Health

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.
Jocelyn Kelly, Elizabeth Colantuoni, Courtland Robinson, and Michele R Decker. 4/2018. “From the battlefield to the bedroom: a multilevel analysis of the links between political conflict and intimate partner violence in Liberia.” BMJ Global Health, 3, 2. Read PublicationAbstract

Objectives Assess the link between levels of armed conflict and postconflict intimate partner violence (IPV) experienced by women in Liberia.

Methods Armed Conflict Location and Event Data Project data were used to measure conflict-related fatalities in districts in Liberia during the country’s civil war from 1999 to 2003. These data were linked to individual-level data from the 2007 Demographic and Health Survey, including past-year IPV. Multilevel logistic models accounting for the clustering of women within districts evaluated the relationship of conflict fatalities with postconflict past-year IPV. Additional conflict measures, including conflict events and cumulative years of conflict, were assessed.

Results After adjusting for individual-level characteristics correlated with IPV, residence in a conflict fatality-affected district was associated with a 50% increase in risk of IPV (adjusted OR (aOR): 1.55, 95% CI 1.26 to 1.92). Women living in a district that experienced 4–5 cumulative years of conflict were also more likely to experience IPV (aOR 1.88, 95% CI 1.29 to 2.75).

Conclusion Residing in a conflict-affected district even 5 years after conflict was associated with postconflict IPV.

Policy implications Recognising and preventing postconflict IPV violence is important to support long-term recovery in postconflict settings.

Susan Andrea Bartels, Saja Michael, Sophie Roupetz, Stephanie Garbern, Lama Kilzar, Harveen Bergquist, Nour Bakhache, Colleen Davison, and Annie Bunting. 1/2018. “Making sense of child, early and forced marriage among Syrian refugee girls: a mixed methods study in Lebanon.” BMJ Global Health, 3, 1. Read PublicationAbstract

The Syrian conflict has resulted in over 2.3 million child refugees in the Middle East and the prevalence of early marriage has reportedly increased among displaced Syrian families. This study explores the underlying factors contributing to child marriage among Syrian refugees in Lebanon with the goal of informing community-based strategies to address the issue.

In July–August 2016, trained interviewers collected self-interpreted stories in Lebanon using Cognitive Edge’s SenseMaker, a mixed-method data collection tool. Participants included married and unmarried Syrian girls, Syrian parents as well as married and unmarried men. Each participant shared a story about the experiences of Syrian girls and then interpreted the story by plotting their perspectives on a variety of questions. Patterns in the responses were analysed in SPSS and the accompanying qualitative narratives were reviewed to facilitate interpretation of the quantitative results.

Ronak B. Patel. 12/2018. “Precision Health in Disaster Medicine and Global Public Health.” Prehospital and Disaster Medicine, 33, 6, Pp. 565 - 566. Read PublicationAbstract
Current debates about precision medicine take different perspectives on its relevance and value in global health. The term has not yet been applied to disaster medicine or humanitarian health, but it may hold significant value. An interpretation of the term for global public health and disaster medicine is presented here for application to vulnerable populations. Embracing the term may drive more efficient use and targeting of limited resources while encouraging innovation and adopting the new approaches advocated in current humanitarian discourse.
Patrick Vinck, Phuong Pham, Kenedy Bungu, Juliet Bedford, and Eric Nilles. 3/2019. “Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu, DR Congo: a population-based survey.” The Lancet Infectious Diseases, 19, 5, Pp. 529-536. Read PublicationAbstract
The current outbreak of Ebola in eastern DR Congo, beginning in 2018, emerged in a complex and violent political and security environment. Community-level prevention and outbreak control measures appear to be dependent on public trust in relevant authorities and information, but little scholarship has explored these issues. We aimed to investigate the role of trust and misinformation on individual preventive behaviours during an outbreak of Ebola virus disease (EVD).

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