Health

Jocelyn Kelly, Alexandria King-Close, and Rachel Perks. 10/2014. “Resources and resourcefulness: Roles, opportunities and risks for women working at artisanal mines in South Kivu, Democratic Republic of the Congo .” Futures, 62, Pp. 95-105. Read PublicationAbstract

Two dominant narratives have characterized the conflict in eastern Democratic Republic of the Congo (DRC): (1) the horrific abuse of women through sexual violence and (2) the use of “conflict minerals” to fuel the fighting. These two advocacy narratives intersect uniquely in artisanal and small-scale mining (ASM) towns and can lead to flawed understandings of the true dynamics of women's experiences in these contexts. Mining areas are important centers of economic activity for women, but also pose distinct risks. A simplistic portrayal of women's victimization in mining towns suppress discussion of their participation in non-conflict political and social processes. Yet, these processes are among the most important to ensure that women secure opportunities for long-term, substantive engagement in mining activities. This paper draws on systematically collected qualitative data from two territories in South Kivu, Walungu and Kalehe, to examine how women negotiate these complex social and economic mining landscapes in eastern Democratic Republic of Congo. Their accounts compel a re-examination of development efforts to remove women from the mines altogether, and to look more closely at the measures available to help them realize their legal rights to work safely and fairly in these contexts.

Jocelyn Kelly, Alexandria King-Close, and Rachel Perks. 10/2014. “Resources and resourcefulness: Roles, opportunities and risks for women working at artisanal mines in South Kivu, Democratic Republic of the Congo .” Futures, 62, Pp. 95-105. Read PublicationAbstract

Two dominant narratives have characterized the conflict in eastern Democratic Republic of the Congo (DRC): (1) the horrific abuse of women through sexual violence and (2) the use of “conflict minerals” to fuel the fighting. These two advocacy narratives intersect uniquely in artisanal and small-scale mining (ASM) towns and can lead to flawed understandings of the true dynamics of women's experiences in these contexts. Mining areas are important centers of economic activity for women, but also pose distinct risks. A simplistic portrayal of women's victimization in mining towns suppress discussion of their participation in non-conflict political and social processes. Yet, these processes are among the most important to ensure that women secure opportunities for long-term, substantive engagement in mining activities. This paper draws on systematically collected qualitative data from two territories in South Kivu, Walungu and Kalehe, to examine how women negotiate these complex social and economic mining landscapes in eastern Democratic Republic of Congo. Their accounts compel a re-examination of development efforts to remove women from the mines altogether, and to look more closely at the measures available to help them realize their legal rights to work safely and fairly in these contexts.

Beth Maclin, Jocelyn Kelly, Justin Kabanga, and Michael VanRooyen. 9/2014. “They have embraced a different behaviour': transactional sex and family dynamics in eastern Congo's Conflict.” Culture, Health & Sexuality. Read PublicationAbstract

The decades-long conflict in eastern Democratic Republic of the Congo (DRC) has resulted in major changes to local economies, strained social networks and insecurity. This environment forces many to pursue unconventional and, at times, socially stigmatised avenues for income. This paper explores the ways in which individuals in eastern DRC engage in, and are affected by, the commoditisation of sex within the context of decades of violent conflict.

Rights Resilience and Program on Gender. 1/2013. "We Came Back with Empty Hands": Understanding the Disarmament, Demobilization and Reintegration of Children Formerly Associated with Armed Groups in the Democratic Republic of the Congo .Abstract

This report documents the experiences and attitudes of former underage combatants in eastern Democratic Republic of the Congo (DRC) who went through the reintegration process, the families and communities who received them and the organizations that funded and implemented reintegration programming. Despite increasing attention to the scope and importance of child soldiering globally, there is still limited systematic research on the successes and challenges of reintegration programming for former underage combatants. This project, a collaboration between the Harvard Humanitarian Initiative and Eastern Congo Initiative, used DRC as a case study to examine the community experiences and attitudes around Disarmament, Demobilization and Reintegration (DDR) programming to generate lessons learned for improving future programming for former underage combatants and at-risk youth.

Jocelyn Kelly and Lindsay Branham. 1/2013. "We Suffer From War and More War": An Assessment of the Impact of the Lord's Resistance Army on Formerly Abducted Children and their Communities in northeastern Democratic Republic of the Congo .Abstract

This study highlights the voices of individuals currently affected by the Lord’s Resistance Army to detail the extensive and systematic devastation felt specifically by formerly abducted children and their communities in northeastern Democratic Republic of the Congo. Respondents stressed that the international community must assist with providing essential services through long-term engagement, including life-saving health services; improving water and sanitation access; and providing psychosocial and educational interventions to formerly abducted children and adults. While these communities are facing emergency-level challenges now, the need for solutions that will last into the future.

Jr. Frederick M. Burkle, P. Gregg Greenough, and Gerald Martone. 1/2014. “The Changing Face of Humanitarian Crises .” Brown Journal of World Affairs, 20, 2, Pp. 19-36.Abstract

The scale and cadence of crises that demand international humanitarian response is increasing. The cumulative frequency and severity of climate change on large populations, rapid and unsustainable urbanization, decreasing biodiversity, and the impending realities of resource scarcities and the armed conflicts they might catalyze are only some of the challenges that loom ahead. It is ironic that while human civilization today possesses the most advanced technologies, global prosperity, and abundance, we face the greatest absolute number of people lacking access to clean water, food, shelter, and basic healthcare.

Adam Khalifa. 6/2014. “Cancer in refugees in Jordan and Syria between 2009 and 2012: challenges and the way forward in humanitarian emergencies.” The Lancet Oncology, 15, 7, Pp. E290-E297. Read PublicationAbstract

Treatment of non-communicable diseases such as cancer in refugees is neglected in low-income and middle-income countries, but is of increasing importance because the number of refugees is growing. The UNHCR, through exceptional care committees (ECCs), has developed standard operating procedures to address expensive medical treatment for refugees in host countries, to decide on eligibility and amount of payment. We present data from funding applications for cancer treatments for refugees in Jordan between 2010 and 2012, and in Syria between 2009 and 2011. Cancer in refugees causes a substantial burden on the health systems of the host countries. Recommendations to improve prevention and treatment include improvement of health systems through standard operating procedures and innovative financing schemes, balance of primary and emergency care with expensive referral care, development of electronic cancer registries, and securement of sustainable funding sources. Analysis of cancer care in low-income refugee settings, particularly in sub-Saharan Africa, is needed to inform future responses.

Jennifer Scott, Sarah Averbach, Anna Merport Modest, Michele Hacker, Sarah Cornish, Danielle Spencer, Maureen Murphy, and Parveen Parmar. 11/2013. “An Assessment of Attitudes Toward Gender Inequitable Sexual and Reproductive Health Norms in South Sudan: a Community-based Participatory Research Approach.” Conflict and Health. Read PublicationAbstract

Communities in South Sudan have endured decades of conflict. Protracted conflict exacerbated reproductive health disparities and gender inequities. This study, conducted prior to the country’s 2011 independence, aimed to assess attitudes toward gender inequitable norms related to sexual relationships and reproductive health and the effects of sex, age, and education on these attitudes.

Jocelyn Kelly and Beth Maclin. 4/2014. Assessing the Impact of Programming to Reduce the Stigmatization of Survivors of Sexual Violence in Eastern Democratic Republic of the Congo.Abstract

This project rigorously evaluated programming that addresses stigma against survivors. In this program evaluation, the Harvard Humanitarian Initiative’s Women in War program worked with the Congolese NGO, Centre d’Assistance Medico-Psychosociale (CAMPS) to assess which parts of their programming are most effective and how to continue to improve services related to reducing stigma. 

Vera Sistenich. 2/2013. “Summary of Polio-Related Attacks on Health Workers”.Abstract

Since 1988, more than 2.5 billion children have been immunized against polio through programs in more than 200 countries involving some 20 million volunteers and an international investment of over US$8 billion. By 2006, polio cases around the world had decreased by over 99% and remained endemic in only four countries – Afghanistan, India, Nigeria and Pakistan – with a handful of other countries reporting sporadic cases. In 2008, the World Health Assembly called for the formulation of a concerted global strategy to eradicate polio from these remaining countries and create a polio-free world. This led to the Global Polio Eradication Initiative (GPEI) Strategic Plan 2010 – 2012, an aggressive action- and time-specific initiative to end polio transmission in the remaining areas where this persisted.

Katherine Albutt, Jocelyn Kelly, Justin Kabanga, and Michael VanRooyen. 4/2017. “Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo.” Disasters, 41, 2, Pp. 211-227. Read PublicationAbstract
Studies report that between 6 per cent and 29 per cent of survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) are rejected by their families and communities. This research project was designed to provide insights into survivors' experiences of stigmatisation and rejection. Surveys were conducted with 310 women as they sought psychosocial services in eastern DRC. In total, 44.3 per cent of women reported suffering rejection after sexual violence. The majority of women felt that their status in the household (58.0 per cent) and community (54.9 per cent) diminished after rape. The odds of rejection were greater among women reporting ongoing displacement, pregnancy owing to sexual violence, worsening family relations, and diminished community status. This work highlights the extremely high levels of loss associated with the war in eastern DRC, particularly among survivors of sexual violence. The rejection of a survivor of rape has concrete and devastating psychosocial consequences.
Brett D. Nelson, Michael VanRooyen, Maya Fehling, Margaret E. Tiernan, Zina Maan Jarrah, Saeed Albezreh, Narra Martineau, and Abdulmohsen Alhokair. 1/2015. Examining the needs of at-risk youth in the Middle East and North Africa: A multi-method landscape analysis and systematic literature review.Abstract
Opportunities for youth can be severely limited among many communities in the Middle East and North Africa (MENA) region that are disrupted by conflict or impoverishment. Recent political and economic factors, as well as a rapidly growing youth population, have greatly increased the vulnerability of at-risk youth in the MENA region. This HHI study utilized a multi-method approach -- including systematic reviews of the peer-reviewed and gray literatures, stakeholder analyses, and in-region discussions with youth and stakeholders -- to identify the current needs, activities, stakeholders, and opportunities related to at-risk youth in the MENA region. It is our hope that this initial report and its recommendations will be a starting point of discussion and collaboration as we develop a cross-disciplinary, cross-institutional Middle East Youth in Crisis Project based at the Harvard Humanitarian Initiative.
10/2016. “Declaration from Academic Humanitarian Training Centers on Syria”.Abstract
Given the current humanitarian crisis in Syria where patients, healthcare workers, and hospitals are under attack, we the undersigned, without presumption of authority or judgment, stand in solidarity with our healthcare colleagues and declare their right to international health neutrality. For many decades, we have provided global healthcare professionals with education and training in humanitarian assistance in sudden onset disasters and conflicts worldwide. In this training and education, each and every healthcare provider, both civilian and military, is made aware of the inherent protections provided to them under international humanitarian law (IHL), including the four Geneva Conventions of 1949, as well as the principles and rules of IHL applicable to the conduct of hostilities, including the targeting of hospitals and medical facilities. These must be upheld. 
Jocelyn Kelly, Lindsay Branham, and Michele R. Decker. 5/2016. “Abducted children and youth in Lord’s Resistance Army in Northeastern Democratic Republic of the Congo (DRC): mechanisms of indoctrination and control.” Conflict and Health. Read PublicationAbstract
Globally, an estimated 300,000 children under the age of 18 participate in combat situations; those in armed groups in particular suffer prolonged exposure to psychological and physical abuse. The Lord’s Resistance Army (LRA) is a rebel movement known for its widespread conscription of children; yet little is known about this process once the group moved beyond northern Uganda. In this paper, we describe the processes related to abduction and indoctrination of youth by the LRA in northeastern Democratic Republic of the Congo ( DRC).
Jocelyn Kelly, Katherine Albutt, Justin Kabanga, Kimberley Anderson, and Michael VanRooyen. 12/2017. “Rejection, acceptance and the spectrum between: understanding male attitudes and experiences towards conflict-related sexual violence in eastern Democratic Republic of Congo.” BMC Women's Health, 17. Read PublicationAbstract
Female survivors of sexual violence in conflict experience not only physical and psychological sequelae from the event itself, but often many negative social outcomes, such as rejection and ostracisation from their families and community. Male relatives – whether husbands, fathers, brothers – play a key role in determining how the family and community respond to a survivor of sexual violence. Understanding these perspectives could help improve services for survivors of sexual violence, as well as their families and communities.

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