Importance: In 2018 to 2020, the Democratic Republic of the Congo experienced the world’s second largest Ebola virus disease (EVD) outbreak, killing 2290 individuals; women were disproportionately infected (57% of all cases) despite no evidence of differential biological EVD risk. Understanding how gender norms may influence exposure to EVD, intensity, and prognosis as well as personal protective behaviors against the virus is important to disease risk reduction and control interventions.
Objective: To assess whether men and women differ in personal protective behaviors (vaccine acceptance, health-seeking behaviors, physical distancing) and the mediating role of EVD information and knowledge, perceived disease risk, and social relations.
Design, Setting, and Participants: This cross-sectional, multistage cluster survey study of 1395 randomly selected adults was conducted in the Ebola-affected regions of North Kivu from April 20, 2019, to May 10, 2019. Path analyses were conducted using structural equation modeling to examine associations among study variables. Statistical analysis was conducted from August 2019 to May 2020.
Main Outcomes and Measures: The main behavioral outcomes of interest were (1) vaccine acceptance, (2) formal health care seeking, and (3) self-protective behaviors. The primary factor of interest was self-reported gender identity. We also assessed sociodemographic factors.
Results: Among the study’s 1395 participants, 1286 (93%) had Nande ethnicity and 698 (50%) were women; the mean (SD) age was 34.5 (13.1) years. Compared with female participants, male participants reported significantly higher levels of education, wealth, and mobile phone access. There were associations found between gender and all EVD preventive behavioral outcomes, with evidence for mediation through EVD knowledge and belief in rumors. Men reported greater EVD knowledge accuracy compared with women (mean [SE] score for men: 12.06 [0.13] vs women: 11.08 [0.16]; P < .001), and greater knowledge accuracy was associated with increases in vaccine acceptance (β = 0.37; P < .001), formal care seeking (β = 0.39; P < .001), and self-protective behaviors (β = 0.35; P < .001). Lower belief in rumors was associated with greater vaccine acceptance (β = −0.30; P < .001), and greater EVD information awareness was associated with increased adoption of self-protective behaviors (β = 0.23; P < .001).
Conclusions and Relevance: This survey study found gender differences in adopting preventive protective behaviors against EVD. These findings suggest that it is critical to design gender-sensitive communication and vaccination strategies, while engaging women and their community as a whole in any response to infectious disease outbreaks. Research on the potential link between gender and sociodemographics factors associated with disease risk and outcomes is needed.
The drivers of human displacement are becoming more and more complex, ranging from conflict and persecution to the increasingly pertinent variables of heightened mobility and social media influences. Of rapidly but appropriately escalating concern is the impact of climate change. While the intensity and severity of climate-induced disasters and climate-related migration will be unevenly distributed across space and time, the World Bank estimates that approximately 140 million people will be displaced globally due to climate-related reasons by 2050. The effects of climate change are expected to be particularly pronounced in Africa, where rising temperatures, unpredictable anomalous rainfall and high vulnerability to extreme natural hazards will continue to exacerbate conflict and harm local and regional human, economic, and environmental security.
In the East and Horn of Africa (EHoA) in particular, the dependence on rain-fed agriculture and pastoralism means that livelihoods and food security are inextricably linked and affected by long-term or sudden environmental changes and natural hazards. The extreme natural hazards that have struck EHoA in recent years have caused widespread hunger, displacement, loss of critical infrastructure and livelihoods, and death
In an effort to understand the complex variables that influence migration, the International Organization for Migration (IOM) developed the Displacement Tracking Matrix (DTM) to track and gather information about populations on the move. The Flow Monitoring Registry (FMR) captures a wealth of data about the migratory routes, the demographics and nationality of migrants, reasons for migration, modes of transportation used to facilitate movement, and vulnerabilities experienced by these populations. While the descriptive data provides a wealth of information, more can be done to analyze the complexities of and interactions between migration, conflict, environmental changes, and climate-related events. Climate projections further suggest that environmental changes will likely further lead to decreased water availability, lowered agricultural productivity, and increased disease transmission in the region, producing complex ramifications regarding local and regional conflicts, economics, politics, and migration.
The porous borders in EHoA have contributed to some of the highest volumes of cross border movement in the world. In 2020 alone, EHoA hosted 6.5 million internally displaced persons (IDPs) and 3.5 million refugees and asylum seekers.6 In the same year, the Horn of Africa experienced unusually high levels of precipitation leading to disastrous floods and landslides and creating ideal conditions for an detrimental locust plague towards the end of 2019 that devastated crops and disrupted livelihoods. The extreme precipitation experienced across much of the Horn in 2019 was preceded by anomalous rainfall the previous year. 2018 was particularly hot and dry in the Horn of Africa, with positive temperature anomalies of around 2°C and below-average precipitation contributing to drought-like conditions in Somalia, Eritrea, and Djibouti while Kenya and Sudan experienced above-average precipitation.8 The drought-like conditions in Somalia, Eritrea, and Djibouti contributed to widespread food insecurity that affected approximately 12 million people. These extreme weather conditions are increasingly exacerbating the already complex and interconnected factors driving migration in the Horn of Africa, and are only expected to escalate in the future.
For this study, the IOM RDH in Nairobi partnered with the Humanitarian Geoanalytics Program at the Harvard Humanitarian Initiative to leverage spatial analytics to investigate migration flows in the East and Horn of Africa and Yemen. Geospatial analytics hold tremendous potential to introduce new ways of thinking, build research capacity, study impacts, and facilitate costeffective programming. The adoption of geospatial methods into research oriented towards populations on the move, gives us the capacity to accurately characterize the spatial heterogeneity of migrating populations. Furthermore, by incorporating environmental variables into this spatial analysis, we begin to reveal relationships previously undiscovered that could contribute to a richer understanding regarding migration in the region.
The International Organization for Migration (IOM) Regional Data Hub (RDH) for the East and Horn of Africa partnered with the Humanitarian Geoanalytics Program (HumGeo) at the Harvard Humanitarian Initiative (HHI) to analyze the complexities of and interactions between migration, conflict, environmental changes, and climate-related events in Yemen, and the East and Horn of Africa between 2018 and 2020.
This research aims to answer the following questions through a variety of geospatial analyses:
1) How did out-migration rates in any given administrative region change over time and, was it statistically significant compared to administrative regions around it?
2) How do the numbers of migrants and the overall migration trends vary across space and time, for each cited reason for migration (aka ‘driver of migration’)?
3) How do environmental variables, e.g. temperature and precipitation, correlate with outmigration in in the East and Horn of Africa?
This study provides new insights into out-migration patterns in the region, demonstrates a novel way to investigate changing reasons for out-migration using a variety of spatial analysis methods, and establishes a foundation for future studies to analyze the complex and evolving relationship between migration and climate change that will continue to intensify in the years to come.
In light of human rights violations in Northern Uganda, this research note presents preliminary data on Ugandans’ attitudes on peace and justice. The findings reflect the respondents’ desires for truth reconciliation as well as their desires to hold perpetuators of violence accountable for their actions. However, the findings show that justice is not a top priority for Ugandans in comparison to more tangible needs for health, peace, money, and education. A majority of Ugandans in the North are open to the reintegration of former LRA members in society, albeit conditionally on diminished social and political rights for past LRA leaders.
After two decades of armed conflict waged by the Lord’s Resistance Army (LRA) in Northern Uganda, Ugandans and the international community remain divided on how to effectively pursue and obtain peace and justice. This study presents Ugandans’ exposures to violence, the needs and concerns of displaced peoples, and opinions on specific transitional justice mechanisms as the country moves forward. Additionally, the study proposes that controversies over interventions in the region may be resolved by the local and international adoption of a comprehensive strategy that aims to achieve both peace and justice.
This report includes a detailed evaluation of the clinical, surgical and managerial capacity at Panzi Hospital, and also capacity evaluations of hospitals in Kaziba, Kalonge, Walungu, Uvira, Kakawende, Kaniola, and Nyatende.
Since the late 1980s, the Lord’s Resistance Army (LRA), a spiritualist rebel group with no clear political agenda, has abducted tens of thousands of children and adults to serve as porters and soldiers. In the early 1990s, children who escaped from the LRA or were captured by Ugandan soldiers were often paraded in the streets in the hope that someone would identify them. This treatment prompted a group of parents of abducted children to establish the Gulu Support the Children Organization (GUSCO), a reception center in Gulu, in 1994. In December 2005, the Berkeley-Tulane Initiative on Vulnerable Populations launched The Database Project to better document abduction and help improve the capacity of 8 reception centers in the northern districts of Gulu, Kitgum, Pader, Apac, and Lira to collect and analyze information about former LRA abductees.
Ravaged by 21 years of war and destruction, Northern Uganda faces serious obstacles in achieving reconciliation and accountability for violations of human rights and international humanitarian law. While security in the region has improved since the migration of the Lord’s Resistance Army to the Congo, Ugandans continue to struggle with the aftereffects of an era of violence. This study relays Ugandans’ views on peace, mechanisms for justice, and reintegration, and consequently recommends that the Ugandan government and international community act in concert to develop a strategy for peace-building, justice, socioeconomic development, and poverty reduction in the North.
Nowhere to Turn is a report documenting the scope and long-term impact of rape and other sexual violence experienced by women who fled attacks on their villages in Darfur and are now refugees in neighboring Chad. The report is based on a scientific study, conducted in partnership with Physicians for Human Rights, of women's accounts of rape and other crimes against humanity that they have experienced in Darfur, as well as rape and deprivations of basic needs in refugee camps in Chad.
After years of armed conflict, instability, and human rights violations, in 2006 the Democratic Republic of Congo (DRC) held its first elections since independence. Despite this success, eastern DRC grapples with major challenges in achieving security, social reconstruction, and transitional justice. This study presents the needs and priorities of the Congolese population in light of prevailing social and political instability, and recommends that the Congolese government and international community take steps to monitor and implement peace negotiations, security, and good governance as the country moves forward.
This report uses both quantitative and qualitative methods to explore sexual violence in the Democratic Republic of Congo. Results from this report show the sexual violence perpetrated by armed actors in the DRC has features that indicate rape is being used as a weapon of war. The violence in DRC embodies a new kind of war emerging in the 21st century - one that occurs in villages more than battlefields and affects more civilians than armed combatants.
Liberia has made progress in peacebuilding and reconstruction in the aftermath of a 14-year long civil war, but the country continues to face challenges in overcoming the results of a legacy of violence. This study, undertaken in November and December 2010, provides insight into Liberians’ current priorities for peacebuilding, their perceptions of post-conflict security, and existing dispute and dispute resolution mechanisms. The findings suggest that while Liberians are generally positive about the country’s prospects for peace and security, the fears and inequalities perpetuated by years of civil strife continue to reverberate throughout the country. This study provides recommendations to address the existing problems of gaping socioeconomic disparities, limited access to information, a weakened security sector, and the diminished quality of current dispute resolution systems. It also supports inter-ethnic national dialogue on truth, reconciliation, and the underlying causes of the war.
Satellite Sentinel Project (SSP) analysis of DigitalGlobe satellite imagery captured on 28 June has identified four vehicles consistent with BM-21 mobile multiple rocket launcher (MRL) systems at an apparent Sudan Armed Forces (SAF) camp southwest of El Obeid, North Kordofan, Sudan.