Medicine, Conflict and Survival最新文献

Rates of global conflict have increased by over 40% from 2020 to 2023, increasing the demands on healthcare systems and impacting healthcare training, education and workforce. There is a need for innovative educational support from the international community. Distance education is a sustainable avenue that is not as contingent on travel, political, or financial restrictions. We sought to undertake a preliminary scoping exercise of the issues involved in delivering distance medical teaching to conflict zones, by reviewing examples in the literature and interviewing key stakeholders in this field. We found that there was need and scope to deliver specific, case-based, non-practical teaching, and to re-connect medical personnel with the international community and research. We propose recommendations to achieve this: directing purpose according to learner needs, evaluations and care outcomes; maintaining patient confidentiality and anonymity; supplementing, rather than undermining, existing educational infrastructures; co-ordinating with relevant stakeholders and expatriates, whilst maintaining neutrality; and consider the use of pre-existing, low-cost online scripts and social media platforms, as well as non-live, low-bandwidth modes of technology.

The author argues that medical care in the Dutch East Indies, should be re-evaluated from successful to disastrous. The author first defines a medical disaster as one in which medical care has fallen short due to its own shortcomings- or even intentionally. This contrasts with a disaster for humankind, in which also many are to be regretted, but for which healthcare is not to blame, because of, for instance, a lack of resources, manpower or knowledge. The author then looks at three different types of medical care: Red Cross aid; the public health policy to eradicate leprosy; and the military medical aid given to the Indonesian population (1946-1949). In all these colonial interests were a priority, if not the driving force. Medical humanitarianism came second at best. This produced outcomes that should be called medically disastrous. Partly this is not new: medical historians have identified colonial medicine as a tool of empire before. But what it nevertheless had achieved, defined as the medical 'good', was seldom questioned, cutting off medical acts and their results from their context. The question must be asked if it isn't it time to call Dutch medical care in Indonesia disastrous in itself?

This study aimed to examine the mental health issues and trauma faced by Iraqi IDPs post-2014. Adhering to PRISMA guidelines, we conducted a literature search in PubMed, Scopus, and Google Scholar, identifying 208 articles. After excluding 190 articles for duplication and ineligibility, we ultimately included 18 studies. The Joanna Briggs Institute critical evaluation checklist was used for quality assessment. Studies involved 5,764 participants from diverse ethno-religious groups including Arabs, Kurds, Christians, and Yazidis. Participants were mostly female (55.5%), male (38.4%), and the smallest and largest study samples were 29 and 1,256, respectively. Ages ranged from 12.18 to 43.34 years. The results revealed a high prevalence of PTSD at 61.9%, with depression and anxiety rates at 49% and 51%, respectively, and suicidal behaviours at 67.5%. Among IDP subgroups, PTSD and suicidal behaviours were particularly high among Yazidi-enslaved girls and women, at 90.6% and 67.55% respectively. Major trauma exposures included forced displacement, encounters with combat and violence, enslavement, and witnessing the death or abuse of relatives. Critical contributing factors to mental health problems were gender (being female), economic instability, prolonged displacement, exposure to combat, experiences of rape and torture, and limited access to services. The mental health support of this vulnerable population is critical.

This study aimed to vividly describe the direct and severe health impacts of conflict in the Eastern Mediterranean Region (EMR) using data from the Global Burden of Disease (GBD). It also sought to quantify the staggering portion of economic damage attributable to the health burden of conflict and terrorism. From 1990 to 2019, the region endured the devastating effects of conflict and terrorism. These circumstances led to 64%, 50%, and 35% of all causes of Disability-Adjusted Life Years (DALYs) in Libya, Syria, and Palestine, respectively, in 2011, 2016, and 2008. These figures represent not just statistics but the profound human cost of these conflicts. The health-related economic burden (HEB) due to conflict was estimated at $4.6 billion in Iraq, $3.7 billion in Afghanistan, and $1.7 billion in Libya in current international dollars. However, due to missing data, the HEB could not be calculated for Yemen and Syria despite significant conflict-related DALYs. In 2019, the HEB to Current Health Expenditure (CHE) ratio, which indicates the proportion of the health-related economic burden compared to health expenditure, was 30% in Afghanistan and 25% in Iraq. This high ratio underscores the significant strain that conflict places on the health systems.

The bulk of research exploring the impacts of Boko Haram-induced crisis in Nigeria's Northeast region focuses on the country's social, economic, and political conditions while the understanding on the welfare of vulnerable populations - children living in the conflict-ridden communities is sparse. This study addresses the sparsity by investigating the plights of children who became orphans in the wake of horrific Boko Haram attacks in the region in the mid-2010s. Using a qualitative method, we draw insights from Damaturu, Yobe State, where three hundred and eight (orphaned) children were recruited and interviewed. Based on our analysis of the interview data, we argue that they suffered life-threatening situations - parental fatalities by insurgents, alms begging, hard labour for sustenance, degrading living conditions, sexual exploitation, and recruitment into armed groups for violence. The cumulative effects of the attacks made them unsafe and vulnerable to unconventional coping strategies and delinquency amidst the precarity of decent living in the communities. We provide key research and policy-relevant evidence in advancing the understanding of the predicaments of children in wars and socio-politically precarious environments. Also, we underscore the need for holistic and targeted interventions that include vulnerable children in post-insurgency humanitarian efforts to mitigate their discomfort and improve their living conditions.