Humanitarian aid: some political realities.
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Biomedical subjects
Publications and source records attributed to Egbert Sondorp.
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BACKGROUND: Following natural disasters, mismanagement of the dead has consequences for the psychological well-being of survivors. However, no technical guidelines currently exist for managing mass fatalities following large natural disasters. Existing methods of mass fatality management are not directly transferable as they are designed for transport accidents and acts of terrorism. Furthermore, no information is currently available about post-disaster management of the dead following previous large natural disasters. METHODS AND FINDINGS: After the tsunami disaster on 26 December 2004, we conducted three descriptive case studies to systematically document how the dead were managed in Thailand, Indonesia, and Sri Lanka. We considered the following parameters: body recovery and storage, identification, disposal of human remains, and health risks from dead bodies. We used participant observations as members of post-tsunami response teams, conducted semi-structured interviews with key informants, and collected information from published and unpublished documents. Refrigeration for preserving human remains was not available soon enough after the disaster, necessitating the use of other methods such as dry ice or temporary burial. No country had sufficient forensic capacity to identify thousands of victims. Rapid decomposition made visual identification almost impossible after 24-48 h. In Thailand, most forensic identification was made using dental and fingerprint data. Few victims were identified from DNA. Lack of national or local mass fatality plans further limited the quality and timeliness of response, a problem which was exacerbated by the absence of practical field guidelines or an international agency providing technical support. CONCLUSIONS: Emergency response should not add to the distress of affected communities by inappropriately disposing of the victims. The rights of survivors to see their dead treated with dignity and respect requires practical guidelines and technical support. Mass fatality management following natural disasters needs to be informed by further field research and supported by a network of regional and international forensic institutes and agencies.
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In this first special theme issue, Emerging Themes in Epidemiology publishes a collection of articles on the theme of Epidemiology in conflict. Violent conflict is an issue of great sensitivity within public health, but more structured research and reasoned discussion will allow us to better mitigate the public health impacts of war, and place the public health community in a more informed position in discussions about possible interventions in future conflicts.
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Both conflict and climate change may produce serious negative health consequences. However, there is insufficient evidence that climate change, e.g. through environmental degradation or fresh water shortages, leads to conflict as is often claimed. Also, current theory on cause of conflict would refute this hypothesis.
This article examines war and peacetime ethnic relations at Vukovar General Hospital in Croatia's Eastern Slavonia region. A negotiated peace agreement paved the way for a multi-sectored approach to the reintegration of Eastern Slavonia back into the state and rapprochement between ethnic groups under the supervision of a United Nations transitional administration. This case study provides a glimpse into the realities of those peace-building processes on an institutional level in Eastern Slavonia's healthcare system. The reintegration of Vukovar hospital, the transition of Eastern Slavonia's health sector and peace-building in the region in general received much deserved accolades despite some flaws and minor setbacks. These experiences can still serve as a model for the rest of Croatia and for other countries emerging from civil conflicts.
The security and foreign policy communities have increasingly addressed global health problems as threats to national security. Global health is a humanitarian endeavour that seeks to improve the world's health including the most vulnerable peoples, while national security works to protect the interests of people within a given state. The major statements of security policy by the United States and United Kingdom link the self-protective interests of national security with the humanitarian objectives of global health. While there is potential to expand global health activities through partnership with the security and foreign policy communities, treating global health issues as national security threats may focus attention disproportionately on countries or diseases which pose security threats to wealthy nations, rather than on the greatest threats to global health. The global health community should carefully scrutinise areas where global health and national security interests overlap.