Health

Ismail Lubbad, Allan Hill, and Cari Jo Clark. 6/2006. Population Projections for Socioeconomic Development in the Gaza Strip.Abstract

By all accounts, demographic pressures in the Gaza Strip — in terms of population density, age structure, and growth rate — are extraordinarily high compared to neighboring countries and regions. This population pressure, combined with limited resources and territorial isolation, places immense strain on public services, social and political institutions, and the natural environment. At the same time, insecurity resulting from a deteriorating political context leads to further poverty and unemployment. Together these conditions require both immediate attention and long-term development planning, both of which are, admittedly, difficult in an environment of continuing political uncertainties. Since September 2000, the Gaza population has suffered periods of protracted closure imposed by the Israeli authorities. This has had deleterious consequences on the socioeconomic situation in the Gaza Strip. Currently, 30.3% of the Gazan workforce is unemployed. Concomitantly, poverty is rampant. As of 2004, 37.2% of Gazan families were below the poverty line, 26.0% of whom experienced extreme poverty suggesting that the majority of poor households in Gaza are unable to meet their most basic needs. These challenges to human security are exacerbated by the fact that approximately 64% of the Gaza population are refugees , approximately half of whom still reside in camps.

Lynne Hudson, Siobhan McNally, Sera Bonds, Leilani Johnson, Jennyfer Dulyx, Courtney Hilbert, Simran Bains, and Rachel Bedenbaugh. 2010. Picking Up the Pieces: Women's Health Needs Assessment, Fond Parisien, Haiti.Abstract

Circle of Health International (COHI) conducted this Women's Health Needs Assessment to identify the specific and immediate needs of women, and to provide evidence-based recommendations for short and long-term women's health programming in the Fond Parisien area. These recommendations are based on the results of surveys conducted with 64 women living in the American Refugee Committee (ARC) camp in Fond Parisien. This document highlights the present and future needs of the women living in this IDP camp, and provides specific recommendations to address the unique health needs of women within this population.

HPCR. 1/2002. Internal Displacement in Afghanistan: New Challenges.Abstract

The ongoing military action in Afghanistan is deepening what was already a severe humanitarian crisis. Further displacement of civilians will have a profound impact upon the ability of the country and its people to recover. The movement of civilian populations in search of security, as a result of conflict, or food, as a result of drought, has characterized the long conflict in Afghanistan. The continuing flight of civilians from urban areas, in the face of aerial attacks, compounds a humanitarian situation that was already grave, due to a long and devastating drought in many parts of the country. Over the coming winter, more than a million internally displaced persons (IDPs) will require emergency assistance simply to survive. Apart from the immediate impact on the livelihoods of the displaced and their hosts, forced movement affects social relations and traditions within affected communities. It is important to take stock of these changes, and related shifts in community- or tribal-level politics that might occur during displacement, in efforts to support the recovery of vulnerable communities. This policy brief aims to provide a concise point of reference for those planning responses to the complex range of issues resulting from displacement. It includes a number of active links to the most relevant and reliable information sources. It concludes with a range of operational recommendations for international organizations, governments and NGOs working on this issue.

6/2018. “An Innovative Global Diplomacy Public Health Student Program – Lessons from the Field in a Post-Conflict Medellin, Colombia”.Abstract

For over fifty years, Colombia has been embroiled in conflict, displacing nearly seven million people, second only to Syria for the highest number of internally displaced persons (IDPs) in the world. Most are displaced to urban environments into dense informal settlements with inadequate water, sanitation, shelter and power infrastructure. The city of Medellín, has become home to over 200,000 IDPs in informal agglomerations. Medellín’s transformation to a city of progress and innovation through the promotion of “social urbanism” is an example of how collaboration between city institutions and government sectors can address issues of poverty, violence, equality, engagement, and reintegration of displaced populations in Colombia.

The Post-Conflict Colombia Public Health Project is a collaborative academic exchange program aimed at bringing together public health students from the United States and Colombia for the purpose of understanding between the people of both countries. The project aims to educate students while also providing direct service and fostering long-term cross-cultural relationships and sustainable projects. Seminars, skill building workshops, cultural experiences, and community engagement are used to build professional competencies and inform policy recommendations for future projects. Despite the limited research on the educational impact of short-term global emersion programs, small scale evaluations point to an increase in learners’ cross-cultural adaptability. The believed benefit to students’ professional and personal development must be balanced with ethical considerations including preparedness of students, health and safety risks, cultural sensitivity, and issues of sustainability. In order to address these concerns, programs should be developed collaboratively through bi-directional participatory relationships, incorporating both education and direct service components, and promoting local capacity building and long-term sustainability.

Our course pairs 16 carefully selected graduate-level public health and medical students from Harvard and Universidad de Antioquia, who will serve as both student and citizen ambassadors, to come together and share about their culture, values, and experiences through the lens of diplomacy and dialogue to make a meaningful impact in the people and country of Colombia. The course examines the social development model of Medellín and its impact on advances in peace, social equity, and health. Beyond the theoretical concepts, students will learn to apply them to the Granizal community in order to create practical solutions that are sustainable, scalable, innovative, and measurable.

As other disciplines move away from curricula limited to rote learning and fact-based content, public health and policy education will also benefit from incorporating experiential and competency-based learning with an emphasis on skill building in leadership, management, policy-making, and research.5 The Institute of Medicine’s 2003 report, Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century, recommends eight content areas as essential to graduate level public health education programs: informatics, genomics, communication, cultural competence, community-based participatory research, global health, policy and law, and public health ethics.6 The report further acknowledges the importance of developing international relationships between academic institutions, community organizations, and health agencies for collaboration in interdisciplinary and community-based research, learning, and service. Health disparities, issues of social justice, and public health threats from infectious disease are less and less confined by political and geographic boundaries. The future generation of leaders in public health and policy must be able to bridge nations and cultures through diplomacy and be equipped to develop innovative strategies and partnerships across professional disciplines and on a global scale.

While several public health approaches have been documented in the literature, we describe a model for a multi-institutional and cross-cultural collaboration based on The Post-Conflict Colombia Public Health Project, a three-week intensive course developed in partnership between the Harvard Humanitarian Initiative, the Open Hands Initiative, and the University of Antioquia. While this model is a public health course focusing on Colombia, the concepts and educational strategies can be applied across academic disciplines and to other countries and communities.

 

Allan G. Hill, Cari Jo Clark, Ismail Lubbad, and Claude Bruderlein. 10/2006. “Hope and Despair over Health in Gaza.” BMJ, 333.Abstract

The Israeli re-invasion of Gaza this July has redrawn the world’s attention to the dire straits of the population living in the Gaza Strip. There, within an area the size of the Isle of Wight, 1.4 million people live without free access to the outside world. Contrary to international hopes, the Israeli decision to withdraw from Gaza in September 2005 has led to increasingly tight control over the movement of goods and people. The destruction of the Gaza power station in addition to the damage to bridges, roads, and other infrastructure can only worsen the plight of Gazans in the coming months.

Theresa Stichick and Claude Bruderlein. 5/2001. “Children Facing Insecurity: New Strategy of Survival in a Global Era”.Abstract

This paper explores the nature of children’s security within the context of modern threats from globalization and new forms of warfare. It analyzes the sources of insecurity faced by children and the survival strategies they and their families employ as a result. Through a number of case-studies, it questions the usefulness of assistance programs that focus on the physical needs of children in isolation of their social and communal environment. As children are in a constant state of development, protecting their security requires more than support against physical harm. The paper argues that four dimensions of security are important for the protection of children in times of war: physiological necessities, safety, communal relationships and opportunities for personal development. Efforts to promote children’s security must involve analysis of these core dimensions and treat the coping strategies of children and their families as a roadmap for protection. The focus of this paper is children affected by war but the analysis also applies to children at risk in other circumstances, from street children, to those living in extreme poverty. Children’s security is particularly at risk in those countries under economic embargo, afflicted by armed conflict or by extreme poverty. Today’s threats take place in the context of wars sustained by the import of small arms and light weapons and are often fought over the control of valuable resources – oil, minerals, timber, gems - whose major markets are in the North. The dislocation caused by these wars fragments families and isolates children. While few of these threats are new, their impact on the life and security of children has increased with the globalization of trade, migration and communication. Civilians, especially children and their families, have been forced to develop new coping mechanisms for their changed situations. Children can no longer be viewed merely as the victims of war. They have taken on new roles as heads of households, child combatants, student leaders and actors in peace building. This paper explores how globalization affects the security of children, particularly in conflict areas. It presents a framework to structure the core dimensions of children’s security and discusses how the survival strategies employed by families and children when protections fail may be used as a signal for improving security conditions for children. The paper was produced for the Human Security Network meeting in Amman, 11-12 May 2001, with a contribution from the Canadian Department for Foreign Affairs and International Trade.

Ronak B. Patel and Thomas F. Burke. 8/2009. “Urbanization - An Emerging Humanitarian Disaster.” The New England Journal of Medicine, 361, 8, Pp. 741-743.Abstract

This paper describes the current rates of urbanization and the developing health consequences framed as a humanitarian crisis. The authors go on to analyze the current state of knowledge and policy on urban health. They lay out the priorities for future research and work and the role for academics, governments and international agencies to prevent the impending deterioration in global health due to rapid urbanization.

Phuong Pham, Patrick Vinck, Mychelle Balthazard, Sokhom Hean, and Eric Stover. 1/2009. So We Will Never Forget: A Population-Based Survey on Attitudes About Social Reconstruction and the Extraordinary Chambers in the Courts of Cambodia.Abstract

30 years after the end of the Khmer Rouge Regime in Cambodia, citizens of the country continue to see themselves as victims of the regime and desire some form of reparations. Nonetheless, citizens wish that the country prioritize problems that Cambodians face in their everyday lives rather than concentrate on punishing crimes committed by the Khmer Rouge. This study presents the views and experiences of Cambodians regarding exposure to violence, overall priorities, and the national criminal justice system. Additionally, the study reveals that citizens desire more knowledge of the regime, feel hatred toward the Khmer Rouge, and demand accountability. Furthermore, the study calls for changes in the structure and governance of the Extraordinary Chambers of the Courts of Cambodia (ECCC) so that Cambodians’ faith in their criminal justice system may be restored.

Physicians Human for Rights and Harvard Humanitarian Initiative. 5/2009. Nowhere to Turn: Failure to Protect, Support and Assure Justice for Darfuri Women.Abstract

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.

Harvard Humanitarian Initiative. 8/2009. Characterizing Sexual Violence in the Democratic Republic of the Congo: Profiles of Violence, Community Responses, and Implications for the Protection of Women.Abstract

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.

Phuong Pham, Patrick Vinck, and Tino Kreutzer. 6/2011. Talking Peace: A Population-Based Survey on Attitudes about Security, Dispute Resolution, and Post-Conflict Reconstruction in Liberia.Abstract

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.

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