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Disaster Concepts and Trends
Published in Emily Ying Yang Chan, Public Health Humanitarian Responses to Natural Disasters, 2017
In a non-disaster situation, the crude mortality rate (CMR) of every country is assumed to be 0.5/per 10,000 people per day, while the under-5 mortality rate (U5MR) is assumed to be 1/per 10,000 people per day. Toole and Waldman (1990) suggested the doubling of CMR, from 0.5 to 1/per 10,000 per day, or the doubling of U5MR from 1.0 to 2.0/per 10,000 people per day, as the emergency threshold. If the situation causes either one of the mortality rates to go beyond this threshold, it is declared as a “state of emergency”, and certain international and humanitarian aid or relief mechanisms should be activated. Likewise, the emergency status is removed when either of the mortality rates falls below this threshold. Figure 2.13 shows the emergency threshold as doubling the baseline crude mortality (see also Knowledge Box 2.4).
Ethics and clinical work in global health *
Published in Andrew D. Pinto, Ross E.G. Upshur, An Introduction to Global Health Ethics, 2013
Athanase Kiromera, Jane Philpott, Sarah Marsh, Adrienne K. Chan
The medical response to the earthquake in Haiti highlights key ethical issues common to humanitarian aid and well outlined in the literature (Hunt 2008). The earthquake catalyzed a rapid response from actors previously unengaged in medical humanitarian work, but whose skills were critically needed in the early response to the disaster. The catastrophic event also occurred in the setting of existing but now incapacitated physical and human resources for health infrastructure. In Haiti, socio-political factors that existed prior to the event also determined ‘structured health risks’ that the humanitarian crisis exacerbated (Pinto 2010; Chung 2012). Clearly the volume and urgency of needs in Haiti were elevated post-earthquake, which required health workers to work extremely long shifts. In settings of disaster relief, where expatriate teams and local teams work closely in a high-pressure situation, differences that exist around cultural frameworks in how health, wellness, disease and disability are understood and experienced can be exacerbated (Hunt 2011).
Refugees and Health in Urban Africa
Published in Igor Vojnovic, Amber L. Pearson, Gershim Asiki, Geoffrey DeVerteuil, Adriana Allen, Handbook of Global Urban Health, 2019
Refugee inflows stretch domestic medical resources and divert health resources away from host communities (Atim 2013). A two-pronged health systems response to an influx of refugees has been applied: a parallel or an integrated health system. Parallel health services are new services developed and implemented by UN agencies and other NGOs specifically designed for refugees separate from services provided to local citizens by their own government. These may be short or long term, but they are different from national or local public services already in place. Refugee camps, for example, use a pure parallel-service model. Integrated services, by contrast, are those that the host country provides to refugees along with services to its citizens, sometimes with technical, financial or implementation support from donors, UN agencies, or NGOs (e.g., allowing refugees access to public schools and hospitals). Historically, humanitarian aid often relies on parallel-service provision because refugees often settle in remote places where government services are either non-existent or hard to access (Culbertson et al. 2016). Going forward, the international community is reassessing approaches to refugee assistance in humanitarian emergencies. This reassessment has two important components. The first is recognition that the parallel delivery of services assumes that most refugees live in camps, yet many refugees integrate into host communities; thus there is a need to create mechanisms and procedures that enable host countries to respond to the needs of refugees living among the urban and rural populations. Second, because refugees are interspersed with local communities and local authorities are critical components of any response, emergency humanitarian responses for refugees must be linked to host country development plans (Culbertson et al. 2016). It is increasingly becoming apparent that many services rendered to refugees require the support of line ministries, municipal authorities, the private sector, police, civil society actors and community groups in the host countries. Refugees attend local public schools, seek medical care in public clinics and hospitals, rent housing from the housing market, make use of water and sanitation systems, and find jobs with local businesses which are under the management of host countries. This means that more actors need to work together rather than working in silos. Recent UNHCR assessments have echoed this need, especially the coordination of actors and their wider engagement in urban areas (Culbertson et al. 2016).
The effect of increases in the Syrian refugee population in Turkey on public maternal and child health outcomes
Published in Health Care for Women International, 2023
The primary focus is to provide emergency and humanitarian aid; further efforts are needed to improve the health of refugee Syrian women. In 2014, three years after the refugee flows began and in response to the health needs of the Syrian refugees and to protect public health, the Ministry of Health signed an understanding with United Nations Population Fund to coordinate the delivery of women’s health services (Samari, 2017; Yıldırım et al., 2019); therefore, Turkey was faced with the burden of providing health services to the refugees. The consequent health policy was designed so that community health centers could provide primary health care services, and the field hospitals and polyclinics could provide secondary health care services, such as routine child immunization programs, and pediatric, reproductive health, and health counseling services (Ekmekci, 2017). However, the lack of health professionals has been one the most significant challenges to fully establishing the planned system. Compared to other EU member states, Turkey has the least number of medical doctors per capita (Organisation for Economic Co-operation and Development [OECD], 2019), and the health units and hospitals in the south and southeast parts of Turkey have faced high refugee influxes (Akçan et al., 2019).
The challenges of global bioethics
Published in Global Bioethics, 2022
Policy-making in healthcare is often driven by concerns for vulnerable populations in need of care and protection. As is obvious in humanitarian aid, for example in disaster relief, the ethical drive to assist is so strong and compelling that it can hardly be criticized; at the same time, it directs our focus on immediate care and relief for individual victims so that we tend to forget that other dimensions are equally important. One dimension is the social context which is often unjust. Another dimension is the perspective of the recipient which is often absent and silent. Bringing in the discourse of rights makes explicit that people should not be regarded as needed victims but as citizens of the world with the same claims and rights as everyone else. Rights dignify rather than victimize; they make people equal and more powerful, and increase the impact of care-based global bioethics.
Sexual and reproductive health, rights and justice in the war against Ukraine 2022
Published in Sexual and Reproductive Health Matters, 2022
Eszter Kismödi, Emma Pitchforth
Sexual and Reproductive Health Matters is calling on the international community and the Ukrainian and Russian governments to pay attention to the sexual and reproductive health and rights, lives, and safety of all populations affected by the Ukrainian situation. Specifically, they should have full access to all humanitarian aid, be protected from violence, abuse and ill treatment, be provided with accessible information, and have access to basic services including water and sanitation, health care, and transport. The international community must account for and must not abandon those who are most at risk – including women, children, persons with disabilities, LGBTQI populations, pregnant people, and those living with HIV. Recipient countries have international and national obligations to provide health services to refugees and migrants to the full extent of the law and to respect and protect the rights and needs of all.