Global & Disaster Medicine

Archive for the ‘Conflict’ Category

December 7, 1941: 2,400 Americans killed and 1,200 wounded


Yemen: No food, no money, but lots of child brides

NYT

“…..beggars congregate outside supermarkets filled with goods; markets are filled with produce in towns where the hungry eat boiled leaves; and restaurants selling rich food are a few hundred yards from hunger wards filled with desperation, pain and death...…”

UNICEF

“…..In the midst of this national catastrophe, desperate families are increasingly turning to child marriage: Today, more than two thirds of girls are married off before the age of 18, compared to 50 percent before the crisis began.

Parents marry off their daughters to be relieved of the cost of their care, or because they believe a husband’s family can offer better protection. Families also sell their daughters for dowry payments to cope with conflict-related hardship. Child brides are especially common in parts of Yemen that host large numbers of displaced people…..”


The UN Security Council passes a resolution demanding that all armed rebel groups in Ebola outbreak zones respect international law.

UN

Adopting Resolution 2439 (2018), Security Council Condemns Attacks by Armed Groups in Democratic Republic of Congo Jeopardizing Response to Ebola Outbreak

The Security Council today adopted a resolution condemning attacks by armed groups in the Democratic Republic of the Congo and their role in exacerbating the country’s ongoing Ebola outbreak, while demanding full, safe, immediate and unhindered access for the humanitarian and medical personnel working to save lives and prevent the virus from spreading across the region.

Adopting resolution 2439 (2018) by consensus, the Council reiterated its deep concern about the Democratic Republic of the Congo’s overall security and humanitarian situation, noting that both are exacerbated by the destabilizing activities of foreign and domestic armed groups.  Recalling that the country’s Government bears the primary responsibility to protect civilians within its territory — including from crimes against humanity and war crimes — it expressed further concern about the security situation in areas affected by the recent Ebola outbreak and called for the immediate cessation of hostilities by all armed groups, including the Allied Democratic Forces (ADF).

Condemning in the strongest terms all attacks by armed groups — including those posing serious security risks for responders and jeopardizing the response to the Ebola outbreak — the Council demanded that all parties fully respect international law and ensure full, safe, immediate and unhindered access for humanitarian and medical personnel, as well as their equipment, transport and supplies.

By other terms of the text, the Council stressed the need for the international community to remain engaged in the strengthening of national health systems in line with the needs of the Government of the Democratic Republic of the Congo, noting that such efforts are instrumental in preventing a deterioration of the present crisis or addressing a future recurrence.  It also emphasized the need for the Government, along with all relevant actors, to enhance efforts to implement — and communicate to the public — the established safety and health protocols and preventive measures to mitigate misinformation and undue alarm about the transmission and extent of the outbreak.

In addition, the Council took note of the World Health Organization’s (WHO) latest risk assessment regarding regional spread, expressing concern about the potential for the virus to expand to Uganda, Rwanda, South Sudan and Burundi.  In that regard, it encouraged the Governments of those countries to continue efforts to prepare for operational readiness and emphasized the importance of maintaining flexible international support — financial, technical and in-kind — to bring the Ebola outbreak successfully under control.

Speaking following the adoption, Taye Atske Selassie (Ethiopia), one of the resolution’s two main co‑sponsors along with Sweden, noted that negotiations on the text were sparked by two recent briefings to the Council from the WHO Director‑General.  Commending the leadership of the Government of the Democratic Republic of the Congo in responding to the Ebola outbreak, he declared:  “Humanitarian actors are operating under enormous difficulties to save lives.”  Today’s resolution underscores the need to address the security risks that are complicating those critical efforts even further.  Welcoming concerted efforts by WHO and the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), he said that while the former has decided that a “public health emergency of international concern” should not be declared at this time, officials remain deeply concerned and have called for intensified and ongoing vigilance.

Carl Skau (Sweden) said the text sends a clear message to all those involved in front‑line response efforts in the Democratic Republic of the Congo and neighbouring countries.  Emphasizing that those working to save lives on the ground must never become targets themselves, he noted that the text commends the continued leadership of the WHO and other relevant actors and aims to remind all stakeholders of the importance of strengthening national health systems.  In addition, it calls for full, safe and unhindered humanitarian access and accelerating funding to combat the outbreak.  Noting that Sweden intends to provide additional funding to those efforts, he asked other Member States to consider doing the same, emphasizing that the Democratic Republic of the Congo stands at a pivotal moment in its history.

The meeting began at 10 a.m. and ended at 10:10 a.m.

Resolution

The full text of resolution 2439 (2018) reads as follows:

The Security Council,

Expressing grave concern about the most recent outbreak of the Ebola virus in the Democratic Republic of the Congo and the fact that this epidemic is occurring in the context of much wider humanitarian needs, in a country whose people have suffered from the recurrence of the disease, armed conflict and violence for the last few decades,

Recognizing the recurring threat of the Ebola virus in the region since it was first discovered in 1976 and recalling its Resolution 2177 (2014) concerning the 2014 Ebola virus outbreak in West Africa,

Recalling its determination in resolution 2409 (2018) that the situation in the Democratic Republic of the Congo continues to constitute a threat to international peace and security in the region, and expressing concern that this security situation negatively impacts the ability to respond to and contain the outbreak of the Ebola virus,

Reaffirming its strong commitment to the sovereignty, independence, unity and territorial integrity of the Democratic Republic of the Congo and all States in the region, and emphasizing the need for cooperation and coordination with the Democratic Republic of the Congo to address the Ebola situation, as well as with the States in the region, as appropriate,

Noting the reports presented to the Security Council on 28 August and on 3 October 2018 by the Director‑General of the World Health Organization (WHO),

Commending the Government of the Democratic Republic of the Congo for its leadership in responding to the Ebola outbreak, particularly for providing free health care in affected health zones, as well as for its daily reporting on the status of the outbreak,

Expressing appreciation for the efforts of all humanitarian and health workers on the ground, including WHO and its partners in the Global Outbreak Alert and Response Network, as well as all other front-line actors involved in the response effort,

Commending the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) for providing support to the efforts of the government of the Democratic Republic of the Congo, WHO and other actors to respond to the Ebola outbreak in an extremely challenging and dangerous environment,

Underscoring the need to address the security situation in the areas affected by the disease and condemning all attacks against civilians,

Expressing outrage and condemning in the strongest terms the recent attacks and the killings of two Congolese health workers attached to a Congolese army unit helping to combat the Ebola outbreak in the Democratic Republic of the Congo,

Recalling resolution 2286 (2016) and urging all parties to the armed conflict to ensure full, safe, immediate and unhindered access for humanitarian personnel and medical personnel, to patients and others in need; condemning acts of violence, attacks and threats intentionally directed against medical personnel and humanitarian personnel exclusively engaged in medical duties, their means of transport and equipment, as well as hospitals and other medical facilities, exclusively fulfilling a medical or humanitarian function, as a violation of international humanitarian law; and deploring the long‑term consequences of such attacks for the civilian population and the health-care system of the Democratic Republic of the Congo,

Recalling the International Health Regulations (2005), which are contributing to global public health security by improving the capacity of all countries to detect, assess, notify and respond to public health threats, underscoring the importance of abiding by these commitments and urging Member States to follow the advice of the WHO Director‑General regarding the current Ebola outbreak,

Taking note of the cross‑border meeting among east African countries held in Entebbe, Uganda, on 3 October 2018, which reviewed the implementation of cross-border disease surveillance activities and the status of emergency preparedness activities in districts that border the Democratic Republic of the Congo and the East African Community; noting the need for awareness creation among district leaders in their roles in implementing the International Health Regulations (2005), and drawing attention to large‑scale population displacements in the region that could contribute to further spread of the Ebola virus,

Underscoring that the control of outbreaks of major infectious diseases requires urgent action and greater national, regional and international collaboration and, in this regard, stressing the crucial and continued need for a WHO coordinated international response in the Democratic Republic of the Congo in collaboration with the Government,

Commending Member States and multilateral organizations that have provided crucial assistance, including financial commitments, technical support and in-kind donations, to support the scaling up of emergency efforts to contain the Ebola outbreak and interrupt transmission of the virus, including by providing flexible funds to relevant United Nations agencies and international organizations, facilitating a more rapid and effective response and enabling them and national governments to purchase supplies and enhance emergency operations in the Democratic Republic of the Congo and neighbouring countries, as well as by collaborating with public and private sector partners to accelerate development of therapeutics, vaccines and diagnostics to treat patients and limit or prevent further infection or transmission,

Welcoming the efforts of the African Union (AU), through the Africa Centre for Disease Control and Prevention (Africa CDC) in providing support to the government of the Democratic Republic of the Congo, WHO and its partners through a united, comprehensive and collective response to the outbreak, including through the deployment of healthcare workers to the eastern part of the Democratic Republic of the Congo,

Emphasizing the role of all relevant United Nations System entities in supporting the national, regional and international efforts to respond to the Ebola outbreak, and recognizing in this regard the leading role of WHO,

Taking note of the WHO protocols to prevent the transmission of the Ebola virus disease between individuals, organizations and populations, and underlining that the Ebola outbreak can be contained, including through the implementation of established safety and health protocols and other preventive measures that have proven effective,

“1.   Reiterates its deep concern regarding the overall security and humanitarian situation in the Democratic Republic of the Congo, exacerbated by destabilizing activities of foreign and domestic armed groups, recalls the strategic importance of the implementation of the Peace, Security and Cooperation (PSC) Framework for the Democratic Republic of the Congo and the region, and reiterates its call to all signatories to fulfil their respective commitments under this Framework in order to address the root causes of conflict and put an end to recurring cycles of violence, and promote lasting regional development;

“2.   Encourages the government of the Democratic Republic of the Congo, WHO, and other Ebola responders to continue to improve the transparency and accuracy of the daily reporting on the status of the outbreak;

“3.   Recalls that the Government of the Democratic Republic of the Congo bears the primary responsibility to protect civilians within its territory and subject to its jurisdiction, including protection from crimes against humanity and war crimes;

“4.   Expresses serious concern regarding the security situation in the areas affected by the Ebola outbreak, which is severely hampering the response efforts and facilitating the spread of the virus in the Democratic Republic of the Congo and the wider region; and calls for immediate cessation of hostilities by all armed groups, including the Allied Democratic Forces (ADF);

“5.   Condemns in the strongest terms all attacks by armed groups, including those posing serious security risks for responders and jeopardizing the response to the Ebola outbreak;

“6.   Demands that all parties to the armed conflict fully respect international law, including, as applicable, international human rights law and international humanitarian law, including their obligations under the Geneva Conventions of 1949 and the obligations applicable to them under the Additional Protocols thereto of 1977 and 2005, and further demands that all parties ensure full, safe, immediate and unhindered access for humanitarian and medical personnel, and their equipment, transport and supplies to the affected areas, and to respect and protect all civilians, including those in the region who are at risk of Ebola, and humanitarian and health workers; stresses that humanitarian response teams and hospitals and other medical facilities providing life-saving assistance and relief to those in need must be respected and protected, and that they must not be a target, in accordance with international law;

“7.   Notes the important positive role of MONUSCO, within its existing mandate, in supporting the efforts of the government of the Democratic Republic of the Congo, WHO and other actors to bring the Ebola outbreak successfully under control and in ensuring, within its area of operations, effective protection of civilians;

“8.   Emphasizes the need for the Government of the Democratic Republic of the Congo, and all relevant actors providing assistance in response to the Ebola outbreak, to enhance efforts to communicate to the public, as well as to implement, the established safety and health protocols and preventive measures to mitigate against misinformation and undue alarm about the transmission and extent of the outbreak among and between individuals and communities; underscores the need to enhance community engagement working closely with religious leaders, youth and women’s groups and with the families themselves, including in the context of resumed humanitarian assistance efforts;

“9.   Emphasizes that men and women are affected differently by the Ebola outbreak and underlines that a gender‑sensitive response that addresses the specific needs of both men and women is required, and stresses the importance of the full, active and meaningful engagement of women in the development of such responses;

“10.  Stresses the need for continuous and improved surveillance of those who have been in contact with infected people as well as the need for following up with Ebola survivors, ensuring they are clinically monitored to prevent any delayed clinical manifestations and the risk of sexual transmission of Ebola; underlines the need to provide Ebola survivors with psychological and social support to help them face and overcome possible stigmatization;

“11.  Takes note of WHO’s latest assessment of the risk of regional spread and expresses great concern about the potential for the virus to spread into Uganda, Rwanda, South Sudan and Burundi and encourages those governments to continue efforts to prepare for operational readiness, in full cooperation with WHO;

“12.  Emphasizes the importance of maintaining international support and engagement — financially, technically and in-kind — to bring the Ebola outbreak successfully under control; stresses in this context the importance of flexible financial support for the response efforts, enabling a more rapid and effective response, also expresses concern that the overall humanitarian appeal for the Democratic Republic of the Congo remains severely underfunded;

“13.  Encourages the Government of the Democratic Republic of the Congo and countries of the region to continue efforts to address and resolve the wider political, security, socioeconomic and humanitarian consequences of the Ebola outbreak, as well as to provide sustainable and responsive public health mechanisms;

“14.  Requests all relevant parts of the United Nations System to accelerate their response to the Ebola outbreak, within the overall coordination of WHO, including by supporting the development and implementation of preparedness and operational plans and liaison and collaboration with governments of the region and those providing assistance;

“15.  Stresses the need for the international community to remain engaged in supporting the strengthening of national health systems, in line with the needs of the government of the Democratic Republic of the Congo, which are instrumental in preventing a deterioration of the present crisis or addressing a future recurrence;

“16.  Welcomes action and results of the WHO Health Emergencies Programme and encourages WHO and the whole United Nations system to build on and benefit from the lessons learned from the Ebola virus outbreak in West Africa in 2014, and to continue to further strengthen its technical leadership and operational support, monitor Ebola transmission, assist in identifying existing response needs and partners to meet those needs to facilitate the availability of essential data and hasten the development and implementation of therapies and vaccines according to best clinical and ethical practices;

“17.  Decides to remain seized of the matter.”

For information media. Not an official record.

“…..There is now a clear and present danger of an imminent and great, big famine engulfing Yemen…..”

NYT

“……And in the hushed hunger wards, ailing infants hover between life and death. Of nearly two million malnourished children in Yemen, 400,000 are considered critically ill — a figure projected to rise by one quarter in the coming months...….”

 


New violence in the DRC threatens to again force the suspension of crucial EBV containment efforts.

NPR

“…..The latest attack comes after two medical workers were killed by a militia in Eastern Congo Saturday while manning a port of entry to try to control the spread of Ebola. It’s believed to be the first time health workers have been killed by rebels in this Ebola outbreak……..”


The United Nations: 13 million people in Yemen are facing starvation.

BBC


Brazil is sending its army to the Venezuelan border to “guarantee law and order” amid an influx of migrants fleeing the crisis-hit country.

BBC

“…..Millions of Venezuelans have fled their country due to hyperinflation, and food and medicine shortages.

Brazil’s move follows recent border clashes between locals and Venezuelans…..”

What is happening in Venezuela?

  • Venezuela is in its fourth year of an economic crisis
  • Brought on by a crash in oil prices in 2014.
  • Four in five Venezuelans live in poverty
  • People queue for hours to buy food
  • Others are dying from a lack of medicine.
  • Some 2.3 million citizens have fled the country since 2014,


“UN Secretary-General António Guterres condemned an air strike by pro-Yemini Government coalition forces, which killed scores of children who were on board a bus travelling through a busy market area…..”

UN

9 August 2018

UN Secretary-General António Guterres on Thursday condemned an air strike by pro-Yemini Government coalition forces, which killed scores of children who were on board a bus travelling through a busy market area in the northern province of Saada.

While the exact death toll remains to be confirmed, initial news reports indicate that the number of casualties could be well above 60, with dozens severely injured. Most of the children were reported to be aged between 10 and 13.

In his  statement, the UN chief called “on all parties to respect their obligations under international humanitarian law, in particular the fundamental rules of distinction, proportionality and precautions in attack,” emphasising that all parties must take “constant care to spare civilians and civilian objects in the conduct of military operations”.

The Secretary-General called for an “independent and prompt investigation” into this incident and extended his “deepest condolences” to the families of the victims.

The Head of the UN Children’s Fund (UNICEF) also strongly condemned the incident and urged the warring parties and international community “to do what’s right for children and bring an end to this conflict”.

“Attacks on children are absolutely unacceptable,” she said UNICEF Executive Director Henrietta Fore  on Twitter. “I’m horrified by the reported airstrike on innocent children, some with UNICEF backpacks. Enough is enough.”

“How many more children will suffer or die before those who can act, do by putting a stop to this scourge?”  said UNICEF’s chief in a statement.

“Attacking children is the lowest any party of this conflict can go,” UNICEF Yemen Resident Representative Meritxell Relaño told UN News. “There is no justification whatsoever to attacking children.”

According to the UN Children’s Fund, since conflict between pro-Government forces and Houthi rebels escalated in 2015, about 2,400 children have been killed and 3,600 maimed in Yemen.

The head of the UN agency there called all warring parties to “respect international humanitarian law,” and spare children, civilians and civilian infrastructure to prevent Yemen from falling “further into the abyss and the humanitarian catastrophe” it has been facing for over three years.

Yemen’s conflict has its roots in uprisings that date back to 2011, but fighting escalated in March 2015, when an international coalition led by Saudi Arabia intervened militarily at the request of Yemen’s President.

Attacks against civilians have been the scourge of this conflict. According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), “tens of civilians were killed in violence in several governorates” in the past 10 days alone. On 3 August, during a particularly deadly attack, one of the last functioning hospitals, Al Thawra in Al Hudaydah, was struck, reportedly causing the death of dozens of vulnerable, sick and injured civilians.

“It’s hard to believe we live in a world where children should live in fear of such attacks, yet here we are. This doesn’t have to be their reality though. Parties to the conflict and those who have influence over them, including Security Council members, can and should choose to end this catastrophe for the sake of Yemen’s children,” stressed the UNICEF chief.

“We’ve said this before and we are saying it again – parties to the conflict are obliged to do everything possible to protect civilians and civilian infrastructure. This is not a voluntary commitment – it is mandatory on all belligerents,” said Lise Grande, UN Humanitarian Coordinator in Yemen, in the latest OCHA report on the situation there. “So many people have died in Yemen – this conflict has to stop.”


Yemen: Allegedly, an airstrike by the Saudi-led coalition fighting Shiite rebels hit a bus in a market in northern Yemen on Thursday, killing at least 43 people, including children, and wounding as many as 63


Attacks on Medical Education across the Globe

Attacks on Medical Education : Document

“…..The aim of this report is to explore an impact of violence on medical education, with its specific components, such as education facilities, teaching hospitals, libraries, professors, medical students and all other directly related components…..”

“….Venezuealan Case Studies:

Threats / intimidation of medical personnel of the Central Hospital of San Cristóbal during protests: During the month of April and May several threats were reported against the personnel of the Central Hospital of San Cristóbal, Táchira state, because the National Guards forbade treating the wounded during social protests, intimidating some doctors who attended these wounded youth, despite the multiple protests that took place in the hospital, this intimidation did not stop.

Tear gas pumps near the Del Valle maternal and child hospital on 04/20/2017: The use of tear gas bombs by the Bolivarian National Police and the Bolivarian National Guard in Longaray and the Intercomunal Avenue of El Valle affected the patients of El Valle Children’s Maternity Hospital. Gases seeped into hospital facilities affecting workers, mothers and newborns17.

Detention of the professor of medical school of the Universidad Central de Venezuela, MD Óscar Noya, on 04/20/2017: Oscar Noya is a doctor and professor at the Central University of Venezuela (UCV). He works continuously for the population that lives in the upper Orinoco. Through the Twitter social network it was possible to know that in the afternoon of Thursday, April 20, Dr. Oscar Noya was arrested, when participated in the protest. Moya was helping people affected by tear gas in Santa Monica, Caracas…..”


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