Articles

Comments on the article: “Syrian refugees in Lebanon: the search for universal health coverage”

This letter intends to clarify information and misconceptions found in the article “Syrian refugees in Lebanon: the search for universal health coverage” which was published June 1st, 2016, and to challenge th...

Authors: Walid Ammar, Alissar Radi and Fadi El-Jardali

Excess mortality in refugees, internally displaced persons and resident populations in complex humanitarian emergencies (1998–2012) – insights from operational data

Complex humanitarian emergencies are characterised by a break-down of health systems. All-cause mortality increases and non-violent excess deaths (predominantly due to infectious diseases) have been shown to o...

Authors: Peter Heudtlass, Niko Speybroeck and Debarati Guha-Sapir

Psychosocial wellbeing and physical health among Tamil schoolchildren in northern Sri Lanka

Mental disorders contribute to the global disease burden and have an increased prevalence among children in emergency settings. Good physical health is crucial for mental well-being, although physical health i...

Authors: Alexander Hamilton, Charlie Foster, Justin Richards and Rajendra Surenthirakumaran

Dangerous crossing: demographic and clinical features of rescued sea migrants seen in 2014 at an outpatient clinic at Augusta Harbor, Italy

In recent years Europe has received an increasing influx of migrants, many of whom risked their lives crossing the Mediterranean Sea. In October 2013, Italy launched a search and rescue operation at sea in res...

Authors: Alessia Trovato, Anthony Reid, Kudakwashe C. Takarinda, Chiara Montaldo, Tom Decroo, Philip Owiti, Francesco Bongiorno and Stefano Di Carlo

Syrian refugees in Lebanon: the search for universal health coverage

The crisis in Syria has forced more than 4 million people to find refuge outside Syria. In Lebanon, in 2015, the refugee population represented 30 % of the total population. International health assistance has...

Authors: Karl Blanchet, Fouad M. Fouad and Tejendra Pherali

Abducted children and youth in Lord’s Resistance Army in Northeastern Democratic Republic of the Congo (DRC): mechanisms of indoctrination and control

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 Resis...

Authors: Jocelyn TD Kelly, Lindsay Branham and Michele R. Decker

The mortality in Gaza in July—September 2014: a retrospective chart-review study

The majority of Gazans who were killed or injured in the 2014 Israel—Gaza war were civilians, and one-fourth of the population were internally displaced. As the Gaza Strip is a small territory, the whole popul...

Authors: Arild Vaktskjold, Mohammad Yaghi, Usama Balawi, Bjørn Iversen and Wendy Venter

Comprehensive development and testing of the ASIST-GBV, a screening tool for responding to gender-based violence among women in humanitarian settings

Conflict affected refugees and internally displaced persons (IDPs) are at increased vulnerability to gender-based violence (GBV). Health, psychosocial, and protection services have been implemented in humanita...

Authors: A. L. Wirtz, N. Glass, K. Pham, N. Perrin, L. S. Rubenstein, S. Singh and A. Vu

A quantitative assessment of termination of sexual violence-related pregnancies in eastern Democratic Republic of Congo

Sexual violence is prevalent in eastern Democratic Republic of Congo (DRC), and has resulted in sexual violence-related pregnancies (SVRPs). Despite restrictive laws, women may seek to terminate SVRPs; however...

Authors: Shada A. Rouhani, Jennifer Scott, Gillian Burkhardt, Monica A. Onyango, Sadia Haider, Ashley Greiner, Katherine Albutt, Michael VanRooyen and Susan A. Bartels

Why don’t humanitarian organizations provide safe abortion services?

Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors’ observations suggest th...

Authors: Therese McGinn and Sara E. Casey

Global assistance in caring for Syrian refugees

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Authors: Mujalli Mhailan Murshidi

Retrospective analysis of reproductive health indicators in the United Nations High Commissioner for Refugees post-emergency camps 2007–2013

The United Nations Refugee Agency’s Health Information System issues analytical reports on the current camp conditions and trends for priority reproductive health issues. The goal was to assess the status of r...

Authors: Jennifer Whitmill, Curtis Blanton, Sathyanarayanan Doraiswamy, Nadine Cornier, Marian Schilperood, Paul Spiegel and Barbara Tomczyk

Attitudes of Palestinian medical students on the geopolitical barriers to accessing hospitals for clinical training: a qualitative study

The movement of Palestinians in the occupied Palestinian territories is restricted by bureaucratic and physical obstacles. To date, no studies have examined the barriers that Palestinian medical students face ...

Authors: Sarrah Shahawy and Megan Diamond

Road traffic fatalities in selected governorates of Iraq from 2010 to 2013: prospective surveillance

The insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries. As road t...

Authors: Eva Leidman, Maret Maliniak, Abdul-Salam Saleh Sultan, Ahmed Hassan, Syed Jaffar Hussain and Oleg O. Bilukha

Acknowledgement of manuscript reviewers 2015

The editors of Conflict and Health would like to thank all our reviewers who have contributed to the journal in Volume 9 (2015).

Authors: Ruwan Ratnayake, Bayard Roberts, Michelle Gaffey and Adrianna Murphy

Psychometric properties and reliability of the Assessment Screen to Identify Survivors Toolkit for Gender Based Violence (ASIST-GBV): results from humanitarian settings in Ethiopia and Colombia

Refugees and internally displaced persons who are affected by armed-conflict are at increased vulnerability to some forms of sexual violence or other types of gender-based violence. A validated, brief and easy...

Authors: Alexander Vu, Andrea Wirtz, Kiemanh Pham, Sonal Singh, Leonard Rubenstein, Nancy Glass and Nancy Perrin

Neonatal outcomes of Syrian refugees delivered in a tertiary hospital in Ankara, Turkey

We retrospectively reviewed the medical records of all Syrian immigrants from the TurkishSyrian border who delivered the Zekai Tahir Burak Maternity and Teaching Hospital Neonatal Intensive Care Unit (NICU) in...

Authors: Mehmet Büyüktiryaki, Fuat Emre Canpolat, Evrim Alyamaç Dizdar, Nilüfer Okur and Gülsüm Kadıoğlu Şimşek

Soap is not enough: handwashing practices and knowledge in refugee camps, Maban County, South Sudan

Refugees are at high risk for communicable diseases due to overcrowding and poor water, sanitation, and hygiene conditions. Handwashing with soap removes pathogens from hands and reduces disease risk. A hepati...

Authors: Raina M Phillips, Jelena Vujcic, Andrew Boscoe, Thomas Handzel, Mark Aninyasi, Susan T Cookson, Curtis Blanton, Lauren S Blum and Pavani K Ram

Providing surgery in a war-torn context: the Médecins Sans Frontières experience in Syria

Since 2011, civil war has crippled Syria leaving much of the population without access to healthcare. Various field hospitals have been clandestinely set up to provide basic healthcare but few have been able t...

Authors: Miguel Trelles, Lynette Dominguez, Katie Tayler-Smith, Katrin Kisswani, Alberto Zerboni, Thierry Vandenborre, Silvia Dallatomasina, Alaa Rahmoun and Marie-Christine Ferir

Psychological distress and its associations with past events in pregnant women affected by armed conflict in Swat, Pakistan: a cross sectional study

The public health significance of maternal mental health is well established. Armed conflicts expose populations to events that could have long-term negative consequences for mental health of pregnant women an...

Authors: Muhammad Naseem Khan, Anna Chiumento, Mukesh Dherani, Katie Bristow, Siham Sikander and Atif Rahman

Coping among trauma-affected youth: a qualitative study

Eastern Democratic Republic of Congo has endured decades of conflict resulting in widespread experiences of conflict related trauma and destruction to health and social infrastructure. The aim of this qualitat...

Authors: Megan Cherewick, Anjalee Kohli, Mitima Mpanano Remy, Clovis Mitima Murhula, Arsene Kajabika Bin Kurhorhwa, Alfred Bacikenge Mirindi, Nadine Mwinja Bufole, Jean Heri Banywesize, Gisele Mushengezi Ntakwinja, Gracia Mitima Kindja and Nancy Glass

Child health in Syria: recognising the lasting effects of warfare on health

The war in Syria, now in its fourth year, is one of the bloodiest in recent times. The legacy of war includes damage to the health of children that can last for decades and affect future generations. In this a...

Authors: Delan Devakumar, Marion Birch, Leonard S. Rubenstein, David Osrin, Egbert Sondorp and Jonathan C. K. Wells

Militarization, human rights violations and community responses as determinants of health in southeastern Myanmar: results of a cluster survey

The Myanmar army and ethnic armed groups agreed to a preliminary ceasefire in 2012, but a heavy military presence remains in southeastern Myanmar. Qualitative data suggested this militarization can result in h...

Authors: William W. Davis, Luke C. Mullany, Matt Schissler, Saw Albert and Chris Beyrer

The influence of maternal health education on the place of delivery in conflict settings of Darfur, Sudan

Armed conflict and socio-demographic characteristics of internally displaced persons (IDPs) are very important factors that influence the provision of reproductive health (RH) in humanitarian settings. Materna...

Authors: Izzeldin F. Adam

Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building

Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. A systems dynamics analysis was conducted to identify key pathways of threat to provision and emerging pat...

Authors: Alastair K. Ager, Martina Lembani, Abdulaziz Mohammed, Garba Mohammed Ashir, Ahmad Abdulwahab, Helen de Pinho, Peter Delobelle and Christina Zarowsky

Internal displacement and the Syrian crisis: an analysis of trends from 2011–2014

Since the start of the Syrian crisis in 2011, civil unrest and armed conflict in the country have resulted in a rapidly increasing number of people displaced both within and outside of Syria. Those displaced f...

Authors: Shannon Doocy, Emily Lyles, Tefera D. Delbiso and Courtland W. Robinson

Coincident polio and Ebola crises expose similar fault lines in the current global health regime

In 2014, the World Health Organization (WHO) declared two "public health emergencies of international concern", in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. ...

Authors: Philippe Calain and Caroline Abu Sa’Da

Conflict, displacement and sexual and reproductive health services in Mali: analysis of 2013 health resources availability mapping system (HeRAMS) survey

Little is known specifically about the effects of conflict and displacement on provision of sexual and reproductive health (SRH) services. We aimed to understand the association between levels of conflict and ...

Authors: Özge Tunçalp, Ibrahima Socé Fall, Sharon J. Phillips, Inga Williams, Massambou Sacko, Ousmane Boubacar Touré, Lisa J. Thomas and Lale Say

Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: qualitative evidence using the most significant change technique

More than a decade of conflict has weakened the health system in the Democratic Republic of Congo and decreased its ability to respond to the needs of the population. Community scorecards have been conceived a...

Authors: Lara S. Ho, Guillaume Labrecque, Isatou Batonon, Viviana Salsi and Ruwan Ratnayake

A pilot study of a portable hand washing station for recently displaced refugees during an acute emergency in Benishangul-Gumuz Regional State, Ethiopia

Diarrheal disease is a common cause of morbidity and mortality. Displaced populations are especially vulnerable due to overcrowded camps and limited access to water and sanitation facilities, increasing the ri...

Authors: Farah Husain, Colleen Hardy, Lemlem Zekele, David Clatworthy, Curtis Blanton and Thomas Handzel

Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specifi...

Authors: Zohra S. Lassi, Wafa Aftab, Shabina Ariff, Rohail Kumar, Imtiaz Hussain, Nabiha B. Musavi, Zahid Memon, Sajid B. Soofi and Zulfiqar A. Bhutta

Perceptions, attitude and use of family planning services in post conflict Gulu district, northern Uganda

Northern Uganda was severely affected by two decades of civil war that led to the displacement and encampment of an estimated 1.6 million inhabitants. The objective of this study was to assess community perspe...

Authors: Christopher Garimoi Orach, George Otim, Juliet Faith Aporomon, Richard Amone, Stephen Acellam Okello, Beatrice Odongkara and Henry Komakech

Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone

Ebola seems to be a particular risk in conflict affected contexts. All three of the countries most affected by the 2014-15 outbreak have a complex conflict-affected recent history. Other major outbreaks in the...

Authors: Barbara McPake, Sophie Witter, Sarah Ssali, Haja Wurie, Justine Namakula and Freddie Ssengooba

Mental health of displaced and returnee populations: Insight from the Sri Lankan post-conflict experience

The month of May 2015 marked the sixth year since the end of conflict in Sri Lanka. The cause of death, destruction and displacement, three decades of conflict has had a major impact on health, especially on m...

Authors: Chesmal Siriwardhana

Integrating staff well-being into the Primary Health Care system: a case study in post-conflict Kosovo

Staff well-being including stress awareness and stress management skills is usually not a priority in (mental) health policies. In Kosovo, the level of stress amongst primary health care (PHC) professionals is...

Authors: Albertien van der Veen, Tineke van Pietersom, Barbara Lopes Cardozo, Feride Rushiti, Genc Ymerhalili and Ferid Agani

Mechanisms underpinning interventions to reduce sexual violence in armed conflict: A realist-informed systematic review

Sexual violence is recognised as a widespread consequence of armed conflict and other humanitarian crises. The limited evidence in literature on interventions in this field suggests a need for alternatives to ...

Authors: Jo Spangaro, Chinelo Adogu, Anthony B. Zwi, Geetha Ranmuthugala and Gawaine Powell Davies

Assessments of health services availability in humanitarian emergencies: a review of assessments in Haiti and Sudan using a health systems approach

Assessing the availability of health services during humanitarian emergencies is essential for understanding the capacities and weaknesses of disrupted health systems. To improve the consistency of health faci...

Authors: Jason W. Nickerson, Janet Hatcher-Roberts, Orvill Adams, Amir Attaran and Peter Tugwell

Analyzing Katana referral hospital as a complex adaptive system: agents, interactions and adaptation to a changing environment

This study deals with the adaptation of Katana referral hospital in Eastern Democratic Republic of Congo in a changing environment that is affected for more than a decade by intermittent armed conflicts. His o...

Authors: Hermès Karemere, Nathalie Ribesse, Bruno Marchal and Jean Macq

“Impact of and response to increased tuberculosis prevalence among Syrian refugees compared with Jordanian tuberculosis prevalence: case study of a tuberculosis public health strategy”

By the summer of 2014, the Syrian crisis resulted in a regional humanitarian emergency with 2.9 million refugees, including 608,000 in Jordan. These refugees access United Nations High Commissioner for Refugee...

Authors: Susan T. Cookson, Hiba Abaza, Kevin R. Clarke, Ann Burton, Nadia A. Sabrah, Khaled A. Rumman, Nedal Odeh and Marwan Naoum

Access to healthcare for the most vulnerable migrants: a humanitarian crisis

A series of Médecins Sans Frontières projects for irregular migrants over the past decade have consistently documented high rates of 14 physical and sexual trauma, extortion and mental illness amidst severe he...

Authors: Kevin Pottie, Jorge Pedro Martin, Stephen Cornish, Linn Maria Biorklund, Ivan Gayton, Frank Doerner and Fabien Schneider

Diabetes in an emergency context: the Malian case study

The World Health Organization proposes 6 building blocks for health systems. These are vulnerable to challenges in many contexts. Findings from a 2004 assessment of the health system in Mali for diabetes care ...

Authors: Stéphane Besançon, Ibrahima-Soce Fall, Mathieu Doré, Assa Sidibé, Olivier Hagon, François Chappuis and David Beran

A cross-case comparative analysis of international security forces’ impacts on health systems in conflict-affected and fragile states

Destruction of health systems in fragile and conflict-affected states increases civilian mortality. Despite the size, scope, scale and political influence of international security forces intervening in fragil...

Authors: Margaret Bourdeaux, Vanessa Kerry, Christian Haggenmiller and Karlheinz Nickel

A tool to improve competence in the management of emergency patients by rural clinic health workers: a pilot assessment on the Thai-Myanmar border

Shoklo Malaria Research Unit has been providing health care in remote clinics on the Thai-Myanmar border to refugee and migrant populations since 1986 and 1995, respectively. Clinics are staffed by local healt...

Authors: Lilian Stanley, Thaw Htwe Min, Hla Hla Than, Marie Stolbrink, Kathryn McGregor, Cindy Chu, François H Nosten and Rose McGready

Health status and health needs of older refugees from Syria in Lebanon

The flight of Syrian and Palestinian families into Lebanon from Syria included a number of older refugees. This study sought to characterize the physical and emotional conditions, dietary habits, coping practi...

Authors: Jonathan Strong, Christopher Varady, Najla Chahda, Shannon Doocy and Gilbert Burnham

Health in the service of state-building in fragile and conflict affected contexts: an additional challenge in the medical-humanitarian environment

Global health policy and development aid trends also affect humanitarian health work. Reconstruction, rehabilitation and development initiatives start increasingly earlier after crisis, unleashing tensions bet...

Authors: Mit Philips and Katharine Derderian

Neuropsychiatric disorders among Syrian and Iraqi refugees in Jordan: a retrospective cohort study 2012–2013

The burden of neuropsychiatric disorders in refugees is likely high, but little has been reported on the neuropsychiatric disorders that affect Syrian and Iraqi refugees in a country of first asylum. This anal...

Authors: Erica D McKenzie, Paul Spiegel, Adam Khalifa and Farrah J Mateen

Advancing reproductive health on the humanitarian agenda: the 2012-2014 global review

Authors: Sarah K Chynoweth

Availability and distribution of human resources for provision of comprehensive emergency obstetric and newborn care in Afghanistan: a cross-sectional study

For over a decade, Afghanistan’s Ministry of Public Health and its international development partners have invested in strengthening the national health workforce and establishing a system of primary health ca...

Authors: Manizha Faqir, Partamin Zainullah, Hannah Tappis, Jaime Mungia, Sheena Currie and Young Mi Kim

An assessment of antenatal care among Syrian refugees in Lebanon

After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian ref...

Authors: Matthew Benage, P Gregg Greenough, Patrick Vinck, Nada Omeira and Phuong Pham

Assessing the experiences of intra-uterine device users in a long-term conflict setting: a qualitative study on the Thailand-Burma border

In Burma, severe human rights violations, civil conflict, and the persecution of ethnic and linguistic minority populations has resulted in the displacement of millions of people, many of whom now reside as in...

Authors: Jillian Gedeon, Saw Nanda Hsue, Meredith Walsh, Cari Sietstra, Hay MarSan and Angel M Foster