Global & Disaster Medicine

Archive for the ‘Humanitarian’ Category

“….Moria, a camp of around 9,000 people living in a space designed for just 3,100, where squalid conditions and an inscrutable asylum process have led to what aid groups describe as a mental health crisis…..”

NYT

“……The overcrowding is so extreme that asylum seekers spend as much as 12 hours a day waiting in line for food that is sometimes moldy. Last week, there were about 80 people for each shower, and around 70 per toilet, with aid workers complaining about raw sewage leaking into tents where children are living. Sexual assaults, knife attacks and suicide attempts are common...…..”

 


Healthcare delivery after Florence

Modern Health

When Atrium Health’s mobile hospital unit arrived into Burgaw, N.C., on Tuesday from its home-base in Charlotte, residents of the rural area had been without medical care for days in the wake of Hurricane Florence. They lined up for help even as the medical team was setting up in a Family Dollar parking lot.

The area’s Pender Memorial Hospital, a critical access hospital, was evacuated ahead of the storm and remained closed because of flooding. The nearest open hospital sat at least 50 miles to the south in Wilmington, N.C., a city unreachable by ground transportation after rising floodwaters cut if off from the rest of the state.

Within 18 hours Atrium Health’s Med-1 mobile hospital team of 32 physicians, nurses and other clinicians had treated more than 50 patients, many with chronic diseases, such as heart disease or diabetes. Their conditions had been exacerbated by the stress of the hurricane, loss of electricity or homes and the lack of medical care. Others suffered minor injuries that turned major after becoming infected by unclean water and debris…..Hospitals prepared extensively for the hurricane by stocking up on fuel, water, food and medical supplies as part of emergency plans that had been tested and honed by past disasters.

Many had evacuated patients well enough to be moved to make room for the injured they expected to see after the storm.

Others had sheltered in place—their nurses, physicians, management and other essential staff working in shifts day after day to care for their communities. Once the winds subsided, hospitals worked with their suppliers to get additional food, water and medicine before flooding became worse……”

 


Overall last year, 139 aid workers were killed, 102 wounded and 72 kidnapped in the line of duty

UN

 


Jordan | Syrian Arab Republic: Dara’a, Qunaitra, Sweida Flash Update as of 7/2/18

RW

Highlights

  • Sustained hostilities in south-west Syria since 17 June have led to the displacement of an estimated 271,800 individuals as of 2 July. Of those, approximately 60,000 displaced to areas in close proximity to the Nasib/Jaber border crossing with Jordan, including the free zone, and some 164,000 IDPs have moved towards camps and villages in Quneitra, close to the Golan Heights area.
  • Since the start of military operations, the UN has received reports of dozens deaths, including women and children. Additional reports also suggest indiscriminate attacks on health facilities, schools, civil defense centers and offices of local NGOs.
  • On 1-2 July, the UN provided humanitarian assistance to displaced individuals at the Jaber/Nasib border area in Jordan. The 37-truck convoy carried sufficient water and NFI stocks to cover the needs of an estimated 35,000 people.

 

 

Highlights  Sustained hostilities in south-west Syria since 17 June have led to the displacement of an estimated 271,800 individuals as of 2 July. Of those, approximately 60,000 displaced to areas in close proximity to the Nasib/Jaber border crossing with Jordan, including the free zone, and some 164,000 IDPs have moved towards camps and villages in Quneitra, close to the Golan Heights area.  Since the start of military operations, the UN has received reports of dozens deaths, including women and children. Additional reports also suggest indiscriminate attacks on health facilities, schools, civil defense centers and offices of local NGOs.  On 1-2 July, the UN provided humanitarian assistance to displaced individuals at the Jaber/Nasib border area in Jordan. The 37-truck convoy carried sufficient water and NFI stocks to cover the needs of an estimated 35,000 people.

Situation Overview
Since the start of military operations in south-west Syria, the UN has received dozens of reports of civilian deaths, including women and children. Additional reports also suggest indiscriminate attacks on health facilities, schools, civil defense centers and NGO offices. Most health and educational facilities in southern Syria remain closed due to widespread airstrikes and hostilities on the ground.
Sustained hostilities since 17 June have led to the displacement of an estimated 271,800 individuals within non-state armed group-controlled areas in Dara’a and Quneitra governorate as of 2 July. Of those, approximately 164,000 IDPs have moved towards camps and villages in Quneitra, close to the Golan Heights area, while some 60,000 have been displaced to areas in close proximity of the border with Jordan, including the Nasib/Jaber border crossing and the Free Zone. The Governments of Jordan and Israel continue to maintain the borders closed and have announced that Syrian IDPs will not be permitted to cross into their respective countries.
The living conditions of IDPs stranded at the Jordanian border are severe, with IDPs lacking shelter and basic items and subject to dusty desert winds and high temperatures of up to 45 degrees Celsius. The displaced lack regular access to clean drinking water and healthcare, and local sources on the ground report that at least twelve children, two women, and one elderly man died in areas close to the Jordanian border due to scorpion bites, dehydration and diseases transmitted through contaminated water. Some critical medical cases, however, have been able to seek treatment at medical facilities in Ramtha and Irbid in Jordan.
Between 29 June and 1 July, in response to intense air and ground-based strikes on various areas of Dara’a governorate, the local populations of several areas located in south-eastern Syria, such as Jizeh, Mseifra, Sayda, Kahil, and Tiba, pre-emptively left their towns for areas they perceive to be safer. The coinciding displacement of humanitarian workers from the area and the high fuel prices and/or lack of fuel have impacted the ability of humanitarian organizations to relocate humanitarian supplies in eastern Dara’a to the new areas of population concentration.

Since the Government of Syria (GoS) announced the establishment of four “corridors” on 27 June, through which individuals can move towards GoS-controlled areas, some initial estimates indicate that 12,000 to 15,000 people have reportedly crossed into GoS-held areas in Dara’a governorate. Many of the IDPs are making their way towards the Jbab shelter, with approximately 2,500 people still at the shelter, whilst others have left towards areas in which they can stay with host communities and secure alternative shelter arrangements. As of 30 June, there have reportedly been 80 medevac cases from Jbab to hospitals in Damascus, and some 400 families have moved onwards to Rural Damascus. An estimated 2,000 people have also crossed into Sweida governorate.

Humanitarian Access

Humanitarian Access (on hold): Since 27 June, the UN has not been able to proceed with humanitarian cross-border convoys due to ongoing hostilities and lack of security guarantees from the parties. A convoy continues to be stationed at Ramtha ready to cross once security conditions allow  South-West Dar’a towards North-West Dar’a /Qunaitra (open)  West to East crossing inside Syria (open)  Ramtha UN convoy crossing point from Jordan remains open, with operations on hold.
Jordan | Syria: Humanitarian Situation in Dar’a, Qunaitra and Sweida, Flash Update, as of 2 July 2018

Humanitarian cross-line access (requiring access approvals): The United Nations and its humanitarian partners stand ready to respond through cross-line deliveries from inside Syria. These require access permissions from the Government of Syria.

Medical evacuations (partial): Medical evacuations of urgent cases who require treatment in Jordan require the permission of the Government of Jordan. Negotiations to secure access for emergency medical evacuations remains ongoing, with twelve cases treated at the Ramtha and Irbid hospitals.

Commercial and civilian access routes between Dar’a and Qunaitra and Sweida (suspended):
Many commercial and civilian access roads between the three southern governorates have been closed or became inaccessible. However, some crossings remain open for civilian and commercial movements.  The Sweida road is reported to be closed, preventing the replenishments of markets.  Kherbet Ghazaleh (Gharia West): closed for commercial traffic  Kherbet Ghazaleh (Dael): closed for commercial traffic  Kafar Sham (Dier Bakhat): closed for commercial traffi Preparedness and Response  On 1-2 July, an inter-agency UN emergency convoy comprising 37 trucks (mobilized jointly by UNHCR, UNICEF, UNFPA and WFP) was dispatched to the border area in Jordan. The convoy carried sufficient water and NFI stocks for 35,000 beneficiaries (10,000 at the free zone and a further 25,000 beyond). On 1 July, 869 UNICEF family hygiene kits and 580 UNFPA dignity kits and 150 UNFPA clean home delivery kits were delivered to displaced communities at the Tower 58 crossing point. UNHCR partners provided health care services to approximately 40 patients at the free zone through a medical team comprised of one medical doctor, two nurses and a pharmacist assistant. A total of twelve cases were referred to the Ramtha and Irbid hospitals.  As of 30 June, WFP, through partners on the ground, has distributed emergency food assistance sufficient for some 180,000 people, with some people receiving a second round of assistance. Deliveries include ready-to-eat rations (RTEs), regular food rations, and nutrition supplies for the prevention of malnutrition in children under two years of age. WFP, through its partners, also distributed 10,220 food rations sufficient for 51,100 people in Tal Shihab, in addition to 12,500 food rations sufficient for 62,500 people at the Nasib and Mataiyeh border area.  Core relief items, including basic shelter materials sufficient for 60,000 people, have been prepositioned. The UN stands ready to scale up response to people in need through the most direct routes wherever access allows.

For further information, please contact: Sarah Muscroft, Head of OCHA Jordan, muscroft@un.org Kristele Younes, Head of OCHA Syria, younes4@un.org

For more information, please visit www.unocha.org and www.reliefweb.int.


Syrian refugees fleeing the current government offensive face scorpion bites, dehydration, and contaminated water,

NY Times

  • At least 15 Syrians have died in camps near the Jordanian border because of “scorpion bites, dehydration and diseases transmitted through contaminated water,” according to a report published this week by the United Nations Office for the Coordination of Humanitarian Affairs.

  • Twelve of the dead were children; two women and one elderly man also died.

  • More than 320,000 people in the Dara’a region have been displaced by the fighting

  • Most are living in campsites near the Jordanian border and the Israeli-controlled Golan Heights without adequate shelter, food or water.

  • Thousands are sleeping in the open desert.

 


Yemen’s humanitarian crisis can turn into a catastrophe with fighting at the port city of Hudaida

LA Times

  • Since early 2015, more than 10,000 people have been killed
  • Since 2015, some 2 million have been driven from their homes because of the fighting between a Saudi-led coalition and Iranian-backed Houthi rebels.
  • Some 22 million people, rely on aid
  • 8.4 million of them are facing famine.
  • The country has been plagued by the largest cholera epidemic in recorded history, with 1 million suspected cases
  • Meanwhile, Hudaida is home to about 600,000 people and a port responsible for 70 percent of imports into Yemen
  • The fighting in and around the port city could ignite a humanitarian catastrophe.


An Arab military coalition invaded Yemen’s main Red Sea port on Wednesday, worsening what is already the world’s most severe humanitarian disaster by disrupting the delivery of food and other supplies to millions of Yemenis.

NY Times


The Venezuelan health system: A total collapse

Lancet

“…..a 65% increase in maternal mortality and a 30% increase in infant mortality, with 11 466 infants dying during 2016. It also revealed that while Venezuela had been the first country in the world to eliminate malaria in populated areas, this and other diseases such as diphtheria, which had previously been controlled, had returned in several outbreaks.…..most laboratory services and hospital nutrition services are only available intermittently or are completely inoperative. Shortages of items such as basic medicines, catheters, surgical supplies, and infant formula are highlighted in the survey; 14% of intensive care units have been shut down because they are unable to operate and 79% of the facilities analysed have no water at all.……..”

 


Emergency Trauma Response to the Mosul Offensive, 2016-2017

Fox, H., Stoddard, A. & Davidoff, J. (2018). Emergency trauma response to the Mosul offensive, 2016-2017: A review of issues and challenges. Humanitarian Outcomes, March.

“…..Despite certain weaknesses and limitations, the WHO-coordinated response succeeded in implementing a
large-scale, military-style referral chain system in highly difficult conditions and unquestionably saved lives.
An independent analysis of the data performed by a research team at John Hopkins Centre for Humanitarian
Health estimates that the WHO-coordinated trauma referral pathway saved between 1,500 and 1,800 lives –
approximately 600-1,330 civilians and the remaining majority combatants.

The total number of people treated is impossible to independently verify. WHO reporting cites that as of 7 August
2017, ‘some 20,449 people from Mosul city were referred through the established trauma pathways’.  But these
figures include patients being counted multiple times as they passed through the referral pathway. The Iraqi
Department of Health estimated that 10,000 to 12,000 ‘medical activities’ were performed…….Despite these constraints, between October 2016 and November 2018, MSF performed 20,334 emergency room
consultations (of which 4,135 were ‘war trauma’3 cases and 1,594 were ‘red’ cases4) and 31,242 primary health care
consultations. These emergency room and primary health consultations resulted in 3,601 surgical interventions,
1,178 deliveries and 2,647 inpatient admissions……”

 case study by Johns Hopkins. :  Document

IRIN opinion


The Greek island of Lesbos: Migration crisis

NY Times

“…..Some 5,500 people are detained in Moria, about 2,500 more than the camp was designed to hold……..

Rain soaks through the tents, and there is a lack of electricity and hot water in the showers, even in winter. The public toilets and showers are soiled with feces. As bad as the food is, it often runs out. The lines — for everything — are endless. Fights break out constantly. Violence, theft and rape are constant threats……”

 


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