounts of information produced by different sources, such as social media content, and, hence, they are a prime case for the use of artificial intelligence (AI) techniques to help identify relevant information and make it actionable. To identify challenges and opportunities for using AI in humanitarian health crises, we reviewed the literature on the use of AI techniques to process social media. We performed a narrative literature review aimed at identifying examples of the use of AI in humanitarian health crises. Our search strategy was designed to get a broad overview of the different applications of AI in a humanitarian health crisis and their challenges. A total of 1459 articles were screened, and 24 articles were included in the final analysis. Successful case studies of AI applications in a humanitarian health crisis have been reported, such as for outbreak detection. A commonly shared concern in the reviewed literature is the technical challenge of analyzing large amounts of data in real time. Data interoperability, which is essential to data sharing, is also a barrier with regard to the integration of online and traditional data sources. Human and organizational aspects that might be key factors for the adoption of AI and social media remain understudied. There is also a publication bias toward high-income countries, as we identified few examples in low-income countries. Further, we did not identify any examples of certain types of major crisis, such armed conflicts, in which misinformation might be more common. The feasibility of using AI to extract valuable information during a humanitarian health crisis is proven in many cases. There is a lack of research on how to integrate the use of AI into the work-flow and large-scale deployments of humanitarian aid during a health crisis. Copyright © 2018 Elsevier B.V. All rights reserved.

Humanitarian Intervention: Is it an Emerging Responsibility?

DTIC Science & Technology

2010-03-25

a cure . Affected countries collapse into anarchy. Violent uprisings occur across the globe. International trade slows to a crawl. Governments...the 1918 pandemic, work absentee rates were 20-40% in some areas. Railroad worker absenteeism threatened transportation systems in the U.S.74 21

Assistance for emergency health.

PubMed

Rivera, Antonio

2002-03-01

The public health agencies of Pacific island nations have the responsibility of maintaining health during national emergencies. Assistance for completion of this task is available to the Pacific islands in the form of technical, informational, educational and humanitarian aid. Assistance for Pacific island preparedness and response may originate from local, jurisdictional, regional and international levels. The Internet also now offers many useful resources for disaster education, collaboration and aid. This article discusses mechanisms and resources that Pacific island health officials may utilize to promote emergency health within their own jurisdictions.

The humanitarian emergency in Burundi: evaluation of the operational strategy for management of nutritional crisis.

PubMed

Rossi, Laura; Verna, Daniel; Villeneuve, Susie L

2008-07-01

To evaluate the impact and appropriateness of programmes for the management and treatment of severe malnutrition in emergency situations. A central unified database was set up with all data and statistics provided by nutritional centres (NC) active in Burundi. The paper describes the case of Burundi as an example of the response of the humanitarian community to nutritional crisis. Since 1999, more than one million (1,054,210) severely malnourished patients were treated in NC established in Burundi. Peaks of beneficiaries were registered in 2000 and 2001; the admission rate started to decrease in 2002. In 2004, twenty therapeutic feeding centres (TFC) and 224 supplementary feeding centres (SFC) were active for the treatment of 127,420 beneficiaries. Nutritional programmes were present in every province with a coverage rate of 55%. The most convincing impact of the nutritional programme in Burundi was the reduction of mortality rate in children under 5 years of age; an impact on the prevalence of acute malnutrition could not be demonstrated. Children under 5 years old accounted for 62% of beneficiaries in TFC and 76% in SFC. TFC performance indicators fulfilled the minimum standards in disaster response; the performance of SFC was not so optimal with a low recovery rate (69% v. >80%) and a high non-respondent rate (16% v. <5%). With the combination of coverage and cure rate, the programme met 44% of the assessed needs in 2004. In Burundi the stabilisation of security conditions permitted a combination of humanitarian responses ranging from emergency activities to strengthening of community-based initiatives that could correct the coverage and impact limitations.

Early Warning of Food Security Crises in Urban Areas: The Case of Harare, Zimbabwe, 2007

NASA Technical Reports Server (NTRS)

Brown, Molly E.; Funk, Christopher C.

2008-01-01

In 2007, the citizens of Harare, Zimbabwe began experiencing an intense food security crisis. The crisis, due to a complex mix of poor government policies, high inflation rates and production decline due to drought, resulted in a massive increase in the number of food insecure people in Harare. The international humanitarian aid response to this crisis was largely successful due to the early agreement among donors and humanitarian aid officials as to the size and nature of the problem. Remote sensing enabled an early and decisive movement of resources greatly assisting the delivery of food aid in a timely manner. Remote sensing data gave a clear and compelling assessment of significant crop production shortfalls, and provided donors of humanitarian assistance a single number around which they could come to agreement. This use of remote sensing data typifies how remote sensing may be used in early warning systems in Africa.

Humanitarian responses to mass violence perpetrated against vulnerable populations.

PubMed Central

Gellert, G. A.

1995-01-01

This multidisciplinary review links three areas of legitimate inquiry for practitioners of medicine and public health. The first is occurrences of mass violence or genocide perpetrated against vulnerable populations, with a focus on the failure of national and international mechanisms to prevent or predict such violence. The second is evolving concepts of national sovereignty and an emerging framework in which the imperative to assist vulnerable populations supersedes a state's right to self determination. The last is how medical, public health, and other systems of surveillance and rapid assessment of mass violence can accelerate public awareness and facilitate structured, consistent political decision making to prevent mass violence and to provide international humanitarian assistance. Images p1000-a PMID:7580643

Civilian-military coordination in the emergency response in Indonesia.

PubMed

Joyce, Neil

2006-10-01

Military and civilian humanitarian interventions in severely affected Indonesian province of Aceh are described following the tsunami of December 26. Specific events and activities illustrate the comparative roles of these types of agencies and how collaboration should recognize the abilities and limitations of each.

UAV Deployment Exercise for Mapping Purposes: Evaluation of Emergency Response Applications.

PubMed

Boccardo, Piero; Chiabrando, Filiberto; Dutto, Furio; Tonolo, Fabio Giulio; Lingua, Andrea

2015-07-02

Exploiting the decrease of costs related to UAV technology, the humanitarian community started piloting the use of similar systems in humanitarian crises several years ago in different application fields, i.e., disaster mapping and information gathering, community capacity building, logistics and even transportation of goods. Part of the author's group, composed of researchers in the field of applied geomatics, has been piloting the use of UAVs since 2006, with a specific focus on disaster management application. In the framework of such activities, a UAV deployment exercise was jointly organized with the Regional Civil Protection authority, mainly aimed at assessing the operational procedures to deploy UAVs for mapping purposes and the usability of the acquired data in an emergency response context. In the paper the technical features of the UAV platforms will be described, comparing the main advantages/disadvantages of fixed-wing versus rotor platforms. The main phases of the adopted operational procedure will be discussed and assessed especially in terms of time required to carry out each step, highlighting potential bottlenecks and in view of the national regulation framework, which is rapidly evolving. Different methodologies for the processing of the acquired data will be described and discussed, evaluating the fitness for emergency response applications.

Developing Institutional Capacity for Reproductive Health in Humanitarian Settings: A Descriptive Study

PubMed Central

Tran, Nguyen-Toan; Dawson, Angela; Meyers, Janet; Krause, Sandra; Hickling, Carina

2015-01-01

Introduction Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS), yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS. Materials and Methods Descriptive study using an online questionnaire tool. Results Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%). Agencies reported working with refugees (81%), internally-displaced (87%) and stateless persons (20%), in camp-based settings (78%), and in urban (83%) and rural settings (78%). Sixty-eight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHS-related disaster risk reduction (DRR), emergency management and coordination, delivery of the Minimum Initial Services Package (MISP) for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, management of sexually-transmitted infections, adolescent RH, and family planning. Approximately half of participants reported that their institutions had experienced an increase in dedicated budget and staff for RHHS, a fifth no change, and 1 in 10 a decrease. The Interagency RH Kits were reportedly the most commonly used supplies to support RHHS implementation. Conclusion The results suggest overall growth in institutional capacity in RHHS over the past decade, indicating that the field has matured and expanded from crisis response to include RHHS into DRR and other elements of the emergency management cycle. It is critical to consolidate the progress to date, address gaps, and sustain momentum. PMID:26331474

Food security and humanitarian assistance among displaced Iraqi populations in Jordan and Syria.

PubMed

Doocy, Shannon; Sirois, Adam; Anderson, Jamie; Tileva, Margarita; Biermann, Elizabeth; Storey, J Douglas; Burnham, Gilbert

2011-01-01

The Iraq conflict resulted in the largest displacement in the Middle East in recent history, and provision of health services to the displaced population presents a critical challenge. With an increase in the number of people affected by complex emergencies and the number of people displaced in urban settings, the international community must adapt intervention strategies to meet the specific demands and contexts of this population. The study aimed to provide information on food security and livelihoods for Iraqi refugees in Syria and Jordan to inform humanitarian assistance planning. National cross-sectional cluster sample surveys of displaced Iraqi populations displaced were conducted in Jordan (October 2008) and Syria (March 2009). Clusters of ten households were randomly selected using probability-based sampling; a total of 1200 and 813 Iraqi households in Jordan and Syria, respectively, were interviewed about food security and receipt of humanitarian assistance. In Syria, 60% of households reported the household food situation had declined since the arrival period as compared to 46% in Jordan. Food aid receipt was reported by 18.0% of households in Jordan and 90.3% of households in Syria. In Jordan, 10.2% of households received cash assistance and in Syria 25.3% of households received cash assistance. In Jordan, cash assistance was associated with low socioeconomic status, large household size, and UNHCR registration. In Syria, female headed households, Damascus residents, families with children, and those registered with UNHCR were more likely to receive cash assistance. Food insecurity remains a concern among displaced Iraqi households in both Jordan and Syria. Improved targeting of both food and cash assistance and the expansion of cash-based programs could lead to a more effective use of funds and facilitate the implementation of assistance programs that are sustainable in the context of declining funding availability. Copyright © 2010 Elsevier Ltd. All rights reserved.

Spatiotemporal Detection of Unusual Human Population Behavior Using Mobile Phone Data

PubMed Central

Dobra, Adrian; Williams, Nathalie E.; Eagle, Nathan

2015-01-01

With the aim to contribute to humanitarian response to disasters and violent events, scientists have proposed the development of analytical tools that could identify emergency events in real-time, using mobile phone data. The assumption is that dramatic and discrete changes in behavior, measured with mobile phone data, will indicate extreme events. In this study, we propose an efficient system for spatiotemporal detection of behavioral anomalies from mobile phone data and compare sites with behavioral anomalies to an extensive database of emergency and non-emergency events in Rwanda. Our methodology successfully captures anomalous behavioral patterns associated with a broad range of events, from religious and official holidays to earthquakes, floods, violence against civilians and protests. Our results suggest that human behavioral responses to extreme events are complex and multi-dimensional, including extreme increases and decreases in both calling and movement behaviors. We also find significant temporal and spatial variance in responses to extreme events. Our behavioral anomaly detection system and extensive discussion of results are a significant contribution to the long-term project of creating an effective real-time event detection system with mobile phone data and we discuss the implications of our findings for future research to this end. PMID:25806954

The elephant in the room: collaboration and competition among relief organizations during high-profile disasters.

PubMed

Subbarao, Italo; Wynia, Matthew K; Burkle, Frederick M

2010-01-01

The non-governmental organizations (NGOs) that assume the bulk of emergency care during large-scale disasters in the developing world must expend considerable time and resources to ensure donations to sustain their field operations. This long-standing dilemma for the humanitarian community can create a competitive environment that: Compromises the delivery and quality of services, Allows the effectiveness of operations to be compromised by a lack of cooperation and collaboration, Disrupts the timely and accurate coordination and analysis of outcome measures that are crucial to successful response in the future, and Undermines the long-term capacity of indigenous aid organizations. This article addresses problems and potential solutions for improved coordination and long-term capacity-building of humanitarian aid.

32 CFR 204.8 - Benefits for which no fee shall be assessed.

Code of Federal Regulations, 2012 CFR

2012-07-01

... incidental services rendered. (14) Administrative services offered by reference or reading rooms to inspect... declassification following such review. (16) Services of a humanitarian nature performed in such emergency...-governmental agreements to recover all or part of costs shall not be negotiated. Rather, it means the...

32 CFR 204.8 - Benefits for which no fee shall be assessed.

Code of Federal Regulations, 2013 CFR

2013-07-01

... incidental services rendered. (14) Administrative services offered by reference or reading rooms to inspect... declassification following such review. (16) Services of a humanitarian nature performed in such emergency...-governmental agreements to recover all or part of costs shall not be negotiated. Rather, it means the...

32 CFR 204.8 - Benefits for which no fee shall be assessed.

Code of Federal Regulations, 2011 CFR

2011-07-01

... incidental services rendered. (14) Administrative services offered by reference or reading rooms to inspect... declassification following such review. (16) Services of a humanitarian nature performed in such emergency...-governmental agreements to recover all or part of costs shall not be negotiated. Rather, it means the...

Rethinking the social history in the era of biolegitimacy: global health and medical education in the care of Palestinian and Syrian refugees in Beirut, Lebanon.

PubMed

Premkumar, Ashish; Raad, Kareem; Haidar, Mona H

2016-01-01

The critiques leveled towards medical humanitarianism by the social sciences have yet to be felt in medical education. The elevation of biological suffering, at the detriment of sociopolitical contextualization, has been shown to clearly impact both acute and long-term care of individuals and communities. With many medical students spending a portion of their educational time in global learning experiences, exposure to humanitarianism and its consequences becomes a unique component of biomedical education. How does the medical field reconcile global health education with the critiques of humanitarianism? This paper argues that the medical response to humanitarian reason should begin at the level of a social history. Using experiential data culled from fieldwork with Palestinian and Syrian refugees in Lebanon, the authors argue that an expanded social history, combined with knowledge derived from the social sciences, can have significant clinical implications. The ability to contextualize an individual's disease and life within a complex sociopolitical framework means that students must draw on disciplines as varied as anthropology, sociology, and political history to further their knowledge base. Moreover, situating these educational goals within the framework of physician advocacy can build a strong base in medical education from both a biomedical and activist perspective.

Access to healthcare for the most vulnerable migrants: a humanitarian crisis.

PubMed

Pottie, Kevin; Martin, Jorge Pedro; Cornish, Stephen; Biorklund, Linn Maria; Gayton, Ivan; Doerner, Frank; Schneider, Fabien

2015-01-01

A series of Médecins Sans Frontières projects for irregular migrants over the past decade have consistently documented high rates of 14 physical and sexual trauma, extortion and mental illness amidst severe healthcare, food, and housing limitations. Complex interventions were needed to begin to address illness and barriers to healthcare and to help restore dignity to the most vulnerable women, children and men. Promising interventions included mobile clinics, use of cultural mediators, coordination with migrant-friendly entities and NGOs and integrating advocacy programs and mental health care with medical services. Ongoing interventions, research and coordination are needed to address this neglected humanitarian crisis.

Rapid response: email, immediacy, and medical humanitarianism in Aceh, Indonesia.

PubMed

Grayman, Jesse Hession

2014-11-01

After more than 20 years of sporadic separatist insurgency, the Free Aceh Movement and the Indonesian government signed an internationally brokered peace agreement in August 2005, just eight months after the Indian Ocean tsunami devastated Aceh's coastal communities. This article presents a medical humanitarian case study based on ethnographic data I collected while working for a large aid agency in post-conflict Aceh from 2005 to 2007. In December 2005, the agency faced the first test of its medical and negotiation capacities to provide psychiatric care to a recently amnestied political prisoner whose erratic behavior upon returning home led to his re-arrest and detention at a district police station. I juxtapose two methodological approaches-an ethnographic content analysis of the agency's email archive and field-based participant-observation-to recount contrasting narrative versions of the event. I use this contrast to illustrate and critique the immediacy of the humanitarian imperative that characterizes the industry. Immediacy is explored as both an urgent moral impulse to assist in a crisis and a form of mediation that seemingly projects neutral and transparent transmission of content. I argue that the sense of immediacy afforded by email enacts and amplifies the humanitarian imperative at the cost of abstracting elite humanitarian actors out of local and moral context. As a result, the management and mediation of this psychiatric case by email produced a bureaucratic model of care that failed to account for complex conditions of chronic political and medical instability on the ground. Copyright © 2014 Elsevier Ltd. All rights reserved.

Forced displacement and women's security in Colombia.

PubMed

Meertens, Donny

2010-04-01

In the protracted Colombian conflict, assistance to internally displaced persons has developed in the context of contradictory political processes. The Colombian government's launching of a transitional justice process in the midst of armed conflict has generated a complex situation displaying both conflict and post-conflict characteristics. The progressive Constitutional Court rulings on internal displacement, in particular the gender-sensitive Auto 092, constitute an attempt to bring together humanitarian interventions and transitional justice measures in a rights-based framework. However, the national government is reluctant to adopt them fully and local realities still hamper their integrated implementation. Displaced women, therefore, remain in an especially vulnerable position. This paper argues that gender-sensitive humanitarian interventions must take into account all of these complexities of scale and political process in order to make legal frameworks more effective at the local level. In these contexts, interventions should pay particular attention to strategies that contribute to transforming pre-existing gender regimes.

A Research Agenda for Humanitarian Health Ethics

PubMed Central

Hunt, Matthew; Schwartz, Lisa; Pringle, John; Boulanger, Renaud; Nouvet, Elysée; O'Mathúna, Dónal; Arya, Neil; Bernard, Carrie; Beukeboom, Carolyn; Calain, Philippe; de Laat, Sonya; Eckenwiler, Lisa; Elit, Laurie; Fraser, Veronique; Gillespie, Leigh-Anne; Johnson, Kirsten; Meagher, Rachel; Nixon, Stephanie; Olivier, Catherine; Pakes, Barry; Redwood-Campbell, Lynda; Reis, Andreas; Renaldi, Teuku; Singh, Jerome; Smith, Maxwell; Von Schreeb, Johan

2014-01-01

This paper maps key research questions for humanitarian health ethics: the ethical dimensions of healthcare provision and public health activities during international responses to situations of humanitarian crisis. Development of this research agenda was initiated at the Humanitarian Health Ethics Forum (HHE Forum) convened in Hamilton, Canada in November 2012. The HHE Forum identified priority avenues for advancing policy and practice for ethics in humanitarian health action. The main topic areas examined were: experiences and perceptions of humanitarian health ethics; training and professional development initiatives for humanitarian health ethics; ethics support for humanitarian health workers; impact of policies and project structures on humanitarian health ethics; and theoretical frameworks and ethics lenses. Key research questions for each topic area are presented, as well as proposed strategies for advancing this research agenda. Pursuing the research agenda will help strengthen the ethical foundations of humanitarian health action. PMID:25687273

Changes in mortality rates and humanitarian conditions in Darfur, Sudan 2003-2007.

PubMed

Garfield, Richard; Polonsky, Jonny

2010-01-01

The Darfur region of Sudan has been an intense focus of humanitarian concern since rebellions began there early in 2003. In 2004, the US Secretary of State declared that conflict in Darfur represented genocide. Since 2003, many sample surveys and various mortality estimates for Darfur have been made. Nonetheless, confusion and controversy surrounding mortality levels and trends have continued. For this project, results were reviewed from the highest quality field surveys on mortality in Darfur conducted between 2003 and 2008. Trend analysis demonstrated a dramatic decline in mortality over time in Darfur. By 2005, mortality levels had fallen below emergency levels and have continued to decline. Deaths directly due violence have declined as a proportion of all of the deaths in Darfur. Declining mortality in Darfur was not associated with other proximate improvements in well-being, such as improved nutrition. Without large-scale, humanitarian intervention, continuing high rates of mortality due to violence likely would have occurred. If mortality had continued at the high rate documented in 2004, by January 2009, there would have been 330,000 additional deaths. With the humanitarian assistance provided through the United Nations and non-governmental organizations, these people are alive today. A focus on excess deaths among noncombatants may draw attention away from other needs, such as establishing better security, improving service delivery to the displaced, and advocating for internally displaced persons to be reached today and to re-establish their lives and livelihoods tomorrow.

Research ethics in the context of humanitarian emergencies.

PubMed

O'Mathúna, Dónal

2015-02-01

Research is needed to make responses to disasters and humanitarian emergencies more evidence-based. Such research must also adhere to the generally accepted principles of research ethics. While research into health interventions used in disasters raises distinctive ethical concerns, seven ethical principles developed for clinical research are applied here to disaster research. Practical examples from disaster settings are used to demonstrate how these ethical principles can be applied. This reveals that research ethics needs to be seen as much more than a mechanism to obtain ethical approval for research. Research ethics involves ethical principles and governance frameworks, but must also consider the role of ethical virtues in research. Virtues are essential to ensure that researchers do what they believe is ethically right and resist what is unethical. Research ethics that truly protects participants and promotes respect needs to include training in ethical virtues to ensure disaster research is carried out to the highest ethical standards. This article is based on a presentation at the Evidence Aid Symposium on 20 September 2014, in Hyderabad, India. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Approaches to Vaccination Among Populations in Areas of Conflict

PubMed Central

Nnadi, Chimeremma; Etsano, Andrew; Uba, Belinda; Ohuabunwo, Chima; Melton, Musa; Nganda, Gatei wa; Esapa, Lisa; Bolu, Omotayo; Mahoney, Frank; Vertefeuille, John; Wiesen, Eric; Durry, Elias

2017-01-01

Vaccination is an important and cost-effective disease prevention and control strategy. Despite progress in vaccine development and immunization delivery systems worldwide, populations in areas of conflict (hereafter, “conflict settings”) often have limited or no access to lifesaving vaccines, leaving them at increased risk for morbidity and mortality related to vaccine-preventable disease. Without developing and refining approaches to reach and vaccinate children and other vulnerable populations in conflict settings, outbreaks of vaccine-preventable disease in these settings may persist and spread across subnational and international borders. Understanding and refining current approaches to vaccinating populations in conflict and humanitarian emergency settings may save lives. Despite major setbacks, the Global Polio Eradication Initiative has made substantial progress in vaccinating millions of children worldwide, including those living in communities affected by conflicts and other humanitarian emergencies. In this article, we examine key strategic and operational tactics that have led to increased polio vaccination coverage among populations living in diverse conflict settings, including Nigeria, Somalia, and Pakistan, and how these could be applied to reach and vaccinate populations in other settings across the world. PMID:28838202

A hybrid inventory management system respondingto regular demand and surge demand

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mohammad S. Roni; Mingzhou Jin; Sandra D. Eksioglu

2014-06-01

This paper proposes a hybrid policy for a stochastic inventory system facing regular demand and surge demand. The combination of two different demand patterns can be observed in many areas, such as healthcare inventory and humanitarian supply chain management. The surge demand has a lower arrival rate but higher demand volume per arrival. The solution approach proposed in this paper incorporates the level crossing method and mixed integer programming technique to optimize the hybrid inventory policy with both regular orders and emergency orders. The level crossing method is applied to obtain the equilibrium distributions of inventory levels under a givenmore » policy. The model is further transformed into a mixed integer program to identify an optimal hybrid policy. A sensitivity analysis is conducted to investigate the impact of parameters on the optimal inventory policy and minimum cost. Numerical results clearly show the benefit of using the proposed hybrid inventory model. The model and solution approach could help healthcare providers or humanitarian logistics providers in managing their emergency supplies in responding to surge demands.« less

Satellite-based emergency mapping using optical imagery: experience and reflections from the 2015 Nepal earthquakes

NASA Astrophysics Data System (ADS)

Williams, Jack G.; Rosser, Nick J.; Kincey, Mark E.; Benjamin, Jessica; Oven, Katie J.; Densmore, Alexander L.; Milledge, David G.; Robinson, Tom R.; Jordan, Colm A.; Dijkstra, Tom A.

2018-01-01

Landslides triggered by large earthquakes in mountainous regions contribute significantly to overall earthquake losses and pose a major secondary hazard that can persist for months or years. While scientific investigations of coseismic landsliding are increasingly common, there is no protocol for rapid (hours-to-days) humanitarian-facing landslide assessment and no published recognition of what is possible and what is useful to compile immediately after the event. Drawing on the 2015 Mw 7.8 Gorkha earthquake in Nepal, we consider how quickly a landslide assessment based upon manual satellite-based emergency mapping (SEM) can be realistically achieved and review the decisions taken by analysts to ascertain the timeliness and type of useful information that can be generated. We find that, at present, many forms of landslide assessment are too slow to generate relative to the speed of a humanitarian response, despite increasingly rapid access to high-quality imagery. Importantly, the value of information on landslides evolves rapidly as a disaster response develops, so identifying the purpose, timescales, and end users of a post-earthquake landslide assessment is essential to inform the approach taken. It is clear that discussions are needed on the form and timing of landslide assessments, and how best to present and share this information, before rather than after an earthquake strikes. In this paper, we share the lessons learned from the Gorkha earthquake, with the aim of informing the approach taken by scientists to understand the evolving landslide hazard in future events and the expectations of the humanitarian community involved in disaster response.

UAV Deployment Exercise for Mapping Purposes: Evaluation of Emergency Response Applications

PubMed Central

Boccardo, Piero; Chiabrando, Filiberto; Dutto, Furio; Giulio Tonolo, Fabio; Lingua, Andrea

2015-01-01

Exploiting the decrease of costs related to UAV technology, the humanitarian community started piloting the use of similar systems in humanitarian crises several years ago in different application fields, i.e., disaster mapping and information gathering, community capacity building, logistics and even transportation of goods. Part of the author’s group, composed of researchers in the field of applied geomatics, has been piloting the use of UAVs since 2006, with a specific focus on disaster management application. In the framework of such activities, a UAV deployment exercise was jointly organized with the Regional Civil Protection authority, mainly aimed at assessing the operational procedures to deploy UAVs for mapping purposes and the usability of the acquired data in an emergency response context. In the paper the technical features of the UAV platforms will be described, comparing the main advantages/disadvantages of fixed-wing versus rotor platforms. The main phases of the adopted operational procedure will be discussed and assessed especially in terms of time required to carry out each step, highlighting potential bottlenecks and in view of the national regulation framework, which is rapidly evolving. Different methodologies for the processing of the acquired data will be described and discussed, evaluating the fitness for emergency response applications. PMID:26147728

Novel methods for detecting buried explosive devices

NASA Astrophysics Data System (ADS)

Kercel, Stephen W.; Burlage, Robert S.; Patek, David R.; Smith, Cyrus M.; Hibbs, Andrew D.; Rayner, Timothy J.

1997-07-01

Oak Ridge National Laboratory and Quantum Magnetics, Inc. are exploring novel landmine detection technologies. Technologies considered here include bioreporter bacteria, swept acoustic resonance, nuclear quadrupole resonance (NQR), and semiotic data fusion. Bioreporter bacteria look promising for third-world humanitarian applications; they are inexpensive, and deployment does not require high-tech methods. Swept acoustic resonance may be a useful adjunct to magnetometers in humanitarian demining. For military demining, NQR is a promising method for detecting explosive substances; of 50,000 substances that have been tested, one has an NQR signature that can be mistaken for RDX or TNT. For both military and commercial demining, sensor fusion entails two daunting tasks, identifying fusible features in both present-day and emerging technologies, and devising a fusion algorithm that runs in real-time on cheap hardware. Preliminary research in these areas is encouraging. A bioreporter bacterium for TNT detection is under development. Investigation has just started in swept acoustic resonance as an approach to a cheap mine detector for humanitarian use. Real-time wavelet processing appears to be a key to extending NQR bomb detection into mine detection, including TNT-based mines. Recent discoveries in semiotics may be the breakthrough that will lead to a robust fused detection scheme.

Globalisation and climate change in Asia: the urban health impact.

PubMed

Munslow, Barry; O'Dempsey, Tim

2010-01-01

Asia's economic development successes will create new policy areas to address, as the advances made through globalisation create greater climate change challenges, particularly the impact on urban health. Poverty eradication and higher standards of living both increase demand on resources. Globalisation increases inequalities and those who are currently the losers will carry the greatest burden of the costs in the form of the negative effects of climate change and the humanitarian crises that will ensue. Of four major climate change challenges affecting the environment and health, two—urban air pollution and waste management—can be mitigated by policy change and technological innovation if sufficient resources are allocated. Because of the urban bias in the development process, these challenges will probably register on policy makers' agenda. The second two major challenges—floods and drought—are less amenable to policy and technological solutions: many humanitarian emergency challenges lie ahead. This article describes the widely varying impact of both globalisation and climate change across Asia. The greatest losers are those who flee one marginal location, the arid inland areas, only to settle in another marginal location in the flood prone coastal slums. Effective preparation is required, and an effective response when subsequent humanitarian crises occur.

Electronic medical records in humanitarian emergencies - the development of an Ebola clinical information and patient management system.

PubMed

Jobanputra, Kiran; Greig, Jane; Shankar, Ganesh; Perakslis, Eric; Kremer, Ronald; Achar, Jay; Gayton, Ivan

2016-01-01

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record "pairs" on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.

Yemen's Unprecedented Humanitarian Crisis: Implications for International Humanitarian Law, the Geneva Convention, and the Future of Global Health Security.

PubMed

Ripoll Gallardo, Alba; Burkle, Frederick M; Ragazzoni, Luca; Della Corte, Francesco

2016-10-01

The current humanitarian crisis in Yemen is unprecedented in many ways. The Yemeni War tragedy is symptomatic of gross failures to recognize, by combatants, existing humanitarian law and the Geneva Convention that have become the new norm in unconventional armed conflicts and are increasingly replicated in Africa, Afghanistan, and other areas of the Middle East with dire consequences on aid workers and the noncombatant population. The health and humanitarian professions must take collective responsibility in calling for all belligerent parties to cease the massacre and commit to guaranteed medical assistance, humanitarian aid, and the free flow of information and respect for the humanitarian principles that protect the neutrality and impartiality of the humanitarian workforce. (Disaster Med Public Health Preparedness. 2016;page 1 of 3).

Conflict Humanitarian and Natural Knowledge: The Way to Exit from It

ERIC Educational Resources Information Center

Masalimova, Alfiya R.; Benin, Vladislav L.

2016-01-01

The urgency of the problem, which is developed in the article enclosed in an emerged reducing tendency, and sometimes a complete rejection of importance of the humanities knowledge at the current stage of scientific development. The article shows that in the context of the overestimation the role of natural and technical education by modern…

Emerging Inclusive Education in the United Nations Relief and Works Agency for Palestine Refugees in the Near East: A Review of the Literature

ERIC Educational Resources Information Center

Rodriguez, Jacqueline A.; Dieker, Lisa A.

2018-01-01

For refugee children with disabilities, international agencies provide largely humanitarian assistance, including education. However, the obstacles associated with refugee existence can impede progress in the movement towards educating children with disabilities in inclusive settings. This literature review summarizes the historical progression…

Digital Humanitarians: How Big Data Is Changing the Face of Humanitarian Response : Patrick Meier, 2015, CRC Press (Boca Raton, FL, 978-1-4822-4839-5, 259 pp.).

PubMed

Dave, Anushree

2017-12-01

This is a review of Patrick Meier's 2015 book, Digital Humanitarians: How Big Data Is Changing the Face of Humanitarian Response. The book explores the role of technologies such as high-resolution satellite imagery, online social media, drones, and artificial intelligence in humanitarian responses during disasters such as the 2010 Haiti earthquake. In this analysis, the book is examined using a humanitarian health ethics perspective.

The practice of humanitarianism: a village birthing clinic in Palestine.

PubMed

Wick, Livia

2011-01-01

Discourses and practices surrounding humanitarian organisations have changed over time. This is certainly the case for Palestinian non-governmental organisations, which have followed the structural and ideological transformations observed in local, regional and international contexts. There have been three successive but interlocking generations of groups active in health in Palestine: charitable societies, popular committees, and donor-based entities. Against this background, a village clinic in the West Bank is seen to have gone through various incarnations in the context of an emerging neo-liberal economic, administrative and political environment. Despite the critiques justifiably addressed towards them, non-governmental organisations may in some cases be functionally fluid. Communities and people continue to use them strategically in their relations with states, political groups, individuals and receivers of aid, making them potential networking sites in the context of an ongoing occupation.

American physicians and dual loyalty obligations in the "war on terror"

PubMed Central

Singh, Jerome Amir

2003-01-01

Background Post-September 11, 2001, the U.S. government has labeled thousands of Afghan war detainees "unlawful combatants". This label effectively deprives these detainees of the protection they would receive as "prisoners of war" under international humanitarian law. Reports have emerged that indicate that thousands of detainees being held in secret military facilities outside the United States are being subjected to questionable "stress and duress" interrogation tactics by U.S. authorities. If true, American military physicians could be inadvertently becoming complicit in detainee abuse. Moreover, the American government's openly negative views towards such detainees could result in military physicians not wanting to provide reasonable care to detainees, despite it being their ethical duty to do so. Discussion This paper assesses the physician's obligations to treat war detainees in the light of relevant instruments of international humanitarian law and medical ethics. It briefly outlines how detainee abuse flourished in apartheid South Africa when state physicians became morally detached from the interests of their detainee patients. I caution U.S physicians not to let the same mindset befall them. I urge the U.S. medical community to advocate for detainee rights in the U.S, regardless of the political culture the detainee emerged from. I offer recommendations to U.S physicians facing dual loyalty conflicts of interest in the "war on terror". Summary If U.S. physicians are faced with a conflict of interest between following national policies or international principles of humanitarian law and medical ethics, they should opt to adhere to the latter when treating war detainees. It is important for the U.S. medical community to speak out against possible detainee abuse by the U.S. government. PMID:12892567

Corruption in emergency procurement.

PubMed

Schultz, Jessica; Søreide, Tina

2008-12-01

Corruption in emergency procurement reduces the resources available for life-saving operations, lowers the quality of products and services provided, and diverts aid from those who need it most.(1) It also negatively influences public support for humanitarian relief, both in the affected country and abroad. This paper aims to unpack and analyse the following question in order to mitigate risk: how and where does corruption typically occur, and what can be done? Suggested strategies reflect a multi-layered approach that stresses internal agency control mechanisms, conflict-sensitive management, and the need for common systems among operators.

Identification of current priorities for research in humanitarian action: proceedings of the First Annual UN OCHA Policy and Research Conference.

PubMed

Foran, Mark P; Greenough, Paul G; Thow, Andrew; Gilman, Daniel; Schütz, Andreas; Chandran, Rahul; Baiocchi, Allegra

2012-06-01

On December 12-13, 2011, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) hosted a humanitarian policy and research conference on the theme of "Risk, Adaptation and Innovation in Humanitarian Action." The four sessions of the conference covered humanitarian action in a changing world, adaptation and innovation in humanitarian action, humanitarian action in protracted and violent conflict, and effective humanitarian action. This special report contains summaries of presentations in each session and the conclusions resulting from the discussions throughout. Through a process of open discussion, debate, and a closing survey, the conference participants identified four top priorities in humanitarian research for the coming years: evidence-driven humanitarian decision-making; accountability and transparency; risk and agility; and partnership. In addition to plans for a 2nd Annual Research and Policy conference in December of 2012, specific outcomes of the conference include a series of regional workshops in 2012 and 2013, launching with Asia, Africa and the Middle East; creation of Policy Working Groups (PWG) for each research priority identified; and a new flagship OCHA publication, to be launched in late 2012 or early 2013, which will share the progress made on the research priorities identified.

Health diplomacy through collaboration and a story of hope in tsunami-ravaged Banda Aceh, Indonesia: A U.S. Public Health Service nurse officer perspective.

PubMed

Pryor, Thomas

2006-10-01

As a registered nurse, I have witnessed the powerful influence of bedside care for > 10 years. Yet my experience aboard the USNS Mercy--the first interagency deployment designed to provide humanitarian assistance to tsunami-stricken Indonesia--revealed a direct link between individual bedside care and health diplomacy. Despite desperate medical and humanitarian needs in the province of Banda Aceh, the Mercy was met with suspicion and resistance by the Indonesian government. In the first few days, it seemed uncertain that the Mercy would be asked to assist in any humanitarian capacity. The Mercy crew and staff agreed only to assist at the request of the Indonesian government. Ultimately it was the emergent medical needs of a 10-year-old survior, evacuated to the ship by Australian and German organizations, which established the seeds of health diplomacy between the United States and Indonesia. This article explores the ways in which health diplomacy can be fostered by individual medical and nursing care, through the story of one young survivor of the East Asian tsunami. My experience of compassionate and culturally centered care aboard the USNS Mercy touched the hearts and minds of care providers and, ultimately, won the trust of local government officials and the people of Banda Aceh.

Humanitarian Consequences of Land Mines.

ERIC Educational Resources Information Center

Rutherford, Ken

1997-01-01

Investigates the human and economic consequences of the continuing use and abandonment of land mines. Discusses the reasons for the worldwide proliferation (over 85 million uncleared mines in at least 62 countries) and the legal complexities in curtailing their use. Includes a brief account by a land-mine victim. (MJP)

Use of Oral Cholera Vaccine in Complex Emergencies: What Next? Summary Report of an Expert Meeting and Recommendations of WHO

PubMed Central

Chaignat, Claire-Lise; Monti, Victoria

2007-01-01

Two meetings of the World Health Organization (WHO)—in 1999 and 2002—had examined the potential use of oral cholera vaccines (OCVs) as an additional public-health tool for the control of cholera. In the light of the work accomplished since 2002, WHO convened a third meeting to reexamine with a group of experts the role that OCVs might play in preventing potential outbreaks of cholera in crisis situations and to discuss the use of OCVs in endemic settings. The aim of the meeting was to agree a framework for the recommendations of WHO on these subjects and to consider the pertinence of further demonstration projects in endemic settings. The meeting addressed key issues, including currently-available vaccines, surveillance, and cholera-control measures in complex emergencies, and past experiences of using OCVs. More than 40 participants took part in the discussions, representing cholera-prone countries, humanitarian organizations, scientific institutions, United Nations agencies, and WHO. The experts agreed that when considering the use of OCVs in emergencies, a multidisciplinary approach is essential and that the prevention and control of cholera should be envisaged within the larger context of public-health priorities in times of crisis. As for the use of OCVs in endemic settings, all participants acknowledged that further data need to be collected before a clear definition of endemicity and potential vaccination strategies can be established. Results of further studies on the vaccines per se are also awaited. Recommendations relating to the use of OCVs (a) in complex emergencies and (b) in endemic settings were elaborated, and a decision-making tool for assessing the pertinence of use of OCVs in emergency settings was drafted. The document was finalized by an ad-hoc working group convened in Geneva on 1 March 2006 and is now available for field-testing. After testing, that should be carried out with the involvement of WHO and feedback from field partners, the decision-making tool will be adapted and disseminated. PMID:17985828

Use of oral cholera vaccine in complex emergencies: what next? Summary report of an expert meeting and recommendations of WHO.

PubMed

Chaignat, Claire-Lise; Monti, Victoria

2007-06-01

Two meetings of the World Health Organization (WHO)-in 1999 and 2002-had examined the potential use of oral cholera vaccines (OCVs) as an additional public-health tool for the control of cholera. In the light of the work accomplished since 2002, WHO convened a third meeting to reexamine with a group of experts the role that OCVs might play in preventing potential outbreaks of cholera in crisis situations and to discuss the use of OCVs in endemic settings. The aim of the meeting was to agree a framework for the recommendations of WHO on these subjects and to consider the pertinence of further demonstration projects in endemic settings. The meeting addressed key issues, including currently-available vaccines, surveillance, and cholera-control measures in complex emergencies, and past experiences of using OCVs. More than 40 participants took part in the discussions, representing cholera-prone countries, humanitarian organizations, scientific institutions, United Nations agencies, and WHO. The experts agreed that when considering the use of OCVs in emergencies, a multidisciplinary approach is essential and that the prevention and control of cholera should be envisaged within the larger context of public-health priorities in times of crisis. As for the use of OCVs in endemic settings, all participants acknowledged that further data need to be collected before a clear definition of endemicity and potential vaccination strategies can be established. Results of further studies on the vaccines per se are also awaited. Recommendations relating to the use of OCVs (a) in complex emergencies and (b) in endemic settings were elaborated, and a decision-making tool for assessing the pertinence of use of OCVs in emergency settings was drafted. The document was finalized by an ad-hoc working group convened in Geneva on 1 March 2006 and is now available for field-testing. After testing, that should be carried out with the involvement of WHO and feedback from field partners, the decision-making tool will be adapted and disseminated.

A multivariate method for estimating mortality rates among children under 5 years from health and social indicators in Iraq.

PubMed

Garfield, R; Leu, C S

2000-06-01

Many reports on Iraq suggest that a rise in rates of death and disease have occurred since the Gulf War of January/February 1991 and the economic sanctions that followed it. Four preliminary models, based on unadjusted projections, were developed. A logistic regression model was then developed on the basis of six social variables in Iraq and comparable information from countries in the State of the World's Children report. Missing data were estimated for this model by a multiple imputation procedure. The final model depends on three socio-medical indicators: adult literacy, nutritional stunting of children under 5 years, and access to piped water. The model successfully predicted both the mortality rate in 1990, under stable conditions, and in 1991, following the Gulf War. For 1996, after 5 years of sanctions and prior to receipt of humanitarian food via the oil for food programme, this model shows mortality among children under 5 to have reached an estimated 87 per 1000, a rate last experienced more than 30 years ago. Accurate and timely estimates of mortality levels in developing countries are costly and require considerable methodological expertise. A rapid estimation technique like the one developed here may be a useful tool for quick and efficient estimation of mortality rates among under 5 year olds in countries where good mortality data are not routinely available. This is especially true for countries with complex humanitarian emergencies where information on mortality changes can guide interventions and the social stability to use standard demographic methods does not exist.

The moral sense of humanitarian actors: an empirical exploration.

PubMed

Rességuier, Anaïs

2018-01-01

This paper examines humanitarianism's moral positioning above private and political interests to save lives and alleviate suffering. It does not aim to assess the legitimacy of this stance, but rather to probe the way in which humanitarian actors relate to this moral dimension in their everyday work. It investigates empirically humanitarian ethics from the perspective of humanitarian actors, drawing on interviews conducted in Beirut, Lebanon, in 2014. As it is exploratory, three key conceptual innovations were required. The first of these is the introduction of the tools developed to consider a neglected reality: humanitarian actors' 'moral sense' vis-à-vis the humanitarian sector's 'moral culture'. Second, the study shows how the sector's moral culture is structured around the notion of 'concern for persons in need'. Third, it analyses the way in which the sector and its actors handle the asymmetrical relationships encountered daily. Ultimately this paper seeks to valorise humanitarian actors' creativity in their common practices and explore potential challenges to it. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Global emergency medicine: a review of the literature from 2014.

PubMed

Becker, Torben K; Bartels, Susan; Hansoti, Bhakti; Jacquet, Gabrielle A; Lunney, Kevin; Marsh, Regan; Osei-Ampofo, Maxwell; Lam, Christopher; Levine, Adam C

2015-08-01

The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners. This year 6,376 articles written in six languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. A total of 477 articles were deemed appropriate by at least one reviewer and approved by the editor for formal scoring of overall quality and importance. Of the 477 articles that met our predetermined inclusion criteria, 63% were categorized as emergency care in resource-limited settings, 13% as EM development, and 23% as disaster and humanitarian response. Twenty-five articles received scores of 17.5 or higher and were selected for formal summary and critique. Inter-rater reliability for two reviewers using our scoring system was good, with an intraclass correlation coefficient of 0.657 (95% confidence interval = 0.589 to 0.713). Studies and reviews focusing on infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource-limited settings represented the majority of articles selected for final review. In 2014, there were fewer total articles, but a slightly higher absolute number of articles screening in for formal scoring, when compared to the 2013 review. The number of EM development articles decreased, while the number of disaster and humanitarian response articles increased. As in prior years, the majority of articles focused on infectious diseases and trauma. © 2015 by the Society for Academic Emergency Medicine.

The Development of a Humanitarian Health Ethics Analysis Tool.

PubMed

Fraser, Veronique; Hunt, Matthew R; de Laat, Sonya; Schwartz, Lisa

2015-08-01

Introduction Health care workers (HCWs) who participate in humanitarian aid work experience a range of ethical challenges in providing care and assistance to communities affected by war, disaster, or extreme poverty. Although there is increasing discussion of ethics in humanitarian health care practice and policy, there are very few resources available for humanitarian workers seeking ethical guidance in the field. To address this knowledge gap, a Humanitarian Health Ethics Analysis Tool (HHEAT) was developed and tested as an action-oriented resource to support humanitarian workers in ethical decision making. While ethical analysis tools increasingly have become prevalent in a variety of practice contexts over the past two decades, very few of these tools have undergone a process of empirical validation to assess their usefulness for practitioners. A qualitative study consisting of a series of six case-analysis sessions with 16 humanitarian HCWs was conducted to evaluate and refine the HHEAT. Participant feedback inspired the creation of a simplified and shortened version of the tool and prompted the development of an accompanying handbook. The study generated preliminary insight into the ethical deliberation processes of humanitarian health workers and highlighted different types of ethics support that humanitarian workers might find helpful in supporting the decision-making process.

Prevention of common healthcare-associated infections in humanitarian hospitals.

PubMed

Murphy, Richard A; Chua, Arlene C

2016-08-01

Humanitarian medical organizations focus on vulnerable patients with increased risk for healthcare-associated infections (HAIs) and are obligated to minimize them in inpatient departments (IPDs). However, in doing so humanitarian groups face considerable obstacles. This report will focus on approaches to reducing common HAIs that the authors have found to be helpful in humanitarian settings. HAIs are common in humanitarian contexts but there are few interventions or guidelines adapted for use in poor and conflict-affected settings to improve prevention and guide surveillance. Based on existing recommendations and studies, it appears prudent that all humanitarian IPDs introduce a basic infection prevention infrastructure, assure high adherence to hand hygiene with wide accessibility to alcohol-based hand rub, and develop pragmatic surveillance based on clinically evident nosocomial infection. Although microbiology remains out of reach for most humanitarian hospitals, rapid tests offer the possibility of improving the diagnosis of HAIs in humanitarian hospitals in the decade ahead. There is a dearth of new studies that can direct efforts to prevent HAIs in IPDs in poor and conflict-affected areas and there is a need for practical, field-adapted guidelines from professional societies, and international bodies to guide infection prevention efforts in humanitarian environments.

31 CFR 515.575 - Humanitarian projects.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Humanitarian projects. 515.575 Section..., Authorizations, and Statements of Licensing Policy § 515.575 Humanitarian projects. Specific licenses may be... such additional transactions as are directly incident to certain humanitarian projects in or related to...

Emergency response in a global health crisis: epidemiology, ethics, and Ebola application.

PubMed

Salerno, Jennifer; Hlaing, WayWay M; Weiser, Thomas; Striley, Catherine; Schwartz, Lisa; Angulo, Frederick J; Neslund, Verla S

2016-04-01

The link between ethics and epidemiology can go unnoticed in contemporary gatherings of professional epidemiologists or trainees at conferences and workshops, as well as in teaching. Our goal is to provide readers with information about the activities of the College and to provide a broad perspective on a recent major issue in epidemiology. The Ethics Committee of the American College of Epidemiology (ACE) presented a plenary session at the 2015 Annual Meeting in Atlanta, GA, on the complexities of ethics and epidemiology in the context of the 2014-2015 Ebola virus disease outbreak and response in West Africa. This article presents a summary and further discussion of that plenary session. Three main topic areas were presented: clinical trials and ethics in public health emergencies, public health practice, and collaborative work. A number of key ethical concepts were highlighted and discussed in relation to Ebola and the ACE Ethics Guidelines. The Ebola virus disease outbreak is an example of a public health humanitarian crisis from which we hope to better understand the role of professional epidemiologists in public health practice and research and recognize ethical challenges epidemiologists faced. Copyright © 2016 Elsevier Inc. All rights reserved.

Evidence Aid approach to gap analysis and priority setting of questions for systematic reviews in disasters.

PubMed

Kayabu, Bonnix

2015-02-01

This article is based on a presentation at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. Ten years after the Indian Ocean Tsunami, Evidence Aid and it parters and other humanitarian stakeholders met to update about Evidence Aid work and discussed it future. The Evidence Aid approach to fill in the gap on the production and use of evidence in disater sector and other humanitarian health emergencies was widely discussed. Iterative approach to prioritise evidence reinforced Evidence Aid principle of independacy and a coordinated international orgasisation. The generation of 30 research questions during the prioritisation process contitute the first big step for Evidence Aid to become a one stop shop for the seach evidence on the effectiveness of interventions in disasters. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Mental health and psychosocial support in humanitarian emergencies.

PubMed

van Ommeren, M; Hanna, F; Weissbecker, I; Ventevogel, P

2015-09-28

Armed conflicts and natural disasters impact negatively on the mental health and well-being of affected populations in the short- and long-term and affect the care of people with pre-existing mental health conditions. This paper outlines specific actions for mental health and psychosocial support by the health sector in the preparedness, response and recovery phases of emergencies. Broad recommendations for ministries of health are to: (1) embed mental health and psychosocial support in national health and emergency preparedness plans; (2) put in place national guidelines, standards and supporting tools for the provision of mental health and psychosocial support during emergencies; (3) strengthen the capacity of health professionals to identify and manage priority mental disorders during emergencies; and (4) utilize opportunities generated by the emergency response to contribute to development of sustainable mental health-care services.

The 2016 World Humanitarian Summit Report Card: Both Failing Marks and Substantive Gains for an Increasingly Globalized Humanitarian Landscape

PubMed Central

V. Canyon, Deon; Burkle, Frederick M.

2016-01-01

Outcomes of the World Humanitarian Summit were mixed with some refreshing new directions being endorsed and a lack of systemic reform. The selective agenda and OCHAs lack of success in engaging pre-meeting political participation not only hampered the Summit’s ability to deal with global issues and institutional reform, but also alienated it from leading aid agencies and governments. The UN’s failure to commit to humanitarian principles and global disarray of the humanitarian system indicates the need for extensive reform or a new global humanitarian body. This agency needs to employ a decentralized model to manage aid funds, assume coordination of international responses, resolve civil-military coordination, cater for people affected by both conflict and disasters, and professionalize the humanitarian career.  PMID:27679738

[The Referral Field Hospital of the Emergency Response Unit (ERU) of the German Red Cross].

PubMed

Schnabel, M; Munz, R; Bohe, M

2000-07-14

Emergency Response units (ERUs) have been developed as a part of the International Federation of Red Cross and Red Crescent Societies strategy to provide fast and effective medical and technical help to victims of disasters of any kind. ERUs provide timely, professional and organised response in a standardised and streamlined way by a balanced composition of professional staff and predesigned equipment. The German Red Cross ERUs "Referral Hospital" and "Specialised Water" took part in the world wide humanitarian help for refugees during the Kosovo war and actually for earthquake victims in Turkey. During the Kosovo-operation the ERU "Referral Hospital" and "Specialised Water" were situated in Macedonia close to the kosovarian boarder at refugee camp Stenkovec I. The Field-Hospital was responsible for all kind of medical emergencies, for a total number of more than 50,000 refugees. During the mission 6225 patients were treated in our Out Patient Department; 541 were hospitalised. Among those 102 medium and major surgical procedures and 105 deliveries were performed. Surprisingly there was no increased rate of infections or perinatal deaths. During the Kosovo war and actually in Turkey the ERU concept prove itself to be a powerful strategy to provide fast needed medical help to victims of different kind of disasters. Humanitarian work in situations of war, internal disorder and various states of emergency in foreign countries and cultures demand flexibility and the ability to improvise while working under such conditions. The confrontation with non-combatants injured by buried landmines is underlining the growing world-wide demand for a total ban on these vile weapons.

Fellowships in international emergency medicine in the USA: a comparative survey of program directors' and fellows' perspectives on the curriculum.

PubMed

Jacquet, Gabrielle A; Vu, Alexander; Ewen, William B; Hansoti, Bhakti; Andescavage, Steven; Price, David; Suter, Robert E; Bayram, Jamil D

2014-01-01

Experts have proposed core curriculum components for international emergency medicine (IEM) fellowships. This study examined perceptions of program directors (PDs) and fellows on whether IEM fellowships cover these components, whether their perspectives differ and the barriers preventing fellowships from covering them. From 1 November 2011 to 30 November 2011, a survey was administered to PDs, current fellows and recent graduates of the 34 US IEM fellowships. Respondents quantified their fellowship experience in six proposed core curriculum areas: emergency medicine (EM) systems development, EM education, humanitarian assistance, public health, emergency medical services and disaster medicine. Analysis was performed regarding what per cent of programmes fulfil the six curriculum areas. A paired t test determined the difference between PDs' and fellows' responses. Agreement between PDs and fellows within the same programme was determined using a κ statistic. Only 1/18 (6%) (according to fellows) to 2/24 (8%) (according to PDs) of programmes expose fellows to all six components. PDs consistently reported higher exposure than fellows. The difference in mean score between PDs and fellows was statistically significant (p<0.05) in three of the 6 (50%) core curriculum elements: humanitarian aid, public health and disaster medicine. Per cent agreement between PDs and fellows within each programmes ranged from poor to fair. While IEM fellowships have varying structure, this study highlights the importance of further discussion between PDs and fellows regarding delineation and objectives of core curriculum components. Transparent curricula and open communication between PDs and fellows may reduce differences in reported experiences.

77 FR 49782 - Extension of the Application Deadline for Humanitarian Awards Pilot Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

...] Extension of the Application Deadline for Humanitarian Awards Pilot Program AGENCY: United States Patent and... Trademark Office (USPTO) announced the Humanitarian Awards Pilot Program, which recognizes patent holders... extending the deadline for applications to the Humanitarian Awards Pilot Program by two months until October...

Pneumonia Prevention during a Humanitarian Emergency: Cost-effectiveness of Haemophilus Influenzae Type B Conjugate Vaccine and Pneumococcal Conjugate Vaccine in Somalia.

PubMed

Gargano, Lisa M; Hajjeh, Rana; Cookson, Susan T

2015-08-01

Pneumonia is a leading cause of death among children less than five years old during humanitarian emergencies. Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae are the leading causes of bacterial pneumonia. Vaccines for both of these pathogens are available to prevent pneumonia. Problem This study describes an economic analysis from a publicly funded health care system perspective performed on a birth cohort in Somalia, a country that has experienced a protracted humanitarian emergency. An impact and cost-effectiveness analysis was performed comparing: no vaccine, Hib vaccine only, pneumococcal conjugate vaccine 10 (PCV10) only, and both together administered through supplemental immunization activities (SIAs). The main summary measure was the incremental cost per disability-adjusted life-years (DALYs) averted. One-way sensitivity analysis was conducted for uncertainty in parameter values. Each SIA would avert a substantial number of cases and deaths. Compared with no vaccine, the DALYs averted by two SIAs for two doses of Hib vaccine was US $202.93 (lower and upper limits: $121.80-$623.52), two doses of PCV10 was US $161.51 ($107.24-$227.21), and two doses of both vaccines was US $152.42 ($101.20-$214.42). Variables that influenced the cost-effectiveness for each strategy most substantially were vaccine effectiveness, case fatality rates (CFRs), and disease burden. The World Health Organization (WHO) defines a cost-effective intervention as costing one to three times the per capita gross domestic product (GDP; in 2011, for Somalia=US $112). Based on the presented model, Hib vaccine alone, PCV10 alone, or Hib vaccine and PCV10 given together in SIAs are cost-effective interventions in Somalia. The WHO/Strategic Advisory Group of Experts decision-making factors for vaccine deployment appear to have all been met: the disease burden is large, the vaccine-related risk is low, prevention in this setting is more feasible than treatment, the vaccine duration probably is sufficient for the vulnerable period of the child's life, cost is reasonable, and herd immunity is possible.

Stabilisation and humanitarian access in a collapsed state: the Somali case.

PubMed

Menkhaus, Ken

2010-10-01

Somalia today is the site of three major threats: the world's worst humanitarian crisis; the longest-running instance of complete state collapse; and a robust jihadist movement with links to Al-Qa'ida. External state-building, counter-terrorism and humanitarian policies responding to these threats have worked at cross-purposes. State-building efforts that insist humanitarian relief be channelled through the nascent state in order to build its legitimacy and capacity undermine humanitarian neutrality when the state is a party to a civil war. Counter-terrorism policies that seek to ensure that no aid benefits terrorist groups have the net effect of criminalising relief operations in countries where poor security precludes effective accountability. This paper argues that tensions between stabilisation and humanitarian goals in contemporary Somalia reflect a long history of politicisation of humanitarian operations in the country. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

In Search of the ‘New Informal Legitimacy’ of Médecins Sans Frontières

PubMed Central

Calain, Philippe

2012-01-01

For medical humanitarian organizations, making their sources of legitimacy explicit is a useful exercise, in response to: misperceptions, concerns over the ‘humanitarian space’, controversies about specific humanitarian actions, challenges about resources allocation and moral suffering among humanitarian workers. This is also a difficult exercise, where normative criteria such as international law or humanitarian principles are often misrepresented as primary sources of legitimacy. This essay first argues for a morally principled definition of humanitarian medicine, based on the selfless intention of individual humanitarian actors. Taking Médecins Sans Frontières (MSF) as a case in point, a common source of moral legitimacy for medical humanitarian organizations is their cosmopolitan appeal to distributive justice and collective responsibility. More informally, their legitimacy is grounded in the rightfulness of specific actions and choices. This implies a constant commitment to publicity and accountability. Legitimacy is also generated by tangible support from the public to individual organizations, by commitments to professional integrity, and by academic alliances to support evidence-based practice and operational research. PMID:22442647

"Nationals" and "expatriates": challenges of fulfilling "sans frontières" ("without borders") ideals in international humanitarian action.

PubMed

Shevchenko, Olga; Fox, Renée C

2008-01-01

The international humanitarian organization, Médecins Sans Frontières (MSF), is strongly committed to principles of universalism, egalitarianism, and equity, in both its internal and external relations. Nevertheless, the organization distinguishes between so-called "national" staff members (those who are indigenous to the countries where MSF projects are located), and "expatriate" staff (those who are involved in projects outside their countries of residence), in certain ways that it has self-critically termed "discriminatory", "colonialist", and even "racist". It has resolved to remedy such practices. Through a first-hand case study of MSF activities in Russia, this article demonstrates that the dynamics of the "nationals"/ "expatriates" divide is a more complex phenomenon than MSF's self-accusatory diagnosis implies; that a fuller recognition and utilization of nationals' local knowledge would mitigate some of the conditions of inequality and inequity that they experience; but that it would not necessarily be desirable to expunge all differences between the two groups of staff Furthermore, because they are intrinsic to the structure and conditions of international humanitarian action, some of these differences could not easily be elminated by MSF, or by any other organization engaged in this kind of action.

International Emergency Psychiatry Challenges: Disaster Medicine, War, Human Trafficking, Displaced Persons.

PubMed

Jaung, Michael; Jani, Suni; Banu, Sophia; Mackey, Joy M

2017-09-01

Mental health disorders are a major cause of morbidity and a growing burden in low-income and middle-income countries; but there is little existing literature on the detailed epidemiology, diagnosis, and treatment in low-resource settings. Special situations with vulnerable populations, such as those created by international humanitarian emergencies, refugees or internally displaced people, and victims of human trafficking, are increasing in prevalence. These victims are often resettled in developed countries and come to the emergency department seeking care. To better care for these populations, knowledge of specialized psychosocial and cultural considerations should inform the comprehensive psychiatric assessment and treatment plan. Copyright © 2017 Elsevier Inc. All rights reserved.

Alternative approaches for studying humanitarian interventions: propensity score methods to evaluate reintegration packages impact on depression, PTSD, and function impairment among child soldiers in Nepal.

PubMed

Kohrt, B A; Burkey, M; Stuart, E A; Koirala, S

2015-01-01

Ethical, logistical, and funding approaches preclude conducting randomized control trials (RCTs) in some humanitarian crises. A lack of RCTs and other intervention research has contributed to a limited evidence-base for mental health and psychosocial support (MHPS) programs after disasters, war, and disease outbreaks. Propensity score methods (PSMs) are an alternative analysis technique with potential application for evaluating MHPS programs in humanitarian emergencies. PSMs were used to evaluate impacts of education reintegration packages (ERPs) and other (vocational or economic) reintegration packages (ORPs) v. no reintegration programs on mental health of child soldiers. Propensity scores were used to determine weighting of child soldiers in each of the three treatment arms. Multiple linear regression was used to estimate adjusted changes in symptom score severity on culturally validated measures of depression, post-traumatic stress disorder (PTSD), and functional impairment from baseline to 1-year follow-up. Among 258 Nepali child soldiers participating in reintegration programs, 54.7% completed ERP and 22.9% completed ORP. There was a non-significant reduction in depression by 0.59 (95% CI -1.97 to 0.70) for ERP and by 0.60 (95% CI -2.16 to 0.96) for ORP compared with no treatment. There were non-significant increases in PTSD (1.15, 95% CI -1.55 to 3.86) and functional impairment (0.91, 95% CI -0.31 to 2.14) associated with ERP and similar findings for ORP (PTSD: 0.66, 95% CI -2.24 to 3.57; functional impairment (1.05, 95% CI -0.71 to 2.80). In a humanitarian crisis in which a non-randomized intervention assignment protocol was employed, the statistical technique of PSMs addressed differences in covariate distribution between child soldiers who received different integration packages. Our analysis did not demonstrate significant changes in psychosocial outcomes for ERPs and ORPs. We suggest the use of PSMs in evaluating non-randomized interventions in humanitarian crises when non-randomized conditions are not utilized.

Weather patterns, food security and humanitarian response in sub-Saharan Africa.

PubMed

Haile, Menghestab

2005-11-29

Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hence the economic and social well being of rural communities. The rainfall pattern in sub-Saharan Africa is influenced by large-scale intra-seasonal and inter-annual climate variability including occasional El Niño events in the tropical Pacific resulting in frequent extreme weather event such as droughts and floods that reduce agricultural outputs resulting in severe food shortages. Households and communities facing acute food shortages are forced to adopt coping strategies to meet the immediate food requirements of their families. These extreme responses may have adverse long-term, impacts on households' ability to have sustainable access to food as well as the environment. The HIV/AIDS crisis has also had adverse impacts on food production activities on the continent. In the absence of safety nets and appropriate financial support mechanisms, humanitarian aid is required to enable households effectively cope with emergencies and manage their limited resources more efficiently. Timely and appropriate humanitarian aid will provide households with opportunities to engage in productive and sustainable livelihood strategies. Investments in poverty reduction efforts would have better impact if complemented with timely and predictable response mechanisms that would ensure the protection of livelihoods during crisis periods whether weather or conflict-related. With an improved understanding of climate variability including El Niño, the implications of weather patterns for the food security and vulnerability of rural communities have become more predictable and can be monitored effectively. The purpose of this paper is to investigate how current advances in the understanding of climate variability, weather patterns and food security could contribute to improved humanitarian decision-making. The paper will propose new approaches for triggering humanitarian responses to weather-induced food crises.

Progress and gaps in reproductive health services in three humanitarian settings: mixed-methods case studies

PubMed Central

2015-01-01

Background Reproductive health (RH) care is an essential component of humanitarian response. Women and girls living in humanitarian settings often face high maternal mortality and are vulnerable to unwanted pregnancy, unsafe abortion, and sexual violence. This study explored the availability and quality of, and access barriers to RH services in three humanitarian settings in Burkina Faso, Democratic Republic of the Congo (DRC), and South Sudan. Methods Data collection was conducted between July and October 2013. In total, 63 purposively selected health facilities were assessed: 28 in Burkina Faso, 25 in DRC, and nine in South Sudan, and 42 providers completed a questionnaire to assess RH knowledge and attitudes. Thirty-four focus group discussions were conducted with 29 members of the host communities and 273 displaced married and unmarried women and men to understand access barriers. Results All facilities reported providing some RH services in the prior three months. Five health facilities in Burkina Faso, six in DRC, and none in South Sudan met the criteria as a family planning service delivery point. Two health facilities in Burkina Faso, one in DRC, and two in South Sudan met the criteria as an emergency obstetric and newborn care service delivery point. Across settings, three facilities in DRC adequately provided selected elements of clinical management of rape. Safe abortion was unavailable. Many providers lacked essential knowledge and skills. Focus groups revealed limited knowledge of available RH services and socio-cultural barriers to accessing them, although participants reported a remarkable increase in use of facility-based delivery services. Conclusion Although RH services are being provided, the availability of good quality RH services was inconsistent across settings. Commodity management and security must be prioritized to ensure consistent availability of essential supplies. It is critical to improve the attitudes, managerial and technical capacity of providers to ensure that RH services are delivered respectfully and efficiently. In addition to ensuring systematic implementation of good quality RH services, humanitarian health actors should meaningfully engage crisis-affected communities in RH programming to increase understanding and use of this life-saving care. PMID:25798189

Weather patterns, food security and humanitarian response in sub-Saharan Africa

PubMed Central

Haile, Menghestab

2005-01-01

Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hence the economic and social well being of rural communities. The rainfall pattern in sub-Saharan Africa is influenced by large-scale intra-seasonal and inter-annual climate variability including occasional El Niño events in the tropical Pacific resulting in frequent extreme weather event such as droughts and floods that reduce agricultural outputs resulting in severe food shortages. Households and communities facing acute food shortages are forced to adopt coping strategies to meet the immediate food requirements of their families. These extreme responses may have adverse long-term impacts on households' ability to have sustainable access to food as well as the environment. The HIV/AIDS crisis has also had adverse impacts on food production activities on the continent. In the absence of safety nets and appropriate financial support mechanisms, humanitarian aid is required to enable households effectively cope with emergencies and manage their limited resources more efficiently. Timely and appropriate humanitarian aid will provide households with opportunities to engage in productive and sustainable livelihood strategies. Investments in poverty reduction efforts would have better impact if complemented with timely and predictable response mechanisms that would ensure the protection of livelihoods during crisis periods whether weather or conflict-related. With an improved understanding of climate variability including El Niño, the implications of weather patterns for the food security and vulnerability of rural communities have become more predictable and can be monitored effectively. The purpose of this paper is to investigate how current advances in the understanding of climate variability, weather patterns and food security could contribute to improved humanitarian decision-making. The paper will propose new approaches for triggering humanitarian responses to weather-induced food crises. PMID:16433102

Training Humanitarian Professionals at a Distance: Testing the Feasibility of Distance Learning with Humanitarian Professionals

ERIC Educational Resources Information Center

Bollettino, Vincenzo; Bruderlein, Claude

2008-01-01

Training is an essential part of the professional development of staff working for international humanitarian organizations. While humanitarian workers are being deployed around the world to provide life-saving relief assistance in often-hazardous missions, it is imperative for organizations to ensure that staff members understand the mission and…

Public health equity in refugee situations

PubMed Central

2011-01-01

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction. Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions. PMID:21575218

Public health equity in refugee situations.

PubMed

Leaning, Jennifer; Spiegel, Paul; Crisp, Jeff

2011-05-16

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

Guide to Nongovernmental Organizations for the Military. A primer for the military about private, voluntary, and nongovernmental organizations operating in humanitarian emergencies globally

DTIC Science & Technology

2009-01-01

mission or charter; can o en become too removed and lose in uence over NGO o cers and sta . Problema c if poor decision- making becomes common...4,604.87 $11,565.24 40 Social infrastructure and services $ 1,216.31 $3,252.96 37 Economic infrastructure $3,121.84 $11,793.81 26 Agriculture, forestry...bibliography/en. �“Public health leaders using social media to convey emergencies: New tools a boon.�” Social media tools such as Twi er and

Negotiating health and life: Syrian refugees and the politics of access in Lebanon.

PubMed

Parkinson, Sarah E; Behrouzan, Orkideh

2015-12-01

In the context of ongoing armed conflicts in Libya, Syria, Yemen, and Iraq, it is vital to foster nuanced understandings of the relationship between health, violence, and everyday life in the Middle East and North Africa. In this article, we explore how healthcare access interacts with humanitarian bureaucracy and refugees' daily experiences of exile. What are the stakes involved with accessing clinical services in humanitarian situations? How do local conditions structure access to healthcare? Building on the concept of "therapeutic geographies," we argue for the integration of local socio-political context and situated knowledge into understandings of humanitarian healthcare systems. Using evidence gathered from participant observation among Syrian and Palestinian refugees in Lebanon, we demonstrate how procedures developed to facilitate care-such as refugee registration and insurance contracting-can interact with other factors to simultaneously prevent and/or disincentivize refugees' accessing healthcare services and expose them to structural violence. Drawing on two interconnected ethnographic encounters in a Palestinian refugee camp and in a Lebanese public hospital, we demonstrate how interactions surrounding the clinical encounter reveal the social, political, and logistical complexities of healthcare access. Moreover, rather than hospital visits representing discrete encounters with the Lebanese state, we contend that they reveal important moments in an ongoing process of negotiation and navigation within and through the constraints and uncertainties that shape refugee life. As a result, we advocate for the incorporation of situated forms of knowledge into humanitarian healthcare practices and the development of an understanding of healthcare access as nested in the larger experience of everyday refugee life. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dilemmas and controversies within civilian and military organizations in the execution of humanitarian aid in Iraq: a review.

PubMed

Morton, Melinda J; Burnham, Gilbert M

2010-01-01

Civilian humanitarian assistance organizations and military forces are working in a similar direction in many humanitarian operations around the world. However, tensions exist over the role of the military in such operations. The purpose of this article is to review cultural perspectives of civilian and military actors and to discuss recent developments in civil-military humanitarian collaboration in the provision of health services in Iraq for guiding such collaborative efforts in postconflict and other settings in future. Optimal collaborative efforts are most likely to be achieved through the following tenets: defining appropriate roles for military forces at the beginning of humanitarian operations (optimally the provision of transportation, logistical coordination, and security), promoting development of ongoing relationships between civilian and military agencies, establishment of humanitarian aid training programs for Department of Defense personnel, and the need for the military to develop and use quantitative aid impact indicators for assuring quality and effectiveness of humanitarian aid.

Failing to protect humanitarian workers: lessons from Britain and Voluntary Aid Detachments in the Second World War.

PubMed

Verma, Amol A

2017-09-01

This paper draws on official records of international and British organizations, newspaper reports, and volunteer memoirs to study the failure to protect humanitarian workers in the Second World War. The Second World War saw a significant expansion in the use of air warfare and flying missiles and these technological advances posed a grave threat to civilians and humanitarian workers. In this context, the International Committee of the Red Cross advocated unsuccessfully to restrict air warfare and create safe hospital zones. The British Government grappled with the tension between military and humanitarian objectives in setting its bombardment policy. Ultimately, humanitarian principles were neglected in pursuit of strategic aims, which endangered civilians and left humanitarian workers particularly vulnerable. British Voluntary Aid Detachment nurses experienced more than six-fold greater fatality rates than civil defence workers and the general population. The lessons from failures to protect humanitarian workers in the face of evolutions in warfare remain profoundly relevant.

Shelter strategies, humanitarian praxis and critical urban theory in post-crisis reconstruction.

PubMed

Fan, Lilianne

2012-07-01

The paper seeks to link contemporary thinking on urban shelter in the humanitarian sector to debates in the field of 'critical urban theory'. It argues that current humanitarian thinking on urban shelter shares many common concerns with critical urban theory, but that these concerns are rarely translated effectively into humanitarian practice. It attributes this disconnect not only to weaknesses in implementation capacity, but also to the need to reorient humanitarian action to address more definitively questions of power and justice. Humanitarian actors need to step back from product-delivery approaches and find ways of integrating into their analytical, planning, implementation and monitoring tools questions about access, exclusion and the historically specific ways in which these aspects converge in particular urban spaces. By doing so, the humanitarian community would benefit from a more explicit, systematic and sustained engagement with the catalytic theoretical resources that critical urban theory has to offer. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

[The health of migrants at the Greece-Macedonia border].

PubMed

Moutamalle, Raphaël

2016-01-01

At the border between Greece and Macedonia, a transit camp for refugees is turning into a permanent camp. The management of the health emergency is assured by international teams from several humanitarian organisations, including the French Red Cross. The organisation of the care team, the cultural differences and the lack of resources are just some of the factors to be considered. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Naval Medical Research and Development News. Volume 7, Issue 3, March 2015

DTIC Science & Technology

2016-02-29

coordinated with the WHO on a combined animal/human health consultation mission to Egypt, including experts from the World Organization of Animal Health ...actively in emerging global health challenges like this. As we do so, we offer distinct diplomatic value as an expression of U.S. humanitarian and...scientific leadership, while also advancing health security and scientific progress. The biannual Navy Medical Research and Development Enterprise

Cyclone preparedness and response: an analysis of lessons identified using an adapted military planning framework.

PubMed

Tatham, Peter; Oloruntoba, Richard; Spens, Karen

2012-01-01

The United Kingdom uses the Defence Lines of Development (DLOD) framework to analyse and understand the key components and costs of a military capability. Rooted in the Resource Based View (RBV) of a firm, an adapted DLOD approach is employed to explore, analyse and discuss the preparedness, planning and response strategies of two markedly different countries (Australia and Bangladesh) when faced with a major cyclone event of a comparable size. Given the numerous similarities in the challenges facing military forces in a complex emergency and humanitarian agencies in a natural disaster, the paper demonstrates the applicability of the DLOD framework as an analysis and planning tool in the cyclone preparedness planning and response phases, and more broadly within the disaster management area. In addition, the paper highlights the benefit to disaster managers, policymakers and researchers of exploiting comparative cross-learning opportunities from disaster events, drawn from different sectors and countries. © 2012 The Author(s). Disasters © Overseas Development Institute, 2012.

An Electronic Competency-Based Evaluation Tool for Assessing Humanitarian Competencies in a Simulated Exercise.

PubMed

Evans, Andrea B; Hulme, Jennifer M; Nugus, Peter; Cranmer, Hilarie H; Coutu, Melanie; Johnson, Kirsten

2017-06-01

The evaluation tool was first derived from the formerly Consortium of British Humanitarian Agencies' (CBHA; United Kingdom), now "Start Network's," Core Humanitarian Competency Framework and formatted in an electronic data capture tool that allowed for offline evaluation. During a 3-day humanitarian simulation event, participants in teams of eight to 10 were evaluated individually at multiple injects by trained evaluators. Participants were assessed on five competencies and a global rating scale. Participants evaluated both themselves and their team members using the same tool at the end of the simulation exercise (SimEx). All participants (63) were evaluated. A total of 1,008 individual evaluations were completed. There were 90 (9.0%) missing evaluations. All 63 participants also evaluated themselves and each of their teammates using the same tool. Self-evaluation scores were significantly lower than peer-evaluations, which were significantly lower than evaluators' assessments. Participants with a medical degree, and those with humanitarian work experience of one month or more, scored significantly higher on all competencies assessed by evaluators compared to other participants. Participants with prior humanitarian experience scored higher on competencies regarding operating safely and working effectively as a team member. This study presents a novel electronic evaluation tool to assess individual performance in five of six globally recognized humanitarian competency domains in a 3-day humanitarian SimEx. The evaluation tool provides a standardized approach to the assessment of humanitarian competencies that cannot be evaluated through knowledge-based testing in a classroom setting. When combined with testing knowledge-based competencies, this presents an approach to a comprehensive competency-based assessment that provides an objective measurement of competency with respect to the competencies listed in the Framework. There is an opportunity to advance the use of this tool in future humanitarian training exercises and potentially in real time, in the field. This could impact the efficiency and effectiveness of humanitarian operations. Evans AB , Hulme JM , Nugus P , Cranmer HH , Coutu M , Johnson K . An electronic competency-based evaluation tool for assessing humanitarian competencies in a simulated exercise. Prehosp Disaster Med. 2017;32(3):253-260.

Professionalization of anesthesiologists and critical care specialists in humanitarian action: a nationwide poll among italian residents.

PubMed

Ripoll Gallardo, Alba; Ingrassia, Pier Luigi; Ragazzoni, Luca; Djalali, Ahmadreza; Carenzo, Luca; Burkle, Frederick M; Della Corte, Francesco

2015-02-01

Over the last decades, humanitarian crises have seen a sharp upward trend. Regrettably, physicians involved in humanitarian action have often demonstrated incomplete preparation for these compelling events which have proved to be quite different from their daily work. Responders to these crises have included an unpredictable mix of beginner-level, mid-level, and expert-level providers. The quality of care has varied considerably. The international humanitarian community, in responding to international calls for improved accountability, transparency, coordination, and a registry of professionalized international responders, has recently launched a call for further professionalization within the humanitarian assistance sector, especially among academic-affiliated education and training programs. As anesthetists have been involved traditionally in medical relief operations, and recent disasters have seen a massive engagement of young physicians, the authors conducted, as a first step, a poll among residents in Anesthesia and Critical Care Medicine in Italy to evaluate their interest in participating in competency-based humanitarian assistance education and in training incorporated early in residencies. The Directors of all the 39 accredited anesthesia/critical care training programs in Italy were contacted and asked to submit a questionnaire to their residents regarding the objectives of the poll study. After acceptance to participate, residents were enrolled and asked to complete a web-based poll. A total of 29 (74%) of the initial training programs participated in the poll. Out of the 1,362 questionnaires mailed to residents, 924 (68%) were fully completed and returned. Only 63(6.8%) of the respondents voiced prior participation in humanitarian missions, but up to 690 (74.7%) stated they were interested in participating in future humanitarian deployments during their residency that carried over into their professional careers. Countrywide, 896 (97%) favored prior preparation for residents before participating in humanitarian missions, while the need for a specific, formal, professionalization process of the entire humanitarian aid sector was supported by 889 (96.2%). In Italy, the majority of anesthesia/critical care residents, through a formal poll study, affirmed interest in participating in humanitarian assistance missions and believe that further professionalization within the humanitarian aid sector is required. These results have implications for residency training programs worldwide.

Transitioning mental health & psychosocial support: from short-term emergency to sustainable post-disaster development. Humanitarian Action Summit 2011.

PubMed

Patel, P P; Russell, J; Allden, K; Betancourt, T S; Bolton, P; Galappatti, A; Hijazi, Z; Johnson, K; Jones, L; Kadis, L; Leary, K; Weissbecker, I; Nakku, J

2011-12-01

The Working Group (WG) on Mental Health and Psychosocial Support participated in its second Humanitarian Action Summit in 2011. This year, the WG chose to focus on a new goal: reviewing practice related to transitioning mental health and psychosocial support programs from the emergency phase to long-term development. The Working Group's findings draw on a review of relevant literature as well as case examples. The objective of the Working Group was to identify factors that promote or hinder the long term sustainability of emergency mental health and psychosocial interventions in crisis and conflict, and to provide recommendations for transitioning such programs from relief to development. The Working Group (WG) conducted a review of relevant literature and collected case examples based on experiences and observations of working group members in implementing mental and psychosocial programming in the field. The WG focused on reviewing literature on mental health and psychosocial programs and interventions that were established in conflict, disaster, protracted crisis settings, or transition from acute phase to development phase. The WG utilized case examples from programs in Lebanon, the Gaza Strip, Sierra Leone, Aceh (Indonesia), Sri Lanka, and New Orleans (United States). The WG identified five key thematic areas that should be addressed in order to successfully transition lasting and effective mental health and psychosocial programs from emergency settings to the development phase. The five areas identified were as follows: Government and Policy, Human Resources and Training, Programming and Services, Research and Monitoring, and Finance. The group identified several recommendations for each thematic area, which were generated from key lessons learned by working group members through implementing mental health and psychosocial support programs in a variety of settings, some successfully sustained and some that were not.

Governing sexual behaviour through humanitarian codes of conduct.

PubMed

Matti, Stephanie

2015-10-01

Since 2001, there has been a growing consensus that sexual exploitation and abuse of intended beneficiaries by humanitarian workers is a real and widespread problem that requires governance. Codes of conduct have been promoted as a key mechanism for governing the sexual behaviour of humanitarian workers and, ultimately, preventing sexual exploitation and abuse (PSEA). This article presents a systematic study of PSEA codes of conduct adopted by humanitarian non-governmental organisations (NGOs) and how they govern the sexual behaviour of humanitarian workers. It draws on Foucault's analytics of governance and speech act theory to examine the findings of a survey of references to codes of conduct made on the websites of 100 humanitarian NGOs, and to analyse some features of the organisation-specific PSEA codes identified. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

The Lebanese-Syrian crisis: impact of influx of Syrian refugees to an already weak state.

PubMed

Cherri, Zeinab; Arcos González, Pedro; Castro Delgado, Rafael

2016-01-01

Lebanon, a small Middle Eastern country facing constant political and national unity challenges with a population of approximately 300,000 Palestinian and Iraqi refugees, has welcomed more than 1.2 million Office of the United Nations Commissioner for Refugees (UNHCR)-registered Syrian refugees since 2012. The Government of Lebanon considers individuals who crossed Lebanese-Syrian borders since 2011 as "displaced", emphasizing its long-standing position that Lebanon is not a state for refugees, refusing to establish camps, and adopting a policy paper to reduce their numbers in October 2014. Humanitarian response to the Syrian influx to Lebanon has been constantly assembling with the UNHCR as the main acting body and the Lebanon Crisis Response Plan as the latest plan for 2016. Review of secondary data from gray literature and reports focusing on the influx of Syrian refugees to Lebanon by visiting databases covering humanitarian response in complex emergencies. Limitations include obtaining majority of the data from gray literature and changing statistics due to the instability of the situation. The influx of Syrian refugees to Lebanon, an already weak and vulnerable state, has negatively impacted life in Lebanon on different levels including increasing demographics, regressing economy, exhausting social services, complicating politics, and decreasing security as well as worsened the life of displaced Syrians themselves. Displaced Syrians and Lebanese people share aggravating hardships of a mutual and precarious crisis resulting from the Syrian influx to Lebanon. Although a lot of response has been initiated, both populations still lack much of their basic needs due to lack of funding and nonsustainable program initiatives. The two major recommendations for future interventions are to ensure continuous and effective monitoring and sustainability in order to alleviate current and future suffering in Lebanon.

The Lebanese–Syrian crisis: impact of influx of Syrian refugees to an already weak state

PubMed Central

Cherri, Zeinab; Arcos González, Pedro; Castro Delgado, Rafael

2016-01-01

Background Lebanon, a small Middle Eastern country facing constant political and national unity challenges with a population of approximately 300,000 Palestinian and Iraqi refugees, has welcomed more than 1.2 million Office of the United Nations Commissioner for Refugees (UNHCR)-registered Syrian refugees since 2012. The Government of Lebanon considers individuals who crossed Lebanese–Syrian borders since 2011 as “displaced”, emphasizing its long-standing position that Lebanon is not a state for refugees, refusing to establish camps, and adopting a policy paper to reduce their numbers in October 2014. Humanitarian response to the Syrian influx to Lebanon has been constantly assembling with the UNHCR as the main acting body and the Lebanon Crisis Response Plan as the latest plan for 2016. Methods Review of secondary data from gray literature and reports focusing on the influx of Syrian refugees to Lebanon by visiting databases covering humanitarian response in complex emergencies. Limitations include obtaining majority of the data from gray literature and changing statistics due to the instability of the situation. Results The influx of Syrian refugees to Lebanon, an already weak and vulnerable state, has negatively impacted life in Lebanon on different levels including increasing demographics, regressing economy, exhausting social services, complicating politics, and decreasing security as well as worsened the life of displaced Syrians themselves. Conclusion Displaced Syrians and Lebanese people share aggravating hardships of a mutual and precarious crisis resulting from the Syrian influx to Lebanon. Although a lot of response has been initiated, both populations still lack much of their basic needs due to lack of funding and nonsustainable program initiatives. The two major recommendations for future interventions are to ensure continuous and effective monitoring and sustainability in order to alleviate current and future suffering in Lebanon. PMID:27471417

Matching response to context in complex political emergencies: 'relief', 'development', 'peace-building' or something in-between?

PubMed

White, P; Cliffe, L

2000-12-01

There is an ongoing debate over the value and pitfalls of the policy and practice of 'linking relief and development' or 'developmental relief' in aid responses to complex political emergencies (CPEs). Driven by concerns about relief creating dependence, sometimes doing harm and failing to address root causes of emergencies despite its high cost, pursuit of both relief and development has become a dominant paradigm among international aid agencies in CPEs as in 'natural' disasters. In CPEs a third objective of 'peace-building' has emerged, along with the logic that development can itself help prevent or resolve conflict and sustain peace. However, this broadening of relief objectives in ongoing CPEs has recently been criticised on a number of counts, central concerns being that it leads to a dilution of commitment to core humanitarian principles and is overly optimistic. This paper addresses these issues in the light of two of the CPEs studied by the COPE project: Eritrea and Somalia/Somaliland. It is argued that the debate has so far suffered from lack of clarity about what we mean by 'relief', 'development' and, for that matter, 'rehabilitation' and 'peace-building'. The wide spectrum of possible aid outcomes does not divide neatly into these categories. The relief-development divide is not always as clear-cut, technically or politically, as the critics claim. Moreover such distinctions, constructed from the point of view of aid programmers, are often of little relevance to the concerns of intended beneficiaries. Second, there has been insufficient attention to context: rather than attempting to generalise within and across CPE cases, a more productive approach would be to examine more closely the conditions under which forms of aid other than basic life support can fruitfully be pursued. This leads to consideration of collective agency capacity to respond effectively to diverse needs in different and changing circumstances.

How do emergency managers use social media platforms?

PubMed

Bennett, DeeDee M

2014-01-01

Social media platforms are increasingly becoming a useful tool for victims, humanitarians, volunteers, and the general public to communicate during disasters. Research has shown that there are multiple advantages to using social media and the applicability of these platforms crosses several different types of disasters (human-caused, natural, and terrorist) here in the United States and abroad. However, some emergency management agencies have been reluctant to use social media as one of their many communications tools. In this study, the usefulness of social media for emergency management was examined over a 30-day period following a series of tornadoes. Using an observational approach, the public posts disseminated from an emergency management agency were analyzed to determine how two social media platforms were used. The findings show how emergency management agencies could leverage the connectedness of social media to reach victims and make unlikely partnerships.

Where to go? Strategic modelling of access to emergency shelters in Mozambique.

PubMed

Gall, Melanie

2004-03-01

This paper, through spatial-analysis techniques, examines the accessibility of emergency shelters for vulnerable populations, and outlines the benefits of an extended and permanently established shelter network in central Mozambique. The raster-based modelling approach considers data on land cover, locations of accommodation centres in 2000, settlements and infrastructure. The shelter analysis is a two-step process determining access for vulnerable communities first, followed by a suitability analysis for additional emergency shelter sites. The results indicate the need for both retrofitting existing infrastructure (schools, health posts) to function as shelters during an emergency, and constructing new facilities - at best multi-purpose facilities that can serve as social infrastructure and shelter. Besides assessing the current situation in terms of availability and accessibility of emergency shelters, this paper provides an example of evaluating the effectiveness of humanitarian assistance without conventional mechanisms like food tonnage and number of beneficiaries.

The United States Humanitarian Demining Program: Civil-Military Relations in Humanitarian Demining

DTIC Science & Technology

2015-05-23

human suffering. The result was ‘humanitarian demining’, a new term which involves the removal of emplaced mines and provides information and education ...determine whether to approve the request. If approved, the HDP would design a demining/land mine education program to meet the requesting nation’s needs.31...11 Secretary of Defense establish a program to educate , train, and advise other nations on the establishment of humanitarian demining programs

Mixed Methods Research Strategies with Deaf People: Linguistic and Cultural Challenges Addressed

ERIC Educational Resources Information Center

Wilson, Amy T.; Winiarczyk, Rowena E.

2014-01-01

Deaf people, members of a complex global language minority, have been excluded from positions of power in the field of humanitarian aid and development assistance, as well as from playing a significant role in the conduct of research that affects their lives. Deaf people rarely lead or participate as researchers in studies about their own…

Humanitarian presence and urban development: new opportunities and contrasts in Goma, DRC.

PubMed

Büscher, Karen; Vlassenroot, Koen

2010-04-01

This paper examines the impact of the presence of international humanitarian organisations on local urban transformation processes in the city of Goma, Democratic Republic of the Congo (DRC). Rather than evaluating the direct effects of humanitarian interventions and strategies, it focuses on the indirect but profound effects of the presence of this 'humanitarian sector'. It argues that the international humanitarian presence became a significant factor in the recent shaping and reshaping of the city's profile and has reinforced competition over the urban political and socioeconomic space. The paper evaluates the direct and indirect impact of the international humanitarian presence on the local urban economy and the larger political economy of war in eastern DRC. It analyses how this presence has reinforced processes of spatial reconfiguration, how it has influenced urban planning, and how it has affected dynamics of gentrification and marginalisation on the urban spatial level.

Action-based flood forecasting for triggering humanitarian action

NASA Astrophysics Data System (ADS)

Coughlan de Perez, Erin; van den Hurk, Bart; van Aalst, Maarten K.; Amuron, Irene; Bamanya, Deus; Hauser, Tristan; Jongma, Brenden; Lopez, Ana; Mason, Simon; Mendler de Suarez, Janot; Pappenberger, Florian; Rueth, Alexandra; Stephens, Elisabeth; Suarez, Pablo; Wagemaker, Jurjen; Zsoter, Ervin

2016-09-01

Too often, credible scientific early warning information of increased disaster risk does not result in humanitarian action. With financial resources tilted heavily towards response after a disaster, disaster managers have limited incentive and ability to process complex scientific data, including uncertainties. These incentives are beginning to change, with the advent of several new forecast-based financing systems that provide funding based on a forecast of an extreme event. Given the changing landscape, here we demonstrate a method to select and use appropriate forecasts for specific humanitarian disaster prevention actions, even in a data-scarce location. This action-based forecasting methodology takes into account the parameters of each action, such as action lifetime, when verifying a forecast. Forecasts are linked with action based on an understanding of (1) the magnitude of previous flooding events and (2) the willingness to act "in vain" for specific actions. This is applied in the context of the Uganda Red Cross Society forecast-based financing pilot project, with forecasts from the Global Flood Awareness System (GloFAS). Using this method, we define the "danger level" of flooding, and we select the probabilistic forecast triggers that are appropriate for specific actions. Results from this methodology can be applied globally across hazards and fed into a financing system that ensures that automatic, pre-funded early action will be triggered by forecasts.

Israel: Background and Relations with the United States

DTIC Science & Technology

2010-01-07

provided a grant of 15% of an investment of up to $3.5 billion or $525 million to secure the deal. In May 2006, prominent U.S. investor Warren Buffet ...emergence of a geographically contiguous Palestinian state. On April 14, 2004, however, President Bush noted the need to take into account changed...between military needs and taking into account humanitarian considerations needs to be found.”114 P.L. 111-117, the Consolidated Appropriations Act

The Southwest Pacific: U.S. Interests and China’s Growing Influence

DTIC Science & Technology

2007-07-06

additional $200,000 for emergency shelter, water , health, and sanitation provided through humanitarian organizations. Since 1995, USAID/OFDA has...China operates a large tuna fishing fleet in Fijian waters and has agreed to help develop a hydro power plant in the country. China, Taiwan, and the...accept Tuvalu’s entire population should rising sea levels inundate the island, which lies within five meters above water . The government of Tuvalu expects

Ethics in humanitarian services: report on the earthquake in Nepal.

PubMed

Aacharya, Ramesh P; Tiwari, Sanjeeb; Shrestha, Tirtha M

2017-01-01

The Nepal earthquake was one of the biggest natural calamities of the year 2015. This paper attempts to explore the ethical issues involved in the humanitarian services rendered during the crisis and thereafter. The four principles of biomedical ethics - autonomy, beneficence, non-maleficence, and justice - are discussed in relation to the relief activities immediately following the disaster and the subsequent long-term activities, such as rehabilitation, wherever applicable. The discussion touches upon public health components such as vulnerable populations, environmental ethics and justice for the future. Incorporating ethical principles into the response to disasters is of vital importance to ensure that healthcare complies with professional norms and ethical standards, and is in tune with the medical needs of the local culture. Beneficence is prioritised, while non-maleficence and autonomy tend to be ignored. Justice, particularly distributive justice, deserves due attention in the context of limited resources, not only during the emergency phase but also during the phases of rehabilitation and planning for the future.

Participation, political economy and protection: food aid governance in Darfur, Sudan.

PubMed

Young, Helen; Maxwell, Daniel

2013-10-01

Humanitarian food assistance aims to meet short-term emergency needs, yet often it is sustained over many years and develops its own systems and infrastructure that interact with local governance and local communities. This paper explores the links between participation and local governance, as well as the implications for exclusion of certain groups, the dignity of those involved, and protection issues. The paper proposes a framework for reviewing the governance functions and capacities of local Food Relief Committees, based on the following criteria: accountability; gender equity; legitimacy and authority; representativeness; responsiveness; and transparency. A case study of the Darfur region reviews how local governance evolves as a result of both the wider conflict and of adapting to the international humanitarian system, itself a form of governance. The paper concludes by proposing three strategies for enhancing participation and applying lessons learned: improved analysis of participation; linking programming strategies and protection; and taking account of governance functions and capacities. © 2013 The Author(s). Disasters © Overseas Development Institute, 2013.

Recovery and identification of human remains in post-conflict environments: A comparative study of the humanitarian forensic programs in Cyprus and Kosovo.

PubMed

Mikellide, Maria

2017-10-01

This study follows the humanitarian forensic programs in Cyprus and Kosovo over a ten-year period with an emphasis on the role of local capacity building. It begins by providing an in-depth historical account of forensic activities, followed by a comparison of the rate of excavations, exhumations and identifications. Through this analysis, a repeated pattern emerges whereby forensic activities in Kosovo start with a surge in values, which drop drastically in the first few years of operations, followed by a steadily declining productivity curve. By contrast, in Cyprus, activities begin modestly, with lower values allowing for some modest growth. Close observation of the two programs provides indications as to the factors that may influence the development of forensic programs as well as the elements that need to be set in place to create an environment conducive to greater sustainability through local ownership and responsibility. Copyright © 2017 Elsevier B.V. All rights reserved.

A manufactu(RED) ethics: labor, HIV, and the body in Lesotho's "sweat-free" garment industry.

PubMed

Kenworthy, Nora J

2014-12-01

Employing mostly women and producing for major U.S. labels, Lesotho's primarily foreign-owned garment industry undertook efforts to become "sweat-free" in 2006; simultaneously, it also began producing for the Product(RED) campaign. This article explores the parameters and ethical challenges of an industry-wide, public-private partnership providing HIV prevention and treatment services in this industry. Here, HIV services are intimately bound up in emerging patterns of humanitarian consumption and the production of an ethical industry. Within this ethical production zone, all is not what it seems: Labor violations persist, workers confront occupational hazards, and an elaborate theatrics of ethical practice plays out on the factory floor during routine inspections. This article explores the place and purpose of HIV treatment in the context of such humanitarian fetishism, highlighting the uses to which worker bodies are put and the conceptions of bodily well-being that prevail in these new "moral" economies. © 2014 by the American Anthropological Association.

Characteristics, determinants and perspectives of experienced medical humanitarians: a qualitative approach

PubMed Central

Asgary, Ramin; Lawrence, Katharine

2014-01-01

Objective To explore the characteristics, motivations, ideologies, experience and perspectives of experienced medical humanitarian workers. Design We applied a qualitative descriptive approach and conducted in-depth semistructured interviews, containing open-ended questions with directing probes, with 44 experienced international medical aid workers from a wide range of humanitarian organisations. Interviews were coded and analysed, and themes were developed. Setting International non-governmental organisations (INGOs) and United Nations (UN). Results 61% of participants were female; mean age was 41.8 years with an average of 11.8 years of humanitarian work experience with diverse major INGOs. Significant core themes included: population's rights to assistance, altruism and solidarity as motives; self-identification with the mission and directives of INGOs; shared personal and professional morals fostering collegiality; accountability towards beneficiaries in areas of programme planning and funding; burnout and emotional burdens; uncertainties in job safety and security; and uneasiness over changing humanitarian principles with increasing professionalisation of aid and shrinking humanitarian access. While dissatisfied with overall aid operations, participants were generally satisfied with their work and believed that they were well-received by, and had strong relationships with, intended beneficiaries. Conclusions Despite regular use of language and ideology of rights, solidarity and concepts of accountability, tension exists between the philosophy and practical incorporation of accountability into operations. To maintain a humanitarian corps and improve aid worker retention, strategies are needed regarding management of psychosocial stresses, proactively addressing militarisation and neo-humanitarianism, and nurturing individuals’ and organisations’ growth with emphasis on humanitarian principles and ethical practices, and a culture of internal debate, reflection and reform. PMID:25492274

Ebola's Would-be Refugees: Performing Fear and Navigating Asylum During a Public Health Emergency.

PubMed

Lawrance, Benjamin N

2018-04-20

Chronic and acute illnesses sit uncomfortably with asylum claiming and refugee mobilities. The story of a Sierra Leonean, an athlete who feared Ebola and sought refuge in the UK, provides an opening to examine protection discourses that invoke fear, trauma, and crisis metaphors, to understand how asylum claims are performed, and how related petitions are adjudicated during public health emergencies of international concern. Ebola is revealed as a novel claim strategy, and thus a useful subject matter to investigate the shifting modalities of migrant agency, the unstable fabric of medical humanitarianism, and knowledge production in moments of exceptionality.

Non-governmental organizational health operations in humanitarian crises: the case for technical support units.

PubMed

Greenough, P Gregg; Nazerali, Rahim; Fink, Sheri; VanRooyen, Michael J

2007-01-01

As the humanitarian health response industry grows, there is a need for technical health expertise that can build an evidence base around outcome measures and raise the quality and accountability of the health relief response. We propose the formation of technical support units (TSUs), entities of health expertise institutionalized within humanitarian non-governmental organizations (NGOs), which will bridge the gap between the demand for evidence-based, humanitarian programming and the field capacity to accomplish it. With the input of major humanitarian NGOs and donors, this paper discusses the attributes and capacities ofTSUs; and the mechanisms for creating and enhancing TSUs within the NGO management structure.

Nutrition in humanitarian crises.

PubMed

Bagchi, K; Musani, A; Tomeh, L; Taha, A

2004-11-01

It is anticipated that humanitarian crisis situations will continue to occur in countries of the Eastern Mediterranean Region affecting large segments of vulnerable populations. Subsequently the magnitude and effectiveness of the humanitarian response, particularly for food and nutrition, must be based on best practices and sound information of affected populations. To bridge the burgeoning gap between the food and nutrition needs of affected populations and the available resources, four key areas need to be addressed by the humanitarian agencies: adequate knowledge and skills in public health nutrition; effective coordination between humanitarian organizations when conducting nutritional assessments and interventions; efficient and appropriate delivery of services; communication, awareness and advocacy. This paper discusses approaches to how these may be improved.

75 FR 74678 - Bureau for Democracy, Conflict and Humanitarian Assistance; Office of Food for Peace Announcement...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-01

... Democracy, Conflict and Humanitarian Assistance; Office of Food for Peace Announcement of Request for..., Conflict and Humanitarian Assistance. [FR Doc. 2010-30195 Filed 11-30-10; 8:45 am] BILLING CODE P ...

Emerging and Reemerging Diseases in the World Health Organization (WHO) Eastern Mediterranean Region-Progress, Challenges, and WHO Initiatives.

PubMed

Buliva, Evans; Elhakim, Mohamed; Tran Minh, Nhu Nguyen; Elkholy, Amgad; Mala, Peter; Abubakar, Abdinasir; Malik, Sk Md Mamunur Rahman

2017-01-01

The Eastern Mediterranean Region (EMR) of the World Health Organization (WHO) continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human-animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1) infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous support of WHO, to build and maintain a resilient public health system for detection and response to all acute public health events.

Emerging and Reemerging Diseases in the World Health Organization (WHO) Eastern Mediterranean Region—Progress, Challenges, and WHO Initiatives

PubMed Central

Buliva, Evans; Elhakim, Mohamed; Tran Minh, Nhu Nguyen; Elkholy, Amgad; Mala, Peter; Abubakar, Abdinasir; Malik, Sk Md Mamunur Rahman

2017-01-01

The Eastern Mediterranean Region (EMR) of the World Health Organization (WHO) continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human–animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1) infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous support of WHO, to build and maintain a resilient public health system for detection and response to all acute public health events. PMID:29098145

Humanitarian Use Device and Humanitarian Device Exemption regulatory programs: pros and cons.

PubMed

Bernad, Daniel Maxwell

2009-03-01

The US FDA established the Humanitarian Use Device (HUD) and Humanitarian Device Exemption (HDE) program to encourage medical device firms to address rare diseases. Despite being in existence for over a decade, there has only been one peer-reviewed publication examining this field. The objective of this report is to investigate how the HUD/HDE program differs from the standard regulatory system, discuss its potential advantages and disadvantages, and to speculate which humanitarian devices will be brought to market within the next 5 years. A total of 40 semistructured interviews with stakeholders, representing approximately half (n = 20, 49%) of the firms that have successfully obtained HDE-approved products, were performed in order to acquire the primary data for this paper. There appear to be short-term gains and long-term drains associated with launching humanitarian devices to market. This report aims to provide sponsors with information that may allow them to make better decisions during their product development of humanitarian devices and may, hopefully, also play a role in encouraging other sponsors to take the necessary steps forward in helping to find treatments for patients with rare diseases.

The challenge of civil-military relations in international peace operations.

PubMed

Pugh, M

2001-12-01

The relationship between military and civilian humanitarian organisations has developed in an increasingly integrative way. Military initiatives to institutionalise the relationship, since the interventions in Somalia and the Balkans, entail a dilution of humanitarian independence as was manifested in practice in Kosovo. Further, the state-centric foundations of military intervention run counter to the potential for humanitarian organisations to foster a cosmopolitan ethos that would not only preserve humanitarian principles but also contest statist assumptions about conflict, development and power.

Characteristics, determinants and perspectives of experienced medical humanitarians: a qualitative approach.

PubMed

Asgary, Ramin; Lawrence, Katharine

2014-12-08

To explore the characteristics, motivations, ideologies, experience and perspectives of experienced medical humanitarian workers. We applied a qualitative descriptive approach and conducted in-depth semistructured interviews, containing open-ended questions with directing probes, with 44 experienced international medical aid workers from a wide range of humanitarian organisations. Interviews were coded and analysed, and themes were developed. International non-governmental organisations (INGOs) and United Nations (UN). 61% of participants were female; mean age was 41.8 years with an average of 11.8 years of humanitarian work experience with diverse major INGOs. Significant core themes included: population's rights to assistance, altruism and solidarity as motives; self-identification with the mission and directives of INGOs; shared personal and professional morals fostering collegiality; accountability towards beneficiaries in areas of programme planning and funding; burnout and emotional burdens; uncertainties in job safety and security; and uneasiness over changing humanitarian principles with increasing professionalisation of aid and shrinking humanitarian access. While dissatisfied with overall aid operations, participants were generally satisfied with their work and believed that they were well-received by, and had strong relationships with, intended beneficiaries. Despite regular use of language and ideology of rights, solidarity and concepts of accountability, tension exists between the philosophy and practical incorporation of accountability into operations. To maintain a humanitarian corps and improve aid worker retention, strategies are needed regarding management of psychosocial stresses, proactively addressing militarisation and neo-humanitarianism, and nurturing individuals' and organisations' growth with emphasis on humanitarian principles and ethical practices, and a culture of internal debate, reflection and reform. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Measuring the way forward in Haiti: grounding disaster relief in the legal framework of human rights.

PubMed

Klasing, Amanda M; Moses, P Scott; Satterthwaite, Margaret L

2011-07-14

This article provides results from an online survey of humanitarian workers and volunteers that was conducted in May and June 2010. The purpose of the survey was to understand how the humanitarian aid system adopts or incorporates human rights into its post-natural disaster work and metrics. Data collected from Haiti suggest that humanitarians have embraced a rights-based approach but that they do not agree about how this is defined or about what standards and indicators can be considered rights-based. This disagreement may reveal that humanitarians are aware of a mismatch between the rights-based approach to post-disaster humanitarian work and the legal framework of human rights. Using participation and accountability as examples, this article identifies and examines this mismatch and suggests that the humanitarian aid system should more fully embrace engagement with the human rights framework. To do so, the article concludes, humanitarian actors and the human rights community should have an open dialogue about the development of metrics that accurately reflect and monitor adherence to the legal framework of human rights. This would allow the humanitarian aid system to ensure its interventions enhance the capacity of the disaster-affected state to fulfill its human rights obligations, and would allow humanitarian and human rights actors alike to measure the impact of such interventions on the realization of human rights in post-natural disaster settings. Copyright © 2011 Klasing, Moses, and Satterthwaite. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Ethics and images of suffering bodies in humanitarian medicine.

PubMed

Calain, Philippe

2013-12-01

Media representations of suffering bodies from medical humanitarian organisations raise ethical questions, which deserve critical attention for at least three reasons. Firstly, there is a normative vacuum at the intersection of medical ethics, humanitarian ethics and the ethics of photojournalism. Secondly, the perpetuation of stereotypes of illness, famine or disasters, and their political derivations are a source of moral criticism, to which humanitarian medicine is not immune. Thirdly, accidental encounters between members of the health professions and members of the press in the humanitarian arena can result in misunderstandings and moral tension. From an ethics perspective the problem can be specified and better understood through two successive stages of reasoning. Firstly, by applying criteria of medical ethics to the concrete example of an advertising poster from a medical humanitarian organisation, I observe that media representations of suffering bodies would generally not meet ethical standards commonly applied in medical practice. Secondly, I try to identify what overriding humanitarian imperatives could outweigh such reservations. The possibility of action and the expression of moral outrage are two relevant humanitarian values which can further be spelt out through a semantic analysis of 'témoignage' (testimony). While the exact balance between the opposing sets of considerations (medical ethics and humanitarian perspectives) is difficult to appraise, awareness of all values at stake is an important initial standpoint for ethical deliberations of media representations of suffering bodies. Future pragmatic approaches to the issue should include: exploring ethical values endorsed by photojournalism, questioning current social norms about the display of suffering, collecting empirical data from past or potential victims of disasters in diverse cultural settings, and developing new canons with more creative or less problematic representations of suffering bodies than the currently accepted stereotypes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Surgery for children in low-income countries affected by humanitarian emergencies from 2008 to 2014: The Médecins Sans Frontières Operations Centre Brussels experience☆,☆☆,★,★★

PubMed Central

Flynn-O’Brien, Katherine T.; Trelles, Miguel; Dominguez, Lynette; Hassani, Ghulam Hiadar; Akemani, Clemence; Naseer, Aamer; Ntawukiruwabo, Innocent Bagura; Kushner, Adam L.; Rothstein, David H.; Stewart, Barclay T.

2018-01-01

Purpose Pediatric surgical care is deficient in developing countries disrupted by crisis. We aimed to describe pediatric surgical care at Médecins Sans Frontières-Brussels (MSF-OCB) projects to inform resource allocation and define the pediatric-specific skillset necessary for humanitarian surgical teams. Methods Procedures performed by MSF-OCB from July 2008 to December 2014 were reviewed. Project characteristics, patient demographics and clinical data were described. Multivariable logistic regression was performed to determine predictors of perioperative death. Results Of 109,828 procedures, 26,284 were performed for 24,576 children (22% of all procedures). The most common pediatric operative indication was trauma (13,984; 57%). Nine percent of all surgical indications were due to violence (e.g., land mines, firearms, gender-based violence, etc.). The majority of procedures (19,582; 75%) were general surgical, followed by orthopedic (4350; 17%), and obstetric/gynecologic/urologic (2135; 8%). Perioperative death was low (42; 0.17%); independent predictors of death included age <1 year, use of general anesthesia with a definitive airway, and operation during conflict. Conclusion Surgical care for children comprised nearly a quarter of all procedures performed by MSF-OCB between 2008 and 2014. Attention to trauma surgery and infant perioperative care is particularly needed. These findings are important when resourcing projects and training surgical staff for humanitarian missions. PMID:26454469

Surgery for children in low-income countries affected by humanitarian emergencies from 2008 to 2014: The Médecins Sans Frontières Operations Centre Brussels experience.

PubMed

Flynn-O'Brien, Katherine T; Trelles, Miguel; Dominguez, Lynette; Hassani, Ghulam Hiadar; Akemani, Clemence; Naseer, Aamer; Ntawukiruwabo, Innocent Bagura; Kushner, Adam L; Rothstein, David H; Stewart, Barclay T

2016-04-01

Pediatric surgical care is deficient in developing countries disrupted by crisis. We aimed to describe pediatric surgical care at Médecins Sans Frontières-Brussels (MSF-OCB) projects to inform resource allocation and define the pediatric-specific skillset necessary for humanitarian surgical teams. Procedures performed by MSF-OCB from July 2008 to December 2014 were reviewed. Project characteristics, patient demographics and clinical data were described. Multivariable logistic regression was performed to determine predictors of perioperative death. Of 109,828 procedures, 26,284 were performed for 24,576 children (22% of all procedures). The most common pediatric operative indication was trauma (13,984; 57%). Nine percent of all surgical indications were due to violence (e.g., land mines, firearms, gender-based violence, etc.). The majority of procedures (19,582; 75%) were general surgical, followed by orthopedic (4350; 17%), and obstetric/gynecologic/urologic (2135; 8%). Perioperative death was low (42; 0.17%); independent predictors of death included age <1year, use of general anesthesia with a definitive airway, and operation during conflict. Surgical care for children comprised nearly a quarter of all procedures performed by MSF-OCB between 2008 and 2014. Attention to trauma surgery and infant perioperative care is particularly needed. These findings are important when resourcing projects and training surgical staff for humanitarian missions. Copyright © 2016 Elsevier Inc. All rights reserved.

Virtues and humanitarian ethics.

PubMed

Löfquist, Lars

2017-01-01

This paper analyses the contribution of virtue ethics, the study of good character traits, to the humanitarian context. It argues that a virtue ethics perspective paints a realistic picture of the use of ethical standards in morally complex circumstances. Virtuous relief workers can employ standards in their thinking, but they are also committed to professional excellence that goes beyond any formal code. The concept of virtue ethics places a stress on moral development, which can be facilitated by role models that impart modest and feasible ideals. However, virtue ethics cannot provide simple guidelines on how to resolve difficult situations. It is possible that two virtuous persons can disagree on what should be done in a particular instance. In addition, a virtue ethics perspective emphasises the need for both individuals and organisations to discuss the actual purpose of relief work in order to pinpoint the virtues of a good relief professional. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Social dimensions of science-humanitarian collaboration: lessons from Padang, Sumatra, Indonesia.

PubMed

Shannon, Rachel; Hope, Max; McCloskey, John; Crowley, Dominic; Crichton, Peter

2014-07-01

This paper contains a critical exploration of the social dimensions of the science-humanitarian relationship. Drawing on literature on the social role of science and on the social dimensions of humanitarian practice, it analyses a science-humanitarian partnership for disaster risk reduction (DRR) in Padang, Sumatra, Indonesia, an area threatened by tsunamigenic earthquakes. The paper draws on findings from case study research that was conducted between 2010 and 2011. The case study illustrates the social processes that enabled and hindered collaboration between the two spheres, including the informal partnership of local people and scientists that led to the co-production of earthquake and tsunami DRR and limited organisational capacity and support in relation to knowledge exchange. The paper reflects on the implications of these findings for science-humanitarian partnering in general, and it assesses the value of using a social dimensions approach to understand scientific and humanitarian dialogue. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Save the Children, the humanitarian project, and the politics of solidarity: reviving Dorothy Buxton's vision.

PubMed

Baughan, Emily; Fiori, Juliano

2015-10-01

This paper reflects on the foundational years of Save the Children, one of the oldest and largest Western humanitarian agencies and a mainstay of the humanitarian project. In doing so, it considers how and why, at an early stage, the organisation depoliticised its activities, centring its narrative on the innocent, pre-political child-the image of unsullied humanity. In addition, it seeks to recover the internationalist vision of Save the Children's 'forgotten founder', Dorothy Buxton. Save the Children's turn to non-politics is indicative of the broader depoliticisation of Western humanitarian action. Given the intensely contested spaces in which Western humanitarian non-governmental organisations (NGOs) operate, these entities cannot escape politics. This paper argues that Buxton's efforts to build an international solidarity network through humanitarian action after the end of the First World War in 1918 provide an instructive basis on which these NGOs can pursue a politics of solidarity in the present day. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

From disaster to development: a systematic review of community-driven humanitarian logistics.

PubMed

Bealt, Jennifer; Mansouri, S Afshin

2018-01-01

A plethora of untapped resources exist within disaster-affected communities that can be used to address relief and development concerns. A systematic review of the literature relating to community participation in humanitarian logistics activities revealed that communities are able to form ad hoc networks that have the ability to meet a wide range of disaster management needs. These structures, characterised as Collaborative Aid Networks (CANs), have demonstrated efficient logistical capabilities exclusive of humanitarian organisations. This study proposes that CANs, as a result of their unique characteristics, present alternatives to established humanitarian approaches to logistics, while also mitigating the challenges commonly faced by traditional humanitarian organisations. Furthermore, CANs offer a more holistic, long-term approach to disaster management, owing to their impact on development through their involvement in humanitarian logistics. This research provides the foundation for further theoretical analysis of effective and efficient disaster management, and details opportunities for policy and practice. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Three legacies of humanitarianism in China.

PubMed

Hirono, Miwa

2013-10-01

The rise of China has altered the context of the international humanitarian community of donors and aid agencies. China is becoming one of the key actors in this grouping, undertaking infrastructure projects in areas in which paramount humanitarian challenges exist. The literature discusses how the Chinese approach differs from that of Western donors, but it does not pay much attention to why China concentrates on its state-centric and infrastructure-based approach. This paper seeks to shed some light on this subject by examining the historical evolution of the concept of humanitarianism in China. This evolution has produced three legacies: (i) the ideal of a well-ordered state; (ii) anti-Western sentiment; and (iii) the notion of comprehensive development based on a human-oriented approach. China's policies and discourses on assistance in humanitarian crises today rest on these three legacies. Traditional donors would be well advised to consider carefully the implications of the Chinese understanding of humanitarianism when engaging with the country. © 2013 The Author(s). Disasters © Overseas Development Institute, 2013.

The United States Air Force and Humanitarian Airlift Operations 1947-1994

DTIC Science & Technology

1998-01-01

Flood. Location: Republic of Bolivia. Date(s): February 13 and 28, 1971. Emergency: Heavy rain flooded the Beni and Madre de Dios River valleys of...descended on the Beni and Madre de Dios River valleys of northern Bolivia on the edge of the Amazon basin, flooding Riberalta and surrounding areas... heavy rain flooded river valleys south of Volcan de Fuego, Guatemala, threatening the towns of Singuinala and La Democracia. The Pantaleon River near

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes.

PubMed

Clarinval, Caroline; Biller-Andorno, Nikola

2014-06-23

This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context.

31 CFR 500.572 - Humanitarian projects authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Humanitarian projects authorized. 500.572 Section 500.572 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... humanitarian projects in Vietnam pursuant to this authorization shall file an initial report within 10 business...

31 CFR 538.532 - Humanitarian transshipments to or from Southern Sudan and Darfur authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... from Southern Sudan and Darfur authorized. 538.532 Section 538.532 Money and Finance: Treasury....532 Humanitarian transshipments to or from Southern Sudan and Darfur authorized. The transit or transshipment to or from Southern Sudan and Darfur of goods, technology, or services intended for humanitarian...

75 FR 4526 - Bureau for Democracy, Conflict and Humanitarian Assistance; Office of Food for Peace...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-28

... AGENCY FOR INTERNATIONAL DEVELOPMENT Bureau for Democracy, Conflict and Humanitarian Assistance; Office of Food for Peace; Announcement of FFP Response to Zimbabwe Country Specific Guidance Comments..., Bureau for Democracy, Conflict and Humanitarian Assistance. [FR Doc. 2010-1777 Filed 1-27-10; 8:45 am...

Working in a war zone. The impact on humanitarian health workers.

PubMed

Hewison, Cathy

2003-09-01

The work challenges faced by doctors, nurses and other health professionals in the humanitarian field are overwhelming. This article highlights the psychological effects on humanitarian workers and the support available, both while on a 'mission' and on return home. It is impossible not to be psychologically affected by witnessing gross acts of violence, starvation, epidemics, displacement and despair, or hearing tales of slaughter, rape and killing. Just as those populations who are subjected to traumatic experiences develop post-traumatic psychological problems, so too can those humanitarian workers who assist them.

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes

PubMed Central

Clarinval, Caroline; Biller-Andorno, Nikola

2014-01-01

Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575

The Relationship between Perceived School Climate and the Adolescents' Adherence to Humanitarian Values

ERIC Educational Resources Information Center

Turhan, Muhammed; Akgül, Tülin

2017-01-01

This study investigates the relationship between students' perception of school climate and their adherence to humanitarian values. To this end, the study group consisted of 1094 students in 21 secondary schools in Elazig province of Turkey. The "School Climate Scale," developed by Çalik and Kurt, and the "Humanitarian Values…

78 FR 5185 - Guidance for Industry and Food and Drug Administration Staff; Humanitarian Use Device (HUD...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0847] Guidance for Industry and Food and Drug Administration Staff; Humanitarian Use Device (HUD) Designations... public comment ``Draft Guidance for Industry and Food and Drug Administration Staff on Humanitarian Use...

Humanitarian Information Management Network Effectiveness: An Analysis at the Organizational and Network Levels

ERIC Educational Resources Information Center

Ngamassi Tchouakeu, Louis-Marie

2011-01-01

Massive international response to humanitarian crises such as the South Asian Tsunami in 2004, the Hurricane Katrina in 2005 and the Haiti earthquake in 2010 highlights the importance of humanitarian inter-organizational collaboration networks, especially in information management and exchange. Despite more than a decade old call for more research…

Dividing disasters in Aceh, Indonesia: separatist conflict and tsunami, human rights and humanitarianism.

PubMed

Zeccola, Paul

2011-04-01

This paper examines the interface between human rights and humanitarian action in the context of the conflict and tsunami in Aceh, Indonesia, between 1998 and 2007. It looks at the challenges international humanitarian non-governmental organisations (NGOs) faced as they engaged in human rights work in the conflict period and in conflict-related activities in the post-tsunami period. The paper argues that many large NGOs may have compromised what some would hold to be essential principles for humanitarian action because of domestic political concerns, donor restrictions and resistance among certain NGO chiefs. In contrast with the pre-tsunami period, in which NGOs worked for years amid military operations, in the post-tsunami period NGOs were decidedly apolitical, neglecting the conflict in their tsunami response--despite significant developments that permitted greater political engagement in Aceh's post-conflict transformation. The evidence suggests that NGOs are challenged in contextualising humanitarian responses and that there is a need to underscore donor flexibility and independence in humanitarian action. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

International humanitarian actors and governments in areas of conflict: challenges, obligations, and opportunities.

PubMed

Harvey, Paul

2013-10-01

For too long international humanitarian aid has neglected the primary responsibility of the state to assist and protect its citizens in times of disaster. A focus on the role of the state in contexts where governments are active parties to a conflict and are failing to live up to these responsibilities is difficult and underpins many of the recurring dilemmas of humanitarian action. The fundamental principles of humanitarian action should offer a framework for principled engagement with governments in situations of conflict but too often they are still interpreted as shorthand for ignoring governments. Using principles to inform engagement with both states and other international actors engaged in crises could provide a way forward. However, this would need to be a humanitarian agenda that engages with developing country governments, with non-OECD (Organisation for Economic Co-operation and Development) donors, and with the stabilisation and security agendas of Western governments, and not one that attempts to ring-fence an ever-shrinking isolationist humanitarian space. © 2013 The Author(s). Disasters © Overseas Development Institute, 2013.

Designing and Pre-Positioning Humanitarian Assistance Pack-Up Kits (HA PUKs) to Support Pacific Fleet Emergency Relief Operations

DTIC Science & Technology

2006-12-01

surveying the area within 48 hours of the event and the first U.S. helicopters were airlifting supplies within 72 hours [Garamone, 2006]. 3...earthquakes occur along the Ring of Fire [U.S. Geological Survey , 2006]. The Asia-Pacific region has recorded over 70% of the world’s earthquakes...distribute the items by aggregating the items into one, easily-distributed package. The kit should include soap, toothpaste, a toothbrush, shampoo

The rite of passage of becoming a humanitarian health worker: experiences of retention in Sweden

PubMed Central

Albuquerque, Sara; Eriksson, Anneli; Alvesson, Helle M.

2018-01-01

ABSTRACT Background: Low retention of humanitarian workers poses constraints on humanitarian organisations’ capacity to respond effectively to disasters. Research has focused on reasons for humanitarian workers leaving the sector, but little is known about the factors that can elucidate long-term commitment. Objective: To understand what motivates and supports experienced humanitarian health workers to remain in the sector. Methods: Semi-structured interviews were conducted with 10 experienced nurses who had been on at least three field missions with Médecins Sans Frontières Sweden. Interviews explored factors influencing the decision to go on missions, how nurses were supported and how they looked back on those experiences. Transcripts were analysed through content analysis informed by van Gennep’s concept of ‘Rite of Passage’, combined with elements of the self-determination theory. Results: The findings indicate that their motivations and how nurses thought of themselves, as individuals and professionals, changed over time. For initiation and continued engagement in humanitarian work, participants were motivated by several personal and professional ambitions, as well as altruistic principles of helping others. When starting their first humanitarian missions, nurses felt vulnerable and had low self-esteem. However, through experiencing feelings of autonomy, competence and relatedness during missions, they underwent a process of change and gradually adjusted to new roles as humanitarian health workers. Reintegration in their home community, while maintaining the new roles and skills from the missions, proved very challenging. They individually found their own ways of overcoming the lack of social support they experienced after missions in order to sustain their continuation in the sector. Conclusions: The findings highlight the importance of social environments that facilitate and support the adjustment of individuals during and after field missions. Learning from positive examples, such as nurses with several years of experience, can strengthen strategies of retention, which can ultimately improve the delivery of humanitarian assistance. PMID:29334324

Funding Based on Needs? A Study on the Use of Needs Assessment Data by a Major Humanitarian Health Assistance Donor in its Decisions to Allocate Funds

PubMed Central

Olin, Emma; von Schreeb, Johan

2014-01-01

Background: International humanitarian assistance is essential for disaster-affected populations, particularly in resource scarce settings. To target such assistance, needs assessments are required. According to internationally endorsed principles, donor governments should provide funding for humanitarian assistance based on need. Aim: The aim of this study is to explore a major donor’s use of needs assessment data in decision-making for allocations of funds for health-related humanitarian assistance contributions. Setting: This is a case study of the Swedish International Development Cooperation Agency (Sida), a major and respected international donor of humanitarian assistance. Methods: To explore Sida’s use of needs assessment data in practice for needs-based allocations, we reviewed all decision documents and assessment memoranda for humanitarian assistance contributions for 2012 using content analysis; this was followed by interviews with key personnel at Sida. Results: Our document analysis found that needs assessment data was not systematically included in Sida’s assessment memoranda and decision documents. In the interviews, we observed various descriptions of the concept of needs assessments, the importance of contextual influences as well as previous collaborations with implementing humanitarian assistance organizations. Our findings indicate that policies guiding funding decisions on humanitarian assistance need to be matched with available needs assessment data and that terminologies and concepts have to be clearly defined. Conclusion: Based on the document analysis and the interviews, it is unclear how well Sida used needs assessment data for decisions to allocate funds. However, although our observations show that needs assessments are seldom used in decision making, Sida’s use of needs assessments has improved compared to a previous study. To improve project funds allocations based on needs assessment data, it will be critical to develop distinct frameworks for allocation distributions based on needs assessment and clear definitions, measurements and interpretations of needs. Key words: Needs assessment, humanitarian assistance, disasters, donor decision-making PMID:24894417

The rite of passage of becoming a humanitarian health worker: experiences of retention in Sweden.

PubMed

Albuquerque, Sara; Eriksson, Anneli; Alvesson, Helle M

2018-01-01

Low retention of humanitarian workers poses constraints on humanitarian organisations' capacity to respond effectively to disasters. Research has focused on reasons for humanitarian workers leaving the sector, but little is known about the factors that can elucidate long-term commitment. To understand what motivates and supports experienced humanitarian health workers to remain in the sector. Semi-structured interviews were conducted with 10 experienced nurses who had been on at least three field missions with Médecins Sans Frontières Sweden. Interviews explored factors influencing the decision to go on missions, how nurses were supported and how they looked back on those experiences. Transcripts were analysed through content analysis informed by van Gennep's concept of 'Rite of Passage', combined with elements of the self-determination theory. The findings indicate that their motivations and how nurses thought of themselves, as individuals and professionals, changed over time. For initiation and continued engagement in humanitarian work, participants were motivated by several personal and professional ambitions, as well as altruistic principles of helping others. When starting their first humanitarian missions, nurses felt vulnerable and had low self-esteem. However, through experiencing feelings of autonomy, competence and relatedness during missions, they underwent a process of change and gradually adjusted to new roles as humanitarian health workers. Reintegration in their home community, while maintaining the new roles and skills from the missions, proved very challenging. They individually found their own ways of overcoming the lack of social support they experienced after missions in order to sustain their continuation in the sector. The findings highlight the importance of social environments that facilitate and support the adjustment of individuals during and after field missions. Learning from positive examples, such as nurses with several years of experience, can strengthen strategies of retention, which can ultimately improve the delivery of humanitarian assistance.

Historical Frames and the Politics of Humanitarian Intervention: From Ethiopia, Somalia to Rwanda

ERIC Educational Resources Information Center

Shaw, Ibrahim Seaga

2007-01-01

This article argues that historical frames we often find in news media discourse can skew the way we perceive distant wars, and that this can have a knock-on effect on international humanitarian response within a cosmopolitan framework of global justice. Drawing on an empirical exploration of recent "humanitarian interventions" in…

75 FR 26344 - Temporary Exclusion of the Assessment of Overflight Fees for Humanitarian Flights Related to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... of Overflight Fees for Humanitarian Flights Related to the January 12, 2010, Earthquake in Haiti... the assessment of Overflight Fees for humanitarian flights in response to the earthquake in Haiti. SUMMARY: On January 12, 2010, the nation of Haiti was hit by a devastating earthquake near the heaviest...

Authorship in Global Mental Health Research: Recommendations for Collaborative Approaches to Writing and Publishing

PubMed Central

Kohrt, Brandon A.; Upadhaya, Nawaraj; Luitel, Nagendra P.; Maharjan, Sujen M.; Kaiser, Bonnie N.; MacFarlane, Elizabeth K.; Khan, Noreen

2014-01-01

Background Collaborations among researchers, clinicians, and individuals with mental illness from high-income countries (HICs) and low- and middle-income countries (LMICs) are crucial to produce research, interventions, and policies that are relevant, feasible, and ethical. However, global mental health and cultural psychiatry research publications have been dominated by HIC investigators. Objective The aim of this review was to present recommendations for collaborative writing with a focus on early career researchers in HICs and LMICs. Methods A workshop was conducted with HIC and LMIC investigators in Nepal to discuss lessons learned for collaborative writing. The researchers had experience in cross-cultural psychiatric epidemiology, health services research, randomized controlled trials, and projects with war and disaster-affected populations in complex humanitarian emergencies including child soldiers and refugees. Additional lessons learned were contributed from researchers engaged in similar collaborations in Haiti. Findings A step-by-step process for collaborative writing was developed. Conclusions HIC and LMIC writing collaborations will encourage accurate, ethical, and contextually grounded publications to foster understanding and facilitate reduction of the global burden of mental illness. PMID:24976552

An Early Warning System Based on Syndromic Surveillance to Detect Potential Health Emergencies among Migrants: Results of a Two-Year Experience in Italy

PubMed Central

Napoli, Christian; Riccardo, Flavia; Declich, Silvia; Dente, Maria Grazia; Pompa, Maria Grazia; Rizzo, Caterina; Rota, Maria Cristina; Bella, Antonino

2014-01-01

Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability and usefulness of syndromic surveillance in this specific context. PMID:25140999

Principles for designing and delivering psychosocial and mental healthcare.

PubMed

Williams, Richard; Kemp, V

2018-03-08

The development of the UK's military policy includes the potential for military organisations to deploy in support of humanitarian aid operations. This paper offers an overview of the risks to people's mental health of their exposure to emergencies, major incidents, disasters, terrorism, displacement, postconflict environments in which humanitarian aid is delivered, and deployments to conflict zones. It summarises the psychosocial approach recommended by many contemporary researchers and practitioners. It differentiates the extremely common experience of distress from the mental disorders that people who are affected may develop and introduces the construct of psychosocial resilience. The authors recognise the importance of trajectories of response in separating people who are distressed and require psychosocial care from those who require mental healthcare. Finally, this paper summarises a strategic approach to designing, planning and providing psychosocial and mental healthcare, provides a model of care and outlines the principles for early psychosocial interventions that do not require training in mental healthcare to deliver them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Conducting a desk review to inform the mental health and psychosocial support response to the 2016 Ecuador earthquake

PubMed Central

Troya, M. Isabela; Greene, M. Claire; Santos, Clara Gesteira; Shultz, James M.

2016-01-01

ABSTRACT Following the 7.8 magnitude earthquake that struck Ecuador on 16 April 2016, multiple salient public health concerns were raised, including the need to provide mental health and psychosocial support for individual survivors and their communities. The World Health Organization and the United Nations High Commissioner for Refugees recommend conducting a desk review to summarize existing information, specific to the affected communities, that will support timely, culturally-attuned assessment and delivery of mental health and psychosocial support shortly after the onset of a disaster or humanitarian emergency. The desk review is one component of a comprehensive toolkit designed to inform and support humanitarian actors and their responders in the field. This commentary provides a case example of the development of a desk review that was used to inform personnel responding to the 2016 earthquake in Ecuador. The desk review process is described in addition to several innovations that were introduced to the process during this iteration. Strengths and limitations are discussed, as well as lessons learned and recommendations for future applications. PMID:28265485

Faith-based aid, globalisation and the humanitarian frontline: an analysis of Western-based Muslim aid organisations.

PubMed

De Cordier, Bruno

2009-10-01

This paper focuses on the emergence and modus operandi of Muslim faith-based aid organisations from the West, particularly those from the United Kingdom. Through case studies of Islamic Relief Worldwide and Muslim Hands, it examines the actual and potential added value generated by these humanitarian players in Muslim-majority contexts at times when aid actors from or associated with the West are being perceived by some as instrumental to the political agendas of Western powers, or are being confronted with the consequences thereof. The study analyses Muslim faith-based aid organisations' transnational networks, their implementing partnerships with local faith-based non-governmental organisations (NGOs), and their security position within and their access to insecure contexts, drawing on field examples and opinion from Central Asia, Iraq and Pakistan. It thereby argues that there is ground for an expansion of the role of Muslim aid actors, because of the existence of social and political realities in the field that cannot be always effectively tackled by the dominant international development approaches.

Famines in Africa: is early warning early enough?

PubMed Central

Kim, Jeeyon Janet; Guha-Sapir, Debarati

2012-01-01

Following the second Sahelian famine in 1984–1985, major investments were made to establish Early Warning Systems. These systems help to ensure that timely warnings and vulnerability information are available to decision makers to anticipate and avert food crises. In the recent crisis in the Horn of Africa, alarming levels of acute malnutrition were documented from March 2010, and by August 2010, an impending food crisis was forecast. Despite these measures, the situation remained unrecognised, and further deteriorated causing malnutrition levels to grow in severity and scope. By the time the United Nations officially declared famine on 20 July 2011, and the humanitarian community sluggishly went into response mode, levels of malnutrition and mortality exceeded catastrophic levels. At this time, an estimated 11 million people were in desperate and immediate need for food. With warnings of food crises in the Sahel, South Sudan, and forecast of the drought returning to the Horn, there is an immediate need to institutionalize change in the health response during humanitarian emergencies. Early warning systems are only effective if they trigger an early response. PMID:22745628

Famines in Africa: is early warning early enough?

PubMed

Kim, Jeeyon Janet; Guha-Sapir, Debarati

2012-01-01

Following the second Sahelian famine in 1984-1985, major investments were made to establish Early Warning Systems. These systems help to ensure that timely warnings and vulnerability information are available to decision makers to anticipate and avert food crises. In the recent crisis in the Horn of Africa, alarming levels of acute malnutrition were documented from March 2010, and by August 2010, an impending food crisis was forecast. Despite these measures, the situation remained unrecognised, and further deteriorated causing malnutrition levels to grow in severity and scope. By the time the United Nations officially declared famine on 20 July 2011, and the humanitarian community sluggishly went into response mode, levels of malnutrition and mortality exceeded catastrophic levels. At this time, an estimated 11 million people were in desperate and immediate need for food. With warnings of food crises in the Sahel, South Sudan, and forecast of the drought returning to the Horn, there is an immediate need to institutionalize change in the health response during humanitarian emergencies. Early warning systems are only effective if they trigger an early response.

[Which relationships between civilian-military actions(CMA), civilian and military cooperation (CIMIC)and non-governmental organizations(NGO)?].

PubMed

Grünewald, F; de Geoffroy, V

2002-01-01

This article questions the existence of "governmental humanitarianism" in opposition to "non-governmental" humanitarianism. The authors report the growing implication of civilian and military actors representing governments in responding to crises and express their concern that this tendency could ultimately lead to use of humanitarian action for diplomatic and economic purposes. They stress that unlike non-governmental organizations, state-run humanitarian agencies are subject to political, economic, and geographic factors. In the context of increasingly frequent application of the CMA doctrine, the authors analyze the role of non-governmental organizations in the field during post-crisis reconstruction. They underline the growing problem of organizing bilateral and multilateral assistance operations. They restate the hope expressed by many humanitarian organizations for a return of the rule of law and conclude on the need to develop complementary activities in the field.

Civil Registration and Vital Statistics, Emergencies, and International Law: Understanding the Intersection.

PubMed

Brolan, Claire E; Gouda, Hebe

2017-05-01

Civil registration and vital statistics (CRVS) systems are typically run by governments to record every birth, adoption, death, marriage, and divorce that occurs among a country's population. Registration of vital events provides individuals with a formal relationship with the State and each other, and is the foundation of a person's identity, nationality, and legal status. At a population level, vital statistics are essential for effective planning and implementation of policies and services. Globally, strong CRVS systems are increasingly recognised as a crucial backbone for redressing health inequities and as a priority in strengthening global health and development efforts. Many countries, however, currently lack adequate and reliable CRVS systems, leaving many people vulnerable to statelessness, limited access to important government services (such as education and health services), and effective legal protection. Public health and humanitarian emergencies in such contexts can expose those already disadvantaged and marginalised to heightened risk. CRVS systems weakened by crises make registration difficult or impossible and unregistered people may be displaced or separated from their families, exacerbating their susceptibility. The presence of a strong CRVS system, therefore, can facilitate effective and cost-effective emergency responses, help prevent exploitation of individuals (particularly women and children), and help to rebuild communities post-crisis. This article will consequently review the international legal mandates that exist to strengthen CRVS systems globally, with particular view to public health and humanitarian emergencies. Identity and citizenship, and the socio-political contexts in which these concepts co-exist, are inevitably interconnected with CRVS. This can create potential for CRVS systems and data to be exploited as a political instrument. Grounding CRVS strengthening in a single binding, human rights law instrument is a potential way forward. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

Assessment of health-care waste management in a humanitarian crisis: A case study of the Gaza Strip.

PubMed

Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore

2016-12-01

Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Redefining HHS International Response: Challenges and Recommendations for Interagency Partnerships

DTIC Science & Technology

2009-04-01

Approach and Enhance Interagency Planning, 1. 22 David Hinson , U.S. Military Interaction with Humanitarian Assistance Organizations During Small-Scale...Defense University Press, 1996); http://www.dodccrp.org/files/Hayes_Interagency.pdf (accessed March 2, 2009. 31 Hinson , Military Interaction with...Humanitarian Assistance Organizations, 29. 32 Benton and Ware, “Haiti: A Case Study”. 33 Hinson , Military Interaction with Humanitarian Assistance

Balancing obligations and self-interest: humanitarian program settlers in the Australian labor market.

PubMed

Stevens, C

1997-01-01

"Technological and structural changes in the Australian economy have led to a decline in unskilled and semi-skilled employment and this has had a marked effect on labor market opportunities for immigrants.... This paper reviews the labor market experience of humanitarian program arrivals and considers the policy implications of high levels of unemployment among this group. It is suggested that humanitarian obligations do not end with entry to Australia, and it is in the interests of the receiving society and humanitarian program arrivals for greater public investment in skills development to help improve labor market outcomes among this group." excerpt

Analysis of United States Marine Corps Operations in Support of Humanitarian Assistance and Disaster Relief

DTIC Science & Technology

2013-12-01

reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of...capabilities of the USMC MEU that satisfy demands arising from natural disasters. We follow the humanitarian and military core competencies framework for...satisfy demands arising from natural disasters. We follow the humanitarian and military core competencies framework for studying the USMC

Humanitarian Interventions: Western Imperialism or a Responsibility to Protect?--An Analysis of the Humanitarian Interventions in Darfur

ERIC Educational Resources Information Center

Damboeck, Johanna

2012-01-01

Purpose: The aim of this article is to provide an analysis of the features that have shaped the state's decision-making process in the United Nations, with regard to the humanitarian intervention in Darfur from 2003 onwards. Design/methodology/approach: The methodological approach to the study is a review of political statement papers grounded in…

15 CFR Supplement No. 2 to Part 740 - Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception

Code of Federal Regulations, 2014 CFR

2014-01-01

... Basic Human Needs Under the Humanitarian License Exception No. Supplement No. 2 to Part 740 Commerce and... Supplement No. 2 to Part 740—Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception (a) Health Equipment for the Handicapped Hospital Supplies and Equipment Laboratory...

15 CFR Supplement No. 2 to Part 740 - Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception

Code of Federal Regulations, 2011 CFR

2011-01-01

... Basic Human Needs Under the Humanitarian License Exception No. Supplement No. 2 to Part 740 Commerce and... Supplement No. 2 to Part 740—Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception (a) Health Equipment for the Handicapped Hospital Supplies and Equipment Laboratory...

15 CFR Supplement No. 2 to Part 740 - Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception

Code of Federal Regulations, 2012 CFR

2012-01-01

... Basic Human Needs Under the Humanitarian License Exception No. Supplement No. 2 to Part 740 Commerce and... Supplement No. 2 to Part 740—Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception (a) Health Equipment for the Handicapped Hospital Supplies and Equipment Laboratory...

15 CFR Supplement No. 2 to Part 740 - Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception

Code of Federal Regulations, 2010 CFR

2010-01-01

... Basic Human Needs Under the Humanitarian License Exception No. Supplement No. 2 to Part 740 Commerce and... Supplement No. 2 to Part 740—Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception (a) Health Equipment for the Handicapped Hospital Supplies and Equipment Laboratory...

15 CFR Supplement No. 2 to Part 740 - Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception

Code of Federal Regulations, 2013 CFR

2013-01-01

... Basic Human Needs Under the Humanitarian License Exception No. Supplement No. 2 to Part 740 Commerce and... Supplement No. 2 to Part 740—Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception (a) Health Equipment for the Handicapped Hospital Supplies and Equipment Laboratory...

Supporting Timely Humanitarian Assistance/Disaster Relief (HA/DR) Decisions Through Geospatial Intelligence (GEOINT) and Geographical Information Systems (GIS) Tools

DTIC Science & Technology

2014-05-22

attempted to respond to the advances in technology and the growing power of geographical information system (GIS) tools. However, the doctrine...Geospatial intelligence (GEOINT), Geographical information systems (GIS) tools, Humanitarian Assistance/Disaster Relief (HA/DR), 2010 Haiti Earthquake...Humanitarian Assistance/Disaster Relief (HA/DR) Decisions Through Geospatial Intelligence (GEOINT) and Geographical Information Systems (GIS) Tools

Humanitarian Assistance: An Opportunity Is Lost

DTIC Science & Technology

2009-10-23

national strategic objectives.‖15 General James Jones , then Commander, United States European Command, viewed theater security cooperation programs...Peace, 1. 15Fred Baker, ―Humanitarian Efforts Aid Diplomacy,‖ American Forces Free Press, 23 November 2008. 16 James L. Jones , ―Testimony...Craig Llewellyn . ―Humanitarian Medical Assistance in U.S. Foreign Policy: Is There a Constructive Role for Military Medical Services.‖ The DISAM

Linking Science of Flood Forecasts to Humanitarian Actions for Improved Preparedness and Effective Response

NASA Astrophysics Data System (ADS)

Uprety, M.; Dugar, S.; Gautam, D.; Kanel, D.; Kshetri, M.; Kharbuja, R. G.; Acharya, S. H.

2017-12-01

Advances in flood forecasting have provided opportunities for humanitarian responders to employ a range of preparedness activities at different forecast time horizons. Yet, the science of prediction is less understood and realized across the humanitarian landscape, and often preparedness plans are based upon average level of flood risk. Working under the remit of Forecast Based Financing (FbF), we present a pilot from Nepal on how available flood and weather forecast products are informing specific pre-emptive actions in the local preparedness and response plans, thereby supporting government stakeholders and humanitarian agencies to take early actions before an impending flood event. In Nepal, forecasting capabilities are limited but in a state of positive flux. Whilst local flood forecasts based upon rainfall-runoff models are yet to be operationalized, streamflow predictions from Global Flood Awareness System (GLoFAS) can be utilized to plan and implement preparedness activities several days in advance. Likewise, 3-day rainfall forecasts from Nepal Department of Hydrology and Meteorology (DHM) can further inform specific set of early actions for potential flash floods due to heavy precipitation. Existing community based early warning systems in the major river basins of Nepal are utilizing real time monitoring of water levels and rainfall together with localised probabilistic flood forecasts which has increased warning lead time from 2-3 hours to 7-8 hours. Based on these available forecast products, thresholds and trigger levels have been determined for different flood scenarios. Matching these trigger levels and assigning responsibilities to relevant actors for early actions, a set of standard operating procedures (SOPs) are being developed, broadly covering general preparedness activities and science informed anticipatory actions for different forecast lead times followed by the immediate response activities. These SOPs are currently being rolled out and tested by the Ministry of Home Affairs (MoHA) through its district emergency operation centres in West Nepal. Potential scale up and successful implementation of this science based approach would be instrumental to take forward global commitments on disaster risk reduction, climate change adaptation and sustainable goals in Nepal.

Battles on women's bodies: war, rape and traumatisation in eastern Democratic Republic of Congo.

PubMed

Trenholm, J E; Olsson, P; Ahlberg, B M

2011-01-01

Rape has been used as a weapon in the conflict in eastern Democratic Republic of Congo (DRC) in unprecedented ways. Research into the phenomenon of war-rape is limited, particularly in this context. The aim of this study was to explore perceptions of local leaders in eastern DRC concerning rape and raped women in the war context. Local leaders were chosen for their ability to both reflect and influence their constituencies. Interviews were conducted with 10 local leaders and transcripts subjected to qualitative content analysis. The study suggests that mass raping and the methods of perpetration created a chaos effectively destroying communities and the entire society and that humanitarian aid was often inappropriate. Furthermore, an exclusive focus on raped women missed the extent of traumatisation entire communities suffered. More significantly, the lack of political will, corruption, greed and inappropriate aid creates a tangled web serving to intensify the war. This complexity has implications for humanitarian interventions including public health.

Cognitive frames in psychology: demarcations and ruptures.

PubMed

Yurevich, Andrey V

2009-06-01

As there seems to be a recurrent feeling of crisis in psychology, its present state is analyzed in this article. The author believes that in addition to the traditional manifestations that have dogged psychology since it emerged as an independent science some new features of the crisis have emerged. Three fundamental "ruptures" are identified: the "horizontal" rupture between various schools and trends, the "vertical" rupture between natural science and humanitarian psychology, and the "diagonal" rupture between academic research and applied practice of psychology. These manifestations of the crisis of psychology have recently been compounded by the crisis of its rationalistic foundations. This situation is described in terms of the cognitive systems in psychology which include meta-theories, paradigms, sociodigms and metadigms.

Health impact of the 2004 Andaman Nicobar earthquake and tsunami in Indonesia.

PubMed

Guha-Sapir, Debarati; van Panhuis, Willem Gijsbert

2009-01-01

The human impact of the tsunami that occurred on 26 December 2004 was enormous, with Indonesia bearing a huge proportion of the losses. The aftermath brought predictions of communicable disease outbreaks and widespread fear of epidemics. However, evidence from previous disasters due to natural hazards does not support all of these predictions. The objectives of this study were to: (1) describe the relative importance of infectious diseases and injuries as a consequence of a disaster due to natural hazards; and (2) identify key recommendations for the improvement of control and surveillance of these diseases during and after disasters. A team from the Center for Research on the Epidemiology of Disasters visited Jakarta and Banda Aceh from 11-23 January 2005, and collected data from the Central and Provincial Ministries of Health (MOH), the World Health Organization (WHO), and a field hospital from the International Committee of the Red Cross in Banda Aceh. The epidemiological profiles of diseases before and after the tsunami were compared. Cholera, tetanus, wounds and wound infections, acute respiratory infections, malaria, and dengue were included in this analysis. Certain diseases (e.g., cholera, malaria, dengue) are not always an immediate priority post-disaster. Rates of disaster-related health conditions requiring emergency response fell by half, and became negligible around four weeks after the precipitating events. Some conditions, such as aspiration pneumonia and tetanus, which normally are rare, require special preparedness for emergency personnel. In addition, resistant and rare pathogens are associated with disasters due to natural hazards in the tropics and require specialized knowledge for the rapid and successful treatment of related infections. Within the first four weeks of a disaster, international humanitarian agencies in the health sector should start working with the MOH. The WHO surveillance system established immediately after the tsunami offers lessons for developing a prototype for future emergencies. Guidelines for tetanus and aspiration pneumonia should be included in disaster medicine handbooks, and humanitarian aid groups should be prepared to provide emergency obstetrics and post-natal services. Relief funding after naturally occurring disasters should consider funding sustainability. Donors should know when to stop providing emergency relief funds and transition to recovery/development strategies.

Reason, emotion, compassion: can altruism survive professionalisation in the humanitarian sector?

PubMed

Carbonnier, Gilles

2015-04-01

The humanitarian sector has grown enormously over the past two decades. Some fear that professionalisation comes at the expense of altruistic volunteering. This may be a valid concern if altruism is the product of organisational culture and individual experiences rather than an innate trait. This paper examines advances in evolutionary biology and neurology that provide evidence in support of both the nature and nurture arguments, echoing earlier insights from social sciences. It then questions to what extent humanitarian principles build on altruistic impulses or instead seek to constrain them, and reviews recruitment profiles of selected humanitarian organisations and applicants' letters accordingly. This initial investigation warrants further research to identify how altruism as a personal trait and an organisational principle has influenced diverse humanitarian actors and traditions. This paper outlines how training curricula and organisational reward systems can build on-rather than stifle-natural altruism to nurture critical, reflexive practitioners. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

How sex- and age-disaggregated data and gender and generational analyses can improve humanitarian response.

PubMed

Mazurana, Dyan; Benelli, Prisca; Walker, Peter

2013-07-01

Humanitarian aid remains largely driven by anecdote rather than by evidence. The contemporary humanitarian system has significant weaknesses with regard to data collection, analysis, and action at all stages of response to crises involving armed conflict or natural disaster. This paper argues that humanitarian actors can best determine and respond to vulnerabilities and needs if they use sex- and age-disaggregated data (SADD) and gender and generational analyses to help shape their assessments of crises-affected populations. Through case studies, the paper shows how gaps in information on sex and age limit the effectiveness of humanitarian response in all phases of a crisis. The case studies serve to show how proper collection, use, and analysis of SADD enable operational agencies to deliver assistance more effectively and efficiently. The evidence suggests that the employment of SADD and gender and generational analyses assists in saving lives and livelihoods in a crisis. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Violations of human rights: health practitioners as witnesses.

PubMed

Orbinski, James; Beyrer, Chris; Singh, Sonal

2007-08-25

For humanitarian health-care practitioners bearing witness to violations of human dignity has become synonymous with denunciations, human rights advocacy, or lobbying for political change. A strict reliance on legal interpretations of humanitarianism and human rights is inadequate for fully understanding the problems inherent in political change. With examples from the HIV/AIDS epidemic in the USA, the Rwandan genocide, and physician-led political activism in Nepal, we describe three cases in which health practitioners bearing witness to humanitarian and human-rights issues have had imperfect outcomes. However these acts of bearing witness have been central to the promotion of humanitarianism and human rights, to the pursuit of justice that they have inevitably and implicitly endorsed, and thus to the politics that have or might yet address these issues. Despite the imperfections, bearing witness, having first-hand knowledge of humanitarian and human-rights principles and their limitations, and systematically collecting evidence of abuse, can be instrumental in tackling the forces that constrain the realisation of human health and dignity.

Investigating the strategic antecedents of agility in humanitarian logistics.

PubMed

L'Hermitte, Cécile; Brooks, Benjamin; Bowles, Marcus; Tatham, Peter H

2017-10-01

This study investigates the strategic antecedents of operational agility in humanitarian logistics. It began by identifying the particular actions to be taken at the strategic level of a humanitarian organisation to support field-level agility. Next, quantitative data (n=59) were collected on four strategic-level capabilities (being purposeful, action-focused, collaborative, and learning-oriented) and on operational agility (field responsiveness and flexibility). Using a quantitative analysis, the study tested the relationship between organisational capacity building and operational agility and found that the four strategic-level capabilities are fundamental building blocks of agility. Collectively they account for 52 per cent of the ability of humanitarian logisticians to deal with ongoing changes and disruptions in the field. This study emphasises the need for researchers and practitioners to embrace a broader perspective of agility in humanitarian logistics. In addition, it highlights the inherently strategic nature of agility, the development of which involves focusing simultaneously on multiple drivers. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

The Co-Creation of a Video to Inspire Humanitarianism: How an Educational Entrepreneurial Approach Inspired Humanitarian Workers to Be Mindfully Innovative Whilst Working with Technology

ERIC Educational Resources Information Center

Crotty, Yvonne; Kilboy, Laura

2015-01-01

This paper demonstrates the value of embracing digital technology in order to effect positive change in a non-governmental (NGO) charity organisation, in this case the Irish Charity Crosscause. The outcome of the research was the creation of a charity video, Crosscause: Making a Difference, to showcase humanitarian work in Ireland and Romania with…

Humanitarian Assistance: Adapting the Process to Meet the Military’s Evolving Role in Non-Traditional Missions

DTIC Science & Technology

1993-12-01

action to support humanitarian relief and democratic movements " (Towell, 1992, p. 3761). The U.S. 2 led coalition, from December 1992 through May...similar to planning and executing the movement phase of wartime contingencies. Therefore, these activities in humanitarian relief missions also serve...DISASTZR _ CATUGORIZS ORIGINS ZXARPLUS NATURAL METEOROLOGICAL STORMS, DROUGHTS TOPOLOGICAL FLOODS, LANDSLIDES TELLURIC /TECTONIC EARTHQUAKES BIOLOGICAL

Humanitarian Assistance and ’Soft’ Power Projection

DTIC Science & Technology

2012-05-04

organization consisted of military and civilian leadership, which managed the Pacification Programs throughout Vietnam. This program was a historic example...assistance efforts. The directorate that manages humanitarian assistance operations varies from theater to theater. The J9 Directorate labeled as either...2012) 12 (JP) 3-07.3, I-6. 13 A. Cooper Drury et al, The Politics of Humanitarian Aid: U.S. Foreign Disaster Assistance, 1964-1995, (Cambridge

The League of Nations' rescue of Armenian genocide survivors and the making of modern humanitarianism, 1920-1927.

PubMed

Watenpaugh, Keith David

2010-01-01

The essay centers of the efforts by the League of Nations to rescue women and children survivors of the 1915 Armenian Genocide. This rescue -- a seemingly unambiguous good -- was at once a constitutive act in drawing the boundaries of the international community, a key moment in the definition of humanitarianism, and a site of resistance to the colonial presence in the post-Ottoman Eastern Mediterranean. Drawing from a wide range of source materials in a number of languages, including Turkish, Armenian, and Arabic, the essay brings the intellectual and social context of humanitarianism in initiating societies together with the lived experience of humanitarianism in the places where the act took form. In so doing, it draws our attention to the proper place of the Eastern mediterranean, and its women and children, in the global history of humanitarianism. The prevailing narrative of the history of human rights places much of its emphasis on the post-World War II era, the international reaction to the Holocaust, and the founding of the United Nations. yet contemporary human rights thinking also took place within practices of humanitarianism in the interwar period, and is necessarily inseparable from the histories of refugees, colonialism, and the non-West.

Introducing Jus ante Bellum as a cosmopolitan approach to humanitarian intervention

PubMed Central

Brown, Garrett Wallace; Bohm, Alexandra

2015-01-01

Cosmopolitans often argue that the international community has a humanitarian responsibility to intervene militarily in order to protect vulnerable individuals from violent threats and to pursue the establishment of a condition of cosmopolitan justice based on the notion of a ‘global rule of law’. The purpose of this article is to argue that many of these cosmopolitan claims are incomplete and untenable on cosmopolitan grounds because they ignore the systemic and chronic structural factors that underwrite the root causes of these humanitarian threats. By way of examining cosmopolitan arguments for humanitarian military intervention and how systemic problems are further ignored in iterations of the Responsibility to Protect, this article suggests that many contemporary cosmopolitan arguments are guilty of focusing too narrowly on justifying a responsibility to respond to the symptoms of crisis versus demanding a similarly robust justification for a responsibility to alleviate persistent structural causes. Although this article recognizes that immediate principles of humanitarian intervention will, at times, be necessary, the article seeks to draw attention to what we are calling principles of Jus ante Bellum (right before war) and to stress that current cosmopolitan arguments about humanitarian intervention will remain insufficient without the incorporation of robust principles of distributive global justice that can provide secure foundations for a more thoroughgoing cosmopolitan condition of public right. PMID:29708128

Medical humanitarianism in the United States: alternative healthcare, spirituality and political advocacy in the case of Our Lady Guadalupe Free Clinic.

PubMed

Tiedje, Kristina; Plevak, David J

2014-11-01

Exclusionary practices in dominant market-based systems are recognized as contributing to global health inequities. Undocumented immigrants are particularly vulnerable to unequal access to healthcare. Humanitarian NGOs strive to respond meaningfully to these health inequities among migrants and undocumented immigrants. Few studies describe the work of humanitarian NGOs that advocate for the right to health of undocumented immigrants in high-income countries. This paper discusses immigration, health, and human rights while examining solidarity, spirituality, and advocacy using a U.S.-based example of medical humanitarianism: the 'Our Lady of Guadalupe Free Clinic.' In 2011, the Free Clinic began in the basement of a Catholic parish in Minnesota in response to the lack of access to medical services for undocumented immigrants. Run by a local grassroots organization, it is held every six weeks and offers free primary healthcare to Latino immigrants and the uninsured. In this article, we examine the tricky relationship between humanitarianism and human rights in the U.S. Using ethnography, we draw on participant observation and interviews with 30 clinic volunteers, including health professionals, administrators, language interpreters, and spiritual leaders. The study was conducted September 2012-December 2013 in southern Minnesota. We examine how notions of solidarity, spirituality, and advocacy structure faith-based medical humanitarianism in the U.S. and explore the underlying tensions between the humanitarian mandate, spiritual teachings (social justice, solidarity), and political advocacy. Examining a moment of "crisis" in the Clinic, our study shows that volunteers experience the alliance between spirituality and advocacy with uneasiness. While a spiritual calling may initially motivate volunteers to serve, an embrace of human rights advocacy is important in a sustained effort to provide humanitarian medical care to individuals who fall outside of the political and moral community in the U.S. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implementation of evidence-based humanitarian programs in military-led missions: part I. Qualitative gap analysis of current military and international aid programs.

PubMed

Reaves, Erik J; Schor, Kenneth W; Burkle, Frederick M

2008-12-01

A recent Department of Defense instruction mandates country-specific assessments, identification of interventions, and development of guidance for Department of Defense to plan, train, and prepare for the provision of humanitarian assistance in stability operations. It also directs the use of outcome-based measures of effectiveness and the establishment of processes facilitating transparency of information. Whereas this would align military-led projects closer to the standards of the international aid community, how this process will be developed and implemented within the military has not yet been determined. To begin developing an evidence-based program for military-led humanitarian aid, we conducted a qualitative gap analysis comparing information from a Web search of Department of Defense medical after-action reports, lessons learned, and expert interviews with the internationally accepted standards in humanitarian assistance impact assessment. There is a major gap in the ability of the Department of Defense to assess the impact of humanitarian assistance in stability operations compared with international development standards. Of the 1000 Department of Defense after-action reports and lessons learned reviewed, only 7 (0.7%) reports refer to, but do not discuss, impact assessment or outcome-based measures of effectiveness. This investigation shows that the Department of Defense humanitarian assistance operations are, historically, recorded without documentation using quantifiable health data identifying which aid activities contributed directly to desired outcomes or favorable public opinion, and rarely are analyzed for effectiveness. As humanitarian assistance operations assume an ever greater role in US military strategy, it is imperative that we investigate useful impact assessment models to meet mission directives and, more important, to maximize coordination in a necessarily integrated and cooperative development environment. These findings provide baseline knowledge for the implementation of an evidence-based impact assessment process to validate future Department of Defense humanitarian assistance operations.

Improvements for international medicine donations: a review of the World Health Organization Guidelines for Medicine Donations, 3rd edition.

PubMed

Cañigueral-Vila, Nuria; Chen, Jennifer C; Frenkel-Rorden, Lindsey; Laing, Richard

2015-01-01

Some humanitarian and development organizations respond to major natural disasters and emergencies by donating medicines. Many provide medicines on a routine basis to support health systems, particularly those run by Faith-Based Organizations. Although such donations can provide essential medicines to populations in great need, inappropriate donations also take place, with burdensome consequences. The World Health Organization (WHO) has developed the interagency Guidelines for Medicine Donations for use by donors and recipients in the context of emergency aid and international development assistance. Although comprehensive in nature and transferable to various emergency situations, adjustments to both content and formatting would improve this resource. Recommendations for the next version of these guidelines include: specific wording and consistent formatting; definition of who is a recipient, clear distinction between acute and long-term emergencies, and proper donation procedures pertaining to each; inclusion of visual aides such as flowcharts, checklists, and photos; and improving the citations system.

[Undernutrition in humanitarian crises].

PubMed

Skau, Jutta Kloppenborg Heick; Olsen, Mette; Friis, Henrik; Michaelsen, Kim Fleischer

2010-01-11

Undernutrition is a major cause of morbidity and mortality in emergencies. The response depends on the extent and type of undernutrition in the affected population. Nutritional status is assessed by weight-for-height, mid-upper arm circumference and micronutrient deficiencies. Food aid is distributed in general or selective feeding programmes. Promotion of breastfeeding has been found to be one of the most efficient strategies to prevent undernutrition. There is a lack of evidence to support the optimal composition of food aid products, but there is an increasing focus on the importance of research in this field.

The Strategic and Political Impacts of Collateral Damage from Strike Warfare

DTIC Science & Technology

2015-03-01

damage from strike warfare focuses on legal, humanitarian, and moral issues . To oversimplify, killing non-combatants is bad, but it happens, and not...humanitarian, and moral issues . To oversimplify, killing non- combatants is bad, but it happens, and not always by accident. Therefore, it is instructive...method of bombing. A significant amount of research on the effects of collateral damage from strike warfare focuses on humanitarian and moral issues

Dual loyalties: Everyday ethical problems of registered nurses and physicians in combat zones.

PubMed

Lundberg, Kristina; Kjellström, Sofia; Sandman, Lars

2017-01-01

When healthcare personnel take part in military operations in combat zones, they experience ethical problems related to dual loyalties, that is, when they find themselves torn between expectations of doing caring and military tasks, respectively. This article aims to describe how Swedish healthcare personnel reason concerning everyday ethical problems related to dual loyalties between care and military tasks when undertaking healthcare in combat zones. Abductive qualitative design. Participants and research context: Individual interviews with 15 registered nurses and physicians assigned for a military operation in Mali. Ethical considerations: The participants signed up voluntarily, and requirements for informed consent and confidentiality were met. The research was approved by the Regional Ethics Review Board in Gothenburg (D no. 816-14; 24 November 2014). Three main categories emerged: reasons for not undertaking combat duties, reasons for undertaking combat duties and restricted loyalty to military duties, and 14 subcategories. Reasons for not undertaking combat duties were that it was not in their role, not according to ethical codes or humanitarian law or a breach towards patients. Reasons for undertaking combat duties were that humanitarian law does not apply or has to be treated pragmatically or that it is a case of force protection. Shortage of resources and competence were reasons for both doing and not doing military tasks. Under some circumstances, they could imagine undertaking military tasks: when under threat, if unseen or if not needed for healthcare duties. These discrepant views suggest a lack of a common view on what is ethically acceptable or not, and therefore we suggest further normative discussion on how these everyday ethical problems should be interpreted in the light of humanitarian law and ethical codes of healthcare personnel and following this, further training in ethical reflection before going on military operations.

Learning lessons from field surveys in humanitarian contexts: a case study of field surveys conducted in North Kivu, DRC 2006-2008

PubMed Central

Grais, Rebecca F; Luquero, Francisco J; Grellety, Emmanuel; Pham, Heloise; Coghlan, Benjamin; Salignon, Pierre

2009-01-01

Survey estimates of mortality and malnutrition are commonly used to guide humanitarian decision-making. Currently, different methods of conducting field surveys are the subject of debate among epidemiologists. Beyond the technical arguments, decision makers may find it difficult to conceptualize what the estimates actually mean. For instance, what makes this particular situation an emergency? And how should the operational response be adapted accordingly. This brings into question not only the quality of the survey methodology, but also the difficulties epidemiologists face in interpreting results and selecting the most important information to guide operations. As a case study, we reviewed mortality and nutritional surveys conducted in North Kivu, Democratic Republic of Congo (DRC) published from January 2006 to January 2009. We performed a PubMed/Medline search for published articles and scanned publicly available humanitarian databases and clearinghouses for grey literature. To evaluate the surveys, we developed minimum reporting criteria based on available guidelines and selected peer-review articles. We identified 38 reports through our search strategy; three surveys met our inclusion criteria. The surveys varied in methodological quality. Reporting against minimum criteria was generally good, but presentation of ethical procedures, raw data and survey limitations were missed in all surveys. All surveys also failed to consider contextual factors important for data interpretation. From this review, we conclude that mechanisms to ensure sound survey design and conduct must be implemented by operational organisations to improve data quality and reporting. Training in data interpretation would also be useful. Novel survey methods should be trialled and prospective data gathering (surveillance) employed wherever feasible. PMID:19744319

Travelers' Diarrhea

MedlinePlus

... Climates Humanitarian Aid Workers Humanitarian Aid Workers in Ecuador Insurance International Adoption Jet Lag Last-Minute Travel Long-Term Travel Mass Gatherings Medical Tourism Mental Health Motion Sickness Natural Disasters Pregnant Travelers ...

Virtual Cloud Computing: Effects and Application of Hastily Formed Networks (HFN) for Humanitarian Assistance/Disaster Relief (HA/DR) Missions

DTIC Science & Technology

2011-09-01

COMPUTING: EFFECTS AND APPLICATION OF HASTILY FORMED NETWORKS (HFN) FOR HUMANITARIAN ASSISTANCE/DISASTER RELIEF (HA/DR) MISSIONS by Mark K. Morris...i REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour...SUBTITLE Virtual Cloud Computing: Effects and Application of Hastily Formed Networks (HFN) for Humanitarian Assistance/Disaster Relief (HA/DR) Missions

The Netted Humanitarian: Improving the Information and Communications Technology Assessment Process for Humanitarian Assistance/Disaster Relief (HA/DR) Missions

DTIC Science & Technology

2013-03-01

NGOs, United Nations-Office for the Coordination of Humanitarian Affairs (UN-OCHA), United Nations-World Food Program (UN-WFP), philanthropic...MISSIONS C5. FUNDING NUMBERS 6. AUTHOR( S ) Christian X. Gutierrez 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Naval Postgraduate School...Monterey, CA 93943–5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING /MONITORING AGENCY NAME( S ) AND ADDRESS(ES) N/A 10. SPONSORING

The Need for the United States Army to Possess a Landing Craft with Maneuver Capabilities

DTIC Science & Technology

2015-06-12

Personnel, Facilities and Policy FAA Functional Area Analysis FNA Functional Needs Analysis FSA Functional Solution Analysis HADR Humanitarian ...increase the options available to the JTFC.7 Within the last 25 years, the LCM-8 and other landing craft have been used numerous times for Humanitarian ...and coastal islands after the bridges were destroyed.8 The World Food Program (WFP) and other humanitarian aid providers perfected the use of military

Travelers' Health: Rabies

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Travelers' Health: Poliomyelitis

MedlinePlus

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Travelers' Health: Rubella

MedlinePlus

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Travelers' Health: Cryptosporidiosis

MedlinePlus

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A systematic literature review of the quality of evidence for injury and rehabilitation interventions in humanitarian crises.

PubMed

Smith, James; Roberts, Bayard; Knight, Abigail; Gosselin, Richard; Blanchet, Karl

2015-11-01

Humanitarian crises continue to pose a significant threat to health; the United Nations estimates that 144 million people are directly affected by conflict or environmental disasters. During most humanitarian crises, surgical and rehabilitative interventions remain a priority. This review assessed the quality of evidence that informs injury and physical rehabilitation interventions in humanitarian crises. Peer-reviewed and grey literature sources were assessed in a systematic manner. Selected papers were evaluated using quality criteria based on a modified version of the STROBE protocol. 46 papers met the inclusion criteria. 63 % of the papers referred to situations of armed conflict, of which the Yugoslav Wars were the most studied crisis context. 59 % of the studies were published since the year 2000. However, only two studies were considered of a high quality. While there is now a greater emphasis on research in this sector, the volume of evidence remains inadequate given the growing number of humanitarian programmes worldwide. Further research is needed to ensure a greater breadth and depth of understanding of the most appropriate interventions in different settings.

Educating the humanitarian engineer.

PubMed

Passino, Kevin M

2009-12-01

The creation of new technologies that serve humanity holds the potential to help end global poverty. Unfortunately, relatively little is done in engineering education to support engineers' humanitarian efforts. Here, various strategies are introduced to augment the teaching of engineering ethics with the goal of encouraging engineers to serve as effective volunteers for community service. First, codes of ethics, moral frameworks, and comparative analysis of professional service standards lay the foundation for expectations for voluntary service in the engineering profession. Second, standard coverage of global issues in engineering ethics educates humanitarian engineers about aspects of the community that influence technical design constraints encountered in practice. Sample assignments on volunteerism are provided, including a prototypical design problem that integrates community constraints into a technical design problem in a novel way. Third, it is shown how extracurricular engineering organizations can provide a theory-practice approach to education in volunteerism. Sample completed projects are described for both undergraduates and graduate students. The student organization approach is contrasted with the service-learning approach. Finally, long-term goals for establishing better infrastructure are identified for educating the humanitarian engineer in the university, and supporting life-long activities of humanitarian engineers.

Strange but common bedfellows: the relationship between humanitarians and the military in developing psychosocial interventions for civilian populations affected by armed conflict.

PubMed

Kienzler, Hanna; Pedersen, Duncan

2012-07-01

This essay analyses how the relationships between Cold War and post-Cold War politics, military psychiatry, humanitarian aid and mental health interventions in war and post-war contexts have transformed over time. It focuses on the restrictions imposed on humanitarian interventions and aid during the Cold War; the politics leading to the transfer of the PTSD diagnosis and its treatment from the military to civilian populations; humanitarian intervention campaigns in the post-Cold War era; and the development of psychosocial intervention programs and standards of care for civilian populations affected by armed conflict. Viewing these developments in their broader historical, political and social contexts reveals the politics behind mental health interventions conducted in countries and populations affected by warfare. In such militarized contexts, the work of NGOs providing assistance to people suffering from trauma-related health problems is far from neutral as it depends on the support of the military and plays an important role in the shaping of international politics and humanitarian aid programs.

Guidelines for drug donations.

PubMed Central

Hogerzeil, H. V.; Couper, M. R.; Gray, R.

1997-01-01

Drug donations are usually given in response to acute emergencies, but they can also be part of development aid. Donations may be given directly by governments, by non-governmental organisations, as corporate donations (direct or through private voluntary organisations), or as private donations to single health facilities. Although there are legitimate differences between these donations, basic rules should apply to them all. This common core of "good donation practice" is the basis for new guidelines which have recently been issued by the World Health Organisation after consultation with all relevant United Nations agencies, the Red Cross, and other major international agencies active in humanitarian emergency relief. This article summarises the need for such guidelines, the development process, the core principles, and the guidelines themselves and gives practical advice to recipients and donor agencies. PMID:9116555

Travelers' Health: Hepatitis B

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Travelers' Health: Meningococcal Disease

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Travelers' Health: HIV Infection

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Travelers' Health: Leishmaniasis, Visceral

MedlinePlus

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Travelers' Health: Hepatitis A

MedlinePlus

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Travelers' Health: Varicella (Chickenpox)

MedlinePlus

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Travelers' Health: Japanese Encephalitis

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Travelers' Health: Leishmaniasis, Cutaneous

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Travelers' Health: Injuries and Safety

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Traveler's Health: Avoid Bug Bites

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Travelers' Health: Animal-Associated Hazards

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Go Fast, Go Big, Go Early, and Go Smart: The Air National Guard in Complex Catastrophies

DTIC Science & Technology

2012-06-01

in humanitarian assistance airdrops and helicopter landing zone operations. They can establish “ lily pads ”, or patient transfer staging areas, to...facilitate patient movement out of the incident site. They controlled hundreds of lily pads during Hurricane Katrina.11 With Guardian Angels, they...The collective effort of up to eight ANG MASFs utilized in a lily pad scenario one hour following employment could progressively stage patients out

Rebalancing Pacific Fleet: Operationalize U.S. Third Fleet and Move It into the Indo-Asia-Pacific in Support of the Defense Strategic Guidance

DTIC Science & Technology

2013-05-20

territorial and resource disputes, violent extremism, natural disasters , proliferation, illicit trafficking and more. This complex security...killed by natural disasters annually. Those figures represent 90% and 65% of the world totals, respectively.” 32 The benefits of having two operational...demand …We train to a 5 full range of missions, from humanitarian assistance and disaster relief, to maritime security operations, to amphibious

Incidence, Etiology and Risk Factors for Travelers Diarrhea during a Hospital Ship-Based Military Humanitarian Mission: Continuing Promise 2011 (Open Access Publishers Version)

DTIC Science & Technology

2016-05-12

RESEARCH ARTICLE Incidence, Etiology and Risk Factors for Travelers ’ Diarrhea during a Hospital Ship- Based Military Humanitarian Mission: Continuing...Development Foundation, Bali, Indonesia ☯ These authors contributed equally to this work. *mark.s.riddle10.mil@mail.mil Abstract Travelers ’ diarrhea (TD) is...the most common ailment affecting travelers , including deployed U.S. military. Continuing Promise 2011 was a 5-month humanitarian assistance/disaster

[Laws relevant to international missions of health cooperation].

PubMed

Scaroni, E; Riccardo, F; De Rosa, A G; Russo, G; Pacini, A; Nardi, L; Pacifici, L E

2007-01-01

Both medical doctors and humanitarian operators engaged in health relief or development missions abroad, are called to respect the general principles of international law, that is to say, customary law that is legally compulsory for the International Community and rules deriving from Treaties and International Conventions. Humanitarian operators have to observe also the rules and regulations of the hosting country. They have to respect all rules applying to their humanitarian action and they have to take responsibility towards beneficiaries and donors alike.

Surgical Care of Pediatric Patients in the Humanitarian Setting: The Médecins Sans Frontières Experience, 2012-2013.

PubMed

Trudeau, Maeve O'Neill; Baron, Emmanuel; Hérard, Patrick; Labar, Amy S; Lassalle, Xavier; Teicher, Carrie Lee; Rothstein, David H

2015-11-01

Little is known about the scope of practice and outcomes in pediatric surgery performed by humanitarian organizations in resource-poor settings and conflict zones. This study provides the largest report to date detailing such data for a major nongovernmental organization providing humanitarian surgical relief support in these settings. To characterize pediatric surgical care provision by a major nongovernmental organization in specialized humanitarian settings and conflict zones. A retrospective cohort study was conducted from August 15, 2014, to March 9, 2015, of 59,928 surgical interventions carried out from January 1, 2012, to December 31, 2013, by the Médecins Sans Frontières Operational Centre Paris (MSF-OCP) program in 20 locations, including South Sudan, Yemen, Syria, Gaza, Pakistan, Nigeria, Central African Republic, Democratic Republic of Congo, and the Philippines. Surgical interventions were primarily for general surgical, traumatic, and obstetric emergencies and were categorized by mechanism, type of intervention, American Society of Anesthesia risk classification, and urgency of intervention. Operative indications, type of intervention, and operative case mortality. Among all age groups, 59,928 surgical interventions were performed in dedicated trauma, obstetric, and reconstructive centers for 2 years. Nearly one-third of interventions (18,040 [30.1%]) involved preteen patients (aged <13 years) and 4571 (7.6%) involved teenaged patients (aged 13-17 years). The proportion of violence-related injuries in the preteen group was significantly lower than in the teenage group (4.8% vs 17.5%; P < .001). Burns (50.1%), other accidental injuries (16.4%), and infections (23.4%) composed the bulk of indications in the preteen group. Interventions in the teenage group were principally caused by trauma-related injuries (burns, 22.9%; traffic accidents, 10.1%; gunshot wounds, 8.0%). Crude perioperative case mortality rates were 0.07% in the preteen group, 0.15% in the teenage group, and 0.22% in the adult group (>17 years) (P = .001). One-third of the cases (33.4%) were deemed urgent, while most of the remaining cases (57.7%) were deemed semielective (surgical intervention to be performed within 48 hours). When examining surgical interventions in a population of pediatric patients cared for in the specialized setting of humanitarian aid and conflict zones, burns, other accidental injuries, and infection composed the bulk of indications in the preteen group; interventions in the teenage group were principally caused by trauma-related injuries. Crude perioperative case mortality rates in the preteen group were significantly lower than in the adult group. Further work is needed to examine long-term outcomes of pediatric operations in these settings and to guide context-specific surgical program development.

Travelers' Health: Typhoid and Paratyphoid Fever

MedlinePlus

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Travelers' Health: MERS in the Arabian Peninsula

MedlinePlus

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Psychological aspects of peacekeeping operations

PubMed Central

Raju, M. S. V. K.

2014-01-01

Peacekeeping operations are but one aspect of the systems of peace that have evolved over the past seven decades in a world that is riven with violence of all kinds. With the end of cold war in the late eighties of the last century we have come to see much intrastate violence, in addition to usual interstate hostilities and war, arising out of religious, political, ethnic and economic differences between people. In the changed scenario peacekeeping operations have become complex politico-military-humanitarian efforts. A soldier, trained for conventional military operations, is obliged to participate in the unconventional operations of waging peace in alien lands often in volatile and violent situations and in the process he stands to get exposed to widely variable demands for adjustment that have the potential to bring to the fore many maladaptive responses. Peacekeeping operations also have the potential to offer opportunities for growth and resilience. India is a major player in peacekeeping activities for well over sixty years all over the world. It is necessary for the commanders and mental health professionals to understand the multifarious factors that impinge on the peacekeeping soldier's mind and the emerging patterns of responses thereof for effective management trained manpower and fulfillment of mission objectives PMID:25788805

Psychological aspects of peacekeeping operations.

PubMed

Raju, M S V K

2014-01-01

Peacekeeping operations are but one aspect of the systems of peace that have evolved over the past seven decades in a world that is riven with violence of all kinds. With the end of cold war in the late eighties of the last century we have come to see much intrastate violence, in addition to usual interstate hostilities and war, arising out of religious, political, ethnic and economic differences between people. In the changed scenario peacekeeping operations have become complex politico-military-humanitarian efforts. A soldier, trained for conventional military operations, is obliged to participate in the unconventional operations of waging peace in alien lands often in volatile and violent situations and in the process he stands to get exposed to widely variable demands for adjustment that have the potential to bring to the fore many maladaptive responses. Peacekeeping operations also have the potential to offer opportunities for growth and resilience. India is a major player in peacekeeping activities for well over sixty years all over the world. It is necessary for the commanders and mental health professionals to understand the multifarious factors that impinge on the peacekeeping soldier's mind and the emerging patterns of responses thereof for effective management trained manpower and fulfillment of mission objectives.

Responding to the needs of children in crisis.

PubMed

Jones, Lynne

2008-06-01

This paper explores the issues confronting service providers setting up child and family mental health programmes in conflict, post conflict and disaster areas. Drawing on clinical experience and research in humanitarian settings, it calls for greater attention to the child's perspective, their individuality and the cultural, social and political context in which they live. It argues that those concerned with the psychopathology of children in crises should widen their frame of reference beyond narrowly defined traumatic reactions to include other mental health and psychosocial issues, including the current problems of daily life and the needs of children with pre-existing psychiatric disorders. It recommends culturally valid means of assessment, the creation of age-appropriate services and training for primary healthcare workers. Children's mental health needs in crises are varied, complex and intimately connected with their needs for security, food, shelter, education and family connection. This requires holistic, rights-based approaches that can access resources to address basic needs, advocate for security and protection, and recognize and address the needs of the more vulnerable children. This is the approach recommended by the Inter Agency Standing Committee Guidelines for Mental health and Psychosocial Support in Emergency Settings.

Authorship in global mental health research: recommendations for collaborative approaches to writing and publishing.

PubMed

Kohrt, Brandon A; Upadhaya, Nawaraj; Luitel, Nagendra P; Maharjan, Sujen M; Kaiser, Bonnie N; MacFarlane, Elizabeth K; Khan, Noreen

2014-01-01

Collaborations among researchers, clinicians, and individuals with mental illness from high-income countries (HICs) and low- and middle-income countries (LMICs) are crucial to produce research, interventions, and policies that are relevant, feasible, and ethical. However, global mental health and cultural psychiatry research publications have been dominated by HIC investigators. The aim of this review was to present recommendations for collaborative writing with a focus on early career investigators researchers in HICs and LMICs. A workshop was conducted with HIC and LMIC investigators in Nepal to discuss lessons learned for collaborative writing. The researchers had experience in cross-cultural psychiatric epidemiology, health services research, randomized controlled trials, and projects with war and disaster-affected populations in complex humanitarian emergencies including child soldiers and refugees. Additional lessons learned were contributed from researchers engaged in similar collaborations in Haiti. A step-by-step process for collaborative writing was developed. HIC and LMIC writing collaborations will encourage accurate, ethical, and contextually grounded publications to foster understanding and facilitate reduction of the global burden of mental illness. Copyright © 2014 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Avian Flu (H7N9) in China

MedlinePlus

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Travelers' Health: Vaccine Recommendations for Infants and Children

MedlinePlus

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Working with local nurses to promote hospital-nursing care during humanitarian assignments overseas: experiences from the perspectives of nurses.

PubMed

Tjoflåt, Ingrid; Karlsen, Bjørg; Saetre Hansen, Britt

2016-06-01

To describe how Norwegian expatriate nurses engaged in humanitarian assignments overseas experience working with the local nurses promoting nursing care in the hospital ward. Western countries have a long tradition of providing nurses with expert knowledge in nursing care for humanitarian projects and international work overseas. Studies from humanitarian mission revealed that health workers rarely acknowledge or use the local knowledge. However, there is a lack of studies highlighting expatriate nurses' experiences working with local nurses to promote nursing care in the hospital ward. This study applies a descriptive explorative qualitative design. The data were collected in 2013 by means of seven semi-structured interviews and analysed using qualitative content analysis. The data analyses revealed three themes related to the expatriate nurses' experiences of working with the local nurses to promote nursing care in the hospital ward: (1) Breaking the code, (2) Colliding worlds and (3) Challenges in sharing knowledge. The findings reflect different challenges when working with the local nurses. Findings indicate valuable knowledge gained about local nursing care and the local health and educational system. They also demonstrate challenges for the expatriate nurses related to the local nursing standard in the wards and using the local nurses' experiences and knowledge when working together. The findings can inform nurses, humanitarian organisations and institutions working overseas regarding the recruitment and the preparation of nurses who want to work cross- culturally or in humanitarian missions overseas. © 2016 John Wiley & Sons Ltd.

The medical care programs of the Farm Security Administration, 1932 through 1947: a rehearsal for national health insurance?

PubMed Central

Grey, M R

1994-01-01

At a time of renewed interest in universal health insurance, an examination of earlier periods when society grappled with the link between socioeconomic status and health is fruitful. Between 1935 and 1947, the federal government sponsored a comprehensive medical care program for low-income farmers, sharecroppers, and migrant workers under the auspices of the Farm Security Administration (FSA). Despite the strong opposition of the American Medical Association, humanitarian and economic concerns at the local level often promoted physicians' participation in the program's group prepayment plans. Many FSA leaders clearly saw the program as a model upon which national health insurance might advance. However, in the wake of World War II, the FSA program declined as physicians' income improved, the rural population declined, and traditional ideological objections to federal intervention in medical care resurfaced. The FSA experience illuminates the complex ideological, economic, and humanitarian motivations of American physicians in the face of health care reform. Images p1680-a p1682-a p1684-a PMID:7943497

Single Neurosurgeon Operative Experience at Craig Joint Theater Hospital During the Afghanistan Surge (November 2010 to April 2011), Part II: Humanitarian Cases.

PubMed

Steele, John Joseph

2017-01-01

The Afghanistan Surge saw NATO troops working with their Afghan partners to remove Taliban governance and replace it with a more democratic model. As part of this endeavor, medical support for both trauma and humanitarian cases was needed. Identify and discuss disease trends to better prepare for future combat medical treatments. Retrospective review of operative experience from a neurosurgeon from November 2010 to April 2011. 63 cases were performed on 20 NATO and 43 Afghan patients. Combat-related neurotrauma represented 73% (46/63) of cases and humanitarian cases represented the remainder. The most common diseases among humanitarian cases were benign tumors (29%, 5/17), cranioplasty (23%, 4/17), obstructive hydrocephalus (11%, 2/17), nonobstructive hydrocephalus (11%, 2/17), hemifacial spasm (11%, 2/17), and cerebral angiography (11%, 2/17). There was 1 death from ventriculitis for a complication rate of 6%. In select well-nourished, patients with minimal risk of needing tracheostomy, humanitarian neurosurgery can be safely performed in theater with a complication rate (6%) no worse than patients operated on in the United States. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Motivations, concerns, and expectations of Scandinavian health professionals volunteering for humanitarian assignments.

PubMed

Bjerneld, Magdalena; Lindmark, Gunilla; McSpadden, Lucia Ann; Garrett, Martha J

2006-01-01

International nongovernmental organizations (NGOs) involved in humanitarian assistance employ millions of volunteers. One of the major challenges for the organizations is the high turnover rate among their personnel. Another is recruiting the right persons. As part of a series of studies investigating factors that affect the recruitment process and the success of assignment, this qualitative study examined health professionals' motivations for volunteering, their various concerns, and their expectations about themselves and the organizations for which they would work. The findings from focus group interviews with potential humanitarian volunteers were considered within the framework of Hertzberg's theory of motivations and Maslow's hierarchy of needs. The study has significant implications for personnel policy and practice in the humanitarian sector. Recruitment officers should have the self-actualized person, as described by Maslow, in mind when interviewing candidates. This perspective would make it easier for them to understand the candidates' thoughts and concerns and would lead to more effective interventions. Program officers should have satisfiers and dissatisfiers, as identified by Herzberg, in mind when planning programs. The probability that personnel will leave humanitarian work is lower if they perceive working conditions as good.

Parameterisation of non-homogeneities in buried object detection by means of thermography

NASA Astrophysics Data System (ADS)

Stepanić, Josip; Malinovec, Marina; Švaić, Srećko; Krstelj, Vjera

2004-05-01

Landmines and their natural environment form a system of complex dynamics with variable characteristics. A manifestation of that complexity within the context of thermography-based landmines detection is excessive noise in thermograms. That has severely suppressed application of thermography in landmines detection for the purposes of humanitarian demining. (To be differentiated from military demining and demining for military operations other than war [Land Mine Detection DOD's Research Program Needs a Comprehensive Evaluation Strategy, US GAO Report, GAO-01 239, 2001; International Mine Action Standards, Chapter 4.--Glossary. Available at: < http://www.mineactionstandards.org/IMAS_archive/Final/04.10.pdf>].) The discrepancy between the existing role and the actual potential of thermography in humanitarian demining motivated systematic approach to sources of noise in thermograms of buried objects. These sources are variations in mine orientation relative to soil normal, which modify the shape of mine signature on thermograms, as well as non-homogeneities in soil and vegetation layer above the mine, which modify the overall quality of thermograms. This paper analyses the influence of variable mines, and more generally the influence of axially symmetric buried object orientation on the quality of its signature on thermograms. The following two angles have been extracted to serve as parameters describing variation in orientation: (i) θ--angle between the local vertical axis and mine symmetry axis and (ii) ψ--angle between local vertical axis and soil surface normal. Their influence is compared to the influence of (iii) d--the object depth change, which serves as control parameter. The influences are quantified and ranked within a statistically planned experiment. The analysis has proved that among the parameters listed, the most influential one is statistical interaction dψ, followed with the statistical interaction dθ. According to statistical tests, these two combinations are considered the most significant influences. The results show that the currently applied analysis of thermography in humanitarian demining must be broadened by the inclusion of the variations in mine orientation, otherwise a decrease in the probability of mine detection, due to the presence of a systematic error, occurs.

Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH) Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review.

PubMed

Ramesh, Anita; Blanchet, Karl; Ensink, Jeroen H J; Roberts, Bayard

2015-01-01

Water, sanitation, and hygiene (WASH) interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear. To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts. A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980-2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed. Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU) water quality interventions, with 50% using safe water storage (SWS) and 35% using household water treatment (HWT). All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions). 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap) as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence. The current evidence base on the impact of WASH interventions on health outcomes in humanitarian crises is extremely limited, and numerous methodological limitations limit the ability to determine associative, let alone causal, relationships.

Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH) Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review

PubMed Central

Ramesh, Anita; Blanchet, Karl; Ensink, Jeroen H. J.; Roberts, Bayard

2015-01-01

Background Water, sanitation, and hygiene (WASH) interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear. Aim To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts. Methods A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980–2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed. Results Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU) water quality interventions, with 50% using safe water storage (SWS) and 35% using household water treatment (HWT). All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions). 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap) as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence. Conclusion The current evidence base on the impact of WASH interventions on health outcomes in humanitarian crises is extremely limited, and numerous methodological limitations limit the ability to determine associative, let alone causal, relationships. PMID:26398228

Travelers' Health: Rickettsial (Spotted and Typhus Fevers) and Related Infections (Anaplasmosis and Ehrlichiosis)

MedlinePlus

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International Humanitarian Award.

PubMed

2016-11-01

The International Humanitarian Award recognizes extraordinary humanitarian services and activism by psychologists, including professional and volunteer work conducted primarily in the field with underserved populations. Award recipients are psychologists who, by their extraordinary service at a difficult time, improve the lives and contribute to the well-being of people in a large or small geographic area anywhere in the world. The 2016 recipient of the APA International Humanitarian Award was selected by the 2015 Committee on International Relations in Psychology (CIRP). The members of the 2015 CIRP were Rehman Abdulrehman, PhD (Chair); Gonzalo Bacigalupe, EdD; Silvia S. Canetto, PhD; Amanda Clinton, PhD; Melissa L. Morgan Consoli, PhD; Chryse G. Hatzichristou, PhD; Arpana G. Inman, PhD; Lori Foster Thompson, PhD; and Danny Wedding, PhD. Dr. Abdulrehman, Dr. Morgan Consoli, Dr. Thompson, and Dr. Wedding were members of the subcommittee for the 2016 award. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

International Humanitarian Award.

PubMed

2017-12-01

The International Humanitarian Award recognizes extraordinary humanitarian services and activism by psychologists, including professional and volunteer work conducted primarily in the field with underserved populations. Award recipients are psychologists who, by their extraordinary service at a difficult time, improve the lives and contribute to the well-being of people in a large or small geographic area anywhere in the world. The 2017 recipient of the APA International Humanitarian Award was selected by the 2016 Committee on International Relations in Psychology (CIRP). The members of the 2016 CIRP were Melissa Morgan Consoli, PhD, and Arpana G. Inman, PhD (Co-chairs); Rehman Abdulrehman, PhD; Gonzalo Bacigalupe, EdD; Frederic Bemak, EdD; Brigitte Khoury, PhD; Susan Nolan, PhD; Nancy Sidun, PsyD; and Danny Wedding, PhD. Dr. Morgan Consoli, Dr. Inman, Dr. Nolan, and Doctor Sidun were members of the subcommittee for the 2017 award. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

National mass care strategy: a national integrated approach.

PubMed

Mintz, Amy; Gonzalez, Waddy

2013-01-01

Mass care refers to a wide range of humanitarian activities that collectively provide life- sustaining services, such as emergency sheltering, feeding, reunification, distribution of emergency supplies and recovery information, before or in the aftermath of an emergency or disaster. Most services are coordinated and provided by non-governmental organisations and/or local government. Based on the lessons learned in the aftermath of Hurricanes Katrina and Rita in 2005, the American Red Cross, the Federal Emergency Management Agency and the National Voluntary Organizations Active in Disasters joined efforts to expand national mass care capabilities in order to support survivors in the wake of catastrophic events, as well as to enhance the integration of volunteers and non-governmental organisations into the broader national effort. These efforts resulted in the creation of the National Mass Care Council in 2010, with representatives of Federal and State agencies, voluntary organisations and the private sector working together to develop a unified approach to mass care and to ensure the provision of consistent and uniform services across the USA, regardless of the magnitude of the event.

The Criminalization of Physicians and the Delegitimization of Violence in Turkey.

PubMed

Can, Başak

2016-01-01

In June 2013, protests that erupted in Gezi Park in Istanbul, Turkey were met with state violence, mobilizing hundreds of native physicians to deliver emergency medical care. Drawing on ethnographic fieldwork in makeshift clinics during these protests, interviews with Gezi physicians and analyses of recent laws restricting emergency care provision, in this article I explore the criminalization of clinical practice through legal and coercive means of the government and the delegitimization of state violence through clinical and expert witnessing practices of physicians. As I show, material, legal, and discursive articulations of the idiom of medical neutrality revolve around the tension between medical praxis as neutrality and medical praxis as political participation. I offer a reconsideration of medical humanitarian and human rights regimes in terms of their consequences for inciting, documenting and restricting state violence.

Disaster relief and initial response to the earthquake and tsunami in Meulaboh, Indonesia.

PubMed

Lee, V J; Low, E; Ng, Y Y; Teo, C

2005-10-01

The Singapore Humanitarian Assistance Support Group deployed a team of 32 medical relief workers to Meulaboh, Indonesia to provide medical assistance for victims of the 26 December earthquake and tsunami disaster. The team was deployed at a primary healthcare clinic at an internally displaced persons' (IDP) camp and at the sole hospital's emergency and surgical departments. The team saw a total of 1841 patients, 1371 at the clinic and 446 at the hospital's emergency department, and performed surgery on 24 patients. Tsunami-related trauma cases accounted for 31.8% (142) of cases at the emergency department, 1.6% (22) of cases at the clinic, and 91.7% (22) of surgeries. This paper details the difficulties and lessons learnt by the team, including the lack of important resources for healthcare delivery. Water, sanitation, hygiene, and vector control were some of the problems faced, with the goal to provide the most effective public health for the greatest number of people given the limited resources available.

Global Cancer Humanitarian Award

Cancer.gov

Pat Garcia-Gonzalez of the Max Foundation accepted the first annual NCI Global Cancer Medicine Humanitarian Award for her work in chronic myeloid leukemia at the NCI, Center for Global Health Symposium for Global Cancer Research, held in Boston on March 25, 2015.

A blueprint for professionalizing humanitarian assistance.

PubMed

Walker, Peter; Hein, Karen; Russ, Catherine; Bertleff, Greg; Caspersz, Dan

2010-12-01

International humanitarian response to crises employs 210,000 people and accounts for nearly $15 billion in spending globally each year. Most action is carried out by not-for-profit organizations working with United Nations (UN) agencies, military organizations, and commercial entities. UN agencies employ many technical experts, often retaining them for five or more years. As yet there is no international professional apparatus to promote the quality and integrity of this workforce. This paper reports on research exploring the case for professionalizing humanitarian action through an international professional association, the development of core competencies, and the creation of a universal certification system for aid workers.

A solution from hell: the United States and the rise of humanitarian interventionism, 1991-2003.

PubMed

Wertheim, Stephen

2010-01-01

This article traces the rise of humanitarian interventionist ideas in the US from 1991 to 2003. Until 1997, humanitarian intervention was a relatively limited affair, conceived ad hoc more than systematically, prioritized below multilateralism, aiming to relieve suffering without transforming foreign polities. For this reason, US leaders and citizens scarcely contemplated armed intervention in the Rwandan genocide of 1994: the US 'duty to stop genocide' was a norm still under development. It flourished only in the late 1990s, when humanitarian interventionism, like neoconservatism, became popular in the US establishment and enthusiastic in urging military invasion to remake societies. Now inaction in Rwanda looked outrageous. Stopping the genocide seemed, in retrospect, easily achieved by 5,000 troops, a projection that ignored serious obstacles. On the whole, humanitarian interventionists tended to understate difficulties of halting ethnic conflict, ignore challenges of postconflict reconstruction, discount constraints imposed by public opinion, and override multilateral procedures. These assumptions primed politicians and the public to regard the Iraq war of 2003 as virtuous at best and unworthy of strenuous dissent at worst. The normative commitment to stop mass killing outstripped US or international capabilities—a formula for dashed hopes and dangerous deployments that lives on in the 'responsibility to protect'.

Medical resource preparation and allocation for humanitarian assistance based on module organization.

PubMed

Zhu, Min; Chen, Ruxue; Zhong, Shaobo; Qian, Yangming; Huang, Quanyi

2017-02-01

This research aims to associate the allocation of medical resources with the function of the modular organization and the possible needs for humanitarian assistance missions. The overseas humanitarian medical assistance mission, which was sent after a disaster on the hospital ship Peace Ark, part of China's People's Liberation Army (PLA) Navy, was considered as study model. The cases used for clustering and matching sample formation were randomly selected from the existing information related to Peace Ark's mission. Categories of the reusable resources clustered by this research met the requirement of the actual consumption almost completely (more than 95%) and the categories of non-reusable resources met the requirement by more than 80%. In the mission's original resource preparing plan, more than 30% of the non-reusable resource categories remained unused during the mission. In the original resource preparing plan, some key non-reusable resources inventories were completely exhausted at the end of the mission, while 5% to 30% of non-reusable resources remained in the resource allocation plan generated by this research at the end of the mission. The medical resource allocation plan generated here can enhance the supporting level for the humanitarian assistance mission. This research could lay the foundation for an assistant decision-making system for humanitarian assistance mission.

The ethics of big data as a public good: which public? Whose good?

PubMed Central

2016-01-01

International development and humanitarian organizations are increasingly calling for digital data to be treated as a public good because of its value in supplementing scarce national statistics and informing interventions, including in emergencies. In response to this claim, a ‘responsible data’ movement has evolved to discuss guidelines and frameworks that will establish ethical principles for data sharing. However, this movement is not gaining traction with those who hold the highest-value data, particularly mobile network operators who are proving reluctant to make data collected in low- and middle-income countries accessible through intermediaries. This paper evaluates how the argument for ‘data as a public good’ fits with the corporate reality of big data, exploring existing models for data sharing. I draw on the idea of corporate data as an ecosystem involving often conflicting rights, duties and claims, in comparison to the utilitarian claim that data's humanitarian value makes it imperative to share them. I assess the power dynamics implied by the idea of data as a public good, and how differing incentives lead actors to adopt particular ethical positions with regard to the use of data. This article is part of the themed issue ‘The ethical impact of data science’. PMID:28336800

Online interviewing with interpreters in humanitarian contexts

PubMed Central

Chiumento, Anna; Rahman, Atif; Frith, Lucy

2018-01-01

ABSTRACT Purpose: Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Method: Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. Results: A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Conclusions: Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing. PMID:29532739

Online interviewing with interpreters in humanitarian contexts.

PubMed

Chiumento, Anna; Machin, Laura; Rahman, Atif; Frith, Lucy

2018-12-01

Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing.

Global Health Governance Challenges 2016 – Are We Ready?

PubMed Central

Kickbusch, Ilona

2016-01-01

The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and "the rise of the rest" will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs) and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals - the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health PMID:27285512

Global Health Governance Challenges 2016 - Are We Ready?

PubMed

Kickbusch, Ilona

2016-02-29

The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and "the rise of the rest" will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs) and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals - the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health. © 2016 by Kerman University of Medical Sciences.

The ethics of big data as a public good: which public? Whose good?

PubMed

Taylor, Linnet

2016-12-28

International development and humanitarian organizations are increasingly calling for digital data to be treated as a public good because of its value in supplementing scarce national statistics and informing interventions, including in emergencies. In response to this claim, a 'responsible data' movement has evolved to discuss guidelines and frameworks that will establish ethical principles for data sharing. However, this movement is not gaining traction with those who hold the highest-value data, particularly mobile network operators who are proving reluctant to make data collected in low- and middle-income countries accessible through intermediaries. This paper evaluates how the argument for 'data as a public good' fits with the corporate reality of big data, exploring existing models for data sharing. I draw on the idea of corporate data as an ecosystem involving often conflicting rights, duties and claims, in comparison to the utilitarian claim that data's humanitarian value makes it imperative to share them. I assess the power dynamics implied by the idea of data as a public good, and how differing incentives lead actors to adopt particular ethical positions with regard to the use of data.This article is part of the themed issue 'The ethical impact of data science'. © 2016 The Author(s).

Rapid humanitarian assessments and rationality: a value-of-information study from Iraq, 2003-04.

PubMed

Benini, Aldo; Conley, Charles

2007-03-01

Rapid assessments are one of the standard informational tools in humanitarian response and are supposed to contribute to rational decision-making.(1) The extent to which the assessment organisation itself behaves rationally, however, is an open question. This can be evaluated against multiple criteria, such as the cost and value of the information it collects and its ability to adapt flexibly design or samples when the survey environment changes unforeseeably. An unusual data constellation from two concurrent recent (2003-04) rapid assessments in northern Iraq permits us to model part of the actual assessment behaviour in terms of geographical, community and prior substantive information attributes. The model correctly predicts the decisions, in 79 per cent of the 2,425 local communities in focus, that data collector teams in the Emergency Mine Action Survey made to visit or not to visit. The analysis demonstrates variably rational behaviour under conditions of insecurity, repeated regrouping and incomplete sampling frames. A pronounced bias towards very small rural settlements is irrational for the overall results, but may be a rational strategy of individual survey workers seeking to prolong their employment. Implications for future assessments are sketched in the areas of tools for urban surveys, greater adaptability, including early feedback from users, and sensibility to value-of-information concepts.

Armed Conflict in Syria: Overview and U.S. Response

DTIC Science & Technology

2014-09-17

support humanitarian response needs from the Migration and Refugee Assistance ( MRA -OCO) and International Disaster Assistance (IDA-OCO) accounts. A...and Refugee Assistance ( MRA -OCO) and International Disaster Assistance (IDA-OCO) accounts expected to be used for humanitarian assistance related to

Surgical Burn Care by Médecins Sans Frontières-Operations Center Brussels: 2008 to 2014.

PubMed

Stewart, Barclay T; Trelles, Miguel; Dominguez, Lynette; Wong, Evan; Fiozounam, Hervé Tribunal; Hassani, Ghulam Hiadar; Akemani, Clemence; Naseer, Aemer; Ntawukiruwabo, Innocent Bagura; Kushner, Adam L

Humanitarian organizations care for burns during crisis and while supporting healthcare facilities in low-income and middle-income countries. This study aimed to define the epidemiology of burn-related procedures to aid humanitarian response. In addition, operational data collected from humanitarian organizations are useful for describing surgical need otherwise unmet by national health systems. Procedures performed in operating theatres run by Médecins Sans Frontières-Operations Centre Brussels (MSF-OCB) from July 2008 through June 2014 were reviewed. Surgical specialist missions were excluded. Burn procedures were quantified, related to demographics and reason for humanitarian response, and described. A total of 96,239 operations were performed at 27 MSF-OCB projects in 15 countries between 2008 and 2014. Of the 33,947 general surgical operations, 4,280 (11%) were for burns. This proportion steadily increased from 3% in 2008 to 24% in 2014. People receiving surgical care from conflict relief missions had nearly twice the odds of having a burn operation compared with people requiring surgery in communities affected by natural disaster (adjusted odds ratio, 1.94; 95% confidence interval, 1.46-2.58). Nearly 70% of burn procedures were planned serial visits to the theatre. A diverse skill set was required. Unmet humanitarian assistance needs increased US$400 million dollars in 2013 in the face of an increasing number of individuals affected by crisis and a growing surgical burden. Given the high volume of burn procedures performed at MSF-OCB projects and the resource intensive nature of burn management, requisite planning and reliable funding are necessary to ensure quality for burn care in humanitarian settings.

Understanding and Addressing Vulnerability Following the 2010 Haiti Earthquake: Applying a Feminist Lens to Examine Perspectives of Haitian and Expatriate Health Care Providers and Decision-Makers.

PubMed

Durocher, Evelyne; Chung, Ryoa; Rochon, Christiane; Hunt, Matthew

2016-07-01

Vulnerability is a central concept in humanitarian aid. Discussions of vulnerability in disaster response literature and guidelines for humanitarian aid range from considerations of a universal human vulnerability, to more nuanced examinations of how particular characteristics render individuals more or less at risk. Despite its frequent use, there is a lack of clarity about how vulnerability is conceptualized and how it informs operational priorities in humanitarian assistance. Guided by interpretive description methodology, we draw on the feminist taxonomy of vulnerability presented by Mackenzie, Rogers and Dodds (2014) to examine perspectives of 24 expatriate and Haitian decision-makers and health professionals interviewed between May 2012 and March 2013. The analysis explores concepts of vulnerability and equity in relation to the humanitarian response following the 2010 earthquake in Haiti. Participants' conceptualizations of vulnerability included consideration for inherent vulnerabilities related to individual characteristics (e.g. being a woman or disabled) and situational vulnerabilities related to particular circumstances such as having less access to health care resources or basic necessities. Participants recognized that vulnerabilities could be exacerbated by socio-political structures but felt ill-equipped to address these. The use of the taxonomy and a set of questions inspired by Hurst's (2008) approach to identifying and reducing vulnerability can guide the analysis of varied sources of vulnerability and open discussions about how and by whom vulnerabilities should be addressed in humanitarian responses. More research is required to inform how humanitarian responders could balance addressing acute vulnerability with consideration of systemic and pre-existing circumstances that underlie much of the vulnerability experienced following an acute disaster.

Understanding and Addressing Vulnerability Following the 2010 Haiti Earthquake: Applying a Feminist Lens to Examine Perspectives of Haitian and Expatriate Health Care Providers and Decision-Makers

PubMed Central

Chung, Ryoa; Rochon, Christiane; Hunt, Matthew

2016-01-01

Vulnerability is a central concept in humanitarian aid. Discussions of vulnerability in disaster response literature and guidelines for humanitarian aid range from considerations of a universal human vulnerability, to more nuanced examinations of how particular characteristics render individuals more or less at risk. Despite its frequent use, there is a lack of clarity about how vulnerability is conceptualized and how it informs operational priorities in humanitarian assistance. Guided by interpretive description methodology, we draw on the feminist taxonomy of vulnerability presented by Mackenzie, Rogers and Dodds (2014) to examine perspectives of 24 expatriate and Haitian decision-makers and health professionals interviewed between May 2012 and March 2013. The analysis explores concepts of vulnerability and equity in relation to the humanitarian response following the 2010 earthquake in Haiti. Participants’ conceptualizations of vulnerability included consideration for inherent vulnerabilities related to individual characteristics (e.g. being a woman or disabled) and situational vulnerabilities related to particular circumstances such as having less access to health care resources or basic necessities. Participants recognized that vulnerabilities could be exacerbated by socio-political structures but felt ill-equipped to address these. The use of the taxonomy and a set of questions inspired by Hurst’s (2008) approach to identifying and reducing vulnerability can guide the analysis of varied sources of vulnerability and open discussions about how and by whom vulnerabilities should be addressed in humanitarian responses. More research is required to inform how humanitarian responders could balance addressing acute vulnerability with consideration of systemic and pre-existing circumstances that underlie much of the vulnerability experienced following an acute disaster. PMID:27617037

The Development and Maturation of Humanitarian Psychology

ERIC Educational Resources Information Center

Jacobs, Gerard A.

2007-01-01

Humanitarian psychological support as an organized field is relatively young. Pioneers in the field were involved primarily in providing psychological support to refugees and internally displaced persons in conflict and nonconflict situations. This article describes basic principles for the design of psychological support programs and…

Humanitarian accountability, bureaucracy, and self-regulation: the view from the archive.

PubMed

Roddy, Sarah; Strange, Julie-Marie; Taithe, Bertrand

2015-10-01

This paper contains a systematic exploration of local and national archives and sources relevant to charities and humanitarian fund appeals of the late Victorian and Edwardian eras (1870-1912) in Great Britain. It shows that the charitable world and humanitarian work share the same matrix and originate from the same roots, with considerable overlap between fundraising for domestic charity and overseas relief. These campaigns engaged in crucial self-regulatory processes very early on that involved concepts such as formal accountability and the close monitoring of delivery. Far from lagging behind in terms of formal practices of auditing and accounts, charities and humanitarian funds often were in the pioneering group as compared with mainstream businesses of the period. The charitable sector, notably through the Charity Organisation Society in cooperation with the press, developed and delivered accountability and monitoring, while the state and the Charity Commission played a negligible role in this process. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

On the use of evidence in humanitarian logistics research.

PubMed

Pedraza-Martinez, Alfonso J; Stapleton, Orla; Van Wassenhove, Luk N

2013-07-01

This paper presents the reflections of the authors on the differences between the language and the approach of practitioners and academics to humanitarian logistics problems. Based on a long-term project on fleet management in the humanitarian sector, involving both large international humanitarian organisations and academics, it discusses how differences in language and approach to such problems may create a lacuna that impedes trust. In addition, the paper provides insights into how academic research evidence adapted to practitioner language can be used to bridge the gap. When it is communicated appropriately, evidence strengthens trust between practitioners and academics, which is critical for long-term projects. Once practitioners understand the main trade-offs included in academic research, they can supply valuable feedback to motivate new academic research. Novel research problems promote innovation in the use of traditional academic methods, which should result in a win-win situation: relevant solutions for practice and advances in academic knowledge. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Mental and social health in disasters: the Sphere standards and post-tsunami psychosocial interventions in Asia.

PubMed

Henderson, Silja E K; Elsass, Peter; Berliner, Peter

2016-07-01

The primary objective of this paper is to examine and inform the mental health and psychosocial support standards of the 2011 edition of the Sphere Project's Humanitarian Charter and Minimum Standards in Humanitarian Response. This is done through a qualitative analysis of internal evaluation documents, reflecting four long-term humanitarian psychosocial programmes in different countries in post-tsunami Asia. The analysis yielded three overall conclusions. First, the Sphere standards on mental health and psychosocial support generally are highly relevant to long-term psychosocial interventions after disasters such as the Indian Ocean tsunami of 26 December 2004, and their application in such settings may improve the quality of the response. Second, some of the standards in the current Sphere handbook may lack sufficient guidance to ensure the quality of humanitarian response required. Third, the long-term intervention approach poses specific challenges to programming, a problem that could be addressed by including additional guidance in the publication. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

THE LOSS OF MALAYSIA AIRLINES FLIGHT MH17: A FORENSIC AND HUMANITARIAN TASK.

PubMed

Ranson, David

2015-06-01

While forensic medical tasks are usually associated with supporting the criminal justice system, there are a range of forensic medical skills that can be brought to bear on addressing humanitarian activities. Disaster victim identification is a procedure that has achieved international standardisation through the work of a multinational Interpol Standing Committee. While part of a police organisation, it includes forensic pathologists, anthropologists, odontologists and molecular biologists who provide most of the specialist scientific input regarding identification that is integrated with police processes such as document examination and fingerprinting. The loss of Malaysian Airlines Flight MH17 represented a major activation of these procedures in an environment that had both humanitarian and forensic criminal investigation components. The information that is derived from the processes involved in disaster victim identification has a value that goes far beyond the determination of identity. It has an important humanitarian role in supporting the family and friends of the victims in their bereavement journey.

The psychologization of humanitarian aid: skimming the battlefield and the disaster zone.

PubMed

De Vos, Jan

2011-01-01

Humanitarian aid's psycho-therapeutic turn in the 1990s was mirrored by the increasing emotionalization and subjectivation of fund-raising campaigns. In order to grasp the depth of this interconnectedness, this article argues that in both cases what we see is the post-Fordist production paradigm at work; namely, as Hardt and Negri put it, the direct production of subjectivity and social relations. To explore this, the therapeutic and mental health approach in humanitarian aid is juxtaposed with the more general phenomenon of psychologization. This allows us to see that the psychologized production of subjectivity has a problematic waste-product as it reduces the human to 'Homo sacer', to use Giorgi Agamben's term. Drawing out a double matrix of a de-psychologizing psychologization connected to a politicizing de-politicization, it will further become possible to understand psycho-therapeutic humanitarianism as a case of how, in these times of globalization, psychology, subjectivity and money are all interrelated.

International NGOs and the role of network centrality in humanitarian aid operations: a case study of coordination during the 2000 Mozambique floods.

PubMed

Moore, Spencer; Eng, Eugenia; Daniel, Mark

2003-12-01

In February 2000, Mozambique suffered its worst flooding in almost 50 years: 699 people died and hundreds of thousands were displaced. Over 49 countries and 30 international non-governmental organisations provided humanitarian assistance. Coordination of disaster assistance is critical for effective humanitarian aid operations, but limited attention has been directed toward evaluating the system-wide structure of inter-organisational coordination during humanitarian operations. Network analysis methods were used to examine the structure of inter-organisational relations among 65 non-governmental organisations (NGOs) involved in the flood operations in Mozambique. Centrality scores were used to estimate NGO-specific potential for aid coordination and tested against NGO beneficiary numbers. The average number of relief- and recovery-period beneficiaries was significantly greater for NGOs with high relative to low centrality scores (p < 0.05). This report addresses the significance of these findings in the context of the Mozambican 2000 floods and the type of data required to evaluate system-wide coordination.

Does spending on refugees make a difference? A cross-sectional study of the association between refugee program spending and health outcomes in 70 sites in 17 countries.

PubMed

Tan, Timothy M; Spiegel, Paul; Haskew, Christopher; Greenough, P Gregg

2016-01-01

Numerous simultaneous complex humanitarian emergencies strain the ability of local governments and the international community to respond, underscoring the importance of cost-effective use of limited resources. At the end of 2011, 42.5 million people were forcibly displaced, including 10.4 million refugees under the mandate of the United Nations High Commissioner for Refugees (UNHCR). UNHCR spent US$1.65 billion on refugee programs in 2011. We analyze the impact of aggregate-level UNHCR spending on mortality of refugee populations. Using 2011 budget data, we calculated purchasing power parity adjusted spending, disaggregated by population planning groups (PPGs) and UNHCR Results Framework objectives. Monthly mortality reported to UNHCR's Health Information System from 2011 to 2012 was used to calculate crude (CMR) and under-5 (U5MR) mortality rates, and expressed as ratios to country of asylum mortality. Log-linear regressions were performed to assess correlation between spending and mortality. Mortality data for 70 refugee sites representing 1.6 million refugees in 17 countries were matched to 20 PPGs. Median 2011 spending was $623.27 per person (constant 2011 US$). Median CMR was 2.4 deaths per 1,000 persons per year; median U5MR was 18.1 under-5 deaths per 1,000 live births per year. CMR was negatively correlated with total spending ( p =  0.027), and spending for fair protection processes and documentation ( p =  0.005), external relations ( p =  0.034), logistics and operations support ( p =  0.007), and for healthcare ( p =  0.046). U5MR ratio was negatively correlated with total spending ( p =  0.015), and spending for favorable protection environment ( p =  0.024), fair protection processes and documentation ( p =  0.003), basic needs and essential services ( p =  0.027), and within basic needs, for healthcare services ( p =  0.007). Increased UNHCR spending on refugee populations is correlated with lower mortality, likely reflecting unique refugee vulnerabilities and dependence on aid. Future analyses using more granular data can further elucidate the health impact of humanitarian sector spending, thereby guiding policy choices.

Pre-travel health advice guidelines for humanitarian workers: A systematic review.

PubMed

Costa, Marco; Oberholzer-Riss, Martin; Hatz, Christoph; Steffen, Robert; Puhan, Milo; Schlagenhauf, Patricia

2015-01-01

In the last decades, there have been several natural disasters and global catastrophies with a steady increase in humanitarian relief work. This has resulted in increased research in the field of humanitarian aid, however the focus is mostly on the victims of the disasters and not on the individuals and organisations providing aid. The intent of this research is to review the information available on pre-deployment interventions and recommendations such as vaccinations and other health preserving measures in volunteers and professionals deploying abroad in humanitarian relief missions. We performed a systematic literature review of papers written in English, French, Italian or German. We searched the following databases: Cochrane, PubMed, CINAHL, EMBASE and also hand searched reference lists. The cut-off date for the publication search was November 20th, 2014. In addition to the literature search we also sent a questionnaire to 30 organisations to detail their approach to preparing relief workers. We identified 163 papers of possible relevance and finally included 35 papers in the systematic review. Six organisations provided information on pre-deployment preparation of aid workers. Identified papers show that pre-deployment physical and mental fitness are paramount for success in humanitarian missions. However, in many settings, pre-travel medical and psychological assessments and/or training/education sessions are not mandatory. We identified high-risk hazards for aid workers (often location specific), these included: travellers׳ diarrhoea, vector-borne infections, accidents, violence, tuberculosis, HIV, hepatitis A, leptospirosis, typhoid fever, seasonal and H1N1 influenza. The medical evaluation can identify problems or risk factors, such as psychological frailty, that can be exacerbated by the stressful settings of humanitarian missions. In this pre-travel setting, the status of routine vaccinations can be controlled and completed, medication dispensed and targeted preventive advice provided. A mission specific first-aid kit can be recommended. There is a lack of evidence-based literature on the theme of pre-travel advice guidelines for humanitarian workers. We propose a shared database of literature on this topic as a resource and suggest that some standardization of guidelines would be useful for future planning. Copyright © 2015 Elsevier Ltd. All rights reserved.

Issues in intelligent robots for search and rescue

NASA Astrophysics Data System (ADS)

Casper, Jennifer L.; Micire, Mark; Murphy, Robin R.

2000-07-01

Since the 1995 Oklahoma City bombing and Kobe, Japan, earthquake, robotics researchers have been considering search and rescue as a humanitarian research domain. The recent devastation in Turkey and Taiwan, compounded with the new Robocup Rescue and AAAI Urban Search and Rescue robot competition, may encourage more research. However, roboticists generally go not have access to domain experts: the emergency workers or first providers. This paper shares our understanding of urban search and rescue, based on our active research in this area and training sessions with rescue workers from the Hillsborough County (Florida) Fire Departments. The paper is intended to be a stepping stone for roboticists entering the field.

Assortativity Patterns in Multi-dimensional Inter-organizational Networks: A Case Study of the Humanitarian Relief Sector

NASA Astrophysics Data System (ADS)

Zhao, Kang; Ngamassi, Louis-Marie; Yen, John; Maitland, Carleen; Tapia, Andrea

We use computational tools to study assortativity patterns in multi-dimensional inter-organizational networks on the basis of different node attributes. In the case study of an inter-organizational network in the humanitarian relief sector, we consider not only macro-level topological patterns, but also assortativity on the basis of micro-level organizational attributes. Unlike assortative social networks, this inter-organizational network exhibits disassortative or random patterns on three node attributes. We believe organizations' seek of complementarity is one of the main reasons for the special patterns. Our analysis also provides insights on how to promote collaborations among the humanitarian relief organizations.

Lessons on humanitarian assistance.

PubMed Central

Gracia Antequera, M.; Morales Suárez-Varela, M.

1999-01-01

Conflict almost completely destroyed Rwanda's infrastructure in 1994. Natural disasters, as well as disasters caused by humans, have severely challenged humanitarian aid available within the country. In this study, we have analysed the experiences of nongovernmental organizations since the summer of 1994 to evaluate how these difficulties may be overcome. One of the problems identified has been restrictions on the ability to introduce effective health planning due to the poor quality of available local information. The implementation of effective plans that show due consideration to the environment and society is clearly necessary. Effective monitoring and detailed observation are identified as being essential to the continuity of existing humanitarian assistance. PMID:10444885

Impact of public health emergencies on modern disaster taxonomy, planning, and response.

PubMed

Burkle, Frederick M; Greenough, P Gregg

2008-10-01

Current disaster taxonomy describes diversity, distinguishing characteristics, and common relations in disaster event classifications. The impact of compromised public health infrastructure and systems on health consequences defines and greatly influences the manner in which disasters are observed, planned for, and managed, especially those that are geographically widespread, population dense, and prolonged. What may first result in direct injuries and death may rapidly change to excess indirect illness and subsequent death as essential public health resources are destroyed, deteriorate, or are systematically denied to vulnerable populations. Public health and public health infrastructure and systems in developed and developing countries must be seen as strategic and security issues that deserve international public health resource monitoring attention from disaster managers, urban planners, the global humanitarian community, World Health Organization authorities, and participating parties to war and conflict. We posit here that disaster frameworks be reformed to emphasize and clarify the relation of public health emergencies and modern disasters.

Guidelines for the use of foreign field hospitals in the aftermath of sudden-impact disaster.

PubMed

2003-01-01

Natural and complex disasters can cause a dramatic increase in the demand for emergency medical care. Local health services can be overwhelmed, and damage to clinics and hospitals can render them useless. Many countries maintain mobile field hospitals for defense or humanitarian purposes. Dispatching these facilities to disaster-affected countries would seem an ideal response to emergency medical needs. Unfortunately, experience has shown that in the case of natural disasters, field hospitals often have not met the expectations of recipients and donor institutions. In July 2003, the World Health Organization and Pan American Health Organization sponsored a workshop in El Salvador to discuss the pros and cons of using foreign field hospitals in the aftermath of natural disasters. These guidelines are the result of that workshop. The workshop participants identified different phases when foreign field hospitals and specialized medical personnel are most useful. They can provide advanced trauma care and life support if at the disaster site within 48 hours of the impact of an event; they would provide follow-up care for trauma victims and resumption of routine medical care in the two weeks following the event; during rehabilitation and reconstruction phases (from two months to two or more years), a field hospital might serve as a temporary replacement for damaged health facilities. These guidelines propose conditions that field hospitals and their staff should meet for each of these phases. The guidelines also outline issues that authorities in donor countries and disaster-affected countries should discuss before mobilizing a field hospital.

Breast-feeding in a complex emergency: four linked cross-sectional studies during the Bosnian conflict.

PubMed

Andersson, Neil; Paredes-Solís, Sergio; Legorreta-Soberanis, José; Cockcroft, Anne; Sherr, Lorraine

2010-12-01

To examine changes in breast-feeding and impacts on child health during the Bosnian conflict. Four linked representative cross-sectional household surveys, 1994 to 1997. The countries of former Yugoslavia largely missed the international wave of enthusiasm for breast-feeding of the 1980s and early 1990s. The concern is that breast-feeding deteriorates during humanitarian emergencies, when children need it most. The four surveys visited a random sample of clusters from population registers in the Federation of Bosnia and Herzegovina (BiH) and the Republica Srpska (RS). Interviewers asked about breast-feeding and other factors related to child health, and measured mid upper-arm circumference in 1123 infants aged 1-12 months. One-fifth of infants were not breast-fed at all (220/1087). Muslim and displaced children were less likely to breast-feed; 59 % of Muslim displaced children never breast-fed. Among infants in sites visited by all four surveys, there was no change in the proportion ever breast-fed and a significant increase in duration of breast-feeding and exclusive breast-feeding between 1994 and 1997. Children were breast-fed for shorter durations in male absent households, in frontline communities, the RS, and households that did not receive remittances from abroad. Non-breast-fed children and those who breast-fed for less than 4 months were more likely to be malnourished, as were those with complementary foods added either before or after their sixth month of life. If relief agencies had promoted and supported breast-feeding, this might have avoided some of the increased malnutrition that occurred during the conflict.

John W. Thoburn: International Humanitarian Award

ERIC Educational Resources Information Center

American Psychologist, 2012

2012-01-01

Presents a short biography of the winner of the American Psychological Association's International Humanitarian Award. The 2012 winner, John W. Thoburn, is an extraordinary psychologist who devotes himself consistently to service to underserved populations, especially in the aftermath of natural or human-induced disasters. He exemplifies a genuine…

Humanitarian Engineering Placements in Our Own Communities

ERIC Educational Resources Information Center

VanderSteen, J. D. J.; Hall, K. R.; Baillie, C. A.

2010-01-01

There is an increasing interest in the humanitarian engineering curriculum, and a service-learning placement could be an important component of such a curriculum. International placements offer some important pedagogical advantages, but also have some practical and ethical limitations. Local community-based placements have the potential to be…

Interns at an International, Humanitarian Organization: Career Pathways and Meaning Making

ERIC Educational Resources Information Center

Mather, Peter C.

2008-01-01

This qualitative study examined the career shaping experiences and related meaning making processes of 12 interns at The Carter Center, an international, humanitarian organization. Experiences shaping participants' careers were grouped into the following themes--academics and intellectual curiosity; travel abroad; religion; relationships--family,…

The Justice of Need and the Activation of Humanitarian Norms

ERIC Educational Resources Information Center

Schwartz, Shalom

1975-01-01

Outlines the process leading from the perception of need to altruistic behavior arguing that internalized humanitarian norms mediate this process and that when these norms are activated, behavior may be motivated by the justice of need. Suggestions for further research are made. (Author/AM)

Responding to chemical weapons violations in Syria: legal, health, and humanitarian recommendations.

PubMed

Brooks, Julia; Erickson, Timothy B; Kayden, Stephanie; Ruiz, Raul; Wilkinson, Stephen; Burkle, Frederick M

2018-01-01

The repeated use of prohibited chemical weapons in the Syrian conflict poses serious health, humanitarian, and security threats to civilians, healthcare personnel, and first responders. Moreover, the use of chemical weapons constitutes a clear and egregious violation of international law-likely amounting to a war crime-for which continued impunity is setting a dangerous precedent in relation to current and future conflicts. This debate article calls upon concerned states, organizations, and individuals to respond urgently and unequivocally to this serious breach of international legal and humanitarian norms. Based on health, humanitarian, and legal findings, this article calls for concrete action to: 1) reduce the risk of chemical weapons being used in current and future conflicts; 2) review and support the preparedness equipment and antidote supplies of first responders, humanitarian organizations, and military forces operating in Syria; 3) support international mechanisms for monitoring and enforcing the prohibition on chemical weapons, including through criminal accountability; 4) support civilian victims of chemical weapons attacks, including refugees; and 5) re-commit to the complete elimination of chemical weapons in compliance with the Chemical Weapons Convention (1993), a comprehensive treaty that bans chemical weapons and requires their complete destruction. All involved states and organizations should take urgent steps to ensure the protection of the most vulnerable victims of conflict, including victims of chemical weapons attacks in Syria, and to reinforce international law in the face of such serious violations.

Humanitarian quarantine in practice: medicine, religion and leprosy in New Caledonia.

PubMed

Sykes, Ingrid J

2017-12-01

Medicine and religion worked in close synchronisation during the leprosy outbreak of New Caledonia (1890-1950). Once isolation of leprosy-affected people became mandatory doctors and missionaries came together to promote a particular form of medical practice that tied charitable zeal with cutting-edge medical research, developing a sophisticated set of medical practices that catered for the soul as well as the body. Such practices went hand-in-hand with ideas developed by doctors in the earlier stages of the epidemic about the way in which the disease had entered the Kanak (local Melanesian) population. Doctors and missionaries admitted that immoral colonial channels had upset the delicate balance of local social and biological rhythms. Yet they also believed that the highly contagious nature of the outbreak was linked to the inferior state of Kanak. This paper aims to highlight the way in which the leprosaria system in New Caledonia represented a double-edged moral high-ground within the French medical colonial narrative. It tracks the complex way in which emotionally charged arguments about contagion, science and spirituality constructed an ideology of humanitarian quarantine which was used to justify a highly aggressive form of medical biocontrol.

An Investigation of Commercial Off-the-Shelf Wireless in Support of Complex Humanitarian Disaster Operations in the Argentine Army

DTIC Science & Technology

2012-09-01

Argentina is home to a Jewish community of 200,000, the largest in Latin America (BBC, 2006). Both of these facts have introduced Argentina and the...Argentina, a region highly prone to seismic events. This moderate to strong earthquake (estimated moment magnitudes range from 6.7 to 7.8) destroyed...earthquake took place in San Juan province. It is recorded as a major seismic movement that took place in Argentina and measured magnitude 7.4 on the

A history of forensic anthropology.

PubMed

Ubelaker, Douglas H

2018-04-01

Forensic anthropology represents a dynamic and rapidly evolving complex discipline within anthropology and forensic science. Academic roots extend back to early European anatomists but development coalesced in the Americas through high-profile court testimony, assemblage of documented collections and focused research. Formation of the anthropology section of the American Academy of Forensic Sciences in 1972, the American Board of Forensic Anthropology in 1977/1978 and other organizational advances provided important stimuli for progress. While early pioneers concentrated on analysis of skeletonized human remains, applications today have expanded to include complex methods of search and recovery, the biomechanics of trauma interpretation, isotopic analysis related to diet and region of origin, age estimation of the living and issues related to humanitarian and human rights investigations. © 2018 Wiley Periodicals, Inc.

Memories of an Aid Worker

ERIC Educational Resources Information Center

Daoust, Isabelle

2010-01-01

The author had come to Cote d'Ivoire in April 1999 to work for the International Committee of the Red Cross (ICRC), an independent humanitarian organization dedicated to persuading governments to respect the rules of international humanitarian law (IHL), which are found in the Geneva Conventions. These rules provide impartial protection for the…

The Role of Prepositioned Stocks: Sustaining and Responding to Foreign Humanitarian Assistance and Disaster Relief (HADR) Operations

DTIC Science & Technology

2015-06-12

only emphasize on the response objectives regarding military and interagency focus. Limitations The USG has specified tasks and benchmarks that must...rates. Past data regarding supply and humanitarian services expended allows for accurate forecasting based off the severity of catastrophic damage

The epidemiology of lethal violence in Darfur: using micro-data to explore complex patterns of ongoing armed conflict.

PubMed

de Waal, Alex; Hazlett, Chad; Davenport, Christian; Kennedy, Joshua

2014-11-01

This article describes and analyzes patterns of lethal violence in Darfur, Sudan, during 2008-09, drawing upon a uniquely detailed dataset generated by the United Nations-African Union hybrid operation in Darfur (UNAMID), combined with data generated through aggregation of reports from open-source venues. These data enable detailed analysis of patterns of perpetrator/victim and belligerent groups over time, and show how violence changed over the four years following the height of armed conflict in 2003-05. During the reference period, violent incidents were sporadic and diverse and included: battles between the major combatants; battles among subgroups of combatant coalitions that were ostensibly allied; inter-tribal conflict; incidents of one-sided violence against civilians by different parties; and incidents of banditry. The conflict as a whole defies easy categorization. The exercise illustrates the limits of existing frameworks for categorizing armed violence and underlines the importance of rigorous microlevel data collection and improved models for understanding the dynamics of collective violence. By analogy with the use of the epidemiological data for infectious diseases to help design emergency health interventions, we argue for improved use of data on lethal violence in the design and implementation of peacekeeping, humanitarian and conflict resolution interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

The impact of HIV and AIDS research: a case study from Swaziland

PubMed Central

2011-01-01

Background Swaziland is experiencing the world’s worst HIV and AIDS epidemic. Prevalence rose from four percent of antenatal clinic attendees in 1992 to 42.6 percent in 2004. The Report ‘Reviewing ‘Emergencies’ for Swaziland: Shifting the Paradigm in a New Era’ published in 2007 bought together social and economic indicators. It built a picture of the epidemic as a humanitarian emergency, requiring urgent action from international organisations, donors, and governments. Following a targeted communications effort, the report was believed to have raised the profile of the issue and Swaziland - a success story for HIV and AIDS research. Methods Keen to understand how, where and why the report had an impact, Health Economics and HIV/AIDS Research Division commissioned an assessment to track and evaluate the influence of the research. This tapped into literature on the significance of understanding the research-to-policy interface. This paper outlines the report and its impact. It explores key findings from the assessment and suggests lessons for future research projects. Results The paper demonstrates that, although complex, and not without methodological issues, impact assessment of research can be of real value to researchers in understanding the research-to-policy interface. Conclusion Only by gaining insight into this process can researchers move forward in delivering effective research. PMID:21679390

Providing health services during a civil war: the experience of a garrison town in South Sudan.

PubMed

Kevlihan, Rob

2013-10-01

The impact of conflict, particularly conflict arising during civil wars, on the provision of healthcare is a subject that has not been widely considered in conflict-related research. Combatants often target health services to weaken or to defeat the enemy, while attempts to maintain or improve health systems also can comprise part of counter-insurgency 'hearts-and-minds' strategies. This paper describes the dynamics associated with the provision of health services in Malakal, an important garrison town in South Sudan, during the second Sudanese civil war (1983-2005). Drawing on the concepts of opportunity hoarding and exploitation, it explores the social and political dynamics of service provision in and around the town during the war. These concepts provide a useful lens with which to understand better how health services are affected by conflict, while the empirical case study presented in the paper illustrates dynamics that may be repeated in other contexts. The concepts and case study set out in this paper should prove useful to healthcare providers working in conflict zones, including humanitarian aid agencies and their employees, increasing their understanding of the social and political dynamics that they are likely to face during future conflict-related complex emergencies. © 2013 The Author(s). Disasters © Overseas Development Institute, 2013.

A climate-compatible approach to development practice by international humanitarian NGOs.

PubMed

Clarke, Matthew; de Cruz, Ian

2015-01-01

If current climate-change predictions prove accurate, non-linear change, including potentially catastrophic change, is possible and the environments in which international humanitarian NGOs operate will change figuratively and literally. This paper proposes that a new approach to development is required that takes changing climate into account. This 'climate-compatible approach' to development is a bleak shift from some of the current orthodox positions and will be a major challenge to international humanitarian NGOs working with the most vulnerable. However, it is necessary to address the challenges and context such NGOs face, and the need to be resilient and adaptive to these changes. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

[Overview of an anthropology of the vaccine: a look at the ethics of a humanitarian practice].

PubMed

Laplante, Julie; Bruneau, Julie

2003-01-01

Two interrelated universal practices, humanitarian medicine and immunization, pose certain ethical problems. To shed light on the matter, we present some historical reference points indispensable to an understanding of contemporary vaccination programs, focusing especially on certain anthropological issues posed by this practice as far as representations of the body and of health within populations. Two examples of humanitarian vaccination practices, one used among an autochthonous population and the other among young people on the street, serve to illustrate some thoughts on management of the body and on the resistance displayed by these groups. We then propose paths to follow in re-examining the ethics of vaccination.

Malcolm MacLachlan: International Humanitarian Award.

PubMed

2014-11-01

The International Humanitarian Award recognizes extraordinary humanitarian services and activism by psychologists, including professional and volunteer work conducted primarily in the field with under-served populations. Award recipients are psychologists who, by their extraordinary service at a difficult time, improve the lives and contribute to the well-being of people in a large or small geographic area anywhere in the world. The 2014 recipient is Malcolm MacLachlan. "Focused on the rights and empowerment of vulnerable and marginalized groups, Malcolm MacLachlan's work synthesizes health, rehabilitation, and organizational and political psychology to promote social inclusion and global health." MacLachlan's award citation, biography, and selected bibliography are presented here. PsycINFO Database Record (c) 2014 APA, all rights reserved.

76 FR 77542 - Draft Guidance for Industry and Food and Drug Administration Staff on Humanitarian Use Device...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0847] Draft Guidance for Industry and Food and Drug Administration Staff on Humanitarian Use Device Designations; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and...

Integration of Humanitarian Knowledge in Art and Design Activity

ERIC Educational Resources Information Center

Kamzina, Nadezhda Enovna; Mazina, Julia Ilyinichna; Turganbayeva, Shakhizada Sainbekovna

2016-01-01

The process of integration of humanitarian knowledge is being examined in the article and the development of the project activities and a special outlook on the examples of famous artists, designers and architects are investigated. The forms of creative thinking are systematized and the factors modifying the borders of design knowledge are formed…

Using Contests to Provide Business Students Project-Based Learning in Humanitarian Logistics: PSAid Example

ERIC Educational Resources Information Center

Özpolat, Koray; Chen, Yuwen; Hales, Doug; Yu, Degan; Yalcin, Mehmet G.

2014-01-01

Business students appreciate working on classroom projects that are both enjoyable and useful in preparing them for future careers. Promoting competition among project teams is also used as a method to motivate students. The Humanitarian Logistics Project (HLP) teaches undergraduate students the logistical implications of unsolicited material…

Supporting evidence-based health care in crises: what information do humanitarian organizations need?

PubMed

Turner, Tari; Green, Sally; Harris, Claire

2011-03-01

In crisis situations, there is an enormous burden of disease and very limited resources. To achieve the best possible health outcomes in these situations and ensure that scarce resources are not wasted, knowledge from health research needs to be translated into practice. We investigated what information from health research was needed by humanitarian aid workers in crisis settings and how it could be best provided. Semistructured interviews were conducted by telephone with 19 humanitarian aid workers from a range of organizations around the world and the results analyzed thematically. Participants identified a clear and currently unmet need for access to high-quality health research to support evidence-based practice in crisis situations. They emphasized that research into delivery of health care was potentially more valuable than research into the effectiveness of particular clinical interventions and highlighted the importance of including contextual information to enable the relevance of the research to be assessed. They suggested that providers of health research information and humanitarian aid organizations work together to develop these resources. ©2011 American Medical Association. All rights reserved.

Does need matter? Needs assessments and decision-making among major humanitarian health agencies.

PubMed

Gerdin, Martin; Chataigner, Patrice; Tax, Leonie; Kubai, Anne; von Schreeb, Johan

2014-07-01

Disasters of physical origin, including earthquakes, floods, landslides, tidal waves, tropical storms, tsunamis, and volcanic eruptions, have affected millions of people globally over the past 100 years. Proportionately, there is far greater likelihood of being affected by such disasters in low-income countries than in high-income countries. Furthermore, low-income countries are in need of international assistance following disasters more often than high-income countries. The funding of international humanitarian assistance has increased from USD 12.9 billion in 2006 to an estimated USD 16.7 billion in 2010. The majority of this funding is channelled through humanitarian agencies and is supposed to be distributed based on the need of those affected, as assessed using needs assessments. Such needs assessments may be used to inform decisions internally, to influence others, to justify response decisions, and to obtain funding. Little is known about the quality of needs assessments in practical applications. Consequently, this paper reports on and analyses the views of operational decision-makers in major health-related humanitarian agencies on needs assessments. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

International Humanitarian Law: The legal framework for humanitarian forensic action.

PubMed

Gaggioli, Gloria

2018-01-01

In armed conflicts, death is not an exceptional occurrence, but becomes the rule and occurs on a daily basis. Dead bodies are sometimes despoiled, mutilated, abandoned without any funeral rite and without a decent burial. Unidentified remains may be counted by hundreds or thousands. As a result, families look for years for missing relatives, ignorant of the fate of their loved ones. International Humanitarian Law, also called the laws of war or the law of armed conflict, is an international law branch, which has been developed to regulate and, as far as possible, to humanize armed conflicts. It contains a number of clear and concrete obligations incumbent to belligerent parties on the management of dead bodies, which provide the legal framework for humanitarian forensic action. The purpose of this article is to present, in a simple and concise manner, these rules with a view to extrapolate some key legal principles, such as the obligation to respect the dignity of the dead or the right to know the fate of relatives, which shall guide anyone dealing with human remains. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk and resilience factors affecting the psychological wellbeing of individuals deployed in humanitarian relief roles after a disaster.

PubMed

Brooks, Samantha K; Dunn, Rebecca; Sage, Clara A M; Amlôt, Richard; Greenberg, Neil; Rubin, G James

2015-12-01

When disasters occur, humanitarian relief workers frequently deploy to assist in rescue/recovery efforts. To conduct a systematic review of factors affecting the psychological wellbeing of disaster relief workers and identify recommendations for interventions. We searched MEDLINE®, Embase, PsycINFO® and Web of Science for relevant studies, supplemented by hand searches. We performed thematic analysis on their results to identify factors predicting wellbeing. Sixty-one publications were included. Key themes were: pre-deployment factors (preparedness/training); peri-deployment factors (deployment length/timing; traumatic exposure; emotional involvement; leadership; inter-agency cooperation; support; role; demands and workload; safety/equipment; self-doubt/guilt; coping strategies) and post-deployment factors (support; media; personal and professional growth). As well as role-specific stressors, many occupational stressors not specific to humanitarian relief (e.g. poor leadership, poor support) present a significant health hazard to relief workers. Humanitarian organisations should prioritise strengthening relationships between team members and supervisors, and dealing effectively with non-role-specific stressors, to improve the psychological resilience of their workforce.

Humanitarian Needs Among Displaced and Female-Headed Households in Government-Controlled Areas of Syria.

PubMed

Doocy, Shannon; Lyles, Emily

2017-06-01

To identify unmet needs and assistance priorities of displaced and female-headed households in government-controlled areas of Syria. In mid-2016, we undertook a survey of accessible areas, largely urban and government-controlled, to identify unmet needs and assistance priorities. We used a cluster design with probability sampling to attain a final sample of 2405 households from 10 of 14 governorates; 31 of 65 (47.7%) districts were included that are home to 38.1% of people in need. Displaced and female-headed households were more vulnerable than nondisplaced and male-headed households in numerous sectors. Despite approximately half of surveyed households reporting receipt of humanitarian assistance in the preceding month and apparently effective targeting of assistance by vulnerability, unmet needs were nearly ubiquitous. The humanitarian situation in inaccessible areas of Syria is likely to be considerably worse; thus, findings presented here likely underestimate humanitarian needs. Efforts to expand support to Syria's most vulnerable households are desperately needed as are innovative targeting and modalities that enable more efficient and effective assistance.

Factors influencing humanitarian care and the treatment of local patients within the deployed military medical system: casualty referral limitations.

PubMed

Causey, Marlin; Rush, Robert M; Kjorstad, Randy J; Sebesta, James A

2012-05-01

Humanitarian medical care is an essential task of the deployed military health care system. The purpose of this study was to analyze referral acceptance in treating injured local national patients during Operation Enduring Freedom. A prospective observation study of local nationals who were referred for humanitarian trauma care in Afghanistan from March through August 2009. Sixty-six patients were referred for evacuation for suspected non-coalition-caused injuries. The bed status at the receiving hospital was defined as green (able to accept patients), amber (nearing capacity), and red (at capacity). The only factor associated with acceptance was the accepting hospital bed status (odds ratio = 1.57%, 95% confidence interval, 1.11-2.22; P = .009). Factors not significant were age, the province of origin, the type of referring facility, a prior operation before the request, patient status/affiliation, or the mechanism of injury. Humanitarian medical care is directly related to the capacity for high-acuity care because bed availability is the predominate reason for acceptance or rejection. Published by Elsevier Inc.

Social suffering and the culture of compassion in a morally divided China.

PubMed

Kuah-Pearce, Khun Eng; Kleinman, Arthur; Harrison, Emily

2014-01-01

This collection of essays opens a critical examination of compassionate acts responding to social suffering in the intensely complex moral context of a rapidly changing and globalizing China. Jeanne Shea describes self-compassion among older women in China as a post-revolutionary response to changing opportunities and resistance to consumerism. Khun Eng Kuah-Pearce's essay frames the Buddhist organizations as NGOs and shows compassion being mobilized and its acts being spiritual-philanthropic, not political. The next three papers illuminate the complexity of mobility in a moral sea of changing values. Even as modernity facilitates movement of people away from suffering, the grinding of entangled moral experiences within the mobile group can be the cause of suffering. Shu-Min Huang critiques 'cultural petrification' as the diasporic Yunnan Chinese community in Thailand attempt to preserve the cultural forms and procedures of the world they left behind. Likewise, Richard Madsen shows that the idea of a universalized cultural heritage fails in the face of the 'micro-ecologies'. And yet the modern impulse to universalize beyond China has important implications for transnational compassion and cooperation. The work of the humanitarian organization Médecins Sans Frontières in China, discussed by Kuah-Pearce and Guiheux, challenges the universality of global humanitarian actions. Following the series of essays threaded across intersections of compassion, suffering, and a morally-divided China, the collection closes by looking at the West. Iain Wilkinson discusses the origins of social suffering as a focus of the social sciences, as well as the difficulties of making engaged compassion its task in a morally-divided world.

Why don't humanitarian organizations provide safe abortion services?

PubMed

McGinn, Therese; Casey, Sara E

2016-01-01

Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors' observations suggest that four reasons are typically given for this gap: 'There's no need'; 'Abortion is too complicated to provide in crises'; 'Donors don't fund abortion services'; and 'Abortion is illegal'. However, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99 % of the world's population, abortion is permitted under some circumstances; it is illegal without exception in only six countries. International law supports improved access to safe abortion. As none of the reasons often cited for not providing these services is valid, it is the responsibility of humanitarian NGOs to decide where they stand regarding their commitment to humanitarian standards and women's right to high quality and non-discriminatory health services. Providing safe abortion to women who become pregnant as a result of rape in war may be a more comfortable place for organizations to begin the discussion. Making safe abortion available will improve women's health and human rights and save lives.

Medical humanitarianism, human rights and political advocacy: the case of the Israeli Open Clinic.

PubMed

Gottlieb, Nora; Filc, Dani; Davidovitch, Nadav

2012-03-01

In the context of neo-liberal retrenchments humanitarian NGOs have become alternative healthcare providers that partially fill the vacuum left by the welfare state's withdrawal from the provision of services to migrants and other marginalized populations. In many cases they thus help to build legitimacy for the state's retreat from social responsibilities. Human rights organizations play an important role in advocating for migrants' rights, but in many cases they represent a legalistic and individualized conceptualization of the right to health that limits their claims for social justice. This paper analyzes the interactions and tensions between the discourses of medical humanitarianism, human rights and political advocacy using the example of an "Open Clinic" run by an Israeli human rights organization as a case-study: In 2007 dramatically increasing patient numbers provoked an intense internal debate concerning the proposal to temporarily close the "Open Clinic" in order to press the government to take action. Based on protocols from internal meetings and parliamentary hearings and in-depth interviews, we have analyzed divergent contextualizations of the Clinic's closure. These reflect conflicting notions regarding the Clinic's variegated spectrum of roles--humanitarian, political, legitimizing, symbolic, empowering and organizational--and underlying conceptualizations of migrants' "deservingness". Our case-study thus helps to illuminate NGOs' role in the realm of migrant healthcare and points out options for a possible fruitful relationship between the divergent paradigms of medical humanitarianism, human rights and political advocacy. Copyright © 2011. Published by Elsevier Ltd.

Civil-Military Engagement: An Empirical Account of Humanitarian Perceptions of Civil-Military Coordination During the Response to Typhoon Haiyan.

PubMed

Bollettino, Vincenzo

2016-02-01

This study sought to identify how humanitarian actors in natural disasters coordinate (or communicate) with the military to identify the needs of disaster-affected populations, identify how coordination should be undertaken for the delivery of relief goods, perceive the effectiveness of such coordination, perceive the role that training played in preparation for coordinating with the military and the effectiveness of this training, and view the overall civil-military engagement and its implications for the independence of the humanitarian sector. A survey instrument focused on participant perceptions of the civil-military engagement in response to Typhoon Haiyan in the Philippines was sent to country directors and agency leads who played a role in the response. Although the data supported anecdotal accounts that the coordination between civilian and military actors during the disaster relief efforts in Typhoon Haiyan worked well, they also revealed that fewer than half of the respondents were familiar with the Guidelines on the Use of Foreign Military and Civil Defence Assets in Disaster Relief (the "Oslo Guidelines") and only 12% of respondents thought that the Oslo Guidelines were used to develop organizational policy on humanitarian aid agency engagement with military actors. Humanitarians felt that international militaries and the Philippines Armed Forces played an important role in ensuring that aid reached people in need, particularly in the early days of the response. However, less than half of the respondents were familiar with the Oslo Guidelines.

A Systematic Review of the Amount of Water per Person per Day Needed to Prevent Morbidity and Mortality in (Post-)Disaster Settings

PubMed Central

De Buck, Emmy; Borra, Vere; De Weerdt, Elfi; Vande Veegaete, Axel; Vandekerckhove, Philippe

2015-01-01

Background In order to improve the effectiveness and efficiency of humanitarian efforts, minimum standards for humanitarian assistance and key indicators, showing whether a standard has been attained, have been developed. However, many of these standards and indicators are based on a consensus on best practices and experiences in humanitarian response, because relevant evidence on the impact of humanitarian interventions is often lacking. Objectives One important example of a standard in humanitarian aid in a disaster setting is “water quantity.” The accompanying indicator states how many litres of water are needed per person per day in a disaster setting. It was our objective to determine the evidence base behind this indicator, in order to improve health outcomes such as morbidity (e.g., diarrhoea) and mortality. Methods A systematic review was performed searching The Cochrane Library, Medline and Embase. We included studies performed during disasters and in refugee camps that reported a specific water amount and health-related outcomes related to water shortages, including diarrhoea, cholera, and mortality. We used GRADE to determine the quality of evidence. Results Out of 3,630 articles, 111 references relevant to our question were selected. Based on our selection criteria, we finally retained 6 observational studies, including 1 study that was performed during the disaster and 5 studies in a post-disaster phase. From two studies there is conclusive evidence on the relationship between the amount of water received and diarrhoea or mortality rates in refugee camps. However, overall, these studies do not contain enough data with relevance to a specific amount of water, and the level of evidence is very low. Conclusions More primary research on water amounts in a disaster setting is necessary, so that the humanitarian sector can further professionalise its water-related standards, indicators and interventions. PMID:25961720

Achievements and bottlenecks in humanitarian demining EU-funded research: final results from the EC DELVE project

NASA Astrophysics Data System (ADS)

Sahli, Hichem; Bruschini, Claudio; Van Kempen, Luc; Schleijpen, Ric; den Breejen, Eric

2008-04-01

The EC DELVE Support Action project has analyzed the bottlenecks in the transfer of Humanitarian Demining (HD) technology from technology development to the use in the field, and drawn some lessons learned, basing itself on the assessment of the European Humanitarian Demining Research and Technology Development (RTD) situation from early 1990 until 2006. The situation at the European level was analyzed with emphasis on activities sponsored by the European Commission (EC). This was also done for four European countries and Japan, with emphasis on national activities. The developments in HD during the last 10 years underline the fact that in a number of cases demining related developments have been terminated or at least put on hold. The study also showed that the funding provided by the EC under the Framework Program for RTD has led directly to the creation of an extensive portfolio of Humanitarian Demining technology development projects. The latter provided a range of research and supporting measures addressing the critical issues identified as a result of the regulatory policies developed in the field of Humanitarian Demining over the last ten years. However, the range of instruments available to the EC to finance the necessary research and development were limited, to pre-competitive research. The EC had no tools or programs to directly fund actual product development. As a first consequence, the EC funding program for development of technology for Humanitarian Demining unfortunately proved to be largely unsuitable for the small-scale development needed in a field where there is only a very limited market. As a second consequence, most of the research has been demonstrator-oriented. Moreover, the timeframe for RTD in Humanitarian Demining has not been sufficiently synchronized with the timeframe of the EC policies and regulations. The separation of the Mine Action and RTD funding streams in the EC did also negatively affect the take-up of new technologies. As a conclusion, creating coherence between: (1) the EC policy based on political decisions, (2) RTD, testing and industrialization of equipment, and (3) timely deployment, requires a new way of coordinated thinking: "end-to-end planning" has to be supported by a well organized and coordinated organizational structure involving different DGs and even extending beyond the EU. This was not the case for Mine Action, but appears today to be the case for Environmental Risk Management.

[Definition and evaluation of therapeutic food for severely malnourished children in situations of humanitarian emergencies].

PubMed

Desjeux, J F; Briend, A; Prudhon, C; Greletty, Y; Golden, M H

1998-01-01

Nowadays, median case fatality rate of severely malnourished children treated in hospitals is 23.5%, a rate which has not changed for the last 50 years. This is probably related to the use of inappropriate or even unsafe treatment protocols. This work aimed at reducing case fatality rates of severe malnutrition by developing a treatment protocol and assessing its effectiveness during humanitarian crises. A therapeutic food was designed from pathophysiologic studies and its use adapted to therapeutic feeding centres. This food (F100) contains 100 Kcal/100 ml, with 10% of its energy derived from proteins; it has a low sodium and iron content but is fortified with vitamins and minerals. It can be prepared either at the treatment centre or at an industrial level. Industrial production, which started in 1993 reached 1,500 MT in 1997. In refugee camps, F100 was used according to a strict protocol adapted to local conditions. Intakes started at 100 Kcal/kg/day and reached 200 kcal/kg/day once appetite was restored. A model to assess the risk of death according to weight, height and oedema was developed. First results show that mortality was often below 5%. Hence, it is possible to standardise and evaluate a nutritional treatment in such unfavourable conditions as a refugee camp. Standardised use of F100 can markedly reduce mortality of severely malnourished children.

Using Airborne Remote Sensing to Increase Situational Awareness in Civil Protection and Humanitarian Relief - the Importance of User Involvement

NASA Astrophysics Data System (ADS)

Römer, H.; Kiefl, R.; Henkel, F.; Wenxi, C.; Nippold, R.; Kurz, F.; Kippnich, U.

2016-06-01

Enhancing situational awareness in real-time (RT) civil protection and emergency response scenarios requires the development of comprehensive monitoring concepts combining classical remote sensing disciplines with geospatial information science. In the VABENE++ project of the German Aerospace Center (DLR) monitoring tools are being developed by which innovative data acquisition approaches are combined with information extraction as well as the generation and dissemination of information products to a specific user. DLR's 3K and 4k camera system which allow for a RT acquisition and pre-processing of high resolution aerial imagery are applied in two application examples conducted with end users: a civil protection exercise with humanitarian relief organisations and a large open-air music festival in cooperation with a festival organising company. This study discusses how airborne remote sensing can significantly contribute to both, situational assessment and awareness, focussing on the downstream processes required for extracting information from imagery and for visualising and disseminating imagery in combination with other geospatial information. Valuable user feedback and impetus for further developments has been obtained from both applications, referring to innovations in thematic image analysis (supporting festival site management) and product dissemination (editable web services). Thus, this study emphasises the important role of user involvement in application-related research, i.e. by aligning it closer to user's requirements.

Role 1 Pediatric Trauma Care on the Israeli-Syrian Border-First Year of the Humanitarian Effort.

PubMed

Bitterman, Yuval; Benov, Avi; Glassberg, Elon; Satanovsky, Alexandra; Bader, Tarif; Sagi, Ram

2016-08-01

This article summarizes the experience with Role 1 care for 135 Syrian children who received medical care during the year 2013 as part of an ongoing humanitarian effort. The database included demographic information, point-of-injury assessment and outcome, and was analyzed using SPSS. Trauma casualties were the majority of the group (84 cases), and mostly male. Almost one-third of casualties arrived more than 6 hours after injury, and time of injury was unknown in another third. The most common mechanism of injury was shrapnel (51.2%), followed by gunshot wounds (22.6%). Gunshot wound victims were significantly older than shrapnel and artillery victims (p < 0.01, < 0.05, respectively). Only 14 cases (14.28%) underwent previous interventions in Syria. Most of the casualties (44 cases, 52.4%) underwent at least one procedure during Role 1 treatment with a high overall success rate (93.18%) that was not correlated to Advanced Life Support provider type (physician [MD], emergency medical technician-paramedic, or both). Mortality was low (3 cases). The study cohort exhibits several unique features, including a delay in arrival to medical care, paucity of prior care and information, and the specific mechanisms of injury. Our study suggests that Advanced Life Support providers do not differ significantly in Role 1 treatment choices and procedure success. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

"The Impulse to Help": (Post) Humanitarianism in an Era of the "New" Development Advocacy

ERIC Educational Resources Information Center

Bryan, Audrey

2013-01-01

This paper draws on the Republic of Ireland as a case study of the 'new' development advocacy, i.e. government, philanthropic, and celebrity humanitarian engagement with international development and statutory efforts to deepen understanding of international development among citizens in the global North (Biccum, 2010; 2011). It outlines some of…

Challenges and Psychosocial Growth for Older Volunteers Giving Intensive Humanitarian Service

ERIC Educational Resources Information Center

Piercy, Kathleen W.; Cheek, Cheryl; Teemant, Boyd

2011-01-01

Purpose of the study: We conducted a qualitative study of 38 mid-late life volunteers in intensive humanitarian service to ascertain the challenges, personal changes, and benefits they experienced from their volunteer activities. Intensive volunteering was defined as service done on a 24-hr a day basis at a location away from home. Design and…

Strategies for Civilian-Military Communication

DTIC Science & Technology

2013-04-01

minimum standards in life-saving areas of humanitarian response. OCHA has a website with numerous publications dedicated to humanitarian civ-mil...United States Army War College Class of 2013 DISTRIBUTION STATEMENT: A Approved for Public Release Distribution is Unlimited This... Schools , 3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission on Higher Education is an institutional accrediting agency

Maryland physicians on a humanitarian mission to war-torn Croatia.

PubMed

Laukenmann, B

1993-04-01

Six physicians from Maryland, California, and Utah participated in a 10-day humanitarian mission to Croatia. They spent long hours in antiquated operating rooms performing maxillofacial and extremity reconstructive procedures; most patients were young or war-injured males. Though not a third world country, Croatia urgently needs finances to acquire drugs, supplies, textbooks, and equipment.

A Comparison of the Impact of Two Liberal Arts General Education Core Curricula on Student Humanitarian Values

ERIC Educational Resources Information Center

Hollway, Michael C.

2005-01-01

The purpose of this study of two undergraduate liberal arts core curricula was to answer the following questions: What was the impact on student humanitarian values of a traditional distribution general education core curriculum with a supplementary integrated intervention strategy that requires students to examine personal values and the values…

Operational Use of the US Army Reserve in Foreign Disaster Relief to Support the United States Government’s Strategic Use of Humanitarian Assistance and Disaster Response

DTIC Science & Technology

2015-05-21

FDR). Global climate change , urbanization, growing natural resources scarcity, and other factors will increase the need for humanitarian assistance......additional military support to the United States Government’s agencies in Foreign Disaster Relief (FDR). Global climate change , urbanization, growing

Humanitarian Medical Response to the Syrian Arab Republic (April 7, 2013 to April 23, 2013).

PubMed

Mahomed, Zeyn; Motara, Feroza; Bham, Ahmed

2016-02-01

The Syrian Arab Republic is entrenched in a deadly civil war, plunging the country into a state of chaos. With 3.2 million refugees abroad, 7.6 million internally displaced persons, and more than 200,000 killed, humanitarian assistance and international intervention are in dire need. This report outlines the response to the Syrian humanitarian crisis by a South African-based nongovernmental organization (NGO). It describes the experiences of a health care worker, the patient profiles, and the lessons learned in a war zone. Responding to a nation in need is of paramount importance. In order to maximize the benefit conferred, the team should always attempt to implement measures that leave a lasting legacy.

International Telemedicine/Disaster Medicine Conference: Papers and Presentations

NASA Technical Reports Server (NTRS)

1991-01-01

The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.

On a front line.

PubMed Central

Jones, L.

1995-01-01

Like the patients, doctors in Sarajevo depend largely on humanitarian aid; everyone in the public sector has worked without pay for almost three years. The hospital is on a front line; yet the psychiatric department continues to function, even conducting large scale studies of psychosocial aspects of war in Bosnia-Hercegovina. The type of inpatient morbidity and treatment patterns have changed. A plethora of psychosocial rehabilitation programmes has emerged, including counselling, drop in centres, and attending to special needs of elderly people, schoolchildren, and women. The most prominent psychological symptoms were exhaustion at the prospect of a third winter of war and bewilderment at the Western stereotype of Bosnians as Muslim fundamentalists. Images p1052-a p1053-a PMID:7728062

Ethical dilemmas in medical humanitarian practice: cases for reflection from Médecins Sans Frontières.

PubMed

Sheather, Julian; Shah, Tejshri

2011-03-01

Médecins Sans Frontières (MSF) is an independent medical humanitarian organisation working in over 70 countries. It has provided medical assistance for over 35 years to populations vulnerable through conflict, disease and inadequate health systems. Medical ethics define the starting point of the relationship between medical staff and patients. The ethics of humanitarian interventions and of research in conflict settings are much debated. However, less is known about the ethical dilemmas faced by medical humanitarian staff in their daily work. Ethical dilemmas can be intensified in humanitarian contexts by insecure environments, lack of optimum care, language barriers, potentially heightened power discrepancies between care providers and patients, differing cultural values and perceptions of patients, communities and medical staff. Time constraints, stressful conditions and lack of familiarity with ethical frameworks can prevent reflection on these dilemmas, as can frustration that such reflection does not necessarily provide instant solutions. Lack of reflection, however, can be distressing for medical practitioners and can reduce the quality of care. Ethical reflection has a central role in MSF, and the organisation uses ethical frameworks to help with clinical and programmatic decisions as well as in deliberations over operational research. We illustrate and discuss some real ethical dilemmas facing MSF teams. Only by sharing and seeking guidance can MSF and similar actors make more thoughtful and appropriate decisions. Our aim in sharing these cases is to invite discussion and dialogue in the wider medical community working in crisis, conflict or with severe resource limitations.

Radiology on Board the PLA(N) Peace Ark Hospital Ship During a Humanitarian Medical Relief Mission to the Philippines.

PubMed

Ren, Ai-Jun; Sun, Tao; Wang, Hai-Wei; Ge, He-Quan; Ye, Hong-Jun

2016-02-01

From November 24 to December 10, 2013, the Chinese People's Liberation Army Navy [PLA(N)] hospital ship Peace Ark was deployed to the Leyte Gulf in the Philippines to provide humanitarian medical relief in Tacloban after Typhoon Haiyan. The purpose of this study was to assess the radiological services aboard the ship to provide guidance for future missions. A retrospective review was performed on a cohort of 109 patients who underwent digital radiography (DR) and 59 patients who underwent computed tomography (CT) scans during a 16-day period during a humanitarian medical relief mission to the Philippines. Patient demographics, DR findings, and CT findings were analyzed. The mean age of the 109 DR patients was 39.7 years for the 64 males and 43.7 years for the 45 females. A total of 148 DR examinations were performed of the chest (n=109), extremities (n=35), and spine (n=4). The mean age of the 59 CT patients was 43.8 years for the 32 males and 49.1 years for the 27 females. A total of 72 CT scans were performed of the head and neck (n=36), thorax (n=24), abdomen (n=5), spine (n=4), and extremities (n=3). The imaging findings mainly included disaster-related and non-disaster-related fractures, pulmonary tuberculosis, pulmonary infection, acute brain infarction, intracranial hematoma, and occupying lesions. Analysis of radiological services during a humanitarian medical relief mission to the Philippines provided meaningful information for future humanitarian medical relief missions.

Constructive Convergence: Imagery and Humanitarian Assistance

DTIC Science & Technology

2012-02-01

PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...a dataset different projection , a transformation must be performed on the data that warps the original data into the new projection . Every time data...i Constructive Convergence: Imagery and Humanitarian Assistance Doug Hanchard Center for Technology and National

Effectiveness of Foreign Humanitarian Assistance Operations

DTIC Science & Technology

2017-06-09

activities and money spent. This study investigates the lasting contribution to bilateral partnership from the conduct of U.S. military humanitarian...increasing scrutiny to demonstrate the effectiveness of activities and money spent. This study investigates the lasting contribution to bilateral...increased discussions concerning the money spent on U.S. overseas security commitments. Stemming from the Budget Control Act of 2011, which included

Analysis of Humanitarian Assistance Cargo Transportation

DTIC Science & Technology

2012-06-01

deliver materiel to people in need in their areas of responsibility. This report analyzes the options available to these commands in seeking...Thus, United States combatant commands increasingly rely on humanitarian assistance cargo transportation programs to deliver material to people in need...United States Navy and Marine Corps personnel and people overseas. PH may also arrange for space-available transportation of NGO material to consigned

A resolution expressing the sense of the Senate concerning the humanitarian crisis in Syria and neighboring countries, resulting humanitarian and development challenges, and the urgent need for a political solution to the crisis.

THOMAS, 113th Congress

Sen. Kaine, Tim [D-VA

2014-03-13

Senate - 04/03/2014 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

The use of forensic DNA analysis in humanitarian forensic action: The development of a set of international standards.

PubMed

Goodwin, William H

2017-09-01

DNA analysis was first applied to the identification of victims of armed conflicts and other situations of violence (ACOSV) in the mid-1990s, starting in South America and the Balkans. Argentina was the first country to establish a genetic database specifically developed to identify disappeared children. Following on from these programs the early 2000s marked major programs, using a largely DNA-led approach, identifying missing persons in the Balkans and following the attack on the World Trade Center in New York. These two identification programs significantly expanded the magnitude of events to which DNA analysis was used to help provide the identity of missing persons. Guidelines developed by Interpol (2014) [1] related to best practice for identification of human remains following DVI type scenarios have been widely disseminated around the forensic community; in numerous cases these guidelines have been adopted or incorporated into national guidelines/standards/practice. However, given the complexity of many humanitarian contexts in which forensic science is employed there is a lack of internationally accepted guidelines, related to these contexts, for authorities to reference. In response the Argentine government's Human Rights Division in the Ministry of Foreign Affairs and Worship (MREC) proposed that the United Nations (UN) should promote best practice in the use of forensic genetics in humanitarian forensic action: this was adopted by the UN in Resolutions A/HRC/RES/10/26 and A/HRC/RES/15/5. Following on from the adoption of the resolutions MREC has coordinated, with the support of the International Committee of the Red Cross (ICRC), the drafting of a set of guidelines (MREC, ICRC, 2014) [2], with input from national and international agencies. To date the guidelines have been presented to South America's MERCOSUR and the UN and have been disseminated to interested parties. Copyright © 2017 Elsevier B.V. All rights reserved.

Perspectives from Ethiopia regarding U.S. military humanitarian assistance: how to build a better medical civil action project (MEDCAP).

PubMed

Miles, Shana; Malone, Joseph L

2013-12-01

Assuming that budgetary constraints continue over the next several years, the U.S. military's overseas medical activities including medical civic action projects (MEDCAPs) and humanitarian assistance projects could comprise an increasing proportion of the contributions of U.S. government (USG) to improving global health. We have identified several issues with MEDCAPs in Ethiopia since 2009 that resulted in delays or project cancellations. These were mostly related to lack of a plan to develop sustainable capacities. Although there are many obvious medical needs for civilian populations in Ethiopia, the provision of sustainable development assistance involving these Ethiopian populations on behalf of the USG is a complex undertaking involving coordination with many partners and coordination with several other USG agencies. Military medical professionals planning MEDCAPs and other cooperative global health projects would benefit from consultation and close coordination with U.S. Centers for Disease Control and Prevention (CDC) and U.S. Agency of International Development (USAID) experts who are involved in supporting medium- and long-term health projects in Ethiopia. The establishment of durable military medical academic relationships and involvement of overseas military medical research units could also help promote sustainable projects and build robust professional relationships in global health. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

A decade of emerging indications: deep brain stimulation in the United States.

PubMed

Youngerman, Brett E; Chan, Andrew K; Mikell, Charles B; McKhann, Guy M; Sheth, Sameer A

2016-08-01

OBJECTIVE Deep brain stimulation (DBS) is an emerging treatment option for an expanding set of neurological and psychiatric diseases. Despite growing enthusiasm, the patterns and implications of this rapid adoption are largely unknown. National trends in DBS surgery performed for all indications between 2002 and 2011 are reported. METHODS Using a national database of hospital discharges, admissions for DBS for 14 indications were identified and categorized as either FDA approved, humanitarian device exempt (HDE), or emerging. Trends over time were examined, differences were analyzed by univariate analyses, and outcomes were analyzed by hierarchical regression analyses. RESULTS Between 2002 and 2011, there were an estimated 30,490 discharges following DBS for approved indications, 1647 for HDE indications, and 2014 for emerging indications. The volume for HDE and emerging indications grew at 36.1% annually in comparison with 7.0% for approved indications. DBS for emerging indications occurred at hospitals with more neurosurgeons and neurologists locally, but not necessarily at those with the highest DBS caseloads. Patients treated for HDE and emerging indications were younger with lower comorbidity scores. HDE and emerging indications were associated with greater rates of reported complications, longer lengths of stay, and greater total costs. CONCLUSIONS DBS for HDE and emerging indications underwent rapid growth in the last decade, and it is not exclusively the most experienced DBS practitioners leading the charge to treat the newest indications. Surgeons may be selecting younger and healthier patients for their early experiences. Differences in reported complication rates warrant further attention and additional costs should be anticipated as surgeons gain experience with new patient populations and targets.

Operation Lifeline Sudan.

PubMed

Taylor-Robinson, S D

2002-02-01

The provision of aid in war zones can be fraught with political difficulties and may itself foster inequalities, as it is rare to be allowed access to civilians on both sides of a conflict. Over the past decade, a United Nations (UN) brokered agreement has allowed Operation Lifeline Sudan (OLS), a UN "umbrella" organisation, to provide the diplomatic cover and operational support to allow long term humanitarian and emergency food aid to both the government and the rebel sides in the long-running south Sudanese civil war. Over the years, the destruction of infrastructure in the country has meant that the provision of basic health care has been seriously hampered. Operation Lifeline Sudan has coordinated the work of most of the non-governmental organisations (NGOs), working in this part of Africa. Each NGO has had responsibility for a particular area of the country and has worked closely with the local Sudanese authorities on either side of the conflict, conforming to strict codes of conduct or "ground rules", based on neutrality. Operation Lifeline Sudan has provided an air-bridge for emergency relief supplies in regions where road access is impossible, either because of landmines, or simply because the roads do not exist. The war continues, however, and the underlying causes of war-economic exploitation, marginalisation of communities, lack of political representation, and systematic violence and abuse remain unsolved. The warring factions have brought some OLS operations in south Sudan to a standstill recently, for certain political reasons that could have compromised the neutrality of the OLS-coordinated humanitarian aid schemes. It would appear that the only resolution to the country's problems are external political pressure to get the respective combatants to negotiate and, less probably, an undertaking by countries of the developed world not to continue to supply arms. Nevertheless, OLS may serve as a model for how medical aid can be delivered in an even-handed way to the populations of countries where there is civil war, irrespective of where they may live.

Pre-migration and post-migration factors associated with mental health in humanitarian migrants in Australia and the moderation effect of post-migration stressors: findings from the first wave data of the BNLA cohort study.

PubMed

Chen, Wen; Hall, Brian J; Ling, Li; Renzaho, Andre Mn

2017-03-01

The process of becoming a humanitarian migrant is potentially damaging to mental health. We examined the association between pre-migration and post-migration potentially traumatic events and stressors and mental health, and assessed the moderating effect of post-migration stressors in humanitarian migrants in Australia. In this study, we used the first wave of data between 2013 and 2014 from the Building a New Life in Australia survey. The survey included 2399 migrants who had arrived in Australia holding a permanent humanitarian visa 3-6 months preceding the survey, with 77% and 23% of participants being granted visas through offshore and onshore humanitarian programmes, respectively. Post-traumatic stress disorder (PTSD) was measured with the Post-traumatic Stress Disorder 8 items (PTSD-8) and severe mental illness was measured with the Kessler Screening Scale for Psychological Distress (K6). Pre-migration potentially traumatic events and post-migration stressors related to asylum process and resettlement were measured with a self-reported questionnaire. Of the 2399 participants, 762 (31%; 95% CI 29·4-33·2) had PTSD and 394 (16%; 95% CI 14·2-17·2) had severe mental illness. The mean number of pre-migration potentially traumatic events was 2·1 (SD 1·4). 64%, 59%, 49%, and 18% of participants reported poor social integration, economic problems, worrying about family or friends overseas, and loneliness as post-migration stressors. Pre-migration potentially traumatic events and post-migration stressors were positively associated with PTSD and severe mental illness. Factors significantly modifying the association between pre-migration potentially traumatic events and mental health after controlling for confounding factors were resettlement related stressors, including loneliness (odds ratio 1·17, 95% CI 1·05-1·28 for PTSD and 1·28, 1·16-1·41 for severe mental illness) and the number of social integration stressors (1·10, 1·05-1·16 for PTSD). Our data suggest that post-migration resettlement-related stressors were the most important correlates of mental health in humanitarian migrants, accounting for both direct and indirect associations. Targeting resettlement-related stressors through augmenting psychosocial care programmes and social integration would be a key approach to improve humanitarian migrants' mental health. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

CE: Inside an Ebola Treatment Unit: A Nurse's Report.

PubMed

Wilson, Deborah

2015-12-01

In December 2013, the first cases of the most recent outbreak of Ebola virus disease (formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Liberia for five weeks. This article describes her experiences there. It provides some background, outlines the practices and teams involved, and aims to convey a sense of what it's like to work during an Ebola outbreak and to put a human face on this devastating epidemic.

Challenges in preparing and implementing a clinical trial at field level in an Ebola emergency: A case study in Guinea, West Africa.

PubMed

Carazo Perez, Sara; Folkesson, Elin; Anglaret, Xavier; Beavogui, Abdoul-Habib; Berbain, Emmanuel; Camara, Alseny-Modet; Depoortere, Evelyn; Lefevre, Annabelle; Maes, Piet; Malme, Kristian Nødtvedt; Malvy, Jean-Marie Denis; Ombelet, Sien; Poelaert, Geertrui; Sissoko, Daouda; Tounkara, Alexis; Trbovic, Pierre; Piguet, Pascal; Antierens, Annick

2017-06-01

During the large Ebola outbreak that affected West Africa in 2014 and 2015, studies were launched to evaluate potential treatments for the disease. A clinical trial to evaluate the effectiveness of the antiviral drug favipiravir was conducted in Guinea. This paper describes the main challenges of the implementation of the trial in the Ebola treatment center of Guéckédou. Following the principles of the Good Clinical Research Practices, we explored the aspects of the community's communication and engagement, ethical conduct, trial protocol compliance, informed consent of participants, ongoing benefit/risk assessment, record keeping, confidentiality of patients and study data, and roles and responsibilities of the actors involved. We concluded that several challenges have to be addressed to successfully implement a clinical trial during an international medical emergency but that the potential for collaboration between research teams and humanitarian organizations needs to be highlighted.

Climate change and health research in the Eastern Mediterranean Region.

PubMed

Habib, Rima R; Zein, Kareem El; Ghanawi, Joly

2010-06-01

Anthropologically induced climate change, caused by an increased concentration of greenhouse gases in the atmosphere, is an emerging threat to human health. Consequences of climate change may affect the prevalence of various diseases and environmental and social maladies that affect population health. In this article, we reviewed the literature on climate change and health in the Eastern Mediterranean Region. This region already faces numerous humanitarian crises, from conflicts to natural hazards and a high burden of disease. Climate change is likely to aggravate these emergencies, necessitating a strengthening of health systems and capacities in the region. However, the existing literature on climate change from the region is sparse and informational gaps stand in the way of regional preparedness and adaptation. Further research is needed to assess climatic changes and related health impacts in the Eastern Mediterranean Region. Such knowledge will allow countries to identify preparedness vulnerabilities, evaluate capacity to adapt to climate change, and develop adaptation strategies to allay the health impacts of climate change.

Health care workers in danger zones: a special report on safety and security in a changing environment.

PubMed

Redwood-Campbell, Lynda J; Sekhar, Sharonya N; Persaud, Christine R

2014-10-01

Violence against humanitarian health care workers and facilities in situations of armed conflict is a serious humanitarian problem. Targeting health care workers and destroying or looting medical facilities directly or indirectly impacts the delivery of emergency and life-saving medical assistance, often at a time when it is most needed. Attacks may be intentional or unintentional and can take a range of forms from road blockades and check points which delay or block transport, to the direct targeting of hospitals, attacks against medical personnel, suppliers, patients, and armed entry into health facilities. Lack of access to vital health care services weakens the entire health system and exacerbates existing vulnerabilities, particularly among communities of women, children, the elderly, and the disabled, or anyone else in need of urgent or chronic care. Health care workers, especially local workers, are often the target. This report reviews the work being spearheaded by the Red Cross and Red Crescent Movement on the Health Care in Danger initiative, which aims to strengthen the protections for health care workers and facilities in armed conflicts and ensure safe access for patients. This includes a review of internal reports generated from the expert workshops on a number of topics as well as a number of public sources documenting innovative coping mechanisms adopted by National Red Cross and Red Crescent Societies. The work of other organizations is also briefly examined. This is followed by a review of security mechanisms within the humanitarian sector to ensure the safety and security of health care personnel operating in armed conflicts. From the existing literature, a number of gaps have been identified with current security frameworks that need to be addressed to improve the safety of health care workers and ensure the protection and access of vulnerable populations requiring assistance. A way forward for policy, research, and practice is proposed for consideration. While there is work being done to improve conditions for health care personnel and patients, there need to be concerted actions to stigmatize attacks against workers, facilities, and patients to protect the neutrality of the medical mission.

A Global Drought Observatory for Emergency Response

NASA Astrophysics Data System (ADS)

Vogt, Jürgen; de Jager, Alfred; Carrão, Hugo; Magni, Diego; Mazzeschi, Marco; Barbosa, Paulo

2016-04-01

Droughts are occurring on all continents and across all climates. While in developed countries they cause significant economic and environmental damages, in less developed countries they may cause major humanitarian catastrophes. The magnitude of the problem and the expected increase in drought frequency, extent and severity in many, often highly vulnerable regions of the world demand a change from the current reactive, crisis-management approach towards a more pro-active, risk management approach. Such approach needs adequate and timely information from global to local scales as well as adequate drought management plans. Drought information systems are important for continuous monitoring and forecasting of the situation in order to provide timely information on developing drought events and their potential impacts. Against this background, the Joint Research Centre (JRC) is developing a Global Drought Observatory (GDO) for the European Commission's humanitarian services, providing up-to-date information on droughts world-wide and their potential impacts. Drought monitoring is achieved by a combination of meteorological and biophysical indicators, while the societal vulnerability to droughts is assessed through the targeted analysis of a series of social, economic and infrastructural indicators. The combination of the information on the occurrence and severity of a drought, on the assets at risk and on the societal vulnerability in the drought affected areas results in a likelihood of impact, which is expressed by a Likelihood of Drought Impact (LDI) indicator. The location, extent and magnitude of the LDI is then further analyzed against the number of people and land use/land cover types affected in order to provide the decision bodies with information on the potential humanitarian and economic bearings in the affected countries or regions. All information is presented through web-mapping interfaces based on OGC standards and customized reports can be drawn by the user. The system will be further developed by increasing the number of sectorial impact indicators and validated against known and documented cases around the world. The poster will provide an overview on the system, the LDI and first analysis results.

Private Motive, Humanitarian Intent: A Theory of Ethically Justified Private Intervention

DTIC Science & Technology

2013-06-01

huge numbers of contractors employed during both conflicts demonstrates not only the sheer numbers of willing participants from the private sector ...massive military formations in the global public sector vanished with the end of the Cold War, and the downsizing of militaries throughout the world...the financial 38 ICRC, “International Humanitarian Law – Treaties and Documents,” ICRC.org, http

Justified Humanitarian Intervention: Operation ALLIED FORCE

DTIC Science & Technology

2013-04-25

muster the political will to intervene early and forcefully to prevent escalation, genocide , and spillover to neighboring states that will destroy...increased as the violence escalated. The memory of human rights atrocities in Bosnia, the recent failure by the UN to prevent genocide in Rwanda ...guidance which President Clinton developed during the 1994 genocide in Rwanda . In PDD-25 President Clinton identified “humanitarian disasters requiring

Syria: Overview of the Humanitarian Response

DTIC Science & Technology

2013-09-04

more than two- year civil war in Syria. The humanitarian situation, for one, has garnered significant bipartisan attention. Members have proposed and...the prospect that atrocities reaching the level of crimes against humanity and war crimes by armed groups may have been committed. Outside Syria...the United Nations. Funding commitments made during the first half of 2013 have been incorporated into the revised appeals. As of September 3, 2013

The Question of Gender in (Re)orienting to the Civil Military Relationship within Humanitarian Space

DTIC Science & Technology

2015-04-07

while attending to the gendered nature of the civilian-military relationship from the perspective of feminist theorizing. A qualitative study will...and economic development that is driven by the local community. Notwithstanding such differences in philosophies, values, mandates, cultures, and...organizations, such NGOs involved in humanitarian aid, reconstruction, or development work, must frequently develop strategies for effective civil

Nurse Education, Center of Excellence for Remote and Medically Under-Served Areas (CERMUSA)

DTIC Science & Technology

2013-10-01

humanitarian assistance and disaster response missions throughout the world . To prepare for future military humanitarian missions, nurses turn to...disaster response education modules that include real- world scenarios were designed to inform and create learning opportunities to enhance disaster...preparedness and response. According to the American Public Health Association (2008), “In a rapidly changing world facing natural and man-made

Creating opportunities through mentorship, parental involvement, and safe spaces (COMPASS) program: multi-country study protocol to protect girls from violence in humanitarian settings.

PubMed

Falb, Kathryn L; Tanner, Sophie; Ward, Leora; Erksine, Dorcas; Noble, Eva; Assazenew, Asham; Bakomere, Theresita; Graybill, Elizabeth; Lowry, Carmen; Mallinga, Pamela; Neiman, Amy; Poulton, Catherine; Robinette, Katie; Sommer, Marni; Stark, Lindsay

2016-03-05

Violence against adolescent girls in humanitarian settings is of urgent concern given their additional vulnerabilities to violence and unique health and well-being needs that have largely been overlooked by the humanitarian community. In order to understand what works to prevent violence against adolescent girls, a multi-component curriculum-based safe spaces program (Creating Opportunities through Mentorship, Parental involvement and Safe Spaces - COMPASS) will be implemented and evaluated. The objectives of this multi-country study are to understand the feasibility, acceptability and effectiveness of COMPASS programming to prevent violence against adolescent girls in diverse humanitarian settings. Two wait-listed cluster-randomized controlled trials are being implemented in conflict-affected communities in eastern Democratic Republic of Congo (N = 886 girls aged 10-14 years) and in refugee camps in western Ethiopia (N = 919 girls aged 13-19 years). The intervention consists of structured facilitated sessions delivered in safe spaces by young female mentors, caregiver discussion groups, capacity-building activities with service providers, and community engagement. In Ethiopia, the research centers on the overall impact of COMPASS compared to a wait-list group. In DRC, the research objective is to understand the incremental effectiveness of the caregiver component in addition to the other COMPASS activities as compared to a wait-list group. The primary outcome is change in sexual violence. Secondary outcomes include decreased physical and emotional abuse, reduced early marriage, improved gender norms, and positive interpersonal relationships, among others. Qualitative methodologies seek to understand girls' perceptions of safety within their communities, key challenges they face, and to identify potential pathways of change. These trials will add much needed evidence for the humanitarian community to meet the unique needs of adolescent girls and to promote their safety and well-being, as well as contributing to how multi-component empowerment programming for adolescent girls could be adapted across humanitarian settings. Clinical Trials NCT02384642 (Registered: 2/24/15) & NCT02506543 (Registered: 7/19/15).

Nurses' contribution to short-term humanitarian care in low- to middle-income countries: An integrative review of the literature.

PubMed

Dawson, Sonja; Elliott, Doug; Jackson, Debra

2017-12-01

To appraise the literature related to voluntary humanitarian work provided by international nurses in low- to middle-income countries. Nurses and other health professionals are engaged with both governmental and nongovernmental organisations to provide care within international humanitarian relief and development contexts. Current literature describes accounts of charitable health professional activity within short-term health-focused humanitarian trips; however, there is minimal research describing the care that nurses provide and the professional roles and tasks they fulfil whilst participating in international volunteer healthcare service. Integrative review. A search of articles published between 1995-2015 was conducted using seven bibliographic databases. Inclusion criteria incorporated nurses and allied health professionals' involvement in a volunteer short-term medical team capacity. Papers describing military and/or disaster response with a service-learning focus were excluded. Nineteen papers were selected for review, description and discussion of findings. Findings revealed limited data describing the care nurses provide and the professional roles and tasks they fulfil within the context of international humanitarian short-term medical trips. Issues raised included a description of demographic data regarding participants and sending agencies, motivation for volunteer participation, perceptions of effectiveness of particular programmes and sustainability issues related to cultural, ethical or moral obligations of foreign health professionals working in a low- to middle-income countries. Study findings highlighted that although nurses are recruited and participate in health-focused humanitarian activities in low- to middle-income countries, there is extremely limited documented research about the amount and type of care that nurses specifically provide in this context. Furthermore, when identified, it is most often hidden within studies outlining services provided by healthcare teams and not specific to the discipline of nursing. Further research is therefore required to enable greater understanding of nursing care in this context and to inform prospective volunteers of expected nursing practice. This article provides an analysis of available literature describing nursing involvement within the particular context of short-term medical teams delivering charitable health care. © 2017 John Wiley & Sons Ltd.

Linking rights and standards: the process of developing "rights-based" minimum standards on food security, nutrition and food aid.

PubMed

Young, Helen; Taylor, Anna; Way, Sally-Anne; Leaning, Jennifer

2004-06-01

This article examines the recent revision of the Sphere Minimum Standards in disaster response relating to food security, nutrition and food aid. It describes how the revision attempted to incorporate the principles of the Humanitarian Charter, as well as relevant human rights principles and values into the Sphere Minimum Standards. The initial aim of the revision was to ensure that the Sphere Minimum Standards better reflected the principles embodied in the Humanitarian Charter. This was later broadened to ensure that key legal standards and principles from human rights and humanitarian law were considered and also incorporated, in part to fill the "protection gap" within the existing standards. In relation to the food security, nutrition and food aid standards, it was agreed by participants in the process that the human right to adequate food and freedom from hunger should be incorporated. In relation to more general principles underlying the Humanitarian Charter, itself drawn largely from human rights and humanitarian law, it was agreed that there was a need to strengthen "protection" elements within the standards and a need to incorporate the basic principles of the right to life with dignity, non-discrimination, impartiality and participation, as well as to explore the relevance of the concept of the progressive realisation of the right to food. The questions raised in linking rights to operational standards required thought, on the one hand, about whether the technical standards reflected a deep understanding of the values expressed within the legal instruments, and whether the existing standards were adequate in relation to those legal rights. On the other hand, it also required reflection on how operational standards like Sphere could give concrete content to human rights, such as the right to food and the right to be free from hunger. However, there remain challenges in examining what a rights-based approach will mean in terms of the role of humanitarian agencies as duty-bearers of rights, given that the primary responsibility rests with state governments. It will also require reflection on the modes and mechanisms of accountability that are brought to bear in ensuring the implementation of the Minimum Standards.

Systematic review of the evidence on the effectiveness of sexual and reproductive health interventions in humanitarian crises.

PubMed

Warren, Emily; Post, Nathan; Hossain, Mazeda; Blanchet, Karl; Roberts, Bayard

2015-12-18

This systematic review aims to evaluate evidence on the effectiveness of sexual and reproductive health (SRH) interventions delivered in humanitarian crises. Crisis affected low-income or middle-income countries. Crisis-affected populations in low-income or middle-income countries. Peer-reviewed and grey literature sources were systematically searched for relevant papers detailing interventions from 1 January 1980 until the search date on 30 April 2013. Data from included studies were then extracted, and the papers' quality evaluated using criteria based on modified STROBE and CONSORT checklists. Primary outcomes include, but are not limited to, changes in morbidity, mortality, sexually transmitted infection (STI) diagnosis or gender-based violence. Secondary outcomes include, but are not limited to, reported condom use or skilled attendance at birth. Primary outputs include, but are not limited to, condoms distributed or education courses taught. Of 7149 returned citations, 15 studies met the inclusion criteria. Only one randomised controlled trial was identified. The remaining observational studies were of moderate quality, demonstrating limited use of controls and inadequate attempts to address bias. Evidence of effectiveness was available for the following interventions: impregnated bed nets for pregnant women, subsidised refugee healthcare, female community health workers, and tiered community reproductive health services. The limited evidence base for SRH interventions highlights the need for improved research on the effectiveness of public health interventions in humanitarian crises. While interventions proven efficacious in stable settings are being used in humanitarian efforts, more evidence is required to demonstrate the effectiveness of delivering and scaling-up such interventions in humanitarian crises. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Reshaping US Navy Pacific response in mitigating disaster risk in South Pacific Island nations: adopting community-based disaster cycle management.

PubMed

Reaves, Erik J; Termini, Michael; Burkle, Frederick M

2014-02-01

The US Department of Defense continues to deploy military assets for disaster relief and humanitarian actions around the world. These missions, carried out through geographically located Combatant Commands, represent an evolving role the US military is taking in health diplomacy, designed to enhance disaster preparedness and response capability. Oceania is a unique case, with most island nations experiencing "acute-on-chronic" environmental stresses defined by acute disaster events on top of the consequences of climate change. In all Pacific Island nation-states and territories, the symptoms of this process are seen in both short- and long-term health concerns and a deteriorating public health infrastructure. These factors tend to build on each other. To date, the US military's response to Oceania primarily has been to provide short-term humanitarian projects as part of Pacific Command humanitarian civic assistance missions, such as the annual Pacific Partnership, without necessarily improving local capacity or leaving behind relevant risk-reduction strategies. This report describes the assessment and implications on public health of large-scale humanitarian missions conducted by the US Navy in Oceania. Future opportunities will require the Department of Defense and its Combatant Commands to show meaningful strategies to implement ongoing, long-term, humanitarian activities that will build sustainable, host nation health system capacity and partnerships. This report recommends a community-centric approach that would better assist island nations in reducing disaster risk throughout the traditional disaster management cycle and defines a potential and crucial role of Department of Defense's assets and resources to be a more meaningful partner in disaster risk reduction and community capacity building.

Children in the Syrian Civil War: the Familial, Educational, and Public Health Impact of Ongoing Violence.

PubMed

Elsafti, Abdallah Mohamed; van Berlaer, Gerlant; Al Safadi, Mohammad; Debacker, Michel; Buyl, Ronald; Redwan, Atef; Hubloue, Ives

2016-12-01

The Syrian civil war since 2011 has led to one of the most complex humanitarian emergencies in history. The objective of this study was to document the impact of the conflict on the familial, educational, and public health state of Syrian children. A cross-sectional observational study was conducted in May 2015. Health care workers visited families with a prospectively designed data sheet in 4 Northern Syrian governorates. The 1001 children included in this study originated from Aleppo (41%), Idleb (36%), Hamah (15%), and Lattakia (8%). The children's median age was 6 years (range, 0-15 years; interquartile range, 3-11 years), and 61% were boys. Almost 20% of the children were internally displaced, and 5% had deceased or missing parents. Children lacked access to safe drinking water (15%), appropriate sanitation (23%), healthy nutrition (16%), and pediatric health care providers (64%). Vaccination was inadequate in 72%. More than half of school-aged children had no access to education. Children in Idleb and Lattakia were at greater risk of having unmet public health needs. Younger children were at greater risk of having an incomplete vaccination state. After 4 years of civil war in Syria, children have lost parents, live in substandard life quality circumstances, and are at risk for outbreaks because of worsening vaccination states and insufficient availability of health care providers. (Disaster Med Public Health Preparedness. 2016;10:874-882).

Humanitarian and primary healthcare needs of refugee women and children in Afghanistan.

PubMed

Higgins-Steele, Ariel; Lai, David; Chikvaidze, Paata; Yousufi, Khaksar; Anwari, Zelaikha; Peeperkorn, Richard; Edmond, Karen

2017-12-11

This Commentary describes the situation and healthcare needs of Afghans returning to their country of origin. With more than 600,000 Afghans returned from Pakistan and approximately 450,000 Afghans returned from Iran in 2016, the movement of people, which has been continuing in 2017, presents additional burden on the weak health system and confounds new health vulnerabilities especially for women and children. Stewardship and response is required at all levels: the central Ministry of Public Health, Provincial Health Departments and community leaders all have important roles, while continued support from development partners and technical experts is needed to assist the health sector to address the emergency and primary healthcare needs of returnee and internally displaced women, children and families.

Food Security, Decision Making and the Use of Remote Sensing in Famine Early Warning Systems

NASA Technical Reports Server (NTRS)

Brown, Molly E.

2008-01-01

Famine early warning systems use remote sensing in combination with socio-economic and household food economy analysis to provide timely and rigorous information on emerging food security crises. The Famine Early Warning Systems Network (FEWS NET) is the US Agency for International Development's decision support system in 20 African countries, as well as in Guatemala, Haiti and Afghanistan. FEWS NET provides early and actionable policy guidance for the US Government and its humanitarian aid partners. As we move into an era of climate change where weather hazards will become more frequent and severe, understanding how to provide quantitative and actionable scientific information for policy makers using biophysical data is critical for an appropriate and effective response.

From relief to development: the long-term effects of 'temporary' accommodation on refugees and displaced persons in the Republic of Croatia.

PubMed

Ellis, S; Barakat, S

1996-06-01

The increasing scale of international intervention in conflict is generating new pressures on the humanitarian community. Increased expenditure on emergency relief, static levels of overseas development aid and subsequent lack of funds for development are dictating that agencies design relief projects that positively effect developmental reconstruction. This paper examines the provision of shelter for refugees and displaced persons in the Republic of Croatia and identifies ways in which it has encouraged and discouraged sustainable reconstruction. It argues that to promote lasting reconstruction, programmes must focus on saving livelihoods as well as lives, thus minimising the long-term psychological and physical impacts of aid on refugees, displaced persons and host communities.

Diagnoses, infections and injuries in Northern Syrian children during the civil war: A cross-sectional study.

PubMed

van Berlaer, Gerlant; Elsafti, Abdallah Mohamed; Al Safadi, Mohammad; Souhil Saeed, Saad; Buyl, Ronald; Debacker, Michel; Redwan, Atef; Hubloue, Ives

2017-01-01

The civil war in Syria including the deliberate targeting of healthcare services resulted in a complex humanitarian emergency, seriously affecting children's health. The objectives of this study are to document diagnoses and disease categories in Northern Syrian children after four years of conflict, and to document infectious diseases and injuries in this vulnerable population. In a prospective cross-sectional observational sample study conducted in May 2015, healthcare workers registered demographics, comorbidities, and diagnoses (categorised according to the International Classification of Diseases version 10) in children visited at home and in internally displaced persons camps in four Syrian governorates. Of 1080 filled-out records, 1002 were included. Children originated from Aleppo (41%), Idleb (36%), Hamah (15%) and Lattakia (8%). Median age was 6 years (0-15; IQR 3-11), 61% were boys, 40% were younger than 5 years old. Children suffered from respiratory (29%), neurological (19%), digestive (17%), eye (5%) and skin (5%) diseases. Clinical malnutrition was seen in 4%, accidental injury in 3%, intentional injury in 1%, and mental disorders in 2%. Overall, 64% had features of infectious diseases (OR 0.635; CI 0.605-0.665). Most common comorbidities were chronic respiratory diseases (14, malnutrition (5%), acute flaccid paralysis (5%), and epilepsy (4%). Logistic regression analysis indicated that the risk for children to have communicable diseases was higher in Aleppo than in Idleb (OR 1.7; CI 1.2-2.3), Hamah (OR 4.9; CI 3.3-7.5), or Lattakia (OR 5.5; CI 3.3-9.3). Children in Aleppo and Lattakia were more at risk to be injured than in Idleb (OR 5.6; CI 2.1-14.3), or in Hamah (OR 5.9; CI 1.4-25.6), but more often from intentional violence in Lattakia. Mental problems were more prominent in Hamah. Four years far in the conflict, 64% of the studied children in four Northern Syrian governorates suffer from infections, mostly from respiratory, neurological and digestive origin, while 4% was injured or victim of intentional aggression. Substandard living conditions and the lack of paediatric healthcare put Syrian children at risk for serious infections, epidemics and morbidity, and ask for urgent international humanitarian relief efforts.

Diagnoses, infections and injuries in Northern Syrian children during the civil war: A cross-sectional study

PubMed Central

Al Safadi, Mohammad; Souhil Saeed, Saad; Buyl, Ronald; Debacker, Michel; Redwan, Atef; Hubloue, Ives

2017-01-01

Background The civil war in Syria including the deliberate targeting of healthcare services resulted in a complex humanitarian emergency, seriously affecting children's health. The objectives of this study are to document diagnoses and disease categories in Northern Syrian children after four years of conflict, and to document infectious diseases and injuries in this vulnerable population. Methods In a prospective cross-sectional observational sample study conducted in May 2015, healthcare workers registered demographics, comorbidities, and diagnoses (categorised according to the International Classification of Diseases version 10) in children visited at home and in internally displaced persons camps in four Syrian governorates. Results Of 1080 filled-out records, 1002 were included. Children originated from Aleppo (41%), Idleb (36%), Hamah (15%) and Lattakia (8%). Median age was 6 years (0–15; IQR 3–11), 61% were boys, 40% were younger than 5 years old. Children suffered from respiratory (29%), neurological (19%), digestive (17%), eye (5%) and skin (5%) diseases. Clinical malnutrition was seen in 4%, accidental injury in 3%, intentional injury in 1%, and mental disorders in 2%. Overall, 64% had features of infectious diseases (OR 0.635; CI 0.605–0.665). Most common comorbidities were chronic respiratory diseases (14, malnutrition (5%), acute flaccid paralysis (5%), and epilepsy (4%). Logistic regression analysis indicated that the risk for children to have communicable diseases was higher in Aleppo than in Idleb (OR 1.7; CI 1.2–2.3), Hamah (OR 4.9; CI 3.3–7.5), or Lattakia (OR 5.5; CI 3.3–9.3). Children in Aleppo and Lattakia were more at risk to be injured than in Idleb (OR 5.6; CI 2.1–14.3), or in Hamah (OR 5.9; CI 1.4–25.6), but more often from intentional violence in Lattakia. Mental problems were more prominent in Hamah. Conclusions Four years far in the conflict, 64% of the studied children in four Northern Syrian governorates suffer from infections, mostly from respiratory, neurological and digestive origin, while 4% was injured or victim of intentional aggression. Substandard living conditions and the lack of paediatric healthcare put Syrian children at risk for serious infections, epidemics and morbidity, and ask for urgent international humanitarian relief efforts. PMID:28886038

Development of a competency framework for the nutrition in emergencies sector.

PubMed

Meeker, Jessica; Perry, Abigail; Dolan, Carmel; Emary, Colleen; Golden, Kate; Abla, Caroline; Walsh, Anne; Maclaine, Ali; Seal, Andrew

2014-03-01

There is a recognised need to strengthen capacity in the nutrition in emergencies sector and for greater clarity on the role of emergency nutritionists and the skills they require. Competency frameworks are an important tool for human resource development and have been developed for several other humanitarian sectors. We therefore developed a technical competency framework for practitioners in nutrition in emergencies. Existing competency frameworks were reviewed and interviews conducted to explore methods used in developing competency frameworks for other sectors. Competencies were identified through interviews with field experts, feedback from course trainees, academic course content and job specifications. Competencies were then categorised and behavioural indicators developed for each. The draft framework was then reviewed by members of the Global Nutrition Cluster and modified in an iterative process. Global. Not applicable. A wide range of competencies were identified as essential for nutritionists working in emergencies, covering technical skills and general core competencies. The proposed framework contains twenty competency areas with 161 behavioural indicators categorised into three levels, corresponding to the requirements of progressively more senior roles. Many of the competencies are common across development and emergency nutrition. The proposed technical competency framework should prove to be a valuable tool in creating standards within the sector and promoting effective capacity strengthening and professionalisation. Continued research is needed to validate the framework, optimise methods for assessment, develop approaches to integrate it within the sector and measure its impact on performance.

United States Navy Humanitarian Assistance and Disaster Relief (HADR) Costs: A Preliminary Study

DTIC Science & Technology

2015-08-26

SPONSORED REPORT SERIES United States Navy Humanitarian Assistance and Disaster Relief (HADR) Costs: A Preliminary Study 26 August 2015 Aruna Apte...Graduate School of Business & Public Policy at the Naval Postgraduate School. To request defense acquisition research, to become a research sponsor...inspiration to us, Cullen M. Greenfield, Cameron A . Ingram, Stephen A . Ures, Dana M. Herbert, James A . Prosser, Rachele A . Wharton, Alexander Kaczur

Operational Effectiveness of Smartphones and Apps for Humanitarian Aid and Disaster Relief (HADR) Operations -- A Systems Engineering Study

DTIC Science & Technology

2012-09-01

BlackBerry .............................................................................. 30  b.  MONAX iPhone System...realms and the growing requirement for military forces around the world to conduct humanitarian aid and disaster relief (HADR) operations. Two recent...iPhone OS and the BlackBerry . Regardless of their capabilities, they have all been used in some way or another to assist HADR operations in recent

Cross Roads or Cross Purposes? Tensions Between Military and Humanitarian Providers

DTIC Science & Technology

2012-01-01

tarian action . . . . Although it is fashionable to call humanitarians the new missionaries, it is more accurate to call them the new alchemists ...their objective to help those in need. Alchemist NGOs continue to be tightly linked to projects directly funded by government and intergovernmental...ensure a smooth and cooperative relationship. Perhaps counterin- tuitively, alchemist NGOs’ willingness to be political has, at times, made them more

The Supply of Pharmaceuticals in Humanitarian Assistance Missions: Implications for Military Operations

DTIC Science & Technology

2011-08-01

essential medicines list ( EML ), which provides information The Supply of Pharmaceuticals in Humanitarian Assistance Missions: Implications for...Health Organization (WHO) introduced the concept of the EML to encourage health systems at the country level to focus on a limited number of carefully...be used as a global standard to guide country authorities develop their own national EMLs . 5 In many developing countries, national formularies

31 CFR 585.524 - Humanitarian aid and trade in United Nations Protected Areas of Croatia and those areas of the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Humanitarian aid and trade in United Nations Protected Areas of Croatia and those areas of the Republic of Bosnia and Herzegovina controlled by Bosnian Serb forces. 585.524 Section 585.524 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF...

Novel Methods for Detecting Buried Explosive Devices

DTIC Science & Technology

2007-04-10

NQR ), and semiotic data fusion. Bioreporter bacteria look promising for third-world humanitarian applications; they are inexpensive, and...demining, NQR is a promising method for detecting explosive substances; of 50,000 substances that have been tested, none has an NQR signature that can be...approach to a cheap mine detector for humanitarian use. Real-time wavelet processing appears to be a key to extending NQR bomb detection into mine

Disability, Vulnerability and Citizenship: To What Extent Is Education a Protective Mechanism for Children with Disabilities in Countries Affected by Conflict?

ERIC Educational Resources Information Center

Trani, Jean-Francois; Kett, Maria; Bakhshi, Parul; Bailey, Nicola

2011-01-01

Humanitarian crises as a result of conflict are often characterised by failure of the social contract between the state and its citizens. For a variety of reasons, children with disabilities are often particularly vulnerable in time of humanitarian crisis. This paper draws on research undertaken by the authors in a series of countries affected by…

A System Engineering Study and Concept Development for a Humanitarian Aid and Disaster Relief Operations Management Platform

DTIC Science & Technology

2016-09-01

and network. The computing and network hardware are identified and include routers, servers, firewalls, laptops , backup hard drives, smart phones...deployable hardware units will be necessary. This includes the use of ruggedized laptops and desktop computers , a projector system, communications system...ENGINEERING STUDY AND CONCEPT DEVELOPMENT FOR A HUMANITARIAN AID AND DISASTER RELIEF OPERATIONS MANAGEMENT PLATFORM by Julie A. Reed September

The Ethics of Drone Strikes: Does Reducing the Cost of Conflict Encourage War?

DTIC Science & Technology

2015-09-01

the public debate.”8 Casualty aversion may be closely linked to media coverage that focuses dispro- portionately on anti-war sentiments when soldiers... humanitarian intervention, the re- straint of an aggressive foreign power, and support for an ally facing an internal military threat to its hold on power...for war: counterterrorism, humanitarian intervention, foreign policy restraint, and internal political change. However, the increase in support

Emergency Food Assistance in Northern Syria: An Evaluation of Transfer Programs in Idleb Governorate.

PubMed

Doocy, Shannon; Tappis, Hannah; Lyles, Emily; Witiw, Joseph; Aken, Vicki

2017-06-01

The war in Syria has left millions struggling to survive amidst violent conflict, pervasive unemployment, and food insecurity. Although international assistance funding is also at an all-time high, it is insufficient to meet the needs of conflict-affected populations, and there is increasing pressure on humanitarian stakeholders to find more efficient, effective ways to provide assistance. To evaluate 3 different assistance programs (in-kind food commodities, food vouchers, and unrestricted vouchers) in Idleb Governorate of Syria from December 2014 and March 2015. The evaluation used repeated survey data from beneficiary households to determine whether assistance was successful in maintaining food security at the household level. Shopkeeper surveys and program monitoring data were used to assess the impact on markets at the district/governorate levels and compare the cost-efficiency and cost-effectiveness of transfer modalities. Both in-kind food assistance and voucher programs showed positive effects on household food security and economic measures in Idleb; however, no intervention was successful in improving all outcomes measured. Food transfers were more likely to improve food access and food security than vouchers and unrestricted vouchers. Voucher programs were found to be more cost-efficient than in-kind food assistance, and more cost-effective for increasing household food consumption. Continuation of multiple types of transfer programs, including both in-kind assistance and vouchers, will allow humanitarian actors to remain responsive to evolving access and security considerations, local needs, and market dynamics.

Evaluation of Nutrition Interventions in Children in Conflict Zones: A Narrative Review.

PubMed

Carroll, Grace J; Lama, Sonam D; Martinez-Brockman, Josefa L; Pérez-Escamilla, Rafael

2017-09-01

Food and nutrition insecurity becomes increasingly worse in areas affected by armed conflict. Children affected by conflict, or in war-torn settings, face a disproportionate burden of malnutrition and poor health outcomes. As noted by humanitarian response reviews, there is a need for a stronger evidence-based response to humanitarian crises. To achieve this, we systematically searched and evaluated existing nutrition interventions carried out in conflict settings that assessed their impact on children's nutrition status. To evaluate the impact of nutrition interventions on children's nutrition and growth status, we identified published literature through EMBASE, PubMed, and Global Health by using a combination of relevant text words and Medical Subject Heading terms. Studies for this review must have included children (aged ≤18 y), been conducted in conflict or postconflict settings, and assessed a nutrition intervention that measured ≥1 outcome for nutrition status (i.e., stunting, wasting, or underweight). Eleven studies met the inclusion and exclusion criteria for this review. Five different nutrition interventions were identified and showed modest results in decreasing the prevalence of stunting, wasting, underweight, reduction in severe or moderate acute malnutrition or both, mortality, anemia, and diarrhea. Overall, nutrition interventions in conflict settings were associated with improved children's nutrition or growth status. Emergency nutrition programs should continue to follow recent recommendations to expand coverage and access (beyond refugee camps to rural areas) and ensure that aid and nutrition interventions are distributed equitably in all conflict-affected populations. © 2017 American Society for Nutrition.

The burden of acute respiratory infections in crisis-affected populations: a systematic review

PubMed Central

2010-01-01

Crises due to armed conflict, forced displacement and natural disasters result in excess morbidity and mortality due to infectious diseases. Historically, acute respiratory infections (ARIs) have received relatively little attention in the humanitarian sector. We performed a systematic review to generate evidence on the burden of ARI in crises, and inform prioritisation of relief interventions. We identified 36 studies published since 1980 reporting data on the burden (incidence, prevalence, proportional morbidity or mortality, case-fatality, attributable mortality rate) of ARI, as defined by the International Classification of Diseases, version 10 and as diagnosed by a clinician, in populations who at the time of the study were affected by natural disasters, armed conflict, forced displacement, and nutritional emergencies. We described studies and stratified data by age group, but did not do pooled analyses due to heterogeneity in case definitions. The published evidence, mainly from refugee camps and surveillance or patient record review studies, suggests very high excess morbidity and mortality (20-35% proportional mortality) and case-fatality (up to 30-35%) due to ARI. However, ARI disease burden comparisons with non-crisis settings are difficult because of non-comparability of data. Better epidemiological studies with clearer case definitions are needed to provide the evidence base for priority setting and programme impact assessments. Humanitarian agencies should include ARI prevention and control among infants, children and adults as priority activities in crises. Improved data collection, case management and vaccine strategies will help to reduce disease burden. PMID:20181220

Humanitarian space and well-being: effectiveness of training on a psychosocial intervention for host community-refugee interaction

PubMed Central

Chemali, Zeina; Borba, Christina P. C.; Johnson, Kelsey; Hock, Rebecca S.; Parnarouskis, Lindsey; Henderson, David C.; Fricchione, Gregory L.

2017-01-01

Social and fieldworkers face enormous challenges in assisting millions of Syrian refugees in Lebanon since the Syrian war in 2011. We sought to assess the feasibility and acceptability of an adapted version of the SMART-3RP (Stress Management Relaxation Response Resilience Training) training to address the emotional and physical burden on the humanitarian field. Data were collected using the Symptom Checklist-90 (SCL-90), blood pressure, pulse and a brief qualitative survey at months 0, 3, 6 and 9. We compared mean SCL-90 scores and physiological measures from these time points and subjected qualitative data to a thematic analysis. Mean values of all measures decreased from months 0 to 9, with significance in SCL-90 changes increasing at each visit. Qualitative themes included decreased stress, increased positivity and problem-solving skills, interpersonal and personal benefits of mindfulness practice and the need to continue and expand the programme. Qualitative and quantitative analyses showed a decrease in stress perception and blood pressure, demonstrating the physiological benefits of mind body approaches. We highlight the importance of self-care for humanitarian workers as the basis for the mission’s success. We invite additional research to confirm these findings and their implications for the humanitarian field. PMID:28497699

Money for microbes-Pathogen avoidance and out-group helping behaviour.

PubMed

Laakasuo, Michael; Köbis, Nils; Palomäki, Jussi; Jokela, Markus

2017-02-23

Humans have evolved various adaptations against pathogens, including the physiological immune system. However, not all of these adaptations are physiological: the cognitive mechanisms whereby we avoid potential sources of pathogens-for example, disgust elicited by uncleanliness-can be considered as parts of a behavioural immune system (BIS). The mechanisms of BIS extend also to inter-group relations: Pathogen cues have been shown to increase xenophobia/ethnocentrism, as people prefer to keep their societal in-group norms unaltered and "clean." Nonetheless, little is known how pathogen cues influence people's willingness to provide humanitarian aid to out-group members. We examined how pathogen cues affected decisions of providing humanitarian aid in either instrumental (sending money) or non-instrumental form (sending personnel to help, or accepting refugees), and whether these effects were moderated by individual differences in BIS sensitivity. Data were collected in two online studies (Ns: 188 and 210). When the hypothetical humanitarian crisis involved a clear risk of infection, participants with high BIS sensitivity preferred to send money rather than personnel or to accept refugees. The results suggest that pathogen cues influence BIS-sensitive individuals' willingness to provide humanitarian aid when there is a risk of contamination to in-group members. © 2017 International Union of Psychological Science.

Universal health coverage from multiple perspectives: a synthesis of conceptual literature and global debates.

PubMed

Abiiro, Gilbert Abotisem; De Allegri, Manuela

2015-07-04

There is an emerging global consensus on the importance of universal health coverage (UHC), but no unanimity on the conceptual definition and scope of UHC, whether UHC is achievable or not, how to move towards it, common indicators for measuring its progress, and its long-term sustainability. This has resulted in various interpretations of the concept, emanating from different disciplinary perspectives. This paper discusses the various dimensions of UHC emerging from these interpretations and argues for the need to pay attention to the complex interactions across the various components of a health system in the pursuit of UHC as a legal human rights issue. The literature presents UHC as a multi-dimensional concept, operationalized in terms of universal population coverage, universal financial protection, and universal access to quality health care, anchored on the basis of health care as an international legal obligation grounded in international human rights laws. As a legal concept, UHC implies the existence of a legal framework that mandates national governments to provide health care to all residents while compelling the international community to support poor nations in implementing this right. As a humanitarian social concept, UHC aims at achieving universal population coverage by enrolling all residents into health-related social security systems and securing equitable entitlements to the benefits from the health system for all. As a health economics concept, UHC guarantees financial protection by providing a shield against the catastrophic and impoverishing consequences of out-of-pocket expenditure, through the implementation of pooled prepaid financing systems. As a public health concept, UHC has attracted several controversies regarding which services should be covered: comprehensive services vs. minimum basic package, and priority disease-specific interventions vs. primary health care. As a multi-dimensional concept, grounded in international human rights laws, the move towards UHC in LMICs requires all states to effectively recognize the right to health in their national constitutions. It also requires a human rights-focused integrated approach to health service delivery that recognizes the health system as a complex phenomenon with interlinked functional units whose effective interaction are essential to reach the equilibrium called UHC.

Drivers of Complexity in Humanitarian Operations

DTIC Science & Technology

2013-12-04

catastrophe (including any hurricane, tornado, storm, high water, wind-driven water, tidal wave, tsunami, earthquake, volcanic eruption , landslide, mudslide...shaking) Volcano Volcanic eruption General Flood Flash flood Mass movement wet Landslide Mudslide Extratropical cyclone (winter storm) Local storm Blizzard...24 1 Tornado 25 57 Volcanic   Eruption 26 0 Earthquake (Seismic Activity) 27 4 ^Åèìáëáíáçå=oÉëÉ~êÅÜ=mêçÖê~ã= dê~Çì~íÉ=pÅÜççä=çÑ=_ìëáåÉëë=C=mìÄäáÅ=mçäáÅó

Paediatric and congenital cardiac surgery in emerging economies: surgical 'safari' versus educational programmes.

PubMed

Corno, Antonio F

2016-07-01

To attract the interest of all people potentially involved in humanitarian activities in the emerging economies, in particular giving attention to the basic requirements of the organization of paediatric cardiac surgery activities, the requirements for a successful partnership with the local existing organizations and the basic elements of a patient-centred multidisciplinary integrated approach. Unfortunately, for many years, the interventions in the low and middle income countries were largely limited to short-term medical missions, not inappropriately nicknamed 'surgical safari', because of negative general and specific characteristics. The negative aspects and the limits of the short-term medical missions can be overcome only by long-term educational programmes. The most suitable and consistent models of long-term educational programmes have been combined and implemented with the personal experience to offer a proposal for a long-term educational project, with the following steps: (i) site selection; (ii) demographic research; (iii) site assessment; (iv) organization of surgical educational teams; (v) regular frequency of surgical educational missions; (vi) programme evolution and maturation; (vii) educational outreach and interactive support. Potential limits of a long-term educational surgical programme are: (i) financial affordability; (ii) basic legal needs; (iii) legal support; (iv) non-profit indemnification. The success should not be measured by the number of successful operations of any given mission, but by the successful operations that our colleagues perform after we leave. Considering that the children in need outnumber by far the people able to provide care, in this humanitarian medicine there should be plenty of room for cooperation rather than competition. The main goal should be to provide teaching to local staff and implement methods and techniques to support the improvement of the care of the patients in the long run. This review focuses on the organization of paediatric cardiac activities in the emerging economies, but 'the less privileged parts of the world' can be anywhere, not necessarily limited to economic constraints. Lack of diversity because of social, intellectual, educational and professional growth, the last consisting in cultural stagnation, is responsible for the lack of scientific progress and development. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

The livelihoods of Haitian health-care providers after the january 2010 earthquake: a pilot study of the economic and quality-of-life impact of emergency relief.

PubMed

Haar, Rohini J; Naderi, Sassan; Acerra, John R; Mathias, Maxwell; Alagappan, Kumar

2012-03-02

An effective international response to a disaster requires cooperation and coordination with the existing infrastructure. In some cases, however, international relief efforts can compete with the local work force and affect the balance of health-care systems already in place. This study seeks to evaluate the impact of the international humanitarian response to the 12 January 2010 earthquake on Haitian health-care providers (HHP). Fifty-nine HHPs were surveyed in August of 2010 using a modified World Health Organization Quality of Life-Brief questionnaire (WHOQoL-B) that included questions on respondents' workload before the earthquake, immediately after, and presently. The study population consisted of physicians, nurses, and technicians at public hospitals, non-governmental organization (NGO) clinics, and private offices in Port-au-Prince, Haiti. Following the earthquake, public hospital and NGO providers reported a significant increase in their workload (15 of 17 and 22 of 26 respondents, respectively). Conversely, 12 of 16 private providers reported a significant decrease in workload (p < 0.0001). Although all groups reported working a similar number of hours prior to the earthquake (average 40 h/week), they reported working significantly different amounts following the earthquake. Public hospital and NGO providers averaged more than 50 h/week, and private providers averaged just over 33 h/week of employment (p < 0.001).Health-care providers working at public hospitals and NGOs, however, had significantly lower scores on the WHOQoL-B when answering questions about their environment (p < 0.001), and in open-ended responses often commented about the lack of potable water and poor access to toilets. Providers from all groups expressed dissatisfaction with the scope and quality of care provided at public hospitals and NGO clinics, as well as disappointment with the reduction in patient volume at private practices. The emergency medical response to the January 2010 earthquake in Haiti had the unintended consequence of poorly distributing work among HHPs. To create a robust health-care system in the long term while meeting short-term needs, humanitarian responses should seek to better integrate existing systems and involve local providers in the design and implementation of an emergency program.

Pakistan Earthquake Relief Operations: Leveraging Humanitarian Missions for Strategic Success

DTIC Science & Technology

2010-12-01

PRISM 2, no. 1 leSSoNS leaRNed | 131 On Christmas morning 2005, at Saint Patrick’s Catholic Church in Auckland , New Zealand, a priest stepped up to... economically difficult to sustain. However, the HA/DR cam- paign in Pakistan, Operation Lifeline, provides a useful model of how humanitarian...35 The two field hospitals became symbols of the American-Pakistani military partnership and an asymmetric advantage for the United States as

Climate Change: Potential Effects on Demands for US Military Humanitarian Assistance and Disaster Response

DTIC Science & Technology

2010-11-01

As we do not fully understand how decision-makers will approach future climate- induced requirements, gaming provides a tool for better understanding...result in the need for humanitarian response missions. Those cases involve not only the stress induced by the natural environment, but also the...natural cyclic variability and a warming- induced variability. The pri- mary variability related to SST involves the strength of the storms, rather