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.

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

States of fragility: stabilisation and its implications for humanitarian action.

PubMed

Collinson, Sarah; Elhawary, Samir; Muggah, Robert

2010-10-01

This paper explores the evolution of international stabilisation agendas and their significance for humanitarian action. Stabilisation includes a combination of military, humanitarian, political and economic activities to control, contain and manage areas affected by armed conflict and complex emergencies. Encompassing narrow security objectives and broader peace-building efforts, stabilisation is both a conservative and potentially transformative, comprehensive and long-term agenda. The open-ended approach allows for widely varying interpretations and applications in different circumstances and by different actors with an assortment of implications for humanitarian action. The relationship between the two is highly uncertain and contentious, due not only to the controversies surrounding stabilisation policies, but also to deep-seated ambiguities at the heart of humanitarianism. While humanitarian actors are preoccupied with the growing involvement of the military in the humanitarian sphere, the paper argues that it is trends in the humanitarian-political interface that represent the more fundamental dilemma. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

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…

The supply of pharmaceuticals in humanitarian assistance missions: implications for military operations.

PubMed

Mahmood, Maysaa; Riley, Kevin; Bennett, David; Anderson, Warner

2011-08-01

In this article, we provide an overview of key international guidelines governing the supply of pharmaceuticals during disasters and complex emergencies. We review the World Health Organization's guidelines on pharmaceutical supply chain management and highlight their relevance for military humanitarian assistance missions. Given the important role of pharmaceuticals in addressing population health needs during humanitarian emergencies, a good understanding of how pharmaceuticals are supplied at the local level in different countries can help military health personnel identify the most appropriate supply options. Familiarity with international guidelines involved in cross-border movement of pharmaceuticals can improve the ability of military personnel to communicate more effectively with other actors involved in humanitarian and development spheres. Enhancing the knowledge base available to military personnel in terms of existing supply models and funding procedures can improve the effectiveness of humanitarian military operations and invite policy changes necessary to establish more flexible acquisition and funding regulations.

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

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.

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

Earth Science Data and Models for Improved Targeting of Humanitarian Aid

NASA Technical Reports Server (NTRS)

Brown, Molly E.

2011-01-01

Humanitarian assistance to developing countries has long focused on countries that have political, economic and strategic interest to the United States. Recent changes in global security concerns have heightened the perception that humanitarian action is becoming increasingly politicized. This is seen to be largely driven by the 'global war on terror' along with a push by donors and the United Nations for closer integration between humanitarian action and diplomatic, military and other spheres of engagement in conflict and crisis-affected states (HPG 2010). As we enter an era of rising commodity prices and increasing uncertainty in global food production due to a changing climate, scientific data and analysis will be increasingly important to improve the targeting of humanitarian assistance. Earth science data enables appropriate humanitarian response to complex food emergencies that arise in regions outside the areas of current strategic and security focus. As the climate changes, new places will become vulnerable to food insecurity and will need emergency assistance. Earth science data and multidisciplinary models will enable an information-based comparison of need that goes beyond strategic and political considerations to identify new hotspots of food insecurity as they emerge. These analyses will improve aid targeting and timeliness while reducing strategic risk by highlighting new regions at risk of crisis in a rapidly changing world. Improved targeting with respect to timing and location could reduce cost while increasing the likelihood that those who need aid get it.

Protective Environments and Quality Education in Humanitarian Contexts

ERIC Educational Resources Information Center

Aguilar, Pilar; Retamal, Gonzalo

2009-01-01

This paper reflects the experience of the authors working in the field of humanitarian education during the last two decades. Important changes have been witnessed since the Central American crises of the seventies, the refugee focus of the eighties and the new UN vision of the complex emergency crisis of the nineties resulting from the post Cold…

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

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.

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

PubMed Central

2010-01-01

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

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

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

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.

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.

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.

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

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

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.

VHR satellite imagery for humanitarian crisis management: a case study

NASA Astrophysics Data System (ADS)

Bitelli, Gabriele; Eleias, Magdalena; Franci, Francesca; Mandanici, Emanuele

2017-09-01

During the last years, remote sensing data along with GIS have been largely employed for supporting emergency management activities. In this context, the use of satellite images and derived map products has become more common also in the different phases of humanitarian crisis response. In this work very high resolution satellite imagery was processed to assess the evolution of Za'atari Refugee Camp, built in Jordan in 2012 by the UN Refugee Agency to host Syrian refugees. Multispectral satellite scenes of the Za'atari area were processed by means of object-based classifications. The main aim of the present work is the development of a semiautomated procedure for multi-temporal camp monitoring with particular reference to the dwellings detection. Whilst in the emergency mapping domain automation of feature extraction is widely investigated, in the field of humanitarian missions the information is often extracted by means of photointerpretation of the satellite data. This approach requires time for the interpretation; moreover, it is not reliable enough in complex situations, where features of interest are often small, heterogeneous and inconsistent. Therefore, the present paper discusses a methodology to obtain information for assisting humanitarian crisis management, using a semi-automatic classification approach applied to satellite imagery.

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 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.

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

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

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.

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.

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.

[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.

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.

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.

International Issues: Teleneurology in humanitarian crises: Lessons from the Médecins Sans Frontières experience.

PubMed

Saadi, Altaf; Mateen, Farrah J

2017-07-18

Humanitarian emergencies defined by armed conflict, political strife, famine, or natural disaster can devastate populations rapidly. Neurologic disorders accompany these complex humanitarian emergencies but often go unheeded, exacerbated by a scarcity of neurologists. Teleneurology offers the promise of neurologic care remotely in the face of this inadequate local clinician supply. We describe our experiences as voluntary neurology teleconsultants with Médecins Sans Frontières in order to highlight both the promises and challenges of teleneurology in humanitarian contexts. We identified the major advantages of this service as (1) minimal resources and incurred costs while (2) changing a patient's clinical course favorably, and (3) creating a community for the field referrer and neurology specialist. Current challenges include (1) limited diagnostic resources and difficult diagnostic and therapeutic decision-making, (2) need for greater continuity and familiarity between the field site and neurologist, (3) gaps in the US neurology curriculum to provide expertise for all sites, (4) lack of follow-up and feedback from the field to advise future cases, and (5) low frequency of consultations. Growth opportunities include eventual expansion to the development of a community of neurologists who can provide context-specific care and maximize use of multimedia at low Internet bandwidth. Lessons from our experience may help optimize teleneurology's effect and reduce disparities in neurologic care, particularly in humanitarian crises. © 2017 American Academy of Neurology.

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.

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.

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

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

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

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.

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.

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

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 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.

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.

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.

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

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.

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.

Health Care Providers in War and Armed Conflict: Operational and Educational Challenges in International Humanitarian Law and the Geneva Conventions, Part I. Historical Perspective.

PubMed

Burkle, Frederick M; Kushner, Adam L; Giannou, Christos; Paterson, Mary A; Wren, Sherry M; Burnham, Gilbert

2018-04-30

Since 1945, the reason for humanitarian crises and the way in which the world responds to them has dramatically changed every 10 to 15 years or less. Planning, response, and recovery for these tragic events have often been ad hoc, inconsistent, and insufficient, largely because of the complexity of global humanitarian demands and their corresponding response system capabilities. This historical perspective chronicles the transformation of war and armed conflicts from the Cold War to today, emphasizing the impact these events have had on humanitarian professionals and their struggle to adapt to increasing humanitarian, operational, and political challenges. An unprecedented independent United Nations-World Health Organization decision in the Battle for Mosul in Iraq to deploy to combat zones emergency medical teams unprepared in the skills of decades-tested war and armed conflict preparation and response afforded to health care providers and dictated by International Humanitarian Law and Geneva Convention protections has abruptly challenged future decision-making and deployments. (Disaster Med Public Health Preparedness. 2018;page 1 of 7).

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.

[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.

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.

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.

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...

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.

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 ...

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

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.

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

PubMed

Drifmeyer, Jeff; Llewellyn, Craig

2003-12-01

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.

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.

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.

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

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.

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.

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.

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

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

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.

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...

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).

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.

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.

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).

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

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.

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

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

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.

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…

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

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.

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.

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.

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.

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

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.

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

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

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.

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

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.

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

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

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...

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.

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.

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.

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.

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

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.

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

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…

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

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.

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.

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.

'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.

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.

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

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

Public nutrition in complex emergencies.

PubMed

Young, Helen; Borrel, Annalies; Holland, Diane; Salama, Peter

Public nutrition is a broad-based, problem-solving approach to addressing malnutrition in complex emergencies that combines analysis of nutritional risk and vulnerability with action-oriented strategies, including policies, programmes, and capacity development. This paper focuses on six broad areas: nutritional assessment, distribution of a general food ration, prevention and treatment of moderate malnutrition, treatment of severe malnutrition in children and adults, prevention and treatment of micronutrient deficiency diseases, and nutritional support for at-risk groups, including infants, pregnant and lactating women, elderly people, and people living with HIV. Learning and documenting good practice from previous emergencies, the promotion of good practice in current emergencies, and adherence to international standards and guidelines have contributed to establishing the field of public nutrition. However, many practical challenges reduce the effectiveness of nutritional interventions in complex emergencies, and important research and programmatic questions remain.

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

Emergence: Complexity Pedagogy in Action

PubMed Central

Jonas-Simpson, Christine

2015-01-01

Many educators are looking for new ways to engage students and each other in order to enrich curriculum and the teaching-learning process. We describe an example of how we enacted teaching-learning approaches through the insights of complexity thinking, an approach that supports the emergence of new possibilities for teaching-learning in the classroom and online. Our story begins with an occasion to meet with 10 nursing colleagues in a three-hour workshop using four activities that engaged learning about complexity thinking and pedagogy. Guiding concepts for the collaborative workshop were nonlinearity, distributed decision-making, divergent thinking, self-organization, emergence, and creative exploration. The workshop approach considered critical questions to spark our collective inquiry. We asked, “What is emergent learning?” and “How do we, as educators and learners, engage a community so that new learning surfaces?” We integrated the arts, creative play, and perturbations within a complexity approach. PMID:25838945

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.

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

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.

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.

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.

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.

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.

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.

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

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.

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

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 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

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...

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.

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

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.

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.

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.

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

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

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.

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

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

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.

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...

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

Emergent "Quantum" Theory in Complex Adaptive Systems.

PubMed

Minic, Djordje; Pajevic, Sinisa

2016-04-30

Motivated by the question of stability, in this letter we argue that an effective quantum-like theory can emerge in complex adaptive systems. In the concrete example of stochastic Lotka-Volterra dynamics, the relevant effective "Planck constant" associated with such emergent "quantum" theory has the dimensions of the square of the unit of time. Such an emergent quantum-like theory has inherently non-classical stability as well as coherent properties that are not, in principle, endangered by thermal fluctuations and therefore might be of crucial importance in complex adaptive systems.

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.

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).

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

Child health in complex emergencies.

PubMed Central

Moss, William J.; Ramakrishnan, Meenakshi; Storms, Dory; Henderson Siegle, Anne; Weiss, William M.; Lejnev, Ivan; Muhe, Lulu

2006-01-01

Coordinated and effective interventions are critical for relief efforts to be successful in addressing the health needs of children in situations of armed conflict, population displacement, and/or food insecurity. We reviewed published literature and surveyed international relief organizations engaged in child health activities in complex emergencies. Our aim was to identify research needs and improve guidelines for the care of children. Much of the literature details the burden of disease and the causes of morbidity and mortality; few interventional studies have been published. Surveys of international relief organizations showed that most use World Health Organization (WHO), United Nations Children's Fund (UNICEF), and ministry of health guidelines designed for use in stable situations. Organizations were least likely to have formal guidelines on the management of asphyxia, prematurity, and infection in neonates; diagnosis and management of children with human immunodeficiency virus (HIV) infection; active case-finding and treatment of tuberculosis; paediatric trauma; and the diagnosis and management of mental-health problems in children. Guidelines often are not adapted to the different types of health-care workers who provide care in complex emergencies. Evidence-based, locally adapted guidelines for the care of children in complex emergencies should be adopted by ministries of health, supported by WHO and UNICEF, and disseminated to international relief organizations to ensure appropriate, effective, and uniform care. PMID:16501716

Pattern Formation and Complexity Emergence

NASA Astrophysics Data System (ADS)

Berezin, Alexander A.

2001-03-01

Success of nonlinear modelling of pattern formation and self-organization encourages speculations on informational and number theoretical foundations of complexity emergence. Pythagorean "unreasonable effectiveness of integers" in natural processes is perhaps extrapolatable even to universal emergence "out-of-nothing" (Leibniz, Wheeler). Because rational numbers (R = M/N) are everywhere dense on real axis, any digital string (hence any "book" from "Library of Babel" of J.L.Borges) is "recorded" infinitely many times in arbitrary many rationals. Furthermore, within any arbitrary small interval there are infinitely many Rs for which (either or both) integers (Ms and Ns) "carry" any given string of any given length. Because any iterational process (such as generation of fractal features of Mandelbrot Set) is arbitrary closely approximatable with rational numbers, the infinite pattern of integers expresses itself in generation of complexity of the world, as well as in emergence of the world itself. This "tunnelling" from Platonic World ("Platonia" of J.Barbour) to a real (physical) world is modern recast of Leibniz's motto ("for deriving all from nothing there suffices a single principle").

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.

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.

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

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

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.

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.

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.

The emergence of complexity in prosody and syntax

PubMed Central

Meir, Irit; Dachkovsky, Svetlana; Padden, Carol; Aronoff, Mark

2011-01-01

The relation between prosody and syntax is investigated here by tracing the emergence of each in a new language, Al-Sayyid Bedouin Sign Language. We analyze the structure of narratives of four signers of this language: two older second generation signers, and two about 15 years younger. We find that younger signers produce prosodic cues to dependency between semantically related constituents, e.g., the two clauses of conditionals, revealing a type and degree of complexity in their language that is not frequent in that of the older pair. In these younger signers, several rhythmic and (facial) intonational cues are aligned at constituent boundaries, indicating the emergence of a grammatical system. There are no overt syntactic markers (such as complementizers) to relate clauses; prosody is the only clue. But this prosodic complexity is matched by syntactic complexity inside propositions in the younger signers, who are more likely to use pronouns as abstract grammatical markers of arguments, and to combine predicates with their arguments within in a constituent. As the prosodic means emerge for identifying constituent types and signaling dependency relations between them, the constituents themselves become increasingly complex. Finally, our study shows that the emergence of grammatical complexity is gradual. PMID:23087486

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.

Emergent “Quantum” Theory in Complex Adaptive Systems

PubMed Central

Minic, Djordje; Pajevic, Sinisa

2017-01-01

Motivated by the question of stability, in this letter we argue that an effective quantum-like theory can emerge in complex adaptive systems. In the concrete example of stochastic Lotka-Volterra dynamics, the relevant effective “Planck constant” associated with such emergent “quantum” theory has the dimensions of the square of the unit of time. Such an emergent quantum-like theory has inherently non-classical stability as well as coherent properties that are not, in principle, endangered by thermal fluctuations and therefore might be of crucial importance in complex adaptive systems. PMID:28890591

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.

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

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

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.

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

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

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.

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.

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.

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…

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

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

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.

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

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.

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.

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 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…

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…

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…

Doing Windows: Non-Traditional Military Responses to Complex Emergencies

DTIC Science & Technology

1997-09-01

achieving civil stability and durable peace in states embroiled in complex emergencies. A complex emergency is one which draws every sector of society ...a stable, civil society ? The project involved three distinct phases. First, we conducted an extensive literature review to frame the issues used in...Pursue sustainable security through prevention, mitigation, and preparedness Integrate existing capacities of all elements of society

The emergence of complex behaviours in molecular magnetic materials.

PubMed

Goss, Karin; Gatteschi, Dante; Bogani, Lapo

2014-09-14

Molecular magnetism is considered an area where magnetic phenomena that are usually difficult to demonstrate can emerge with particular clarity. Over the years, however, less understandable systems have appeared in the literature of molecular magnetic materials, in some cases showing features that hint at the spontaneous emergence of global structures out of local interactions. This ingredient is typical of a wider class of problems, called complex behaviours, where the theory of complexity is currently being developed. In this perspective we wish to focus our attention on these systems and the underlying problematic that they highlight. We particularly highlight the emergence of the signatures of complexity in several molecular magnetic systems, which may provide unexplored opportunities for physical and chemical investigations.

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.

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

Humanitarian engineering placements in our own communities

NASA Astrophysics Data System (ADS)

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

2010-05-01

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 transformative for both the student and the community, although this potential is not always seen. In order to investigate the role of local placements, qualitative research interviews were conducted. Thirty-two semi-structured research interviews were conducted and analysed, resulting in a distinct outcome space. It is concluded that local humanitarian engineering placements greatly complement international placements and are strongly recommended if international placements are conducted. More importantly it is seen that we are better suited to address the marginalised in our own community, although it is often easier to see the needs of an outside populace.

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

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.

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.

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...

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…

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…

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

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.

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.

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.

[Emerging infectious diseases: complex, unpredictable processes].

PubMed

Guégan, Jean-François

2016-01-01

In the light of a double approach, at first empirical, later theoretical and comparative, illustrated by the example of the Buruli ulcer and its mycobacterial agent Mycobacterium ulcerans on which I focused my research activity these last ten years by studying determinants and factors of emerging infectious or parasitic diseases, the complexity of events explaining emerging diseases will be presented. The cascade of events occurring at various levels of spatiotemporal scales and organization of life, which lead to the numerous observed emergences, nowadays requires better taking into account the interactions between host(s), pathogen(s) and the environment by including the behavior of both individuals and the population. In numerous research studies on emerging infectious diseases, microbial hazard is described rather than infectious disease risk, the latter resulting from the confrontation between an association of threatening phenomena, or hazards, and a susceptible population. Beyond, the theme of emerging infectious diseases and its links with global environmental and societal changes leads to reconsider some well-established knowledge in infectiology and parasitology. © Société de Biologie, 2017.

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

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…

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 ...

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...

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

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

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

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

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.

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.

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

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

Lessons learned from complex emergencies over past decade.

PubMed

Salama, Peter; Spiegel, Paul; Talley, Leisel; Waldman, Ronald

Major advances have been made during the past decade in the way the international community responds to the health and nutrition consequences of complex emergencies. The public health and clinical response to diseases of acute epidemic potential has improved, especially in camps. Case-fatality rates for severely malnourished children have plummeted because of better protocols and products. Renewed focus is required on the major causes of death in conflict-affected societies--particularly acute respiratory infections, diarrhoea, malaria, measles, neonatal causes, and malnutrition--outside camps and often across regions and even political boundaries. In emergencies in sub-Saharan Africa, particularly southern Africa, HIV/AIDS is also an important cause of morbidity and mortality. Stronger coordination, increased accountability, and a more strategic positioning of non-governmental organisations and UN agencies are crucial to achieving lower maternal and child morbidity and mortality rates in complex emergencies and therefore for reaching the UN's Millennium Development Goals.

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.

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...

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.

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.

Complexities of emergency communication: clinicians' perceptions of communication challenges in a trilingual emergency department.

PubMed

Pun, Jack Kh; Chan, Engle Angela; Murray, Kristen A; Slade, Diana; Matthiessen, Christian Mim

2017-11-01

To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department. Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication. A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview. Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis. Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a

Complex networks as an emerging property of hierarchical preferential attachment.

PubMed

Hébert-Dufresne, Laurent; Laurence, Edward; Allard, Antoine; Young, Jean-Gabriel; Dubé, Louis J

2015-12-01

Real complex systems are not rigidly structured; no clear rules or blueprints exist for their construction. Yet, amidst their apparent randomness, complex structural properties universally emerge. We propose that an important class of complex systems can be modeled as an organization of many embedded levels (potentially infinite in number), all of them following the same universal growth principle known as preferential attachment. We give examples of such hierarchy in real systems, for instance, in the pyramid of production entities of the film industry. More importantly, we show how real complex networks can be interpreted as a projection of our model, from which their scale independence, their clustering, their hierarchy, their fractality, and their navigability naturally emerge. Our results suggest that complex networks, viewed as growing systems, can be quite simple, and that the apparent complexity of their structure is largely a reflection of their unobserved hierarchical nature.

Complex networks as an emerging property of hierarchical preferential attachment

NASA Astrophysics Data System (ADS)

Hébert-Dufresne, Laurent; Laurence, Edward; Allard, Antoine; Young, Jean-Gabriel; Dubé, Louis J.

2015-12-01

Real complex systems are not rigidly structured; no clear rules or blueprints exist for their construction. Yet, amidst their apparent randomness, complex structural properties universally emerge. We propose that an important class of complex systems can be modeled as an organization of many embedded levels (potentially infinite in number), all of them following the same universal growth principle known as preferential attachment. We give examples of such hierarchy in real systems, for instance, in the pyramid of production entities of the film industry. More importantly, we show how real complex networks can be interpreted as a projection of our model, from which their scale independence, their clustering, their hierarchy, their fractality, and their navigability naturally emerge. Our results suggest that complex networks, viewed as growing systems, can be quite simple, and that the apparent complexity of their structure is largely a reflection of their unobserved hierarchical nature.

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.

Humanitarian engineering in the engineering curriculum

NASA Astrophysics Data System (ADS)

Vandersteen, Jonathan Daniel James

There are many opportunities to use engineering skills to improve the conditions for marginalized communities, but our current engineering education praxis does not instruct on how engineering can be a force for human development. In a time of great inequality and exploitation, the desire to work with the impoverished is prevalent, and it has been proposed to adjust the engineering curriculum to include a larger focus on human needs. This proposed curriculum philosophy is called humanitarian engineering. Professional engineers have played an important role in the modern history of power, wealth, economic development, war, and industrialization; they have also contributed to infrastructure, sanitation, and energy sources necessary to meet human need. Engineers are currently at an important point in time when they must look back on their history in order to be more clear about how to move forward. The changing role of the engineer in history puts into context the call for a more balanced, community-centred engineering curriculum. Qualitative, phenomenographic research was conducted in order to understand the need, opportunity, benefits, and limitations of a proposed humanitarian engineering curriculum. The potential role of the engineer in marginalized communities and details regarding what a humanitarian engineering program could look like were also investigated. Thirty-two semi-structured research interviews were conducted in Canada and Ghana in order to collect a pool of understanding before a phenomenographic analysis resulted in five distinct outcome spaces. The data suggests that an effective curriculum design will include teaching technical skills in conjunction with instructing about issues of social justice, social location, cultural awareness, root causes of marginalization, a broader understanding of technology, and unlearning many elements about the role of the engineer and the dominant economic/political ideology. Cross-cultural engineering development

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

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 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.

Locating responsibility: the Sphere Humanitarian Charter and its rationale.

PubMed

Darcy, James

2004-06-01

Criticised by some as a technical initiative that neglects core principles, Sphere was seen by its originators precisely as an articulation of principle. The Humanitarian Charter was the main vehicle through which this was expressed, but its relationship to the Minimum Standards has remained a matter of uncertainty. Specifically, it was unclear in the original (1999) edition of Sphere how the concept of rights informed the Minimum Standards. The revised (2004) edition goes some way to clarifying this in the way the standards are framed, yet the link between the standards and the charter remains unclear. The concern with the quality and accountability of humanitarian assistance, which motivated the attempt to establish system-wide standards through the Sphere Project, was accompanied by a desire to establish such actions in a wider framework of legal and political responsibility. In part, this reflects the conditional nature of the undertaking that agencies make when they adopt Sphere. This aspect of the charter has been neglected, but it is fundamental to an understanding of the standards and their application. This paper considers the rationale of the Sphere Humanitarian Charter and the conceptual model that underpins it. It discusses the relationship between the charter and the Minimum Standards, and the sense in which the latter are properly called "rights-based" (explored further in a related paper herein by Young and Taylor). The author was closely involved in the conception and drafting of the charter, and this paper attempts to convey some of the thinking that lay behind it.

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.

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

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...

"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.

The value of support for aid workers in complex emergencies: a phenomenological study.

PubMed

Hearns, Annette; Deeny, Pat

2007-01-01

More disasters worldwide are now classified as complex emergencies, thereby increasing the threat to life and limb and potentially increasing the psychosocial impact of the experience for aid workers. This study examines the concept of support as perceived by aid workers who had recent experience in complex emergencies. Using a phenomenological approach, 6 professional aid workers were interviewed about their experience. Aid workers who work in complex emergencies do not feel supported at the pre-deployment, during deployment, and after deployment phases. Failure to provide this support may cause disappointment, reduced self-worth, anger with the organization, and feeling of lack of achievement regarding self and the mission. While the study may be limited by the volunteer sample and potential bias in data collection, the findings reiterate a proverbial but important issue in relation to aid relief staff in complex emergencies.

Ergonomics and sustainability: towards an embrace of complexity and emergence.

PubMed

Dekker, Sidney W A; Hancock, Peter A; Wilkin, Peter

2013-01-01

Technology offers a promising route to a sustainable future, and ergonomics can serve a vital role. The argument of this article is that the lasting success of sustainability initiatives in ergonomics hinges on an examination of ergonomics' own epistemology and ethics. The epistemology of ergonomics is fundamentally empiricist and positivist. This places practical constraints on its ability to address important issues such as sustainability, emergence and complexity. The implicit ethical position of ergonomics is one of neutrality, and its positivist epistemology generally puts value-laden questions outside the parameters of what it sees as scientific practice. We argue, by contrast, that a discipline that deals with both technology and human beings cannot avoid engaging with questions of complexity and emergence and seeking innovative ways of addressing these issues. Ergonomics has largely modelled its research on a reductive science, studying parts and problems to fix. In sustainability efforts, this can lead to mere local adaptations with a negative effect on global sustainability. Ergonomics must consider quality of life globally, appreciating complexity and emergent effects of local relationships.

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.

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'.

Experimental econophysics: Complexity, self-organization, and emergent properties

NASA Astrophysics Data System (ADS)

Huang, J. P.

2015-03-01

Experimental econophysics is concerned with statistical physics of humans in the laboratory, and it is based on controlled human experiments developed by physicists to study some problems related to economics or finance. It relies on controlled human experiments in the laboratory together with agent-based modeling (for computer simulations and/or analytical theory), with an attempt to reveal the general cause-effect relationship between specific conditions and emergent properties of real economic/financial markets (a kind of complex adaptive systems). Here I review the latest progress in the field, namely, stylized facts, herd behavior, contrarian behavior, spontaneous cooperation, partial information, and risk management. Also, I highlight the connections between such progress and other topics of traditional statistical physics. The main theme of the review is to show diverse emergent properties of the laboratory markets, originating from self-organization due to the nonlinear interactions among heterogeneous humans or agents (complexity).

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

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.

Core Competencies in Disaster Management and Humanitarian Assistance: A Systematic Review.

PubMed

Ripoll Gallardo, Alba; Djalali, Ahmadreza; Foletti, Marco; Ragazzoni, Luca; Della Corte, Francesco; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Fisher, Philipp; Hreckovski, Boris; Khorram-Manesh, Amir; Komadina, Radko; Lechner, Konstanze; Stal, Marc; Patru, Cristina; Burkle, Frederick M; Ingrassia, Pier Luigi

2015-08-01

Disaster response demands a large workforce covering diverse professional sectors. Throughout this article, we illustrate the results of a systematic review of peer-reviewed studies to identify existing competency sets for disaster management and humanitarian assistance that would serve as guidance for the development of a common disaster curriculum. A systematic review of English-language articles was performed on PubMed, Google Scholar, Scopus, ERIC, and Cochrane Library. Studies were included if reporting competency domains, abilities, knowledge, skills, or attitudes for professionals involved disaster relief or humanitarian assistance. Exclusion criteria included abstracts, citations, case studies, and studies not dealing with disasters or humanitarian assistance. Thirty-eight papers were analyzed. Target audience was defined in all articles. Five references (13%) reported cross-sectorial competencies. Most of the articles (81.6%) were specific to health care. Eighteen (47%) papers included competencies for at least 2 different disciplines and 18 (47%) for different professional groups. Nursing was the most widely represented cadre. Eighteen papers (47%) defined competency domains and 36 (94%) reported list of competencies. Nineteen articles (50%) adopted consensus-building to define competencies, and 12 (31%) included competencies adapted to different professional responsibility levels. This systematic review revealed that the largest number of papers were mainly focused on the health care sector and presented a lack of agreement on the terminology used for competency-based definition.

Emergent Complexity in Conway's Game of Life

NASA Astrophysics Data System (ADS)

Gotts, Nick

It is shown that both small, finite patterns and random infinite very low density ("sparse") arrays of the Game of Life can produce emergent structures and processes of great complexity, through ramifying feedback networks and cross-scale interactions. The implications are discussed: it is proposed that analogous networks and interactions may have been precursors to natural selection in the real world.

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

Evaluations of reproductive health programs in humanitarian settings: a systematic review

PubMed Central

2015-01-01

Provision of reproductive health (RH) services is a minimum standard of health care in humanitarian settings; however access to these services is often limited. This systematic review, one component of a global evaluation of RH in humanitarian settings, sought to explore the evidence regarding RH services provided in humanitarian settings and to determine if programs are being evaluated. In addition, the review explored which RH services receive more attention based on program evaluations and descriptive data. Peer-reviewed papers published between 2004 and 2013 were identified via the Ovid MEDLINE database, followed by a PubMed search. Papers on quantitative evaluations of RH programs, including experimental and non-experimental designs that reported outcome data, implemented in conflict and natural disaster settings, were included. Of 5,669 papers identified in the initial search, 36 papers describing 30 programs met inclusion criteria. Twenty-five papers described programs in sub-Saharan Africa, six in Asia, two in Haiti and three reported data from multiple countries. Some RH technical areas were better represented than others: seven papers reported on maternal and newborn health (including two that also covered family planning), six on family planning, three on sexual violence, 20 on HIV and other sexually transmitted infections and two on general RH topics. In comparison to the program evaluation papers identified, three times as many papers were found that reported RH descriptive or prevalence data in humanitarian settings. While data demonstrating the magnitude of the problem are crucial and were previously lacking, the need for RH services and for evaluations to measure their effectiveness is clear. Program evaluation and implementation science should be incorporated into more programs to determine the best ways to serve the RH needs of people affected by conflict or natural disaster. Standard program design should include rigorous program evaluation, and

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.

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…

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)

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.

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.

Effects of disease salience and xenophobia on support for humanitarian aid.

PubMed

Peterson, Johnathan C; Gonzalez, Frank J; Schneider, Stephen P

2017-01-01

This article examines how disease salience influences attitudes toward two types of humanitarian aid: sending foreign aid and housing refugees. Some have argued that disease salience increases levels of out-group prejudice through what is referred to as the behavioral immune system (BIS), and this increase in out-group prejudice works to shape policy attitudes. However, an alternative mechanism that may explain the effects of disease salience is contamination fear, which would suggest there is no group bias in the effects of disease threat. Existing work largely interprets opposition to policies that assist out-groups as evidence of out-group prejudice. We suggest it is necessary to separate measures of out-group animosity from opinions toward specific policies to determine whether increased out-group prejudice rather than fear of contamination is the mechanism by which disease salience impacts policy attitudes. Across two experiments, disease salience is shown to significantly decrease support for humanitarian aid, but only in the form of refugee support. Furthermore, there is converging evidence to suggest that any influence of disease salience on aid attitudes is not caused by a corresponding increase in xenophobia. We suggest that the mechanism by which disease threat influences policy attitudes is a general fear of contamination rather than xenophobia. These findings go against an important hypothesized mechanism of the BIS and have critical implications for the relationship between disease salience and attitudes toward transnational policies involving humanitarian aid.

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

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

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…

An international surgical collaboration: humanitarian surgery in Brazil.

PubMed

De Rosa, A; Meyer, A; Seabra, A P; Sorge, A; Hack, J; Soares, L A; Chalub, S; Malcher, F; Kingsnorth, A

2016-08-01

Brazil is the fifth most populous country in the world with widespread regional and social inequalities. Regional disparities in healthcare are unacceptably large, with the remote and poor regions of the north and northeast having reduced life expectancy compared to the south region, where life expectancy approaches that of rich countries. We report our experience of a humanitarian surgery mission to the Amazonas state, in the northwest part of Brazil. In August 2014, a team of seven consultant surgeons, and two trainees with the charity 'International Hernia', visited three hospitals in the Amazonas state to provide hernia surgery and training. Eighty-nine hernias were repaired in 74 patients (female = 22, male = 52) with a median age of 44 years (range 2-83 years). Nine patients underwent more than one type of hernia repair, and there were 9 laparoscopic inguinal and ventral incisional hernia repairs. Local doctors were trained in hernia repair techniques, and an International Hernia Symposium was held at the University of the State of Amazonas, Manaus. The humanitarian mission provided hernia surgery to an underserved population in Brazil and training to local doctors, building local sustainability. Continued cooperation between host and international surgeons for future missions to Brazil will ensure continuing surgical training and technical assistance.

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.

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

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

Use of imagery and GIS for humanitarian demining management

NASA Astrophysics Data System (ADS)

Gentile, Jack; Gustafson, Glen C.; Kimsey, Mary; Kraenzle, Helmut; Wilson, James; Wright, Stephen

1997-11-01

In the Fall of 1996, the Center for Geographic Information Science at James Madison University became involved in a project for the Department of Defense evaluating the data needs and data management systems for humanitarian demining in the Third World. In particular, the effort focused on the information needs of demining in Cambodia and in Bosnia. In the first phase of the project one team attempted to identify all sources of unclassified country data, image data and map data. Parallel with this, another group collected information and evaluations on most of the commercial off-the-shelf computer software packages for the management of such geographic information. The result was a design for the kinds of data and the kinds of systems necessary to establish and maintain such a database as a humanitarian demining management tool. The second phase of the work involved acquiring the recommended data and systems, integrating the two, and producing a demonstration of the system. In general, the configuration involves ruggedized portable computers for field use with a greatly simplified graphical user interface, supported by a more capable central facility based on Pentium workstations and appropriate technical expertise.

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,…

[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.

Use of verbal autopsy and social autopsy in humanitarian crises

PubMed Central

Balabanova, Dina

2018-01-01

Introduction Two billion people live in countries affected by conflict, violence and fragility. These are exceptional situations in which mortality shifts dramatically and in which civil registration and vital statistics systems are often weakened or cease to function. Verbal autopsy and social autopsy (VA and SA) are methods used to assign causes of death and understand the contexts in which these occur, in settings where information is otherwise unavailable. This review sought to explore the use of VA and SA in humanitarian crises, with a focus on how these approaches are used to inform policy and programme responses. Methods A rapid scoping review was conducted on the use of VA and SA in humanitarian crises in low and middle-income countries since 1991. Drawing on a maximum variation approach, two settings of application (‘application contexts’) were selected and investigated via nine semi-structured expert interviews. Results VA can determine causes of death in crisis-affected populations where no other registration system is in place. Combined with SA and active community involvement, these methods can deliver a holistic view of obstacles to seeking and receiving essential healthcare, yielding context-specific information to inform appropriate responses. The contexts in which VA and SA are used require adaptations to standard tools, and new mobile developments in VA raise specific ethical considerations. Furthermore, collecting and sythesising data in a timely, continuous manner, and ensuring coordination and communication between agencies, is important to realise the potential of these approaches. Conclusion VA and SA are valuable research methods to foster evidence-informed responses for populations affected by humanitarian crises. When coordinated and communicated effectively, data generated through these methods can help to identify levels, causes and circumstances of deaths among vulnerable groups, and can enable planning and allocating resources

Use of verbal autopsy and social autopsy in humanitarian crises.

PubMed

Thomas, Lisa-Marie; D'Ambruoso, Lucia; Balabanova, Dina

2018-01-01

Two billion people live in countries affected by conflict, violence and fragility. These are exceptional situations in which mortality shifts dramatically and in which civil registration and vital statistics systems are often weakened or cease to function. Verbal autopsy and social autopsy (VA and SA) are methods used to assign causes of death and understand the contexts in which these occur, in settings where information is otherwise unavailable. This review sought to explore the use of VA and SA in humanitarian crises, with a focus on how these approaches are used to inform policy and programme responses. A rapid scoping review was conducted on the use of VA and SA in humanitarian crises in low and middle-income countries since 1991. Drawing on a maximum variation approach, two settings of application ('application contexts') were selected and investigated via nine semi-structured expert interviews. VA can determine causes of death in crisis-affected populations where no other registration system is in place. Combined with SA and active community involvement, these methods can deliver a holistic view of obstacles to seeking and receiving essential healthcare, yielding context-specific information to inform appropriate responses. The contexts in which VA and SA are used require adaptations to standard tools, and new mobile developments in VA raise specific ethical considerations. Furthermore, collecting and sythesising data in a timely, continuous manner, and ensuring coordination and communication between agencies, is important to realise the potential of these approaches. VA and SA are valuable research methods to foster evidence-informed responses for populations affected by humanitarian crises. When coordinated and communicated effectively, data generated through these methods can help to identify levels, causes and circumstances of deaths among vulnerable groups, and can enable planning and allocating resources effectively, potentially improving health system

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.

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.

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

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

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

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…

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

Cleft and Craniofacial Care During Military Pediatric Plastic Surgery Humanitarian Missions.

PubMed

Madsen, Christopher; Lough, Denver; Lim, Alan; Harshbarger, Raymond J; Kumar, Anand R

2015-06-01

-surgical (Pittsburgh Weighted Speech Score) speech score was 12 (range, 6-24). The average postsurgical speech score was 6 (range, 0-21). Average hospital stay was 3 days for cleft surgery. There were no major complications or mortality, 1 reoperation for bleeding or infection, and 12 patients required secondary operations for palatal fistula, unsatisfactory aesthetic result, malocclusion, or velopharygeal dysfunction. Military pediatric plastic surgery humanitarian missions can be executed with similar home institution results after the initiation and evolution of a standardized approach to humanitarian missions. The incorporation of a dedicated logistics support unit, a dedicated operational specialist (senior noncommissioned officer), a speech language pathologist, remote internet follow up, an liaison officer (host nation liaison physician participation), host nation surgical resident participation, and support from the embassy, Military Advisory Attachment Group, and United States Aid and International Development facilitated patient accurate patient evaluation and posttreatment follow-up. Movement of the mission site from a remote more austere environment to a centralized better equipped facility with host nation support to transport patients to the site facilitated improved patient safety and outcomes despite increasing the complexity of surgery performed.

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

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.

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.

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

[Violent outburst from teenagers in the pediatric emergency room: Complex cases].

PubMed

Cohen, L; Gras-Le Guen, C; Fleury, J; Caldagues, E; Dreno, L; Picherot, G; Vabres, N

2017-12-01

Teenagers admitted to the emergency room for a violent attacks episode are increasingly numerous. The source of agitation is multifactorial for these teenagers, often with a complex course. They jeopardize hospital wards, which are often ill-suited for and overwhelmed during these outbursts. This study aims to identify and describe all the teenagers admitted to the hospital over 1 year for a violent outburst and discuss their management. Retrospective and descriptive study of teenagers admitted to the pediatric emergency department of the Nantes University Hospital for a violent outburst in 2015. During this 1-year study, 99 teenagers out of a total of 182 consultations were admitted for a violent outburst. We noted that 85% of them had a previous history of a violent outburst, 70% of them were seeing a psychologist, and 56% were followed by the child welfare services. Most of the outbursts took place at home and were hetero-aggressive. Upon arrival at the pediatric emergency ward, 90% of the teenagers had calmed down. The mean time spent in the emergency ward was 3h42min. Finally, 31% of the teenagers were hospitalized in the general pediatric unit, 14% in the children's psychiatric department, and 8% in the adult psychiatry ward. We observed a high proportion of complex cases in the teenagers admitted to our emergency department for a violent outburst. These teenagers in distress, with a complex previous history, illustrated the relation between violence against themselves and their own violent behavior toward others. Developing short-stay units for a temporary isolation could be an advantageous multidisciplinary approach to allow somatic, psychological, and social evaluation of these vulnerable patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues.

PubMed

Wang, Wei; Huang, Li; Liang, Xuedong

2018-01-06

This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks' statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies.

On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues

PubMed Central

Wang, Wei; Huang, Li; Liang, Xuedong

2018-01-01

This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks’ statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies. PMID:29316614

Emergent explosive synchronization in adaptive complex networks

NASA Astrophysics Data System (ADS)

Avalos-Gaytán, Vanesa; Almendral, Juan A.; Leyva, I.; Battiston, F.; Nicosia, V.; Latora, V.; Boccaletti, S.

2018-04-01

Adaptation plays a fundamental role in shaping the structure of a complex network and improving its functional fitting. Even when increasing the level of synchronization in a biological system is considered as the main driving force for adaptation, there is evidence of negative effects induced by excessive synchronization. This indicates that coherence alone cannot be enough to explain all the structural features observed in many real-world networks. In this work, we propose an adaptive network model where the dynamical evolution of the node states toward synchronization is coupled with an evolution of the link weights based on an anti-Hebbian adaptive rule, which accounts for the presence of inhibitory effects in the system. We found that the emergent networks spontaneously develop the structural conditions to sustain explosive synchronization. Our results can enlighten the shaping mechanisms at the heart of the structural and dynamical organization of some relevant biological systems, namely, brain networks, for which the emergence of explosive synchronization has been observed.

Emergent explosive synchronization in adaptive complex networks.

PubMed

Avalos-Gaytán, Vanesa; Almendral, Juan A; Leyva, I; Battiston, F; Nicosia, V; Latora, V; Boccaletti, S

2018-04-01

Adaptation plays a fundamental role in shaping the structure of a complex network and improving its functional fitting. Even when increasing the level of synchronization in a biological system is considered as the main driving force for adaptation, there is evidence of negative effects induced by excessive synchronization. This indicates that coherence alone cannot be enough to explain all the structural features observed in many real-world networks. In this work, we propose an adaptive network model where the dynamical evolution of the node states toward synchronization is coupled with an evolution of the link weights based on an anti-Hebbian adaptive rule, which accounts for the presence of inhibitory effects in the system. We found that the emergent networks spontaneously develop the structural conditions to sustain explosive synchronization. Our results can enlighten the shaping mechanisms at the heart of the structural and dynamical organization of some relevant biological systems, namely, brain networks, for which the emergence of explosive synchronization has been observed.

Emergence of social complexity among coastal hunter-gatherers in the Atacama Desert of northern Chile

PubMed Central

Marquet, Pablo A.; Santoro, Calogero M.; Latorre, Claudio; Standen, Vivien G.; Abades, Sebastián R.; Rivadeneira, Marcelo M.; Arriaza, Bernardo; Hochberg, Michael E.

2012-01-01

The emergence of complex cultural practices in simple hunter-gatherer groups poses interesting questions on what drives social complexity and what causes the emergence and disappearance of cultural innovations. Here we analyze the conditions that underlie the emergence of artificial mummification in the Chinchorro culture in the coastal Atacama Desert in northern Chile and southern Peru. We provide empirical and theoretical evidence that artificial mummification appeared during a period of increased coastal freshwater availability and marine productivity, which caused an increase in human population size and accelerated the emergence of cultural innovations, as predicted by recent models of cultural and technological evolution. Under a scenario of increasing population size and extreme aridity (with little or no decomposition of corpses) a simple demographic model shows that dead individuals may have become a significant part of the landscape, creating the conditions for the manipulation of the dead that led to the emergence of complex mortuary practices. PMID:22891345

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.

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

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.

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.

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.

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.

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…

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

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.

Human Rights, Humanitarianism, and State Violence: Medical Documentation of Torture in Turkey.

PubMed

Can, Başak

2016-09-01

State authorities invested in developing official expert discourses and practices to deny torture in post-1980 coup d'état Turkey. Documentation of torture was therefore crucial for the incipient human rights movement there in the 1980s. Human rights physicians used their expertise not only to treat torture victims but also to document torture and eventually found the Human Rights Foundation of Turkey (HRFT) in 1990. Drawing on an ethnographic and archival research at the HRFT, this article examines the genealogy of anti-torture struggles in Turkey and argues that locally mediated intimacies and/or hostilities between victims of state violence, human rights physicians, and official forensics reveal the limitations of certain universal humanitarian and human rights principles. It also shows that locally mediated long-term humanitarian encounters around the question of political violence challenge forensic denial of violence and remake the legitimate levels of state violence. © 2015 by the American Anthropological Association.

Stabilising a victor's peace? Humanitarian action and reconstruction in eastern Sri Lanka.

PubMed

Goodhand, Jonathan

2010-10-01

This paper focuses on the 'Sri Lankan model' of counter-insurgency and stabilisation and its implications for humanitarian and development actors. The Sri Lanka case shows that discourses, policies and practices associated with 'stabilisation' are not confined to 'fragile state' contexts in which there is heavy (and often militarised) international engagement--even though exemplars such as Afghanistan and Iraq have tended to dominate debates on this issue. Rather than being a single template, the 'stabilisation agenda' takes on very different guises in different contexts, presenting quite specific challenges to humanitarian and development actors. This is particularly true in settings like Sri Lanka, where there is a strong state, which seeks to make aid 'coherent' with its own vision of a militarily imposed political settlement. Working in such environments involves navigating a highly-charged domestic political arena, shaped by concerns about sovereignty, nationalism and struggles for legitimacy. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

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

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.

Management of disasters and complex emergencies in Africa: The challenges and constraints.

PubMed

Aliyu, Alhaji

2015-01-01

Natural and man-made catastrophes have caused significant destruction and loss of lives throughout human history. Disasters accompany a wide variety of events with multiple causes and consequences often leading to a cascade of related events. African continent has not been spared of these events. A new phenomenon in the continent is terrorism that is fuelled by globalization of arms trade and has contributed significantly to escalation of conflicts in sub-Saharan Africa (SSA) resulting in complex emergencies and destruction of socioeconomic structures. The aim of this paper is to review relevant papers on management of disasters and complex emergencies in Africa and the challenges and constraints against the background of a weakened health system. Systematic search of published literature was conducted between 1990 and 2013. Grey literature (technical reports, government documents), published peer review journals, abstracts, relevant books and internet articles were reviewed. The review revealed that the frequency of both natural and man-made disasters in Africa is escalating. Complex emergencies are also on the increase since the Rwandan crisis in 1994. The impact of these events has overstretched and overwhelmed the health care system that is least prepared to handle and cope with the surge capacity and also render normal services. In conclusion, there is an urgent need for national emergency agencies/departments across Africa to develop a robust emergency preparedness and response plan. Every hospital most have a disaster management committee with flexible disaster management plan to respond to these catastrophes. There is a need for curriculum review in tertiary institutions across SSA to introduce and or expand training in disaster management.

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.

System complexity as a measure of safe capacity for the emergency department.

PubMed

France, Daniel J; Levin, Scott

2006-11-01

System complexity is introduced as a new measure of system state for the emergency department (ED). In its original form, the measure quantifies the uncertainty of demands on system resources. For application in the ED, the measure is being modified to quantify both workload and uncertainty to produce a single integrated measure of system state. Complexity is quantified using an information-theoretic or entropic approach developed in manufacturing and operations research. In its original form, complexity is calculated on the basis of four system parameters: 1) the number of resources (clinicians and processing entities such as radiology and laboratory systems), 2) the number of possible work states for each resource, 3) the probability that a resource is in a particular work state, and 4) the probability of queue changes (i.e., where a queue is defined by the number of patients or patient orders being managed by a resource) during a specified time period. An example is presented to demonstrate how complexity is calculated and interpreted for a simple system composed of three resources (i.e., emergency physicians) managing varying patient loads. The example shows that variation in physician work states and patient queues produces different scores of complexity for each physician. It also illustrates how complexity and workload differ. System complexity is a viable and technically feasible measurement for monitoring and managing surge capacity in the ED.

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

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.

[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.

Fitness landscape complexity and the emergence of modularity in neural networks

NASA Astrophysics Data System (ADS)

Lowell, Jessica

Previous research has shown that the shape of the fitness landscape can affect the evolution of modularity. We evolved neural networks to solve different tasks with different fitness landscapes, using NEAT, a popular neuroevolution algorithm that quantifies similarity between genomes in order to divide them into species. We used this speciation mechanism as a means to examine fitness landscape complexity, and to examine connections between fitness landscape complexity and the emergence of modularity.

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

Humanitarian assistance and disaster relief: changing the face of defense.

PubMed

Laraby, Patrick R; Bourdeaux, Margaret; Casscells, S Ward; Smith, David J; Lawry, Lynn

2009-01-01

The US Department of Defense (DOD) is evolving to meet new security challenges in the twenty-first century. Today's challenges result from growing political, environmental, and economic instability in important areas of the globe that threaten national and global security. Immediate outreach to foreign nations in times of violent instability or natural disaster fosters security and stability both for the affected country and for the United States. Foreign humanitarian assistance (FHA) is a rapidly evolving military mission that addresses conflict prevention, conflict, postconflict, and natural disasters. With DOD's extensive global medical resources, it is often uniquely qualified to execute a critical role in relief and/or public health efforts. When and how the American military will act in FHA and disaster relief is a still evolving doctrine with three issues deserving particular attention: aligning operations with host government leadership, preserving humanitarian space, and tailoring the US military's unique resources to the specific political and medical situation at hand. The DOD's response to a large-scale earthquake in Peru suggests useful approaches to these three issues, provides a template for future FHA mission, and points to strategic decisions and operational capabilities that need further development to establish the FHA mission firmly within DOD's repertoire of security engagement activities.

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...

Emergent sensing of complex environments by mobile animal groups.

PubMed

Berdahl, Andrew; Torney, Colin J; Ioannou, Christos C; Faria, Jolyon J; Couzin, Iain D

2013-02-01

The capacity for groups to exhibit collective intelligence is an often-cited advantage of group living. Previous studies have shown that social organisms frequently benefit from pooling imperfect individual estimates. However, in principle, collective intelligence may also emerge from interactions between individuals, rather than from the enhancement of personal estimates. Here, we reveal that this emergent problem solving is the predominant mechanism by which a mobile animal group responds to complex environmental gradients. Robust collective sensing arises at the group level from individuals modulating their speed in response to local, scalar, measurements of light and through social interaction with others. This distributed sensing requires only rudimentary cognition and thus could be widespread across biological taxa, in addition to being appropriate and cost-effective for robotic agents.

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

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.

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.

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.

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

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.

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.

A Memento of Complexity: The Rhetorics of Memory, Ambience, and Emergence

ERIC Educational Resources Information Center

Southergill, Glen T.

2014-01-01

Drawing from complexity theory, this dissertation develops a schema of rhetorical memory that exhibits extended characteristics. Scholars traditionally conceptualize memory, the fourth canon in classical rhetoric, as place (loci) or image (phantasm). However, memory rhetoric resists the traditional loci-phantasm framework and instead emerges from…

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.

The humanitarian situation in syria: a snapshot in the third year of the crisis.

PubMed

Doocy, Shannon; Delbiso, Tefera D; Guha-Sapir, Debarati

2015-03-03

Between April and June 2014, International Orthodox Christian Charities (IOCC), an International NGO, and the Greek Orthodox Patriarchate of Antioch and All the East (GOPA) conducted a needs assessment of Syrians affected by the crisis with the objective of gaining a better understanding of humanitarian needs and assistance priorities. Findings suggest that interventions that increase access to non-food items, food, medication and education should be prioritized where cost was the primary barrier to accessing goods and services. Cash transfer programs and direct provision of material assistance should be considered, though the most appropriate assistance modality is likely to vary by sector, location and the preferences and prior experience of donors and implementing organizations. Renewed international commitment to funding humanitarian assistance efforts in Syria and neighboring countries where the burden of refugees is greatest is essential from both a human rights perspective and in terms of maintaining stability in the region.

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

Erosion of trust in humanitarian agencies: what strategies might help?

PubMed

Jayasinghe, Saroj

2011-01-01

Aid agencies (AAs) provide a range of humanitarian and health related assistance globally. However, the trust placed on them is eroding. Evidence for this includes accusations of a decline in their humanitarianism, and the increasing number of conflicts with host states. An analysis of the concerns expressed yields two possible reasons: a relative lack of transparency of their work and weak accountability mechanisms. This is further supported by the existing milieu: an absence of internationally accepted instrument or mechanism to check the credentials of INGOs and an opaque system of close links between some of the INGOs and their donors. The article suggests two global strategies to tackle these issues: (a) Increase transparency by establishing a global register of aid agencies. This should have basic information: their main goals and activities, countries they are active in, number of employees, annual turnover of funds (updated regularly), principal financing sources and nature of links with donors. This could also be available as printed manual that should be freely available to client countries. (b) Ensure accountability by developing templates of fair legal instruments (to facilitate and regulate work), and a set of generic rules and procedures of engagement for the interactions between agencies and client states. These should be institutionalized within the regulatory frameworks of countries and included in the Codes of Conduct of NGOs.

Erosion of trust in humanitarian agencies: what strategies might help?

PubMed Central

Jayasinghe, Saroj

2011-01-01

Aid agencies (AAs) provide a range of humanitarian and health related assistance globally. However, the trust placed on them is eroding. Evidence for this includes accusations of a decline in their humanitarianism, and the increasing number of conflicts with host states. An analysis of the concerns expressed yields two possible reasons: a relative lack of transparency of their work and weak accountability mechanisms. This is further supported by the existing milieu: an absence of internationally accepted instrument or mechanism to check the credentials of INGOs and an opaque system of close links between some of the INGOs and their donors. The article suggests two global strategies to tackle these issues: (a) Increase transparency by establishing a global register of aid agencies. This should have basic information: their main goals and activities, countries they are active in, number of employees, annual turnover of funds (updated regularly), principal financing sources and nature of links with donors. This could also be available as printed manual that should be freely available to client countries. (b) Ensure accountability by developing templates of fair legal instruments (to facilitate and regulate work), and a set of generic rules and procedures of engagement for the interactions between agencies and client states. These should be institutionalized within the regulatory frameworks of countries and included in the Codes of Conduct of NGOs. PMID:22110413

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/

Active-Duty Physicians' Perceptions and Satisfaction with Humanitarian Assistance and Disaster Relief Missions: Implications for the Field

PubMed Central

Oravec, Geoffrey J.; Artino, Anthony R.; Hickey, Patrick W.

2013-01-01

Background The United States Department of Defense participates in more than 500 missions every year, including humanitarian assistance and disaster relief, as part of medical stability operations. This study assessed perceptions of active-duty physicians regarding these activities and related these findings to the retention and overall satisfaction of healthcare professionals. Methods and Findings An Internet-based survey was developed and validated. Of the 667 physicians who responded to the survey, 47% had participated in at least one mission. On a 7-point, Likert-type response scale, physicians reported favorable overall satisfaction with their participation in these missions (mean  = 5.74). Perceived benefit was greatest for the United States (mean  = 5.56) and self (mean  = 5.39) compared to the target population (mean  = 4.82). These perceptions were related to participants' intentions to extend their military medical service (total model R 2  = .37), with the strongest predictors being perceived benefit to self (β = .21, p<.01), the U.S. (β = .19, p<.01), and satisfaction (β = .18, p<.05). In addition, Air Force physicians reported higher levels of satisfaction (mean  = 6.10) than either Army (mean  = 5.27, Cohen's d = 0.75, p<.001) or Navy (mean  = 5.60, Cohen's d  = 0.46, p<.01) physicians. Conclusions Military physicians are largely satisfied with humanitarian missions, reporting the greatest benefit of such activities for themselves and the United States. Elucidation of factors that may increase the perceived benefit to the target populations is warranted. Satisfaction and perceived benefits of humanitarian missions were positively correlated with intentions to extend time in service. These findings could inform the larger humanitarian community as well as military medical practices for both recruiting and retaining medical professionals. PMID:23555564

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.

Mitochondrial network complexity emerges from fission/fusion dynamics.

PubMed

Zamponi, Nahuel; Zamponi, Emiliano; Cannas, Sergio A; Billoni, Orlando V; Helguera, Pablo R; Chialvo, Dante R

2018-01-10

Mitochondrial networks exhibit a variety of complex behaviors, including coordinated cell-wide oscillations of energy states as well as a phase transition (depolarization) in response to oxidative stress. Since functional and structural properties are often interwinded, here we characterized the structure of mitochondrial networks in mouse embryonic fibroblasts using network tools and percolation theory. Subsequently we perturbed the system either by promoting the fusion of mitochondrial segments or by inducing mitochondrial fission. Quantitative analysis of mitochondrial clusters revealed that structural parameters of healthy mitochondria laid in between the extremes of highly fragmented and completely fusioned networks. We confirmed our results by contrasting our empirical findings with the predictions of a recently described computational model of mitochondrial network emergence based on fission-fusion kinetics. Altogether these results offer not only an objective methodology to parametrize the complexity of this organelle but also support the idea that mitochondrial networks behave as critical systems and undergo structural phase transitions.

Social media insights for sustainable development and humanitarian action in Indonesia

NASA Astrophysics Data System (ADS)

Amin, Imaduddin; Pramestri, Zakiya; Hodge, George; Lee, Jong Gun

2018-03-01

Tracking human development and humanitarian action has been enhanced by the growth of social media. Twitter is a data source with potential, when used alongside data from surveys, especially the national census, to understand the situation on the ground and track changes. In Indonesia, a country with one of the highest Twitter penetration rates, we seize this opportunity by using Twitter data to produce more timely insights and to enhance evidence-based decision-making. Despite social media’s limitations, namely representativeness and validity, we are able to show its potential by looking at case studies on five different topics; (a) food and agriculture, (b) public health (c) economic well-being (d) urban resilience and (e) humanitarian action. We observe that the insights gained by using Twitter data were derived not only from the content of posts such as understanding public opinion or sentiment, but also from activities related to it, for instance the location and time-stamp of the post, which furthers our real-time understanding of the situation and user behavior changes. In this paper, we also briefly explain “social listener”, a social media monitoring tool that used by Government of Indonesia to understand citizen opinions in social media related to government priorities.

Humanitarian Struggle in Burma's Conflict Zones.

PubMed

Gyo, Moe

The Back Pack Health Worker Team (BPHWT), a community- based health organization, provides primary health care to ethnic people in conflict, remote, and internally displaced areas, in Burma (aka Myanmar), controlled by ethnic armed organizations fighting against the Burma government. Its services include both curative and preventative health care through a network of 1,425 health personnel including community health workers and village-embedded traditional birth attendants and village health workers. The BPHWT organizational and program model may prove useful to Special Operations medical actions in support of insurgent movements and conversely with a host nation's counterinsurgency strategies, which include the extension of its health services into areas that may be remote and/or inhabited by indigenous people and have insurgency potential. In the former respect, special attention is directed toward "humanitarian struggle" that uses health care as a weapon against the counterinsurgency strategies of a country's oppressive military. 2017.

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

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.

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…

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

The Humanitarian Situation in Syria: A Snapshot in the Third Year of the Crisis

PubMed Central

Doocy, Shannon; Delbiso, Tefera D.; Guha-Sapir, Debarati

2015-01-01

Between April and June 2014, International Orthodox Christian Charities (IOCC), an International NGO, and the Greek Orthodox Patriarchate of Antioch and All the East (GOPA) conducted a needs assessment of Syrians affected by the crisis with the objective of gaining a better understanding of humanitarian needs and assistance priorities. Findings suggest that interventions that increase access to non-food items, food, medication and education should be prioritized where cost was the primary barrier to accessing goods and services. Cash transfer programs and direct provision of material assistance should be considered, though the most appropriate assistance modality is likely to vary by sector, location and the preferences and prior experience of donors and implementing organizations. Renewed international commitment to funding humanitarian assistance efforts in Syria and neighboring countries where the burden of refugees is greatest is essential from both a human rights perspective and in terms of maintaining stability in the region. PMID:25821647

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...

The impact of humanitarian context conditions and individual characteristics on aid worker retention.

PubMed

Korff, Valeska P; Balbo, Nicoletta; Mills, Melinda; Heyse, Liesbet; Wittek, Rafael

2015-07-01

High employee turnover rates constitute a major challenge to effective aid provision. This study examines how features of humanitarian work and aid workers' individual characteristics affect retention within one humanitarian organisation, Médecins Sans Frontières (MSF) Holland. The study extends existing research by providing new theoretical explanations of employment opportunities and constraints and by engaging in the first large-scale quantitative analysis of aid worker retention. Using a database of field staff (N=1,955), a logistic regression is performed of the likelihood of reenlistment after a first mission. The findings demonstrate that only 40 per cent of employees reenlist for a second mission with MSF Holland, and that workplace location and security situation, age, and gender have no significant effect. Individuals are less likely to reenlist if they returned early from the first mission for a personal reason, are in a relationship, are medical doctors, or if they come from highly developed countries. The paper reflects on the findings in the light of policy. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

Horizon scanning for emergence of new viruses: from constructing complex scenarios to online games.

PubMed

Gale, P; Breed, A C

2013-10-01

Horizon scanning techniques can be developed to identify novel routes and sources for the emergence of viruses in the medium to long term. Central to horizon scanning is prediction of the complex scenarios through which viruses could emerge before they occur. One approach involves 'spidergrams' in which complex scenarios are generated by combining factors randomly selected from different categories of events. Spidergrams provide a framework for how different factors could interact, irrespective of the virus, and also enable testing of combinations not previously considered but which would be 'tested' in nature by a virus. The emergence of viruses through new routes is often related to changes, for example, in environmental and social factors, and the Internet will undoubtedly be used to identify long-term trends for consideration. In addition, online games may provide horizon scanners with suggestions for new routes and strategies that could be used by emerging viruses. © 2012 Crown copyright Reproduced with the permission of the Controller of Her Majesty's Stationery Office and Animal Health and Veterinary Laboratories Agency.

A Social-Learning Approach to Hazard-Related Knowledge Exchange: Boundary Workers at the Geoscience-Humanitarian Interface

NASA Astrophysics Data System (ADS)

Quinn, Keira; Hope, Max; McCloskey, John

2014-05-01

A Social-Learning Approach to Hazard-Related Knowledge Exchange: Boundary Workers at the Geoscience-Humanitarian Interface Keira Quinn (1), Dr Max Hope (1), Professor John McCloskey (1). (1)University of Ulster Peer-reviewed science has the potential to guide policy-makers and practitioners in developing robust responses to social problems and issues. Despite advances in hazard-related science, it can often be a challenge to translate findings into useful social applications. With natural hazards affecting 2.9 billion people between 2000 and 2012 the need for hazard science to be effectively communicated is undeniable. This is particularly so in humanitarian contexts as non-governmental organisations (NGOs) play a key role in the poorer nations most affected by natural disasters. Past methods of 'knowledge transfer' have tended to lead to misinterpretations and misrepresentations of science to the extent that it is often used incorrectly or not at all. 'Knowledge exchange' is currently heralded as a more effective means of bringing about successful communication and understanding, and is characterised by the presence of shared learning. Central to a knowledge exchange approach is an understanding of the social and organisational contexts within which learning takes place. Here we use Etienne Wenger's social-learning approach to analyse selected aspects of the social context influencing knowledge exchange across the geoscience-humanitarian interface. For Wenger (2000) Communities of Practice (CoP) are bounded organisational and social groups united by their own distinct values, goals and ways of working. The boundaries surrounding CoPs can act as barriers to knowledge exchange but can also create opportunities for new shared learning by challenging existing perspectives and practice. Drawing on the findings of ongoing qualitative research into communication and learning between earthquake scientists and humanitarian NGOs in UK/Ireland, this paper outlines a number

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

Employing moderate resolution sensors in human rights and international humanitarian law monitoring

NASA Astrophysics Data System (ADS)

Marx, Andrew J.

Organizations concerned with human rights are increasingly using remote sensing as a tool to improve their detection of human rights and international humanitarian law violations. However, as these organizations have transitioned to human rights monitoring campaigns conducted over large regions and extended periods of time, current methods of using fine- resolution sensors and manpower-intensive analyses have become cost- prohibitive. To support the continued growth of remote sensing in human rights and international humanitarian law monitoring campaigns, this study researches how moderate resolution land observatories can provide complementary data to operational human rights monitoring efforts. This study demonstrates the capacity of moderate resolutions to provide data to monitoring efforts by developing an approach that uses Landsat Enhanced Thematic Mapper Plus (ETM+) as part of a system for the detection of village destruction in Darfur, Sudan. Village destruction is an indicator of a human rights or international humanitarian law violations in Darfur during the 2004 study period. This analysis approach capitalizes on Landsat's historical archive and systematic observations by constructing a historic spectral baseline for each village in the study area that supports automated detection of a potentially destroyed village with each new overpass of the sensor. Using Landsat's near-infrared band, the approach demonstrates high levels of accuracy when compared with a U.S. government database documenting destroyed villages. This approach is then applied to the Darfur conflict from 2002 to 2008, providing new data on when and where villages were destroyed in this widespread and long-lasting conflict. This application to the duration of a real-world conflict illustrates the abilities and shortcomings of moderate resolution sensors in human rights monitoring efforts. This study demonstrates that moderate resolution satellites have the capacity to contribute

Collaborative Educational Leadership: The Emergence of Human Interactional Sense-Making Process as a Complex System

ERIC Educational Resources Information Center

Jäppinen, Aini-Kristiina

2014-01-01

The article aims at explicating the emergence of human interactional sense-making process within educational leadership as a complex system. The kind of leadership is understood as a holistic entity called collaborative leadership. There, sense-making emerges across interdependent domains, called attributes of collaborative leadership. The…

Using complex auditory-visual samples to produce emergent relations in children with autism.

PubMed

Groskreutz, Nicole C; Karsina, Allen; Miguel, Caio F; Groskreutz, Mark P

2010-03-01

Six participants with autism learned conditional relations between complex auditory-visual sample stimuli (dictated words and pictures) and simple visual comparisons (printed words) using matching-to-sample training procedures. Pre- and posttests examined potential stimulus control by each element of the complex sample when presented individually and emergence of additional conditional relations and oral labeling. Tests revealed class-consistent performance for all participants following training.

The Colorado Humanitarian Surgical Skills Workshop: A Cadaver-Based Workshop to Prepare Residents for Surgery in Austere Settings.

PubMed

Lin, Yihan; Mukhopadhyay, Swagoto; Meguid, Robert A; Kuwayama, David P

Interest in humanitarian surgery is high among surgical and obstetric residents. The Colorado Humanitarian Surgical Skills Workshop is an annual 2-day course exposing senior residents to surgical techniques essential in low- and middle-income countries but not traditionally taught in US residencies. We evaluated the course's ability to foster resident comfort, knowledge, and competence in these skills. The cohort of course participants was studied prospectively. Participants attended didactic sessions followed by skills sessions using cadavers. Sample areas of focus included general surgery (mesh-free hernia repair), orthopedics (powerless external fixation), and neurosurgery (powerless craniotomy). Before and after the course, participants answered a questionnaire assessing confidence with taught skills; took a knowledge-based test composed of multiple choice and open-ended questions; and participated in a manual skills test of tibial external fixation. The Center for Surgical Innovation, University of Colorado School of Medicine. A total of 12 residents (11 general surgical and 1 obstetric) from ten US institutions. After the course, participants perceived increased confidence in performing all 27 taught procedures and ability to practice in low- and middle-income countries. In knowledge-based testing, 10 of 12 residents demonstrated improvement on multiple choice questioning and 9 of 12 residents demonstrated improvement on open-ended questioning with structured scoring. In manual skills testing, all external fixator constructs demonstrated objective improvement on structured scoring and subjective improvement on stability assessment. For senior residents interested in humanitarian surgery, a combination of skills-focused teaching and manual practice led to self-perceived and objective improvement in relevant surgical knowledge and skills. The Colorado Humanitarian Surgical Skills Workshop represents an effective model for transmitting essential surgical

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

"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…

Controlling Emergent Ferromagnetism at Complex Oxide Interfaces

NASA Astrophysics Data System (ADS)

Grutter, Alexander

The emergence of complex magnetic ground states at ABO3 perovskite heterostructure interfaces is among the most promising routes towards highly tunable nanoscale materials for spintronic device applications. Despite recent progress, isolating and controlling the underlying mechanisms behind these emergent properties remains a highly challenging materials physics problems. In particular, generating and tuning ferromagnetism localized at the interface of two non-ferromagnetic materials is of fundamental and technological interest. An ideal model system in which to study such effects is the CaRuO3/CaMnO3 interface, where the constituent materials are paramagnetic and antiferromagnetic in the bulk, respectively. Due to small fractional charge transfer to the CaMnO3 (0.07 e-/Mn) from the CaRuO3, the interfacial Mn ions are in a canted antiferromagnetic state. The delicate balance between antiferromagnetic superexchange and ferromagnetic double exchange results in a magnetic ground state which is extremely sensitive to perturbations. We exploit this sensitivity to achieve control of the magnetic interface, tipping the balance between ferromagnetic and antiferromagnetic interactions through octahedral connectivity modification. Such connectivity effects are typically tightly confined to interfaces, but by targeting a purely interfacial emergent magnetic system, we achieve drastic alterations to the magnetic ground state. These results demonstrate the extreme sensitivity of the magnetic state to the magnitude of the charge transfer, suggesting the potential for direct electric field control. We achieve such electric field control through direct back gating of a CaRuO3/CaMnO3 bilayer. Thus, the CaRuO3/CaMnO3 system provides new insight into how charge transfer, interfacial symmetry, and electric fields may be used to control ferromagnetism at the atomic scale.

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.

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.

Emergent complexity of the cytoskeleton: from single filaments to tissue

PubMed Central

Huber, F.; Schnauß, J.; Rönicke, S.; Rauch, P.; Müller, K.; Fütterer, C.; Käs, J.

2013-01-01

Despite their overwhelming complexity, living cells display a high degree of internal mechanical and functional organization which can largely be attributed to the intracellular biopolymer scaffold, the cytoskeleton. Being a very complex system far from thermodynamic equilibrium, the cytoskeleton's ability to organize is at the same time challenging and fascinating. The extensive amounts of frequently interacting cellular building blocks and their inherent multifunctionality permits highly adaptive behavior and obstructs a purely reductionist approach. Nevertheless (and despite the field's relative novelty), the physics approach has already proved to be extremely successful in revealing very fundamental concepts of cytoskeleton organization and behavior. This review aims at introducing the physics of the cytoskeleton ranging from single biopolymer filaments to multicellular organisms. Throughout this wide range of phenomena, the focus is set on the intertwined nature of the different physical scales (levels of complexity) that give rise to numerous emergent properties by means of self-organization or self-assembly. PMID:24748680

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.

The for-profit sector in humanitarian response: integrating ethical considerations in public policy decision making.

PubMed

Huckel Schneider, Carmen; Negin, Joel

2016-01-01

The engagement of the for-profit private sector in health, social and humanitarian services has become a topic of keen interest. It is particularly contentious in those instances where for-profit organizations have become recipients of public funds, and where they become key decision-makers in terms of how, and to whom, services are provided. We put forward a framework for identifying and organizing the ethical questions to be considered when contracting government services to the for-profit sector, specifically in those areas that have traditionally remained in the public or not-for-profit spheres. The framework is designed to inform both academic debate and practical decision-making regarding the acceptability, feasibility and legitimacy of for-profit organizations carrying out humanitarian work. First, we outline the importance of posing ethical questions in government contracting for-profit vs. not-for-profit organizations. We then outline five key areas to be considered before then examining the extent to which ethics concerns are warranted and how they may be safeguarded.

Secondary harm mitigation: A more humanitarian framework for international drug law enforcement.

PubMed

Blaustein, Jarrett; McLay, Miki; McCulloch, Jude

2017-08-01

This article introduces the concept of 'secondary harm mitigation' as a framework for improving the humanitarian credentials of international drug law enforcement agencies. The concept is rooted in a critical analysis of the compatibility of the harm reduction philosophy with Australia's international drug law enforcement practices. On a utilitarian level, the net benefits of international drug law enforcement are determined to be, at best inconclusive, arguably counterproductive and in most cases, incalculable. On a humanitarian level, international drug law enforcement is also determined to be problematic from a criminological standpoint because it generates secondary harms and it is indifferent to the vulnerability of individuals who participate in illicit drug trafficking. Accordingly, the article concludes that a philosophy of harm reduction grounded in the public health perspective is inadequate for mitigating secondary harms arising from Australia's efforts to combat international illicit drug trafficking. A tentative list of secondary harm mitigation principles is presented and the article argues that secondary harm mitigation should replace supply reduction as a core tenet of Australia's National Drug Strategy. The article also concludes that secondary harm mitigation may provide a viable framework for stimulating a productive dialogue between those who advocate prohibition and those who call for decriminalisation at the global level. Copyright © 2017 Elsevier B.V. All rights reserved.

State humanitarian verticalism versus universal health coverage: a century of French international health assistance revisited.

PubMed

Atlani-Duault, Laëtitia; Dozon, Jean-Pierre; Wilson, Andrew; Delfraissy, Jean-François; Moatti, Jean-Paul

2016-05-28

The French contribution to global public health over the past two centuries has been marked by a fundamental tension between two approaches: State-provided universal free health care and what we propose to call State humanitarian verticalism. Both approaches have historical roots in French colonialism and have led to successes and failures that continue until the present day. In this paper, the second in The Lancet's Series on France, we look at how this tension has evolved. During the French colonial period (1890s to 1950s), the Indigenous Medical Assistance structure was supposed to bring metropolitan France's model of universal and free public health care to the colonies, and French State imperial humanitarianism crystallised in vertical programmes inspired by Louis Pasteur, while vying with early private humanitarian activism in health represented by Albert Schweitzer. From decolonisation to the end of the Cold War (1960-99), French assistance to newly independent states was affected by sans frontièrisme, Health for All, and the AIDS pandemic. Since 2000, France has had an active role in development of global health initiatives and favoured multilateral action for health assistance. Today, with adoption of the 2030 Sustainable Development Goals and the challenges of non-communicable diseases, economic inequality, and climate change, French international health assistance needs new direction. In the context of current debate over global health as a universal goal, understanding and acknowledging France's history could help strengthen advocacy in favour of universal health coverage and contribute to advancing global equity through income redistribution, from healthy populations to people who are sick and from wealthy individuals to those who are poor. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

Identifying humanitarian crises in population surveillance field sites: simple procedures and ethical imperatives.

PubMed

Fottrell, E; Byass, P

2009-02-01

Effective early warning systems of humanitarian crises may help to avert substantial increases in mortality and morbidity, and prevent major population movements. The Butajira Rural Health Programme (BRHP) in Ethiopia has maintained a programme of epidemiological surveillance since 1987. Inspection of the BRHP data revealed large peaks of mortality in 1998 and 1999, well in excess of the normally observed year-to-year variation. Further investigation and enquiry revealed that these peaks related to a measles epidemic, and a serious episode of drought and consequent food insecurity that went undetected by the BRHP. This paper applies international humanitarian crisis threshold definitions to the BRHP data in an attempt to identify suitable mortality thresholds that may be used for the prospective detection of humanitarian crises in population surveillance sites in developing countries. Empirical investigation using secondary analysis of longitudinal population-based cohort data. The daily, weekly and monthly thresholds for crises in Butajira were applied to mortality data for the 5-year period incorporating the crisis periods of 1998-1999. Days, weeks and months in which mortality exceeded each threshold level were identified. Each threshold level was assessed in terms of prospectively identifying the true crisis periods in a timely manner whilst avoiding false alarms. The daily threshold definition is too sensitive to accurately detect impending or real crises in the population surveillance setting of the BRHP. However, the weekly threshold level is useful in identifying important increases in mortality in a timely manner without the excessive sensitivity of the daily threshold. The weekly threshold level detects the crisis periods approximately 2 weeks before the monthly threshold level. Mortality measures are highly specific indicators of the health status of populations, and simple procedures can be used to apply international crisis threshold definitions in

Assessing Complex Emergency Management with Clinical Case-Vignettes: A Validation Study

PubMed Central

2015-01-01

Objective To evaluate whether responses to dynamic case-vignettes accurately reflect actual practices in complex emergency situations. We hypothesized that when obstetricians were faced with vignette of emergency situation identical to one they previously managed, they would report the management strategy they actually used. On the other hand, there is no reason to suppose that their response to a vignette based on a source case managed by another obstetrician would be the same as the actual management. Methods A multicenter vignette-based study was used in 7 French maternity units. We chose the example of severe postpartum hemorrhage (PPH) to study the use of case-vignettes for assessing the management of complex situations. We developed dynamic case-vignettes describing incidents of PPH in several steps, using documentation in patient files. Vignettes described the postpartum course and included multiple-choice questions detailing proposed clinical care. Each participating obstetrician was asked to evaluate 4 case-vignettes: 2 directly derived from cases they previously managed and 2 derived from other obstetricians’ cases. We compared the final treatment decision in vignette responses to those documented in the source-case by the overall agreement and the Kappa coefficient, both for the cases the obstetricians previously managed and the cases of others. Results Thirty obstetricians participated. Overall agreement between final treatment decisions in case-vignettes and documented care for cases obstetricians previously managed was 82% (Kappa coefficient: 0.75, 95% CI [0.62–0.88]). Overall agreement between final treatment decisions in case-vignettes and documented care in vignettes derived from other obstetricians’ cases was only 48% (Kappa coefficient: 0.30, 95% CI [0.12–0.48]). Final agreement with documented care was significantly better for cases based on their own previous cases than for others (p<0.001). Conclusions Dynamic case-vignettes accurately

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

Public health implications of complex emergencies and natural disasters.

PubMed

Culver, Amanda; Rochat, Roger; Cookson, Susan T

2017-01-01

During the last decade, conflict or natural disasters have displaced unprecedented numbers of persons. This leads to conditions prone to outbreaks that imperil the health of displaced persons and threaten global health security. Past literature has minimally examined the association of communicable disease outbreaks with complex emergencies (CEs) and natural disasters (NDs). To examine this association, we identified CEs and NDs using publicly available datasets from the Center for Research on the Epidemiology of Disasters and United Nations Flash and Consolidated Appeals archive for 2005-2014. We identified outbreaks from World Health Organization archives. We compared findings to identify overlap of outbreaks, including their types (whether or not of a vaccine-preventable disease), and emergency event types (CE, ND, or Both) by country and year using descriptive statistics and measure of association. There were 167 CEs, 912 NDs, 118 events linked to 'Both' types of emergencies, and 384 outbreaks. Of CEs, 43% were associated with an outbreak; 24% NDs were associated with an outbreak; and 36% of 'Both' types of emergencies were associated with an outbreak. Africa was disproportionately affected, where 67% of total CEs, 67% of 'Both' events (CE and ND), and 46% of all outbreaks occurred for the study period. The odds ratio of a vaccine-preventable outbreak occurring in a CE versus an ND was 4.14 (95% confidence limits 1.9, 9.4). CEs had greater odds of being associated with outbreaks compared with NDs. Moreover, CEs had high odds of a vaccine-preventable disease causing that outbreak. Focusing on better vaccine coverage could reduce CE-associated morbidity and mortality by preventing outbreaks from spreading.

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…

Cost Analysis of U.S. Navy Humanitarian Assistance and Disaster Relief Missions

DTIC Science & Technology

2014-12-01

93943–5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING /MONITORING AGENCY NAME(S) AND ADDRESS(ES) N/ A 10. SPONSORING/MONITORING AGENCY...as a core competency to its maritime strategy. From 1970 to 2000, the Navy diverted vessels 366 times for HA/DR operations, as opposed to 22 times...Humanitarian Assistance and Disaster Relief as a core competency to its maritime strategy. From 1970 to 2000, the Navy diverted vessels 366 times for HA/DR

Simple Emergent Power Spectra from Complex Inflationary Physics

NASA Astrophysics Data System (ADS)

Dias, Mafalda; Frazer, Jonathan; Marsh, M. C. David

2016-09-01

We construct ensembles of random scalar potentials for Nf-interacting scalar fields using nonequilibrium random matrix theory, and use these to study the generation of observables during small-field inflation. For Nf=O (few ), these heavily featured scalar potentials give rise to power spectra that are highly nonlinear, at odds with observations. For Nf≫1 , the superhorizon evolution of the perturbations is generically substantial, yet the power spectra simplify considerably and become more predictive, with most realizations being well approximated by a linear power spectrum. This provides proof of principle that complex inflationary physics can give rise to simple emergent power spectra. We explain how these results can be understood in terms of large Nf universality of random matrix theory.

Simple Emergent Power Spectra from Complex Inflationary Physics.

PubMed

Dias, Mafalda; Frazer, Jonathan; Marsh, M C David

2016-09-30

We construct ensembles of random scalar potentials for N_{f}-interacting scalar fields using nonequilibrium random matrix theory, and use these to study the generation of observables during small-field inflation. For N_{f}=O(few), these heavily featured scalar potentials give rise to power spectra that are highly nonlinear, at odds with observations. For N_{f}≫1, the superhorizon evolution of the perturbations is generically substantial, yet the power spectra simplify considerably and become more predictive, with most realizations being well approximated by a linear power spectrum. This provides proof of principle that complex inflationary physics can give rise to simple emergent power spectra. We explain how these results can be understood in terms of large N_{f} universality of random matrix theory.

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

Complexation of Contaminants and Aqueous-Phase Ozone with Cyclodextrin for Emerging Contaminant Oxidative Degradation

NASA Astrophysics Data System (ADS)

Khan, N. A.; Carroll, K. C.

2016-12-01

Recalcitrant emerging contaminants in groundwater, such as 1,4-dioxane, require strong oxidants for complete mineralization, whereas strong oxidant efficacy for in-situ chemical oxidation (ISCO) is limited by oxidant decay, reactivity, and non-specificity. Hydroxypropyl-β-cyclodextrin (HPβCD) was examined for its ability to stabilize aqueous phase ozone (O3) and prolong oxidation potential through inclusion complex formation. Partial transformation of HPβCD by O3 was observed but HPβCD proved to be sufficiently resilient and only partially degraded in the presence of O3. The formation of a HPβCD:O3 inclusion clathrate complex was observed, and multiple methods for binding constant measurements carried out and compared for HPβCD complexes with O3 and multiple contaminants. The presence of HPβCD increased the O3 half-life linearly with increasing HPβCD:O3 molar ratio. The O3 half-life in solutions increased by as much as 40-fold relative to HPβCD-free O3 solutions, and complexation reversibility was confirmed. Decay rate coefficients increased for 1,4-dioxane, trichloroethene, and trichloroethane likely due to the formation of HPβCD-O3-contaminant ternary complexes. These results suggest that the use of clathrate stabilizers, such as HPβCD, can support the development of a facilitated-transport enabled ISCO for the O3 treatment of groundwater impacted by recalcitrant emerging contaminants.

[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.

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

[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.

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.

Complex systems thinking in emergency medicine: A novel paradigm for a rapidly changing and interconnected health care landscape.

PubMed

Widmer, Matthew A; Swanson, R Chad; Zink, Brian J; Pines, Jesse M

2017-12-27

The specialty of emergency medicine is experiencing the convergence of a number of transformational forces in the United States, including health care reform, technological advancements, and societal shifts. These bring both opportunity and uncertainty. 21ST CENTURY CHALLENGES: Persistent challenges such as the opioid epidemic, rising health care costs, misaligned incentives, patients with multiple chronic diseases, and emergency department crowding continue to plague the acute, unscheduled care system. The traditional approach to health care practice and improvement-reductionism-is not adequate for the complexity of the twenty-first century. Reductionist thinking will likely continue to produce unintended consequences and suboptimal outcomes. Complex systems thinking provides a perspective and set of tools better suited for the challenges and opportunities facing public health in general, and emergency medicine more specifically. This article introduces complex systems thinking and argues for its application in the context of emergency medicine by drawing on the history of the circumstances surrounding the formation of the specialty and by providing examples of its application to several practice challenges. © 2017 John Wiley & Sons, Ltd.

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.

Integrated care in the emergency department: a complex adaptive systems perspective.

PubMed

Nugus, Peter; Carroll, Katherine; Hewett, David G; Short, Alison; Forero, Roberto; Braithwaite, Jeffrey

2010-12-01

Emergency clinicians undertake boundary-work as they facilitate patient trajectories through the Emergency Department (ED). Emergency clinicians must manage the constantly-changing dynamics at the boundaries of the ED and other hospital departments and organizations whose services emergency clinicians seek to integrate. Integrating the care that differing clinical groups provide, the services EDs offer, and patients' needs across this journey is challenging. The journey is usually accounted for in a linear way - as a "continuity of care" problem. In this paper, we instead conceptualize integrated care in the ED using a complex adaptive systems (CAS) perspective. A CAS perspective accounts for the degree to which other departments and units outside of the ED are integrated, and appropriately described, using CAS concepts and language. One year of ethnographic research was conducted, combining observation and semi-structured interviews, in the EDs of two tertiary referral hospitals in Sydney, Australia. We found the CAS approach to be salient to analyzing integrated care in the ED because the processes of categorization, diagnosis and discharge are primarily about the linkages between services, and the communication and negotiation required to enact those linkages, however imperfectly they occur in practice. Emergency clinicians rapidly process large numbers of high-need patients, in a relatively efficient system of care inadequately explained by linear models. A CAS perspective exposes integrated care as management of the patient trajectory within porous, shifting and negotiable boundaries. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

Fluid technologies: The Bush Pump, the LifeStraw and microworlds of humanitarian design.

PubMed

Redfield, Peter

2016-04-01

Over the past decade, many ingenious, small-scale gadgets have appeared in response to problems of disaster and extreme poverty. Focusing on the LifeStraw, a water filtration device invented by the company Vestergaard Frandsen, I situate this wave of humanitarian design relative to Marianne de Laet and Annemarie Mol's classic article on the Zimbabwe Bush Pump. The LifeStraw shares the Bush Pump's principle of technical minimalism, as well as its ethical desire to improve the lives of communities. Unlike the pump, however, the straw defines itself through rather than against market logic, accepting the premise that one can 'do well while doing good'. Moreover, it does not share the assumed framework of de Laet and Mol's Zimbabwean socio-technical landscape: a postcolonial state happily en route to national self-definition. Nonetheless, it clearly embodies moral affect, if in the idiom of humanitarian concern rather than development. My aim is to open up three interrelated lines of inquiry for discussion. First, I consider aspects of a postcolonial condition at the micro-level of immediate needs, including assumptions about nation-state politics and markets. Second, I emphasize science and technology in the form of infrastructure, the material frontline of norms. Third, I return reflexively to love, and the complicated allure of engagement in academic work.

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

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

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

Channel-transporter complexes: an emerging theme in cell signaling.

PubMed

Abbott, Geoffrey W

2016-11-01

In a recent edition of Biochemical Journal, Mistry et al. described the discovery of a novel protein complex, formed from the epithelial sodium channel (ENaC) and the sodium chloride cotransporter (NCC) [Mistry et al. (2016) Biochem. J. 473, 3237–3252]. The importance of these two proteins in the regulation of salt balance and blood pressure has long been known, as has their overlapping expression in the distal convoluted tubule of the kidney. The new study by Mistry et al. now demonstrates their physical interaction in the kidney and when heterologously co-expressed. Furthermore, the authors demonstrate some degree of functional co-dependence between ENaC and NCC, with pharmacological inhibition of the latter diminishing activity of the former when the two are co-assembled. This novel and potentially important interaction adds to a growing number of recently identified channel-transporter ('chansporter') complexes, which together constitute an emerging theme in cell signaling. © 2016 The Author(s); published by Portland Press Limited on behalf of the Biochemical Society.

Variations in task constraints shape emergent performance outcomes and complexity levels in balancing.

PubMed

Caballero Sánchez, Carla; Barbado Murillo, David; Davids, Keith; Moreno Hernández, Francisco J

2016-06-01

This study investigated the extent to which specific interacting constraints of performance might increase or decrease the emergent complexity in a movement system, and whether this could affect the relationship between observed movement variability and the central nervous system's capacity to adapt to perturbations during balancing. Fifty-two healthy volunteers performed eight trials where different performance constraints were manipulated: task difficulty (three levels) and visual biofeedback conditions (with and without the center of pressure (COP) displacement and a target displayed). Balance performance was assessed using COP-based measures: mean velocity magnitude (MVM) and bivariate variable error (BVE). To assess the complexity of COP, fuzzy entropy (FE) and detrended fluctuation analysis (DFA) were computed. ANOVAs showed that MVM and BVE increased when task difficulty increased. During biofeedback conditions, individuals showed higher MVM but lower BVE at the easiest level of task difficulty. Overall, higher FE and lower DFA values were observed when biofeedback was available. On the other hand, FE reduced and DFA increased as difficulty level increased, in the presence of biofeedback. However, when biofeedback was not available, the opposite trend in FE and DFA values was observed. Regardless of changes to task constraints and the variable investigated, balance performance was positively related to complexity in every condition. Data revealed how specificity of task constraints can result in an increase or decrease in complexity emerging in a neurobiological system during balance performance.

Satisfaction with the humanitarian response to the 2010 Pakistan floods: a call for increased accountability to beneficiaries.

PubMed

Kirsch, Thomas; Siddiqui, Muhammad Ahmed; Perrin, Paul Clayton; Robinson, W Courtland; Sauer, Lauren M; Doocy, Shannon

2013-07-01

Ascertain recipients' level of satisfaction with humanitarian response efforts. A multi-stage, 80×20 cluster sample randomized survey (1800 households) with probability proportional to size of households affected by the 2010 Indus river floods in Pakistan. The floods affected over 18 million households and led to more than 8 billion USD in response dollars. Less than 20% of respondents reported being satisfied with response, though a small increase in satisfaction levels was observed over the three time periods of interest. Within the first month, receipt of hygiene items, food and household items was most strongly predictive of overall satisfaction. At 6 months, positive receipt of medicines was also highly predictive of satisfaction. The proportion of households reporting unmet needs remained elevated throughout the 6-month period following the floods and varied from 50% to 80%. Needs were best met between 1 and 3 months postflood, when response was at its peak. Unmet needs were the greatest at 6 months, when response was being phased down. Access-limiting issues were rarely captured during routine monitoring and evaluation efforts and seem to be a significant predictor in dissatisfaction with relief efforts, at least in the case of Pakistan, another argument in favor of independent, population-based surveys of this kind. There is also need to better identify and serve those not residing in camps. Direct surveys of the affected population can be used operationally to assess ongoing needs, more appropriately redirect humanitarian resources, and ultimately, judge the overall quality of a humanitarian response.

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

Camel milk, amoxicillin, and a prayer: medical pluralism and medical humanitarian aid in the Somali Region of Ethiopia.

PubMed

Carruth, Lauren

2014-11-01

This paper details how exposure to new clinics, diagnostic technologies, and pharmaceuticals during humanitarian relief operations in the Somali Region of Ethiopia shaped local pluralistic health systems and altered the ways in which residents subsequently conceived of and treated illness and disease. Despite rising demand for pharmaceuticals and diagnostic technologies among Somalis in Ethiopia, local ethnophysiologies continued to draw upon popular ideas about humoral flows, divine action, and spirit possession. Demands for therapeutic camel milk, Qur'anic spiritual healing, herbal remedies, and other historically popular therapies persisted, but were shaped by concurrent demands for and understandings of diagnostic biotechnologies and pharmaceutical medications. The reverse was also true: contemporary understandings and uses of non-biomedical healing modalities among Somalis shaped evaluations of clinical care, including healthcare during humanitarian responses. To illustrate these phenomena, based on ethnographic research in eastern Ethiopia between 2007 and 2009, this paper explores three topics vital to Somalis' pluralistic healthcare systems: camel milk and the management of digestive bile; women's experiences and clinical presentations with pain and disorder in their reproductive systems; and the rising popularity of high-tech diagnostic tests. I conclude that medical humanitarian aid never happens in a vacuum or among truly treatment-naïve populations. Instead, aid unfolds within ever-changing and pluralistic health cultures, and it permanently alters and is altered by the frames within which people evaluate and make future decisions about healthcare. Copyright © 2014 Elsevier Ltd. 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...

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.

Innovations in research ethics governance in humanitarian settings.

PubMed

Schopper, Doris; Dawson, Angus; Upshur, Ross; Ahmad, Aasim; Jesani, Amar; Ravinetto, Raffaella; Segelid, Michael J; Sheel, Sunita; Singh, Jerome

2015-02-26

Médecins Sans Frontières (MSF) is one of the world's leading humanitarian medical organizations. The increased emphasis in MSF on research led to the creation of an ethics review board (ERB) in 2001. The ERB has encouraged innovation in the review of proposals and the interaction between the ERB and the organization. This has led to some of the advances in ethics governance described in this paper. We first update our previous work from 2009 describing ERB performance and then highlight five innovative practices: • A new framework to guide ethics review • The introduction of a policy exempting a posteriori analysis of routinely collected data • The preapproval of "emergency" protocols • General ethical approval of "routine surveys" • Evaluating the impact of approved studies. The new framework encourages a conversation about ethical issues, rather than imposing quasi-legalistic rules, is more engaged with the specific MSF research context and gives greater prominence to certain values and principles. Some of the innovations implemented by the ERB, such as review exemption or approval of generic protocols, may run counter to many standard operating procedures. We argue that much standard practice in research ethics review ought to be open to challenge and revision. Continued interaction between MSF researchers and independent ERB members has allowed for progressive innovations based on a trustful and respectful partnership between the ERB and the researchers. In the future, three areas merit particular attention. First, the impact of the new framework should be assessed. Second, the impact of research needs to be defined more precisely as a first step towards being meaningfully assessed, including changes of impact over time. Finally, the dialogue between the MSF ERB and the ethics committees in the study countries should be enhanced. We hope that the innovations in research ethics governance described may be relevant for other organisations carrying out

Environmental Assessment (EA): Proposed Emergency Power Unit Overhaul Complex at Little Mountain Test Annex, Utah

DTIC Science & Technology

2014-03-14

NUMBER FA8201-09-D-0002 Overhaul Complex at Little Mountain Test Annex, Utah 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Streamline Consulting, LLC 1713 N. Sweetwater Lane Farmington, Utah 84025...Hill Air Force Base (AFB) proposes to construct a new emergency power unit overhaul complex at Little Mountain Test Annex, Utah . Buildings 2005

Practice variability in the management of complex febrile seizures by pediatric emergency physicians and fellows.

PubMed

Sales, Justin W; Bulloch, Blake; Hostetler, Mark A

2011-05-01

Febrile seizures are the most common type of childhood seizure and are categorized as simple or complex. Complex febrile seizures (CFSs) are defined as events that are focal, prolonged (> 15 minutes), or recurrent. The management of CFS is poorly defined. The objective of this study was to determine the degree of variability in the emergency department evaluation of children with CFSs. An online survey questionnaire was developed and sent to physicians identified via the listserv of the emergency medicine section of the American Academy of Pediatrics and the pediatric emergency medicine discussion list. The questionnaire consisted of five hypothetical case vignettes describing children under 5 years of age presenting with a CFS. Following review of the first four vignettes, participants were asked if they would (1) obtain blood and urine for evaluation; (2) perform a lumbar puncture; (3) perform neurologic imaging while the child was in the emergency department; (4) admit the child to the hospital; or (5) discharge with follow-up as an outpatient, with either the primary care provider or a neurologist. The final vignette determined if antiepileptic medication would be prescribed by the physician on discharge. Of the 353 physicians who participated, 293 (83%) were pediatric emergency medicine attending physicians and 60 (17%) were pediatric emergency medicine fellows. Overall, 54% of participants indicated that they would obtain blood for evaluation, 62% would obtain urine, 34% would perform a lumbar puncture, and 36% would perform neurologic imaging. The overall hypothetical admission rate for the case vignettes was 42%. This study indicates that extensive variability exists in the emergency department approach to patients with CFS. Our findings suggest that optimal management for CFS remains unclear and support the potential benefit of future prospective studies on this subject.

Evidence for a complex of emergent poleroviruses affecting pepper worldwide.

PubMed

Fiallo-Olivé, Elvira; Navas-Hermosilla, Elisa; Ferro, Camila G; Zerbini, F Murilo; Navas-Castillo, Jesús

2018-05-01

In recent years, symptoms of vein yellowing and leaf roll in pepper crops associated with the presence of poleroviruses (genus Polerovirus, family Luteoviridae) have been emerging in many countries worldwide. Spain was the first country in Europe where the yellowing disease of pepper was observed. In this work, a polerovirus isolate from Spain that infects pepper and has been shown to be transmitted by the aphid Aphis gossyppii (Spain-Almería 2-2013) was sequenced and compared with isolates from Japan, Israel, China and Australia. The genome (6125 nt in length, GenBank accession number KY523072) of the isolate from Spain has the typical organization of poleroviruses and contains seven open reading frames (ORF0 to ORF5 and ORF3a), putatively encoding proteins P0 to P5 and P3a. A comparison of the sequence from Spain with the four complete sequences available for poleroviruses infecting pepper showed a closer relationship to the isolate from Israel and supports the existence of a complex of at least five polerovirus species. Given that the symptoms caused by all pepper poleroviruses described to date are similar, if not identical, we propose to name them "pepper vein yellows virus 1" to "pepper vein yellows virus 5" (PeVYV-1 to PeVYV-5), with PeVYV-5 corresponding to the polerovirus from Spain described in this work. Our results and those published over the last few years have shown that the emergent poleroviruses threatening pepper crops around the world are highly complex due to recombination events.

From Humanitarian Intervention to the Responsibility to Protect: From Kosovo to Libya and Beyond

DTIC Science & Technology

2011-12-01

attacking bridges, highways, airports, telecommunications facilities, electrical production, factories, and oil refineries. 13 Many of these targets...22, no. 3 (September 2008): 285. 29 MAJ Helene E. Caras , ―Humanitarian Intervention in Kosovo: The Importance of Legal and Moral Issues‖ (monograph...Libya resolution to crusades.‖ reuters.com. 21 March 2011. http://www.reuters.com/article/2011/03/21/us-libya-russia-idUSTRE72K3JR20110321. Caras

Operation PATWIN: HMS DARING's experience of providing humanitarian disaster relief following super-Typhoon Haiyan.

PubMed

Butterworth, S J

2014-01-01

Super-Typhoon Haiyan struck the Philippines on 7 November 2013. The initial reports estimated 10 000 fatalities and four million displaced persons. As the United Kingdom's initial response to this disaster, HMS DARING was diverted from her deployment to take part in humanitarian aid, named Operation PATWIN. This article will outline the medical aspects of the relief effort undertaken and aim to identify any lessons that may inform future operations.

Emerging and re-emerging infections.

PubMed

Lim, V K

1999-06-01

An emerging infection is defined as an infection which has newly appeared in a population while a re-emerging infection is one which has existed in the past but its incidence is rapidly increasing. The reasons for the emergence and re-emergence of infections are not well understood but appear to be associated with factors that involve the pathogen, the host and the environment. These factors are often inter-related and act together in a complex manner to bring about changes in patterns of infection. Pathogens are extremely resourceful and possess mechanisms to adapt to new hosts and environments as well as to acquire new virulence traits. Host factors include herd immunity, social behaviour and demographics. Environmental factors like the climate, deforestation and new technologies have an impact on the emergence of infections. The challenge is to contain an infection when it emerges but more importantly to prevent its emergence in the first place. As the emergence of an infection is complex and multifactorial, a multidisciplinary approach is required. Health based strategies alone are insufficient. Social, economic and environmental measures and the political will to implement appropriate policies are equally important.

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.

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…

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.

[The Humanitarian Consultation-hour in Frankfurt am Main: Utilization by Gender, Age, Country of Origin].

PubMed

Schade, M; Heudorf, U; Tiarks-Jungk, P

2015-07-01

The humanitarian consultation-hour is a voluntary, anonymous offer provided by the City of Frankfurt am Main, which was established in December 2001. Here, people without health insurance or undocumented migrants can be treated for free. The aim of this analysis is to investigate the utilization of the consultation-hour by gender, age, country of origin and diagnosis since 2008. The digital data documentation is available since 2008. Data from the years 2008-2013 were considered. The examination date, the date of birth, sex, country of origin, frequency of visits, diseases and medication amongst other data were examined. In the period from 2008 to 2013, 8,574 consultations were counted and 2,384 patients were treated during office hours. The amount of consultations has doubled between 2008 (n=673) and 2009 (n=1,154) and is rising steadily since then (1,911 visits in 2013). The majority of patients come from Africa. Since 2008, an increase of patients from Bulgaria and Romania has been recorded. Approximately two-thirds of the patients are female, one third male. One fifth of those seeking help are children and adolescents under 20 years and adults over 60 years. The most common age group is between 20-40 years old. The main diagnoses include diseases of the cardiovascular and vascular system and the musculoskeletal system, metabolic diseases (diabetes mellitus), digestive diseases and pregnancy/childbirth. The humanitarian consultation-hour is an important offer provided by the Public Health Department of the City of Frankfurt am Main and is used by a large number of people who are seeking help. In particular, people from South Eastern Europe are increasingly visiting the consultation-hour. Activities such as the humanitarian consultation-hour can take over subsidiary activities for a transitional period, however long-term structural solutions must be provided to ensure access to health care for this vulnerable group. © Georg Thieme Verlag KG Stuttgart · New York.

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.

A Study on the Validity of a Task Complexity Measure for Emergency Operating Procedures of Nuclear Power Plants—Comparing With a Subjective Workload

NASA Astrophysics Data System (ADS)

Park, J.; Jung, W.

2006-10-01

In this study, the appropriateness of the task complexity (TACOM) measure that can quantify the complexity of emergency tasks was investigated by comparing subjective workload scores with the associated TACOM scores. To this end, based on the NASA-TLX (task load index) technique, 18 operators were asked to subjectively estimate perceived workload for 23 emergency tasks that were specified in the emergency operating procedures of the reference nuclear power plants. As the result of comparisons, it was observed that subjective workload scores increase in proportion to the increase of TACOM scores. Therefore, it is expect that the TACOM measure can be used as a serviceable method to quantify the complexity of emergency tasks

Using mLearning and MOOCs to Understand Chaos, Emergence, and Complexity in Education

ERIC Educational Resources Information Center

deWaard, Inge; Abajian, Sean; Gallagher, Michael Sean; Hogue, Rebecca; Keskin, Nilgun; Koutropoulos, Apostolos; Rodriguez, Osvaldo C.

2011-01-01

In this paper, we look at how the massive open online course (MOOC) format developed by connectivist researchers and enthusiasts can help analyze the complexity, emergence, and chaos at work in the field of education today. We do this through the prism of a MobiMOOC, a six-week course focusing on mLearning that ran from April to May 2011. MobiMOOC…

Long-running telemedicine networks delivering humanitarian services: experience, performance and scientific output

PubMed Central

Geissbuhler, Antoine; Jethwani, Kamal; Kovarik, Carrie; Person, Donald A; Vladzymyrskyy, Anton; Zanaboni, Paolo; Zolfo, Maria

2012-01-01

Abstract Objective To summarize the experience, performance and scientific output of long-running telemedicine networks delivering humanitarian services. Methods Nine long-running networks – those operating for five years or more– were identified and seven provided detailed information about their activities, including performance and scientific output. Information was extracted from peer-reviewed papers describing the networks’ study design, effectiveness, quality, economics, provision of access to care and sustainability. The strength of the evidence was scored as none, poor, average or good. Findings The seven networks had been operating for a median of 11 years (range: 5–15). All networks provided clinical tele-consultations for humanitarian purposes using store-and-forward methods and five were also involved in some form of education. The smallest network had 15 experts and the largest had more than 500. The clinical caseload was 50 to 500 cases a year. A total of 59 papers had been published by the networks, and 44 were listed in Medline. Based on study design, the strength of the evidence was generally poor by conventional standards (e.g. 29 papers described non-controlled clinical series). Over half of the papers provided evidence of sustainability and improved access to care. Uncertain funding was a common risk factor. Conclusion Improved collaboration between networks could help attenuate the lack of resources reported by some networks and improve sustainability. Although the evidence base is weak, the networks appear to offer sustainable and clinically useful services. These findings may interest decision-makers in developing countries considering starting, supporting or joining similar telemedicine networks. PMID:22589567

Determining medical staffing requirements for humanitarian assistance missions.

PubMed

Negus, Tracy L; Brown, Carrie J; Konoske, Paula

2010-01-01

The primary mission of hospital ships is to provide acute medical and surgical services to U.S. forces during military operations. Hospital ships also provide a hospital asset in support of disaster relief and humanitarian assistance (HA) operations. HA missions afford medical care to populations with vastly different sets of medical conditions from combat casualty care, which affects staffing requirements. Information from a variety of sources was reviewed to better understand hospital ship HA missions. Factors such as time on-site and location shape the mission and underlying goals. Patient encounter data from previous HA missions were used to determine expected patient conditions encountered in various HA operations. These data points were used to project the medical staffing required for future missions. Further data collection, along with goal setting, must be performed to accomplish successful future HA missions. Refining staffing requirements allows deployments to accomplish needed HA and effectively reach underserved areas.

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.

The Legality of Nuclear Weapons Employment under the International Humanitarian Law of Coercion Control.

DTIC Science & Technology

1987-01-01

fm$0 TELMT OF NUICLEMR IdERPONiS EMPLOYMENT UNDERTH 1/ I INTERNRTIOSEL NUIfI.. (U) AIR FORCE INST OF TECH I NRIONT-PATTERSON AFI ON R R PRICE 1967...Coercion Control c. Rank: Major d. Service: United States Air Force e. Date: 1987 I . Number of pages: 106 g. Degree awarded: Master ot Laws (LL.M.) in...33 A. Sources of International Humanitarian Law ............ 33 B. Use of Coercive Force Under International Law ..... 34 C. Basis Principles

Burden of injury during the complex political emergency in northern Uganda

PubMed Central

Lett, Ronald R.; Kobusingye, Olive Chifefe; Ekwaru, Paul

2006-01-01

Background War injury is a public health problem that warrants global attention. This study aims to determine the burden of injury during a complex emergency in sub-Saharan Africa. Methods To determine the magnitude, causes, distribution, risk factors and cumulative burden of injury in a population experiencing armed conflict in northern Uganda since 1986 and to evaluate the living conditions and access to care for injury victims, we took a multistage, stratified, random sampling from the Gulu district to determine the rates of injury from 1994 to 1999. The Gulu district is endemic for malaria, tuberculosis, HIV and malnutrition and has a high maternal death rate. It is 1 of 3 districts in northern Uganda affected by war since 1986. The study participants included 8595 people from 1475 households. Of these, 73.0% lived in temporary housing, 46.0% were internally displaced and 81.0% were under 35 years of age. Trained interviewers administered a 3-part household survey in the local language. Quantitative data on injury, household environment, health care and demography were analyzed. Qualitative data from part 3 of the survey will be reported elsewhere. A similar rural district (Mukono) not affected by war was used for comparison. We studied injury risk factors, mortality and disability rates, accumulated deaths, access to care and living conditions. Results Of the study population, 14% were injured annually: gunshot injuries were the leading cause of death. The annual death rate from war injury was 7.8/1000 (95% confidence interval [CI] 7.0–8.5) and the disability rate was 11.3/1000 (95% CI 10.4–12.2). The annual excess injury mortality was 6.85/1000. Only 4.5% of the injured were combatants. Fifty percent of the injured received first aid, but only 13.0% of those who died reached hospital. The injury mortality in Gulu was 8.35-fold greater than that for Mukono. Conclusions The crisis in Gulu can be considered a complex political emergency. Protracted conflicts

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

PubMed

Akl, Elie A; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

2015-01-01

Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination

The Syrian conflict: a case study of the challenges and acute need for medical humanitarian operations for women and children internally displaced persons.

PubMed

Aburas, Rahma; Najeeb, Amina; Baageel, Laila; Mackey, Tim K

2018-05-11

After 7 years of increasing conflict and violence, the Syrian civil war now constitutes the largest displacement crisis in the world, with more than 6 million people who have been internally displaced. Among this already-vulnerable population group, women and children face significant challenges associated with lack of adequate access to maternal and child health (MCH) services, threatening their lives along with their immediate and long-term health outcomes. While several health and humanitarian aid organizations are working to improve the health and welfare of internally displaced Syrian women and children, there is an immediate need for local medical humanitarian interventions. Responding to this need, we describe the case study of the Brotherhood Medical Center (the "Center"), a local clinic that was initially established by private donors and later partnered with the Syrian Expatriate Medical Association to provide free MCH services to internally displaced Syrian women and children in the small Syrian border town of Atimah. The Center provides a unique contribution to the Syrian health and humanitarian crisis by focusing on providing MCH services to a targeted vulnerable population locally and through an established clinic. Hence, the Center complements efforts by larger international, regional, and local organizations that also are attempting to alleviate the suffering of Syrians victimized by this ongoing civil war. However, the long-term success of organizations like the Center relies on many factors including strategic partnership building, adjusting to logistical difficulties, and seeking sustainable sources of funding. Importantly, the lessons learned by the Center should serve as important principles in the design of future medical humanitarian interventions working directly in conflict zones, and should emphasize the need for better international cooperation and coordination to support local initiatives that serve victims where and when they need it

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review

PubMed Central

Akl, Elie A.; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

2015-01-01

Background Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. Methods We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Results Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. Conclusion This systematic review provides evidence of possible effectiveness of information coordination

A psychosocial approach in humanitarian forensic action: The Latin American perspective.

PubMed

Hofmeister, Ute; Navarro, Susana

2017-11-01

Forensic humanitarian action is aimed at alleviating suffering and maintaining human dignity, with the victims and their families at the core. International recommendations emphasize the importance of psychological support and psychosocial work as an integral part of forensic investigations into missing persons. Psychosocial action does not simply refer to emotional support but is based on the idea of the individual being the holder of rights, encouraging decision taking, affirming actions, and elaborating personal and collective histories. In this framework, forensics and psychosocial sciences need to work in complementary and coordinated interaction for the benefit of the families and communities. For forensic investigations to be restorative - their ultimate humanitarian objective - there are certain additional conditions apart from those of scientific quality and ethics: respect, information and coordination are among the main pillars for forensic action with a psychosocial approach, taking into account the need to treat on an individual and collective level the continuous psychological affectations caused by the disappearance of a loved one. On this basis, psychological and psychosocial accompaniment of the victims can contribute to the victims' healing process and also improve the forensic investigations themselves. This article, which is based on the experience of two decades of practical forensic and psychosocial work in the field, explains the main psychological effects of disappearances and the resulting needs. It gives a short historical overview of the origins and developments in psychosocial support and a perspective in relation to the search for missing persons and forensic interventions in Latin America. It goes on to demonstrate how coordinated interaction among the forensic and psychosocial fields strengthens both of them to the benefit of the affected families, groups and communities. Finally, it takes up some of the international recommendations

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.

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.

The role of the community health nurse in military humanitarian operations: lessons from operation sea signal--Guantanamo Bay, Cuba.

PubMed

Samuels, G L; Sommer, M D

1997-01-01

The military humanitarian mission is an "Operation-Other-Than-War" with a goal of restoring or promoting the ability of a population to care for themselves (U.S. Army, 1990b). One of the primary foci of these operations is the medical care of the target populace. The elements and techniques of primary health care have been used for this purpose, especially as the situation of a population stabilizes and demands a community base for health care programs (Downing, 1989). The knowledge and expertise of a community health nurse is indispensable in both acute and chronic humanitarian situations in performing a comprehensive community needs assessment for the formulation of a community base for health care programs while facilitating a health care system that meets the overall needs of the population. The contributions of community health nurses assigned to Joint Task Force 160, during Operation Sea Signal, bear testimony as to the efficacy of such a "specialized" role in the care of displaced populations.

Hospital ships adrift? Part 1: a systematic literature review characterizing US Navy hospital ship humanitarian and disaster response, 2004-2012.

PubMed

Licina, Derek

2013-06-01

United States foreign policy is tied extensively to health initiatives, many related to the use of military assets. Despite substantial resource investment by the US Department of Defense (DoD) in hospital ship humanitarian assistance and disaster response missions, the impact of this investment is unclear. A systematic literature review of both peer-reviewed and grey literature using eight databases representing the international community and multiple sectors was conducted. Data on the characteristics of missions directly related to US Navy hospital ship humanitarian assistance and disaster response from 2004-2012 were extracted and documented. Of the 1445 sources reviewed, a total of 43 publications met criteria for review. Six (13.9%) met empirical documentation criteria and 37 (86.0%) were considered nonempirical expert opinions and anecdotal accounts that were primarily descriptive in nature. Overall, disaster response accounted for 67.4% (29/43) and humanitarian assistance 25.6% (11/43). Public and private sector participants produced 79.0% (34/43) and 20.9% (9/43) of the publications respectively. Of private sector publications, 88.9% (8/9) focused on disaster response compared to 61.8% (21/34) from the public sector. Of all publications meeting inclusion criteria, 81.4% (35/43) focused on medical care, 9.3% (4/43) discussed partnerships, 4.7% (2/43) training, and 4.7% (2/43) medical ethics and strategic utilization. No primary author publications from the diplomatic, development, or participating host nations were identified. One (2.3%) of the 43 publications was from a partner nation participant. Discussion Without rigorous research methods yielding valid and reliable data-based information pertaining to Navy hospital ship mission impact, policy makers are left with anecdotal reports to influence their decision-making processes. This is inadequate considering the frequency of hospital ship deployments used as a foreign policy tool and the considerable

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

Between a humanitarian ethos and the military efficiency: the early days of the Spanish Red Cross, 1864-1876.

PubMed

Arrizabalaga, Jon; García-Reyes, Juan Carlos

2011-01-01

Spain was officially represented at the preliminary international conference the "International Committee for the Assistance to Sick and Wounded Soldiers" (better known as the "Geneva Committee") organised at Geneva in October 1863; and joined the Red Cross one year later on the occasion of the first Geneva Convention in August 1864. This article explores the ambivalence between the humanitarian ethos and the military efficiency in the early Spanish Red Cross through the works of Nicasio Landa (1830-1891). A medical major of the Spanish Military Health Service, the co-founder of the Spanish section of the Red Cross in 1864, and its general inspector in 1867, Landa was its most active promoter, and responsible for its connections with the Geneva Committee and other national sections of this international association during its early times. He was not only an active correspondent, but also a prolific author of monographs, leaflets and articles in specialized and daily newspapers on humanitarianism and war medicine, in addition to being the founder of the Spanish Red Cross journal La Caridad en la Guerra in 1870.

Eating disorder emergencies: understanding the medical complexities of the hospitalized eating disordered patient.

PubMed

Cartwright, Martina M

2004-12-01

Eating disorders are maladaptive eating behaviors that typically develop in adolescence and early adulthood. Psychiatric maladies and comorbid conditions, especially insulin-dependent diabetes mellitus, frequently co-exist with eating disorders. Serious medical complications affecting all organs and tissues can develop and result in numerous emergent hospitalizations. This article reviews the pathophysiologies of anorexia nervosa, bulimia nervosa, and orthorexia nervosa and discusses the complexities associated with the treatment of medical complications seen in these patients.

Humanitarian IED clearance in Colombia

NASA Astrophysics Data System (ADS)

Hendrickx, J. M. H.; Molina, A.; Diaz, D.; Grasmueck, M.; Moreno, H. A.; Hernández, R. D.

2008-04-01

The development of Improvised Explosive Devices (IED's) by insurgents in Colombia is characterized by a quick response to counter IED measures. Many current IED's do not contain any metal parts and can have any shape or form. Due to the low metal content or the absence of any metal parts, sensors based on metal detection are not useful anymore. Due to the wide variety of sizes, shapes, and enclosure materials of current IED's, one and two-dimensional GPR sensors using a "library" of known shapes as well as acoustic sensors using material characteristic frequencies have become ineffective. Therefore, the Colombian experience strongly suggests that chemical sensors are the way for IED detection in soils since they do not depend on IED metal content, size, or shape but only on the presence of explosives, a necessary ingredient for any IED. Promising recently developed chemical sensors make use of semiconducting organic polymers (SOPs) such as FIDO and laser-induced breakdown spectroscopy (LIBS). Once an explosive has been detected, the IED needs to be identified and located. Therefore, there is a need for three-dimensional high resolution scans for identification of all subsoil features including rocks, roots, and IED's. The recently developed 3D-GPR (Ground Penetrating Radar) can map all features of the subsoil with a spatial resolution of about 2 cm or less. The objectives of this contribution are to inform about the IED problem in Colombia and how novel technologies may contribute to humanitarian IED clearance under humid tropical conditions.

The Epidemiology of Operation Stress during Continuing Promise 2011: A Humanitarian Response and Disaster Relief Mission aboard a US Navy Hospital Ship.

PubMed

Scouten, William T; Mehalick, Melissa L; Yoder, Elizabeth; McCoy, Andrea; Brannock, Tracy; Riddle, Mark S

2017-08-01

Introduction Operational stress describes individual behavior in response to the occupational demands and tempo of a mission. The stress response of military personnel involved in combat and peace-keeping missions has been well-described. The spectrum of effect on medical professionals and support staff providing humanitarian assistance, however, is less well delineated. Research to date concentrates mainly on shore-based humanitarian missions. Problem The goal of the current study was to document the pattern of operational stress, describe factors responsible for it, and the extent to which these factors impact job performance in military and civilian participants of Continuing Promise 2011 (CP11), a ship-based humanitarian medical mission. This was a retrospective study of Disease Non-Battle Injury (DNBI) data from the medical sick-call clinic and from weekly self-report questionnaires for approximately 900 US military and civilian mission participants aboard the USNS COMFORT (T-AH 20). The incidence rates and job performance impact of reported Operational Stress/Mental Health (OS/MH) issues and predictors (age, rank, occupation, service branch) of OS/MH issues (depression, anxiety) were analyzed over a 22-week deployment period. Incidence rates of OS/MH complaints from the sick-call clinic were 3.7% (4.5/1,000 persons) and 12.0% (53/1,000 persons) from the self-report questionnaire. The rate of operational stress increased as the mission progressed and fluctuated during the mission according to ship movement. Approximately 57% of the responders reported no impact on job performance. Younger individuals (enlisted ranks E4-6, officer ranks O1-3), especially Air Force service members, those who had spent only one day off ship, and those who were members of specific directorates, reported the highest rates of operational stress. The overall incidence of OS/MH complaints was low in participants of CP11 but was under-estimated by clinic-based reporting. The OS

Emergence of hysteresis loop in social contagions on complex networks.

PubMed

Su, Zhen; Wang, Wei; Li, Lixiang; Xiao, Jinghua; Stanley, H Eugene

2017-07-21

Understanding the spreading mechanisms of social contagions in complex network systems has attracted much attention in the physics community. Here we propose a generalized threshold model to describe social contagions. Using extensive numerical simulations and theoretical analyses, we find that a hysteresis loop emerges in the system. Specifically, the steady state of the system is sensitive to the initial conditions of the dynamics of the system. In the steady state, the adoption size increases discontinuously with the transmission probability of information about social contagions, and trial size exhibits a non-monotonic pattern, i.e., it first increases discontinuously then decreases continuously. Finally we study social contagions on heterogeneous networks and find that network topology does not qualitatively affect our results.

Humanitarian agencies and authoritarian states: a symbiotic relationship?

PubMed

del Valle, Hernan; Healy, Sean

2013-10-01

The relationship between humanitarian agencies and authoritarian states is of growing concern to Médecins Sans Frontières (MSF), given the recurring difficulties experienced in negotiating access and implementing operations in such contexts. The effort to negotiate and gain approval from states to operate on their territory prompts reflection on the sources of legitimacy for action. Drawing on direct field examples in two countries only very rarely examined--Turkmenistan and Uzbekistan--this paper explores MSF's attempts to offer live-saving medical care there. It shows that successful access negotiations hinged heavily on demonstrating added value (medical relevance) while simultaneously building relationships with authorities, identifying possible allies within health ministries, and hoping that such measures could promote a level of acceptance or trust needed to operate. It is clear that the operational space achieved is bound to remain limited and fragile, and that many compromises have to be considered and judged against ethical principles and the overall impact of the intervention. © 2013 The Author(s). Disasters © Overseas Development Institute, 2013.

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

Geoengineering: re-making climate for profit or humanitarian intervention?

PubMed

Buck, Holly Jean

2012-01-01

Climate engineering, or geoengineering, refers to large-scale climate interventions to lower the earth's temperature, either by blocking incoming sunlight or removing carbon dioxide from the biosphere. Regarded as ‘technofixes’ by critics, these strategies have evoked concern that they would extend the shelf life of fossil-fuel driven socio-ecological systems for far longer than they otherwise would, or should, endure. A critical reading views geoengineering as a class project that is designed to keep the climate system stable enough for existing production systems to continue operating. This article first examines these concerns, and then goes on to envision a regime driven by humanitarian agendas and concern for vulnerable populations, implemented through international development and aid institutions. The motivations of those who fund research and implement geoengineering techniques are important, as the rationale for developing geoengineering strategies will determine which techniques are pursued, and hence which ecologies are produced. The logic that shapes the geoengineering research process could potentially influence social ecologies centuries from now.

Intelligent Multisensor Prodder for Training Operators in Humanitarian Demining

PubMed Central

Fernández, Roemi; Montes, Héctor; Armada, Manuel

2016-01-01

Manual prodding is still one of the most utilized procedures for identifying buried landmines during humanitarian demining activities. However, due to the high number of accidents reported during its practice, it is considered an outmoded and risky procedure and there is a general consensus about the need of introducing upgrades for enhancing the safety of human operators. With the aim of contributing to reduce the number of demining accidents, this paper presents an intelligent multisensory system for training operators in the use of prodders. The proposed tool is able to provide to deminers useful information in two critical issues: (a) the amount of force exerted on the target and if it is greater than the safe limit and, (b) to alert them when the angle of insertion of the prodder is approaching or exceeding a certain dangerous limit. Results of preliminary tests show the feasibility and reliability of the proposed design and highlight the potential benefits of the tool. PMID:27347963

Intelligent Multisensor Prodder for Training Operators in Humanitarian Demining.

PubMed

Fernández, Roemi; Montes, Héctor; Armada, Manuel

2016-06-24

Manual prodding is still one of the most utilized procedures for identifying buried landmines during humanitarian demining activities. However, due to the high number of accidents reported during its practice, it is considered an outmoded and risky procedure and there is a general consensus about the need of introducing upgrades for enhancing the safety of human operators. With the aim of contributing to reduce the number of demining accidents, this paper presents an intelligent multisensory system for training operators in the use of prodders. The proposed tool is able to provide to deminers useful information in two critical issues: (a) the amount of force exerted on the target and if it is greater than the safe limit and, (b) to alert them when the angle of insertion of the prodder is approaching or exceeding a certain dangerous limit. Results of preliminary tests show the feasibility and reliability of the proposed design and highlight the potential benefits of the tool.

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.

Complex Networks in Different Languages: A Study of an Emergent Multilingual Encyclopedia

NASA Astrophysics Data System (ADS)

Pembe, F. Canan; Bingol, Haluk

There is an increasing interest to the study of complex networks in an interdisciplinary way. Language, as a complex network, has been a part of this study due to its importance in human life. Moreover, the Internet has also been at the center of this study by making access to large amounts of information possible. With these ideas in mind, this work aims to evaluate conceptual networks in different languages with the data from a large and open source of information in the Internet, namely Wikipedia. As an evolving multilingual encyclopedia that can be edited by any Internet user, Wikipedia is a good example of an emergent complex system. In this paper, different from previous work on conceptual networks which usually concentrated on single languages, we concentrate on possible ways to compare the usages of different languages and possibly the underlying cultures. This also involves the analysis of local network properties around certain coneepts in different languages. For an initial evaluation, the concept "family" is used to compare the English and German Wikipedias. Although, the work is currently at the beginning, the results are promising.

Pediatric inpatient humanitarian care in combat: Iraq and Afghanistan 2002 to 2012.

PubMed

Edwards, Mary J; Lustik, Michael; Burnett, Mark W; Eichelberger, Martin

2014-05-01

The purpose of this study was to define the scope of combat- and noncombat-related inpatient pediatric humanitarian care provided from 2002 to 2012 by the United States (US) Military in Iraq and Afghanistan. A review of the Patient Administration Systems and Biostatistics Activity (PASBA) database for all admissions from 2002 to 2012 by US military hospitals in Afghanistan and Iraq for children 14 years of age and younger provided data to analyze the use of medical care. North Atlantic Treaty Organization Standardization Agreement (STANAG) injury codes provided injury cause and the ICD-codes provided diagnosis. In-hospital mortality, blood usage, number of invasive procedures, and hospital stay were analyzed by country and injury category. There were 6,273 admissions that met inclusion criteria. In Afghanistan, there were more than twice as many pediatric noncombat-related admissions (2,197) as pediatric combat-related admissions (1,095). In Iraq, the difference was minimal (1,391 noncombat vs 1,590 combat). The most common cause of noncombat-related admission in both countries was injury: primarily motor vehicle related and burns, which varied significantly by age. Older patients (older than 8 years in Afghanistan and older than 4 years in Iraq) were more likely combat victims. Mortality was highest for combat trauma in Iraq (11%) and noncombat trauma in Afghanistan (8%). The in-hospital mortality in both countries was 5% for admissions unrelated to trauma. Resource use was highest for combat trauma in both countries. Noncombat-related medical care was the primary reason for pediatric humanitarian admissions to United States military combat hospitals in Iraq and Afghanistan from 2002 to 2012. Combat-related injuries have a higher mortality than noncombat injuries or other admissions. Published by Elsevier Inc.

Collaborative Response and Recovery from a Foot-and-Mouth Disease Animal Health Emergency: Supporting Decision Making in a Complex Environment with Multiple Stakeholders

DTIC Science & Technology

2013-12-01

RESPONSE AND RECOVERY FROM A FOOT-AND- MOUTH DISEASE ANIMAL HEALTH EMERGENCY: SUPPORTING DECISION MAKING IN A COMPLEX ENVIRONMENT WITH MULTIPLE...Thesis 4. TITLE AND SUBTITLE COLLABORATIVE RESPONSE AND RECOVERY FROM A FOOT-AND- MOUTH DISEASE ANIMAL HEALTH EMERGENCY: SUPPORTING DECISION MAKING...200 words ) This thesis recommends ways to support decision makers who must operate within the multi-stakeholder complex situation of response and

Complex auditory behaviour emerges from simple reactive steering

NASA Astrophysics Data System (ADS)

Hedwig, Berthold; Poulet, James F. A.

2004-08-01

The recognition and localization of sound signals is fundamental to acoustic communication. Complex neural mechanisms are thought to underlie the processing of species-specific sound patterns even in animals with simple auditory pathways. In female crickets, which orient towards the male's calling song, current models propose pattern recognition mechanisms based on the temporal structure of the song. Furthermore, it is thought that localization is achieved by comparing the output of the left and right recognition networks, which then directs the female to the pattern that most closely resembles the species-specific song. Here we show, using a highly sensitive method for measuring the movements of female crickets, that when walking and flying each sound pulse of the communication signal releases a rapid steering response. Thus auditory orientation emerges from reactive motor responses to individual sound pulses. Although the reactive motor responses are not based on the song structure, a pattern recognition process may modulate the gain of the responses on a longer timescale. These findings are relevant to concepts of insect auditory behaviour and to the development of biologically inspired robots performing cricket-like auditory orientation.

Feasibility of a clearing house for improved cooperation between telemedicine networks delivering humanitarian services: acceptability to network coordinators.

PubMed

Wootton, Richard; Bonnardot, Laurent; Geissbuhler, Antoine; Jethwani, Kamal; Kovarik, Carrie; McGoey, Suzanne; Person, Donald A; Vladzymyrskyy, Anton; Zolfo, Maria

2012-10-09

Telemedicine networks, which deliver humanitarian services, sometimes need to share expertise to find particular experts in other networks. It has been suggested that a mechanism for sharing expertise between networks (a 'clearing house') might be useful. To propose a mechanism for implementing the clearing house concept for sharing expertise, and to confirm its feasibility in terms of acceptability to the relevant networks. We conducted a needs analysis among eight telemedicine networks delivering humanitarian services. A small proportion of consultations (5-10%) suggested that networks may experience difficulties in finding the right specialists from within their own resources. With the assistance of key stakeholders, many of whom were network coordinators, various methods of implementing a clearing house were considered. One simple solution is to establish a central database holding information about consultants who have agreed to provide help to other networks; this database could be made available to network coordinators who need a specialist when none was available in their own network. The proposed solution was examined in a desktop simulation exercise, which confirmed its feasibility and probable value. This analysis informs full-scale implementation of a clearing house, and an associated examination of its costs and benefits.

Nonlinear Synergistic Emergence and Predictability in Complex Systems: Theory and Hydro-Climatic Applications

NASA Astrophysics Data System (ADS)

Perdigão, Rui A. P.; Hall, Julia; Pires, Carlos A. L.; Blöschl, Günter

2017-04-01

Classical and stochastic dynamical system theories assume structural coherence and dynamic recurrence with invariants of motion that are not necessarily so. These are grounded on the unproven assumption of universality in the dynamic laws derived from statistical kinematic evaluation of non-representative empirical records. As a consequence, the associated formulations revolve around a restrictive set of configurations and intermittencies e.g. in an ergodic setting, beyond which any predictability is essentially elusive. Moreover, dynamical systems are fundamentally framed around dynamic codependence among intervening processes, i.e. entail essentially redundant interactions such as couplings and feedbacks. That precludes synergistic cooperation among processes that, whilst independent from each other, jointly produce emerging dynamic behaviour not present in any of the intervening parties. In order to overcome these fundamental limitations, we introduce a broad class of non-recursive dynamical systems that formulate dynamic emergence of unprecedented states in a fundamental synergistic manner, with fundamental principles in mind. The overall theory enables innovations to be predicted from the internal system dynamics before any a priori information is provided about the associated dynamical properties. The theory is then illustrated to anticipate, from non-emergent records, the spatiotemporal emergence of multiscale hyper chaotic regimes, critical transitions and structural coevolutionary changes in synthetic and real-world complex systems. Example applications are provided within the hydro-climatic context, formulating and dynamically forecasting evolving hydro-climatic distributions, including the emergence of extreme precipitation and flooding in a structurally changing hydro-climate system. Validation is then conducted with a posteriori verification of the simulated dynamics against observational records. Agreement between simulations and observations is

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

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

Dynamics of analyst forecasts and emergence of complexity: Role of information disparity

PubMed Central

Ahn, Kwangwon

2017-01-01

We report complex phenomena arising among financial analysts, who gather information and generate investment advice, and elucidate them with the help of a theoretical model. Understanding how analysts form their forecasts is important in better understanding the financial market. Carrying out big-data analysis of the analyst forecast data from I/B/E/S for nearly thirty years, we find skew distributions as evidence for emergence of complexity, and show how information asymmetry or disparity affects financial analysts’ forming their forecasts. Here regulations, information dissemination throughout a fiscal year, and interactions among financial analysts are regarded as the proxy for a lower level of information disparity. It is found that financial analysts with better access to information display contrasting behaviors: a few analysts become bolder and issue forecasts independent of other forecasts while the majority of analysts issue more accurate forecasts and flock to each other. Main body of our sample of optimistic forecasts fits a log-normal distribution, with the tail displaying a power law. Based on the Yule process, we propose a model for the dynamics of issuing forecasts, incorporating interactions between analysts. Explaining nicely empirical data on analyst forecasts, this provides an appealing instance of understanding social phenomena in the perspective of complex systems. PMID:28498831

Small Cofactors May Assist Protein Emergence from RNA World: Clues from RNA-Protein Complexes

PubMed Central

Shen, Liang; Ji, Hong-Fang

2011-01-01

It is now widely accepted that at an early stage in the evolution of life an RNA world arose, in which RNAs both served as the genetic material and catalyzed diverse biochemical reactions. Then, proteins have gradually replaced RNAs because of their superior catalytic properties in catalysis over time. Therefore, it is important to investigate how primitive functional proteins emerged from RNA world, which can shed light on the evolutionary pathway of life from RNA world to the modern world. In this work, we proposed that the emergence of most primitive functional proteins are assisted by the early primitive nucleotide cofactors, while only a minority are induced directly by RNAs based on the analysis of RNA-protein complexes. Furthermore, the present findings have significant implication for exploring the composition of primitive RNA, i.e., adenine base as principal building blocks. PMID:21789260

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.

Theorizing the relationship between NGOs and the state in medical humanitarian development projects.

PubMed

Asad, Asad L; Kay, Tamara

2014-11-01

Social scientists have fiercely debated the relationship between non-governmental organizations (NGOs) and the state in NGO-led development projects. However, this research often carries an implicit, and often explicit, anti-state bias, suggesting that when NGOs collaborate with states, they cease to be a progressive force. This literature thus fails to recognize the state as a complex, heterogeneous, and fragmented entity. In particular, the unique political context within which an NGO operates is likely to influence how it carries out its work. In this article, we ask: how do NGOs work and build relationships with different types of states and--of particular relevance to practitioners--what kinds of relationship building lead to more successful development outcomes on the ground? Drawing on 29 in-depth interviews with members of Partners in Health and Oxfam America conducted between September 2010 and February 2014, we argue that NGOs and their medical humanitarian projects are more likely to succeed when they adjust how they interact with different types of states through processes of interest harmonization and negotiation. We offer a theoretical model for understanding how these processes occur across organizational fields. Specifically, we utilize field overlap theory to illuminate how successful outcomes depend on NGOs' ability to leverage resources--alliances and networks; political, financial, and cultural resources; and frames--across state and non-state fields. By identifying how NGOs can increase the likelihood of project success, our research should be of interest to activists, practitioners, and scholars. Copyright © 2014 Elsevier Ltd. All rights reserved.

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...

Complex regulation of HSC emergence by the Notch signaling pathway

PubMed Central

Butko, Emerald; Pouget, Claire; Traver, David

2016-01-01

Hematopoietic stem cells are formed during embryonic development, and serve as the foundation of the definitive blood program for life. Notch signaling has been well established as an essential direct contributor to HSC specification. However, several recent studies have indicated that the contribution of Notch signaling is complex. HSC specification requires multiple Notch signaling inputs, some received directly by hematopoietic precursors, and others that occur indirectly within neighboring somites. Of note, proinflammatory signals provided by primitive myeloid cells are needed for HSC specification via upregulation of the Notch pathway in hemogenic endothelium. In addition to multiple requirements for Notch activation, recent studies indicate that Notch signaling must subsequently be repressed to permit HSC emergence. Finally, Notch must then be reactivated to maintain HSC fate. In this review, we discuss the growing understanding of the dynamic contributions of Notch signaling to the establishment of hematopoiesis during development. PMID:26586199

Market for advanced humanitarian mine detectors

NASA Astrophysics Data System (ADS)

Newnham, Peter; Daniels, David J.

2001-10-01

Uncleared landmines and unexploded ordnance remain a major humanitarian and economic threat in over 60 countries. It is estimated that world wide over US 60 million was spent on mien clearance in 1999. Most of this funding is provided by government aid, often channeled via the UN or European Community. The minefield threat is very varied, with many different types of mien, UXO, terrain and climate type. To cope with this variety a range of demining techniques are used: mechanical techniques such as flails are used for vegetation clearance, however the majority of demining work is still carried out by manual deminers using metal detectors and prodders. Over the last 5 years there has been considerable interest within the scientific and engineering communities in the application of advanced technologies to improve the safety and efficiency of this work. Nevertheless few new products have been introduced into, and accepted by, the demining community. Despite the high political profile of the landmine problem very little e hard dat is available on the real characteristics of the demining equipment market. As part of a European Union supported program to evacuate a multi-sensor handheld mien detector concept, Thales and ERA Technology Ltd have carried out an in-depth assessment of this market. This paper describes the cost- benefits that could accrue to the demining community associated with use of advanced equipment under appropriate conditions and the equipment requirements that result. The dynamics of the demining equipment market and the barriers to entry are discussed.

The influence of humanitarian crises on social functioning among civilians in low- and middle-income countries: A systematic review.

PubMed

Lahiri, Shaon; van Ommeren, Mark; Roberts, Bayard

2017-12-01

Our aim was to systematically review how social functioning is measured, conceptualised, impacted, and associated with mental disorders in populations affected by humanitarian crises. Quantitative studies conducted with civilian populations affected by humanitarian crises in low- and middle-income countries with outcomes of social functioning were examined up to 2014. Data sources included Medline, Embase, PsycInfo, and Global Health, and 8 grey literature sources, yielding 14,350 records, of which 20 studies met inclusion criteria. A descriptive synthesis analysis was used, and the final selected studies assessed for quality using a modified Newcastle-Ottawa Scale. In the 20 studies, social functioning was conceptualised in 6 categories: family functioning, friendship quality, functional impairment, overall social functioning, social adaptation, and social relations. Seventeen studies were cross-sectional, two were cohort, and one a controlled trial. The quality of the studies was generally moderate. The limited evidence suggests that social functioning is a relevant variable. Greater crisis exposure is associated with more severe depression and lower social functioning. The protective role of familial and social resources for social functioning is highlighted in different crisis settings. However, greater research on social functioning and mental health is required.

The fate of human remains in a maritime context and feasibility for forensic humanitarian action to assist in their recovery and identification.

PubMed

Ellingham, Sarah Theresa Dorothea; Perich, Pierre; Tidball-Binz, Morris

2017-10-01

The number of annual maritime fatalities reported in the Mediterranean has more than doubled in the last two years, a phenomenon closely linked to the increase of migrants attempting to reach Europe via the Mediterranean. The majority of victims reportedly never gets recovered, which in part relates to the fact that the mechanisms and interaction of factors affecting marine taphonomy are still largely not understood. These factors include intrinsic factors such as whether the individual was alive or dead at the time of submergence, the individual's stature and clothing, as well as extrinsic factors such including ambient temperature, currents, water depth, salinity and oxygen levels. This paper provides a compilation of the current literature on factors influencing marine taphonomy, recovery and identification procedures for submerged remains, and discusses the implications for the retrieval and identification of maritime mass fatalities as part of the humanitarian response, specifically humanitarian forensic action, to the consequences of the current migration phenomenon. Copyright © 2017. Published by Elsevier B.V.

Let's talk about sex work in humanitarian settings: piloting a rights-based approach to working with refugee women selling sex in Kampala.

PubMed

Rosenberg, Jennifer S; Bakomeza, Denis

2017-11-01

Although it is well known that refugees engage in sex work as a form of livelihood, stigma and silence around this issue persist within humanitarian circles. As a result, these refugees' sexual and reproductive health and rights, and related vulnerabilities, remain overlooked. Their protection and health needs, which are significant, often go unmet at the field level. In 2016, the Women's Refugee Commission and Reproductive Health Uganda partnered to pilot a peer-education intervention tailored to meet the needs of refugee women engaged in sex work in Kampala. Findings from the pilot project suggest the feasibility of adapting existing rights-based and evidence-informed interventions with sex workers to humanitarian contexts. Findings further demonstrate how taking a community empowerment approach can facilitate these refugees' access to a range of critical information, services and support options - from information on how to use contraceptives, to referrals for friendly HIV testing and treatment, to peer counselling and protective peer networks.

Local probe investigation of emergent phenomena in complex oxide heterointerfaces

NASA Astrophysics Data System (ADS)

Huang, Mengchen

Complex oxide heterointerfaces exhibit rich physics as well as many veiled puzzles. LaAlO3/SrTiO3 (LAO/STO) is one of the prototype of such heterointerfaces. In 2004, Ohtomo and Hwang first reported a conducing interface emerged between perovskite oxide insulators LaAlO3 and SrTiO3. Following this seminal discovery, many emergent phenomena like metal-insulator transition, piezoresponse, superconductivity, magnetism, strong spin-orbit coupling and coexistence of superconductivity and magnetism were reported in the fascinating LAO/STO system. However, the origin of the conducting interface is still the subject of intense debate, and the physics behind these emergent phenomena remains a wild space to be explored. My Ph.D. study focused on the emergent phenomena in LAO/STO by using "local probes" -- nanostructures created by conductive atomic force microscope (c-AFM) lithography and the AFM itself. I used piezoresponse force microscope (PFM) to study the electromechanical response in LAO/STO and developed a high-resolution, non-destructive PFM imaging technique to visualize nanostructures at LAO/STO interface. The results indicate that the PFM signal is related to a carrier density mediated interfacial lattice distortion, and surface adsorbates can affect the PFM signal via coupling to the electrons at the interface. I integrated graphene on LAO/STO, created field-effect devices in graphene/LAO/STO and collaborated with Dr. Giriraj Jnawali to investigate the transport properties. The high quality single layer graphene on LAO/STO exhibited the half-integer quantum Hall effect and room temperature weak antilocalization behavior. I performed transport measurements in (110)-oriented LAO/STO to investigate anisotropic quasi one-dimensional superconductivity in nanowires. Based on the results I proposed a plausible explanation related to the Lifshitz transition and anisotropic band structures of nanowires in (110)-oriented LAO/STO. Co-worked with Dr. Keith Brown, I studied

Complexities, Catastrophes and Cities: Emergency Dynamics in Varying Scenarios and Urban Topologies

NASA Astrophysics Data System (ADS)

Narzisi, Giuseppe; Mysore, Venkatesh; Byeon, Jeewoong; Mishra, Bud

Complex Systems are often characterized by agents capable of interacting with each other dynamically, often in non-linear and non-intuitive ways. Trying to characterize their dynamics often results in partial differential equations that are difficult, if not impossible, to solve. A large city or a city-state is an example of such an evolving and self-organizing complex environment that efficiently adapts to different and numerous incremental changes to its social, cultural and technological infrastructure [1]. One powerful technique for analyzing such complex systems is Agent-Based Modeling (ABM) [9], which has seen an increasing number of applications in social science, economics and also biology. The agent-based paradigm facilitates easier transfer of domain specific knowledge into a model. ABM provides a natural way to describe systems in which the overall dynamics can be described as the result of the behavior of populations of autonomous components: agents, with a fixed set of rules based on local information and possible central control. As part of the NYU Center for Catastrophe Preparedness and Response (CCPR1), we have been exploring how ABM can serve as a powerful simulation technique for analyzing large-scale urban disasters. The central problem in Disaster Management is that it is not immediately apparent whether the current emergency plans are robust against such sudden, rare and punctuated catastrophic events.

Global Emergency Medicine: A review of the literature from 2017.

PubMed

Becker, Torben K; Trehan, Indi; Hayward, Alison Schroth; Hexom, Braden J; Kivlehan, Sean M; Lunney, Kevin M; Modi, Payal; Osei-Ampofo, Maxwell; Pousson, Amelia; Cho, Daniel K; Levine, Adam C

2018-05-23

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 global audience of academics and clinical practitioners. This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. Another two reviewers searched the gray literature, yielding an additional 11 articles. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 848 articles met our inclusion criteria and underwent full review. 63% were categorized as emergency care in resource-limited settings, 23% as disaster and humanitarian response, and 14% as emergency medicine development. 21 articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed a Cohen's Kappa of 0.344. In 2017, the total number of articles identified by our search continued to increase. Studies and reviews with a focus on infectious diseases, pediatrics, and trauma represented the majority of top-scoring articles. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

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.

Microsurgery “without borders”: new limits for reconstruction of post-burn sequelae in the humanitarian setting

PubMed Central

Tocco-Tussardi, I.; Presman, B.; Cherubino, M.; Garusi, C.; Bassetto, F.

2016-01-01

Summary Post-burn contractures account for up to 50% of the workload of a plastic surgery team volunteering in developing nations. Best possible outcome most likely requires extensive surgery. However, extensive approaches such as microsurgery are generally discouraged in these settings. We report two successful cases of severe hand contractures reconstructed with free flaps on a surgical mission in Kenya. Microsurgery can be safely performed in the humanitarian setting by an integration of: personal skills; technical means; education of local personnel; follow-up services; and an effective network for communication. PMID:27857655

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.

Cytokine/Antibody complexes: an emerging class of immunostimulants.

PubMed

Mostböck, Sven

2009-01-01

In recent years, complexes formed from a cytokine and antibodies against that respective cytokine (cytokine/Ab complex) have been shown to induce remarkable powerful changes in the immune system. Strong interest exists especially for complexes formed with Interleukin (IL)-2 and anti-IL-2-antibody (IL-2/Ab complex). IL-2/Ab complex activates maturation and proliferation in CD8(+) T cells and natural killer (NK) cells to a much higher degree than conventional IL-2 therapy. In addition, IL-2/Ab complex does not stimulate regulatory T cells as much as IL-2 alone. This suggests the possibility to replace the conventional IL-2 therapy with a therapy using low-dose IL-2/Ab complex. Further synthetic cytokine/Ab complexes are studied currently, including IL-3/Ab complex for its effects on the mast cell population, and IL-4/Ab complex and IL-7/Ab complex for inducing B and T cell expansion and maturation. Cytokine complexes can also be made from a cytokine and its soluble receptor. Pre-association of IL-15 with soluble IL-15 receptor alpha produces a complex with strong agonistic functions that lead to an expansion of CD8(+) T cells and NK cells. However, cytokine/Ab complexes also occur naturally in humans. A multitude of auto-antibodies to cytokines are found in human sera, and many of these auto-antibodies build cytokine/Ab complexes. This review presents naturally occurring auto-antibodies to cytokines and cytokine/Ab complexes in health and disease. It further summarizes recent research on synthetic cytokine/Ab complexes with a focus on the basic mechanisms behind the function of cytokine/Ab complexes.

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

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

Breastfeeding promotion: a vital emergency intervention disregarded?

PubMed

Patten, T

1997-09-01

This article explains the need for promotion of breast feeding among donors and humanitarian aid organizations in emergency situations. Breast feeding offers fewer health hazards than artificial feeding in war or emergency settings. Breast feeding normally also provides the advantage of immune protection for the infant, psychological well-being of the mother and child, fertility regulation, an hygienic food source, and an economic means of feeding infants. Many war casualties are women and children. War casualties are exposed to injury, the disruption of water and food supplies, epidemics, and other detrimental social and environmental conditions. Refugees tend to have a poorer psychological state of health than control populations. This is attributed to displacement, sexual violence, loss of emotion support, and loss of cultural traditions. Women lose traditional sources of independence and authority when their homes are destroyed. Prevailing conditions of conflict that contribute to a mother's anxiety and insecurity may interfere with a mother's "let down" reflex and lactation. Health professionals in emergency settings need to be aware of breast feeding difficulties. Mothers with the proper encouragement and support can overcome their breast feeding difficulties. The promotion of breast feeding is a practical means of helping women gain control over their lives. Breast feeding allows women to feed their infants safely and effectively, to feed their infants by a cheap and sustainable means, to contribute to the well-being of another, to rebuild feelings of confidence, and to reduce intervention costs. Promotion of breast feeding can be started without delay.

[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.

Rice Sheath Rot: An Emerging Ubiquitous Destructive Disease Complex

PubMed Central

Bigirimana, Vincent de P.; Hua, Gia K. H.; Nyamangyoku, Obedi I.; Höfte, Monica

2015-01-01

Around one century ago, a rice disease characterized mainly by rotting of sheaths was reported in Taiwan. The causal agent was identified as Acrocylindrium oryzae, later known as Sarocladium oryzae. Since then it has become clear that various other organisms can cause similar disease symptoms, including Fusarium sp. and fluorescent pseudomonads. These organisms have in common that they produce a range of phytotoxins that induce necrosis in plants. The same agents also cause grain discoloration, chaffiness, and sterility and are all seed-transmitted. Rice sheath rot disease symptoms are found in all rice-growing areas of the world. The disease is now getting momentum and is considered as an important emerging rice production threat. The disease can lead to variable yield losses, which can be as high as 85%. This review aims at improving our understanding of the disease etiology of rice sheath rot and mainly deals with the three most reported rice sheath rot pathogens: S. oryzae, the Fusarium fujikuroi complex, and Pseudomonas fuscovaginae. Causal agents, pathogenicity determinants, interactions among the various pathogens, epidemiology, geographical distribution, and control options will be discussed. PMID:26697031

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

Attitudes towards help-seeking for sexual and gender-based violence in humanitarian settings: the case of Rwamwanja refugee settlement scheme in Uganda.

PubMed

Odwe, George; Undie, Chi-Chi; Obare, Francis

2018-03-12

Sexual and gender-based violence (SGBV) remains a silent epidemic in many humanitarian settings with many survivors concealing their experiences. Attitudes towards help-seeking for SGBV is an important determinant of SGBV service use. This paper examined the association between attitudes towards seeking care and knowledge and perceptions about SGBV among men and women in a humanitarian setting in Uganda. A cross-sectional survey was conducted from May to June 2015 among 601 heads of refugee households (261 females and 340 males) in Rwamwanja Refugees Settlement Scheme, South West Uganda. Analysis entails cross-tabulation with chi-square test and estimation of a multivariate logistic regression model. Results showed increased odds of having a favorable attitude toward seeking help for SGBV among women with progressive attitudes towards SGBV (OR = 2.78, 95% CI: 1.56-4.95); who felt that SBGV was not tolerated in the community (OR = 2.03, 95% CI: 1.03-4.00); those who had not experienced violence (OR = 2.08, 95% CI: 1.06-4.07); and those who were aware of the timing for post-exposure prophylaxis (OR = 3.08, 95% CI: 1.57-6.04). In contrast, results for men sample showed lack of variations in attitude toward seeking help for SGBV for all independent variables except timing for PEP (OR = 2.57, 95% CI: 1.30-5.10). Among individuals who had experienced SGBV, the odds of seeking help was more likely among those with favorable attitude towards seeking help (OR = 4.22, 95% CI: 1.47-12.06) than among those with unfavorable help-seeking attitudes. The findings of the paper suggest that targeted interventions aimed at promoting awareness and progressive attitudes towards SGBV are likely to encourage positive help-seeking attitudes and behaviors in humanitarian contexts.

Coordinating the Provision of Health Services in Humanitarian Crises: a Systematic Review of Suggested Models.

PubMed

Lotfi, Tamara; Bou-Karroum, Lama; Darzi, Andrea; Hajjar, Rayan; El Rahyel, Ahmed; El Eid, Jamale; Itani, Mira; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; El-Jardali, Fadi; Akl, Elie

2016-08-03

Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises. We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models, as case studies. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We also searched websites of relevant organizations. We followed standard systematic review methodology. Our search captured 14,309 citations. The screening process identified 34 eligible papers describing five models of coordination of delivering health services: the "Cluster Approach" (with 16 case studies), the 4Ws "Who is Where, When, doing What" mapping tool (with four case studies), the "Sphere Project" (with two case studies), the "5x5" model (with one case study), and the "model of information coordination" (with one case study). The 4Ws and the 5x5 focus on coordination of services for mental health, the remaining models do not focus on a specific health topic. The Cluster approach appears to be the most widely used. One case study was a mixed implementation of the Cluster approach and the Sphere model. We identified no model of coordination for funding of health service. This systematic review identified five proposed coordination models that have been implemented by entities funding or delivering health service in humanitarian crises. There is a need to compare the effect of these different models on outcomes such as availability of and access to health services.

The emerging role of native mass spectrometry in characterizing the structure and dynamics of macromolecular complexes

PubMed Central

Boeri Erba, Elisabetta; Petosa, Carlo

2015-01-01

Mass spectrometry (MS) is a powerful tool for determining the mass of biomolecules with high accuracy and sensitivity. MS performed under so-called “native conditions” (native MS) can be used to determine the mass of biomolecules that associate noncovalently. Here we review the application of native MS to the study of protein−ligand interactions and its emerging role in elucidating the structure of macromolecular assemblies, including soluble and membrane protein complexes. Moreover, we discuss strategies aimed at determining the stoichiometry and topology of subunits by inducing partial dissociation of the holo-complex. We also survey recent developments in "native top-down MS", an approach based on Fourier Transform MS, whereby covalent bonds are broken without disrupting non-covalent interactions. Given recent progress, native MS is anticipated to play an increasingly important role for researchers interested in the structure of macromolecular complexes. PMID:25676284

Mandated to fail? Humanitarian agencies and the protection of Palestinian children.

PubMed

Hart, Jason; Forte, Claudia Lo

2013-10-01

This paper considers the efforts of United Nations and international agencies to address the threats to Palestinian children arising from Israeli occupation. It contains an account of the reasons why agencies have failed, over many years, to prevent systematic violations by the Israeli authorities and settlers. The discussion is organised around two inter-related domains: institutional and political. The paper argues that, in the occupied Palestinian territory (oPt), limitations to the ways in which child protection has been conceptualised and pursued in practice are abundantly evident. Nevertheless, political pressure by Western donor governments serves to constrain an approach to child protection that is more preventative in nature, that addresses more explicitly Israeli violations of international law, and that reflects the experience and aspirations of Palestinian children themselves. Ultimately, therefore, the failure to protect Palestinian children must be seen not only as a result of humanitarian miscalculation but also as a consequence of political strategy. © 2013 The Author(s). Disasters © Overseas Development Institute, 2013.

Emerging Major Histocompatibility Complex Class I-Related Functions of NLRC5.

PubMed

Chelbi, S T; Dang, A T; Guarda, G

2017-01-01

Recent evidence demonstrates a key role for the nucleotide-binding oligomerization domain-like receptor (NLR) family member NLRC5 (NLR family, CARD domain containing protein 5) in the transcriptional regulation of major histocompatibility complex (MHC) class I and related genes. Detailed information on NLRC5 target genes in various cell types and conditions is emerging. Thanks to its analogy to CIITA (class II major MHC transactivator), a NLR family member known for over 20 years to be the master regulator of MHC class II gene transcription, also the molecular mechanisms underlying NLRC5 function are being rapidly unraveled. MHC class I molecules are crucial in regulating innate and adaptive cytotoxic responses. Whereas CD8 + T cells detect antigens presented on MHC class I molecules by infected or transformed cells, natural killer (NK) lymphocytes eliminate target cells with downregulated MHC class I expression. Data uncovering the relevance of NLRC5 in homeostasis and activity of these two lymphocyte subsets have been recently reported. Given the importance of CD8 + T and NK cells in controlling infection and cancer, it is not surprising that NLRC5 is also starting to emerge as a central player in these diseases. This chapter summarizes and discusses novel insights into the molecular mechanisms underlying NLRC5 activity and its relevance to pathological conditions. A thorough understanding of both aspects is essential to evaluate the clinical significance and therapeutic potential of NLRC5. © 2017 Elsevier Inc. All rights reserved.

A United States Civil Affairs Response to the Pending Humanitarian Crisis Following the Collapse of the North Korean Regime

DTIC Science & Technology

2012-06-08

greater under its new leader, Kim Jong Un. The humanitarian problems, shortages of food, clean water, and medicine, will only become worse... shortages of food, clean water, and medicine, will only become worse following a collapse of the North Korean regime. This study explores the niche role...despite severe food shortages .16 By the 1990s, North Korea was almost completely dependent on foreign food aid. Prior to 1995, North Koreans would eat

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.

Militarized humanitarianism meets carceral feminism: the politics of sex, rights, and freedom in contemporary antitrafficking campaigns.

PubMed

Bernstein, Elizabeth

2010-01-01

Over the past decade, abolitionist feminist and evangelical Christian activists have directed increasing attention toward the “traffic in women” as a dangerous manifestation of global gender inequalities. Despite renowned disagreements around the politics of sex and gender, these groups have come together to advocate for harsher penalties against traffickers, prostitutes’ customers, and nations deemed to be taking insufficient steps to stem the flow of trafficked women. In this essay, I argue that what has served to unite this coalition of "strange bedfellows" is not simply an underlying commitment to conservative ideals of sexuality, as previous commentators have offered, but an equally significant commitment to carceral paradigms of justice and to militarized humanitarianism as the preeminent mode of engagement by the state. I draw upon my ongoing ethnographic research with feminist and evangelical antitrafficking movement leaders to argue that the alliance that has been so efficacious in framing contemporary antitrafficking politics is the product of two historically unique and intersecting trends: a rightward shift on the part of many mainstream feminists and other secular liberals away from a redistributive model of justice and toward a politics of incarceration, coincident with a leftward sweep on the part of many younger evangelicals toward a globally oriented social justice theology. In the final section of this essay, I consider the resilience of these trends given a newly installed and more progressive Obama administration, positing that they are likely to continue even as the terrain of militarized humanitarian action shifts in accordance with new sets of geopolitical interests.

Research review of nongovernmental organizations' security policies for humanitarian programs in war, conflict, and postconflict environments.

PubMed

Rowley, Elizabeth; Burns, Lauren; Burnham, Gilbert

2013-06-01

To identify the most and least commonly cited security management messages that nongovernmental organizations (NGOs) are communicating to their field staff, to determine the types of documentation that NGOs most often use to communicate key security messages, and to distinguish the points of commonality and divergence across organizations in the content of key security messages. The authors undertook a systematic review of available security policies, manuals, and training materials from 20 international humanitarian NGOs using the InterAction Minimum Operating Security Standards as the basis for a review framework. The most commonly cited standards include analytical security issues such as threat and risk assessment processes and guidance on acceptance, protection, and deterrence approaches. Among the least commonly cited standards were considering security threats to national staff during staffing decision processes, incorporating security awareness into job descriptions, and ensuring that national staff security issues are addressed in trainings. NGO staff receive security-related messages through multiple document types, but only 12 of the 20 organizations have a distinct security policy document. Points of convergence across organizations in the content of commonly cited standards were found in many areas, but differences in security risk and threat assessment guidance may undermine communication between aid workers about changes in local security environments. Although the humanitarian community has experienced significant progress in the development of practical staff security guidance during the past 10 years, gaps remain that can hinder efforts to garner needed resources, clarify security responsibilities, and ensure that the distinct needs of national staff are recognized and addressed.

Health Care Providers in War and Armed Conflict: Operational and Educational Challenges in International Humanitarian Law and the Geneva Conventions, Part II. Educational and Training Initiatives.

PubMed

Burkle, Frederick M; Kushner, Adam L; Giannou, Christos; Paterson, Mary A; Wren, Sherry M; Burnham, Gilbert

2018-05-07

ABSTRACTNo discipline has been impacted more by war and armed conflict than health care has. Health systems and health care providers are often the first victims, suffering increasingly heinous acts that cripple the essential health delivery and public health infrastructure necessary for the protection of civilian and military victims of the state at war. This commentary argues that current instructional opportunities to prepare health care providers fall short in both content and preparation, especially in those operational skill sets necessary to manage multiple challenges, threats, and violations under international humanitarian law and to perform triage management in a resource-poor medical setting. Utilizing a historical framework, the commentary addresses the transformation of the education and training of humanitarian health professionals from the Cold War to today followed by recommendations for the future. (Disaster Med Public Health Preparedness. 2018;page 1 of 14).

Global Emergency Medicine: A Review of the Literature From 2016.

PubMed

Becker, Torben K; Hansoti, Bhakti; Bartels, Susan; Hayward, Alison Schroth; Hexom, Braden J; Lunney, Kevin M; Marsh, Regan H; Osei-Ampofo, Maxwell; Trehan, Indi; Chang, Julia; Levine, Adam C

2017-09-01

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 global audience of academics and clinical practitioners. This year 13,890 articles written in four 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. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 716 articles met our inclusion criteria and underwent full review. Fifty-nine percent were categorized as emergency care in resource-limited settings, 17% as EM development, and 24% as disaster and humanitarian response. Nineteen articles received scores of 18.5 or higher out of a maximum score of 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed Cohen's kappa of 0.441. In 2016, the total number of articles identified by our search continued to increase. The proportion of articles in each of the three categories remained stable. Studies and reviews with a focus on infectious diseases, pediatrics, and the use of ultrasound in resource-limited settings represented the majority of articles selected for final review. © 2017 The Authors. Academic Emergency Medicine published by Wiley Periodicals, Inc. on behalf of the Society for Academic Emergency Medicine (SAEM).

Pediatric office emergencies.

PubMed

Fuchs, Susan

2013-10-01

Pediatricians regularly see emergencies in the office, or children that require transfer to an emergency department, or hospitalization. An office self-assessment is the first step in determining how to prepare for an emergency. The use of mock codes and skill drills make office personnel feel less anxious about medical emergencies. Emergency information forms provide valuable, quick information about complex patients for emergency medical services and other physicians caring for patients. Furthermore, disaster planning should be part of an office preparedness plan. Copyright © 2013 Elsevier Inc. All rights reserved.

Emergent categorical representation of natural, complex sounds resulting from the early post-natal sound environment

PubMed Central

Bao, Shaowen; Chang, Edward F.; Teng, Ching-Ling; Heiser, Marc A.; Merzenich, Michael M.

2013-01-01

Cortical sensory representations can be reorganized by sensory exposure in an epoch of early development. The adaptive role of this type of plasticity for natural sounds in sensory development is, however, unclear. We have reared rats in a naturalistic, complex acoustic environment and examined their auditory representations. We found that cortical neurons became more selective to spectrotemporal features in the experienced sounds. At the neuronal population level, more neurons were involved in representing the whole set of complex sounds, but fewer neurons actually responded to each individual sound, but with greater magnitudes. A comparison of population-temporal responses to the experienced complex sounds revealed that cortical responses to different renderings of the same song motif were more similar, indicating that the cortical neurons became less sensitive to natural acoustic variations associated with stimulus context and sound renderings. By contrast, cortical responses to sounds of different motifs became more distinctive, suggesting that cortical neurons were tuned to the defining features of the experienced sounds. These effects lead to emergent “categorical” representations of the experienced sounds, which presumably facilitate their recognition. PMID:23747304

Emergence of a complex and stable network in a model ecosystem with extinction and mutation.

PubMed

Tokita, Kei; Yasutomi, Ayumu

2003-03-01

We propose a minimal model of the dynamics of diversity-replicator equations with extinction, invasion and mutation. We numerically study the behavior of this simple model and show that it displays completely different behavior from the conventional replicator equation and the generalized Lotka-Volterra equation. We reach several significant conclusions as follows: (1) a complex ecosystem can emerge when mutants with respect to species-specific interaction are introduced; (2) such an ecosystem possesses strong resistance to invasion; (3) a typical fixation process of mutants is realized through the rapid growth of a group of mutualistic mutants with higher fitness than majority species; (4) a hierarchical taxonomic structure (like family-genus-species) emerges; and (5) the relative abundance of species exhibits a typical pattern widely observed in nature. Several implications of these results are discussed in connection with the relationship of the present model to the generalized Lotka-Volterra equation.

N-acetyltransferase single nucleotide polymorphisms: Emerging concepts serve as a paradigm for understanding complexities of personalized medicine

PubMed Central

Hein, David W.

2009-01-01

Arylamine N-acetyltransferase 1 (NAT1) and 2 (NAT2) exhibit single nucleotide polymorphisms (SNPs) in human populations that modify drug and carcinogen metabolism. This paper updates the identity, location, and functional effects of these SNPs and then follows with emerging concepts for understanding why pharmacogenetic findings may not be replicated consistently. Using this paradigm as an example, laboratory-based mechanistic analyses can reveal complexities such that genetic polymorphisms become biologically and medically relevant when confounding factors are more fully understood and considered. As medical care moves to a more personalized approach, the implications of these confounding factors will be important in understanding the complexities of personalized medicine. PMID:19379125

The Emergence of Environmental Homeostasis in Complex Ecosystems

PubMed Central

Dyke, James G.; Weaver, Iain S.

2013-01-01

The Earth, with its core-driven magnetic field, convective mantle, mobile lid tectonics, oceans of liquid water, dynamic climate and abundant life is arguably the most complex system in the known universe. This system has exhibited stability in the sense of, bar a number of notable exceptions, surface temperature remaining within the bounds required for liquid water and so a significant biosphere. Explanations for this range from anthropic principles in which the Earth was essentially lucky, to homeostatic Gaia in which the abiotic and biotic components of the Earth system self-organise into homeostatic states that are robust to a wide range of external perturbations. Here we present results from a conceptual model that demonstrates the emergence of homeostasis as a consequence of the feedback loop operating between life and its environment. Formulating the model in terms of Gaussian processes allows the development of novel computational methods in order to provide solutions. We find that the stability of this system will typically increase then remain constant with an increase in biological diversity and that the number of attractors within the phase space exponentially increases with the number of environmental variables while the probability of the system being in an attractor that lies within prescribed boundaries decreases approximately linearly. We argue that the cybernetic concept of rein control provides insights into how this model system, and potentially any system that is comprised of biological to environmental feedback loops, self-organises into homeostatic states. PMID:23696719

The emergence of environmental homeostasis in complex ecosystems.

PubMed

Dyke, James G; Weaver, Iain S

2013-01-01

The Earth, with its core-driven magnetic field, convective mantle, mobile lid tectonics, oceans of liquid water, dynamic climate and abundant life is arguably the most complex system in the known universe. This system has exhibited stability in the sense of, bar a number of notable exceptions, surface temperature remaining within the bounds required for liquid water and so a significant biosphere. Explanations for this range from anthropic principles in which the Earth was essentially lucky, to homeostatic Gaia in which the abiotic and biotic components of the Earth system self-organise into homeostatic states that are robust to a wide range of external perturbations. Here we present results from a conceptual model that demonstrates the emergence of homeostasis as a consequence of the feedback loop operating between life and its environment. Formulating the model in terms of Gaussian processes allows the development of novel computational methods in order to provide solutions. We find that the stability of this system will typically increase then remain constant with an increase in biological diversity and that the number of attractors within the phase space exponentially increases with the number of environmental variables while the probability of the system being in an attractor that lies within prescribed boundaries decreases approximately linearly. We argue that the cybernetic concept of rein control provides insights into how this model system, and potentially any system that is comprised of biological to environmental feedback loops, self-organises into homeostatic states.

Humanitarian Intervention: Is it an Emerging Responsibility?

DTIC Science & Technology