RESUMO
BACKGROUND: Empirical evidence is limited and contradictory on violence against children after internal displacement from natural disasters. Understanding how internal displacement affects violence is key in structuring effective prevention and response. OBJECTIVE: We examined the effect of internal displacement from the 2010 Haitian earthquake on long-term physical, emotional, and sexual violence against children and outlined a methodological framework to improve future evidence quality. PARTICIPANTS AND SETTING: We analyzed violence against adolescent girls and boys within the nationally representative, Haiti Violence Against Children Survey. METHODS: We pre-processed data by matching on pre-earthquake characteristics for displaced and non-displaced children and applied 95 % confidence intervals from McNemar's exact test, with sensitivity analyses, to evaluate differences in violence outcomes between matched pairs after the earthquake. RESULTS: Internal displacement was not associated with past 12-month physical, emotional, and sexual violence two years after the earthquake for girls and boys. Most violence outcomes were robust to potential unmeasured confounding. Odds ratios for any form of violence against girls were 0.84 (95 % CI: 0.52-1.33, p = 0.500) and against boys were 1.03 (95 % CI: 0.61-1.73, p = 1.000). CONCLUSIONS: Internal displacement was not a driver of long-term violence against children in Haiti. Current global protocols in disaster settings may initiate services after the optimal window of time to protect children from violence, and the post-displacement setting may be central in determining violence outcomes. The combination of specific data structures and matching methodologies is promising to increase evidence quality after rapid-onset natural disasters, especially in low-resource settings.
Assuntos
Terremotos/estatística & dados numéricos , Desastres Naturais/normas , Socorro em Desastres/normas , Violência/tendências , Feminino , Haiti , História do Século XXI , Humanos , Masculino , Análise por Pareamento , Inquéritos e QuestionáriosRESUMO
The worst rates of preventable mortality and morbidity among women and children occur in humanitarian settings. Reliable, easy-to-use, standardized, and efficient tools for data collection are needed to enable different organizations to plan and act in the most effective way. In 2015, the World Health Organization (WHO) commissioned a review of tools for data collection on the health of women and children in humanitarian emergencies. An update of this review was conducted to investigate whether the recommendations made were taken forward and to identify newly developed tools. Fifty-three studies and 5 new tools were identified. Only 1 study used 1 of the tools identified in our search. Little has been done in terms of the previous recommendations. Authors may not be aware of the availability of such tools and of the importance of documenting their data using the same methods as other researchers. Currently used tools may not be suitable for use in humanitarian settings or may not include the domains of the authors' interests. The development of standardized instruments should be done with all key workers in the area and could be coordinated by the WHO.
Assuntos
Coleta de Dados/instrumentação , Serviços de Saúde Materno-Infantil/normas , Socorro em Desastres/estatística & dados numéricos , Coleta de Dados/estatística & dados numéricos , Humanos , Serviços de Saúde Materno-Infantil/estatística & dados numéricos , Socorro em Desastres/normasRESUMO
Existe uma tensão extraordinária no sistema humanitário: crises e emergências atingem cada vez mais povos, duram mais e são gradativamente mais complexas. As consequências dos conflitos armados e desastres socioambientais para a saúde mental e bem-estar psicossocial de indivíduos e povos, bem como para a ecologia social e os recursos comunitários significativos, já são reconhecidas e continuamente pesquisadas. Esta tese, a seu turno, explora as práticas e políticas do setor de Saúde Mental em emergências humanitárias e toma como ponto de partida analítico o desenvolvimento das Diretrizes do Comitê Permanente Interagências (IASC) em Saúde Mental e Apoio Psicossocial (SMAPS) em emergências humanitárias, lançadas no ano de 2007, assim como sua subsequente disseminação e configuração de governança, além de sua influência sobre projetos e instituições. As diretrizes IASC representam um marco lógico de importante contribuição para o setor de ajuda humanitária, no entanto, ainda constituem um campo de várias disputas e paradoxos, não só na área das referências teóricas e práticas em SMAPS em emergências humanitárias, como também relativamente à sua inserção em uma economia-política do setor de ajuda humanitária paradoxal nos princípios humanitários e éticos. Essa inserção molda as características particulares do funcionamento das Diretrizes e influencia a maneira como se produzem práticas e políticas. Fundamentando-se na pesquisa-ação, nas experiências do autor, o qual atuou como psicólogo na linha de frente em crises humanitárias na Líbia, Gaza, Síria, Timor-Leste e outros contextos, e em entrevistas com atores internacionalmente renomados e responsáveis pela elaboração e gestão de políticas internacionais do setor global de SMAPS, esta tese examina esse processo em detalhe, considerando o desenvolvimento e evolução das Diretrizes IASC de SMAPS e como, atualmente, a área de SMAPS se configura no interior da economia-política do setor humanitário. Mais explicitamente, analisam-se as maneiras como o discurso e a prática do setor de SMAPS são transformados pela estrutura humanitária que ele engendra. Desse modo, e por meio da discussão de todos esses elementos, este trabalho objetiva realizar uma revisão de elementos que influenciam e permitem o desenvolvimento de assistência humanitária seja cooptada em formas particulares que se articulam a interesses não humanitários, moldando substancial e prejudicialmente os projetos de SMAPS em emergências humanitárias ao redor do mundo
There is extraordinary strain placed on the humanitarian system. Crises and emergencies are occurring more often, affecting more people, and in contexts of increasingly complexity. The impacts of conflict and disaster on mental health as well as on the social ecology and community resources needed for coping and recovery are very well documented. This research explores the politics of mental health and psychosocial programmes in humanitarian settings, and its analytical starting point is the development of the Interagency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support (MHPSS) in Emergencies settings launched in the year of 2007. The research explores how the field was developed, its structural governance, trying to explore the political economy configuration of humanitarian organizations providing MHPSS in its discourses, practices and impact. It is demonstrated the MHPSS IASC guidelines unprecedent contribution to the field, however it shows how it is affected by the political economy of aid that it is fundamentally part of. This structural political economy shapes the field and influences the way SMAPS is provided. Using action research, the author\'s own experiences responding to several humanitarian crises for more than 14 years, and interviews with well-known global MHPSS policy makers, this thesis examines this process in detail, considering how the development of the guidelines has developed and evolved, and how the area currently shapes in the political economy of aid. More explicitly, it analyzes the ways in which the discourse and practice of the MHPSS field are transformed by the humanitarian structure it engenders. Despite the field achievements, action research illustrates that this process allows the development of MHPSS response to be co-opted in particular ways that articulate non-humanitarian interests, substantially and harmfully influencing the MHPSS responses
Assuntos
Socorro em Desastres/economia , Socorro em Desastres/normas , Socorro em Desastres/organização & administração , Apoio Social , Saúde Mental/normas , Política de Saúde , Resgate, Assistência e Proteção em DesastresRESUMO
Emergency physicians (EP) are uniquely suited to provide care in crises as a result of their broad training, ability to work quickly and effectively in high-pressure, austere settings, and their inherent flexibility. While emergency medicine training is helpful to support the needs of crisis-affected and displaced populations, it is not in itself sufficient. In this article we review what an EP should carefully consider prior to deployment.
Assuntos
Atenção à Saúde/organização & administração , Planejamento em Desastres/organização & administração , Medicina de Emergência/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Socorro em Desastres/organização & administração , Altruísmo , Competência Clínica , Gestão de Recursos da Equipe de Assistência à Saúde/organização & administração , Gestão de Recursos da Equipe de Assistência à Saúde/normas , Atenção à Saúde/normas , Planejamento em Desastres/normas , Desastres , Terremotos , Educação , Educação Médica/normas , Medicina de Emergência/normas , Haiti , Humanos , Missões Médicas/organização & administração , Missões Médicas/normas , Avaliação das Necessidades/organização & administração , Avaliação das Necessidades/normas , Papel do Médico , Médicos/organização & administração , Médicos/normas , Qualidade da Assistência à Saúde/normas , Socorro em Desastres/normasRESUMO
El presente se aborda la figura de Henry Dunant, activista en favor de la causa humanitaria, fue testigo de las secuelas de la batalla de Solferino en Italia cuyo impacto le llevó a escribir sus memorias y experiencias en el libro "Un recuerdo de Solferino" en el que reclamó la creación de un cuerpo de voluntarios para socorrer a los heridos de guerra sin distinción del bando que fuera. En 1901, recibió el primer Premio Nobel de la Paz por su papel al fundar el Movimiento Internacional de la Cruz Roja (AU).
The current work is about the figure of Henry Dunant, militant in favor of the humanitarian cause. He was a witness of the sequels of Solferino´s battle, in Italy, the impact of which led him to write his memoirs and experiences in the book "A recollection of Solferino". In it he claimed for the creation of a voluntary corps to help war wounded people without distinction of the band where they fought. In 1901 he was awarded the first Nobel Peace Prize because of its role in the foundation of the International Red Crosse Movement (AU).
Assuntos
Humanos , Masculino , Feminino , Cruz Vermelha/história , Socorro em Desastres/história , Socorro em Desastres/normas , Assistência Médica/história , Assistência Médica/normasRESUMO
This paper looks at how the principles of internationalism have been integral to the Cuban healthcare system and to Cuba's cooperation and medical support in other countries around the world. The paper details the range and scope of Cuban health internationalism and the principles that underpin the Cuban approach of long-term collaboration, humane care, contextualization, trans-disciplinarity, respect for collective/historical memory and an ethical stance. The paper details the role of Cuban psychologists who have contributed to disaster relief work and gives an example of the Cuban approach in relation to Haiti following the earthquake in 2010.
Assuntos
Serviços de Saúde/normas , Internacionalidade , Psicologia/normas , Socorro em Desastres/normas , Cuba , Desastres , Terremotos , HumanosRESUMO
PROBLEM: The earthquake that struck Haiti in January 2010 caused 1.5 million people to be displaced to temporary camps. The Haitian Ministry of Public Health and Population and global immunization partners developed a plan to deliver vaccines to those residing in these camps. A strategy was needed to determine whether the immunization targets set for the campaign were achieved. APPROACH: Following the vaccination campaign, staff from the Ministry of Public Health and Population interviewed convenience samples of households - in specific predetermined locations in each of the camps - regarding receipt of the emergency vaccinations. A camp was targeted for "mop-up vaccination" - i.e. repeat mass vaccination - if more than 25% of the children aged 9 months to 7 years in the sample were found not to have received the emergency vaccinations. LOCAL SETTING: Rapid monitoring was implemented in camps located in the Port-au-Prince metropolitan area. Camps that housed more than 5000 people were monitored first. RELEVANT CHANGES: By the end of March 2010, 72 (23%) of the 310 vaccinated camps had been monitored. Although 32 (44%) of the monitored camps were targeted for mop-up vaccination, only six of them had received such repeat mass vaccination when checked several weeks after monitoring. LESSONS LEARNT: Rapid monitoring was only marginally beneficial in achieving immunization targets in the temporary camps in Port-au-Prince. More research is needed to evaluate the utility of conventional rapid monitoring, as well as other strategies, during post-disaster vaccination campaigns that involve mobile populations, particularly when there is little capacity to conduct repeat mass vaccination.
Assuntos
Desastres , Terremotos , Programas de Imunização/organização & administração , Socorro em Desastres/organização & administração , Haiti , Pesquisa sobre Serviços de Saúde , Humanos , Programas de Imunização/normas , Programas de Imunização/estatística & dados numéricos , Socorro em Desastres/normas , Socorro em Desastres/estatística & dados numéricosRESUMO
The magnitude 7.0 earthquake that struck Haiti on 12 January 2010 devastated the capital city of Port-au-Prince and the surrounding area. The area's hospitals suffered major structural damage and material losses. Project HOPE sought to rebuild the medical equipment and clinical engineering capacity of the country. A team of clinical engineers from the United States of America and Haiti conducted an inventory and assessment of medical equipment at seven public hospitals affected by the earthquake. The team found that only 28% of the equipment was working properly and in use for patient care; another 28% was working, but lay idle for technical reasons; 30% was not working, but repairable; and 14% was beyond repair. The proportion of equipment in each condition category was similar regardless of whether the equipment was present prior to the earthquake or was donated afterwards. This assessment points out the flaws that existed in the medical equipment donation process and reemphasizes the importance of the factors, as delineated by the World Health Organization more than a decade ago, that constitute a complete medical equipment donation.
Assuntos
Desastres , Terremotos , Serviço Hospitalar de Emergência , Equipamentos e Provisões , Cooperação Internacional , Socorro em Desastres/organização & administração , Socorro em Desastres/normas , Haiti , Humanos , Estados UnidosRESUMO
El terremoto de magnitud 7,0 que azotó a Haití el 12 de enero del 2010 devastó la capital, Puerto Príncipe, y sus alrededores. Los hospitales del área afectada sufrieron daños estructurales importantes y pérdidas materiales. El Proyecto Hope procuró reconstruir el equipo médico y la capacidad de ingeniería clínica del país. Un equipo deingenieros clínicos de Estados Unidos y Haití realizó un inventario y una evaluación del equipo médico en siete hospitales públicos afectados por el terremoto. El equipo encontró que solo 28% del equipo estaba funcionando adecuadamente y se usaba para la atención de los pacientes; otro 28% funcionaba pero no se empleaba por razones técnicas; 30% del equipo no funcionaba, pero podía repararse; y 14% no funcionaba y no podía repararse. La proporción de equipo en cada categoría fue similar, independientemente de que el equipo estuviera presente antes del terremoto o se hubiera donado después. Esta evaluación señala las fallas en el proceso de donación de equipo médico y recalca la importancia de los factores que implica una donación completa de equipo médico, ya delineados por la Organización Mundial de la Salud hace más de un decenio.
The magnitude 7.0 earthquake that struck Haiti on 12 January 2010 devastated the capital city of Port-au-Prince and the surrounding area. The areas hospitals suffered major structural damage and material losses. Project HOPE sought to rebuild the medical equipment and clinical engineering capacity of the country. A team of clinical engineers from the United States of America and Haiti conducted an inventory and assessment of medical equipment at seven public hospitals affected by the earthquake. The team found that only 28% of the equipment was working properly and in use for patient care; another 28% was working, but lay idle for technical reasons; 30% was not working, but repairable; and 14% was beyond repair.The proportion of equipment in each condition category was similar regardless of whether the equipment was present prior to the earthquake or was donated afterwards. This assessment points out the flaws that existed in the medical equipment donation process and reemphasizes the importance of the factors, as delineated by the World Health Organization more than a decade ago, that constitute a complete medical equipment donation.
Assuntos
Humanos , Desastres , Terremotos , Serviço Hospitalar de Emergência , Equipamentos e Provisões , Cooperação Internacional , Socorro em Desastres/organização & administração , Socorro em Desastres/normas , Haiti , Estados UnidosRESUMO
This article provides results from an online survey of humanitarian workers and volunteers that was conducted in May and June 2010. The purpose of the survey was to understand how the humanitarian aid system adopts or incorporates human rights into its post-natural disaster work and metrics. Data collected from Haiti suggest that humanitarians have embraced a rights-based approach but that they do not agree about how this is defined or about what standards and indicators can be considered rights-based. This disagreement may reveal that humanitarians are aware of a mismatch between the rights-based approach to post-disaster humanitarian work and the legal framework of human rights. Using participation and accountability as examples, this article identifies and examines this mismatch and suggests that the humanitarian aid system should more fully embrace engagement with the human rights framework. To do so, the article concludes, humanitarian actors and the human rights community should have an open dialogue about the development of metrics that accurately reflect and monitor adherence to the legal framework of human rights. This would allow the humanitarian aid system to ensure its interventions enhance the capacity of the disaster-affected state to fulfill its human rights obligations, and would allow humanitarian and human rights actors alike to measure the impact of such interventions on the realization of human rights in post-natural disaster settings.
Assuntos
Altruísmo , Desastres , Direitos Humanos/legislação & jurisprudência , Avaliação de Programas e Projetos de Saúde/métodos , Socorro em Desastres/legislação & jurisprudência , Fortalecimento Institucional , Coleta de Dados , Feminino , Fidelidade a Diretrizes , Haiti , Humanos , Relações Interinstitucionais , Masculino , Socorro em Desastres/normasRESUMO
Months after a 7.0 magnitude earthquake hit Port-au-Prince, Haiti, over one million remain homeless and living in spontaneous internally displaced person (IDP) camps. Billions of dollars from aid organizations and government agencies have been pledged toward the relief effort, yet many basic human needs, including food, shelter, and sanitation, continue to be unmet. The Sphere Project, "Humanitarian Charter and Minimum Standards in Disaster Response," identifies the minimum standards to be attained in disaster response. From a human rights perspective and utilizing key indicators from the Sphere Project as benchmarks, this article reports on an assessment of the living conditions approximately 12 weeks after the earthquake in Parc Jean Marie Vincent, a spontaneous IDP camp in Port-au-Prince. A stratified random sample of households in the camp, proportionate to the number of families living in each sector, was selected. Interview questions were designed to serve as "key indicators" for the Sphere Project minimum standards. A total of 486 interviews were completed, representing approximately 5% of households in each of the five sectors of the camp. Our assessment identified the relative achievements and shortcomings in the provision of relief services in Parc Jean Marie Vincent. At the time of this survey, the Sphere Project minimum standards for access to health care and quantity of water per person per day were being met. Food, shelter, sanitation, and security were below minimum accepted standard and of major concern. The formal assessment reported here was completed by September 2010, and is necessarily limited to conditions in Haiti before the cholera outbreak in October.
Assuntos
Terremotos , Direitos Humanos , Coleta de Dados , Feminino , Haiti , Humanos , Entrevistas como Assunto , Masculino , Socorro em Desastres/normasRESUMO
Partimos de una ineludible realidad, que es la de estar conviviendo desde el principio de la historia con la gran naturaleza de hermosas montañas inmensos océanos, transparentes cielos pero que continuamente nos recuerdan en sus manifestaciones abruptas y muchas veces impredecibles lo vulnerables que somos los seres vivos incluido el medio ambiente en el que nos desarrollamos. Pero no solo la naturaleza es una amenaza sino también el hombre y su incontenible deseo de transformación del entorno con la tecnología y con su afán de conquista han generado violencia, muerte y destrucción en lo que llamamos eventos de orígen antrópico.Los efectos de los eventos adversos al rebasar la capacidad de respuesta institucional o comunitaria nos llevan a una situación de desastre, término que está definido como desgracia grande , o catástrofe, del griego Kathartikos, cuya traaducción significa vuelta, acontecimiento imprevisto y funesto
Assuntos
Planejamento em Desastres/métodos , Planejamento em Desastres/normas , Planejamento em Desastres/tendências , Socorro em Desastres/normasRESUMO
Partimos de una ineludible realidad, que es la de estar conviviendo desde el principio de la historia con la gran naturaleza de hermosas montañas inmensos océanos, transparentes cielos pero que continuamente nos recuerdan en sus manifestaciones abruptas y muchas veces impredecibles lo vulnerables que somos los seres vivos incluido el medio ambiente en el que nos desarrollamos. Pero no solo la naturaleza es una amenaza sino también el hombre y su incontenible deseo de transformación del entorno con la tecnología y con su afán de conquista han generado violencia, muerte y destrucción en lo que llamamos eventos de orígen antrópico.Los efectos de los eventos adversos al rebasar la capacidad de respuesta institucional o comunitaria nos llevan a una situación de desastre, término que está definido como desgracia grande , o catástrofe, del griego Kathartikos, cuya traaducción significa vuelta, acontecimiento imprevisto y funesto
Assuntos
Planejamento em Desastres/estatística & dados numéricos , Planejamento em Desastres/métodos , Planejamento em Desastres/normas , Planejamento em Desastres/tendências , Socorro em Desastres/normas , Socorro em Desastres/organização & administraçãoRESUMO
In the last years Mexico faced several natural and human provoked disasters. We choose the Mexico City earthquake, the Chichonal volcano eruption, the Guatemala war and its refugees and the Chiapas armed movement. In all of them the INCMNSZ surveillance system proposal has been applied. To establish the intervention we classified the emergencies according to its magnitude and localization. The intervention consisted in: immediate attention of serious cases, immunizations, quimioprofilaxis, personal hygiene, environment control, nutritional assessment and diet definition. The affected population attended were: in the eruption 4.500, in the earthquake 1.000, in the Guatemala war 19.000 and in the Chiapas movement 6.940. Population damaged by the eruption and the war received mass feeding; complementary feeding (vulnerable groups) and therapeutic feeding (people with tuberculosis and serious undernutrition). In the earthquake people received first, prepared food and later they were organized to bring, plan, prepare and distribute their food. In the Chiapas armed movement people received only special baby food. In all cases, population also receive nutritional information and only with the refugees and the Chiapas damaged people the local food production was promoted. We suggest evaluating every emergency program and share experiences to afford this type of situations in a better way.
Assuntos
Desastres , Abastecimento de Alimentos , Socorro em Desastres/organização & administração , Guerra , Humanos , México , Refugiados , Socorro em Desastres/normas , Erupções VulcânicasAssuntos
Países em Desenvolvimento , Morbidade , Preparações Farmacêuticas , Socorro em Desastres , Haiti/epidemiologia , Humanos , Cooperação Internacional , Preparações Farmacêuticas/classificação , Preparações Farmacêuticas/provisão & distribuição , Socorro em Desastres/normas , Estados Unidos , VoluntáriosRESUMO
The average Japanese disaster, according to the British environmental agency Earthscan, kills 63 people. In Peru, however, the average death toll is 2,900 persons. This is because poor countries, and the poorest people within poor countries, are the most vulnerable--and it is vulnerability that kills.