Global Medical Emergencies Document

Razzak J, Usmani MF, Bhutta ZA. Global, regional and national burden of emergency medical diseases using specific emergency disease indicators: analysis of the 2015 Global Burden of Disease Study. BMJ Glob Health 2019;4:e000733. doi:10.1136/ bmjgh-2018-000733

“……In general, an emergency condition was defined as those requiring interventions within minutes to hours to reduce the chance of disability and death and improve health outcomes.
Razzak and his team’s results show a 6 percent increase in deaths of adults and children due to emergency conditions between 1990 and 2015. Over the 25-year period, the most significant decrease was found in upper-middle-income countries, and the lowest level of decrease — between 11 and 15 percent — in poorer nations. Overall, the mortality burden of medical emergencies was found to be more than four times to five times higher in low-income countries around the world compared to high-income countries.
Globally, injuries from accidents, falls and burns (22 percent), heart attacks (17 percent), lung infections (11 percent) and strokes (7 percent) made up the top emergency conditions and diseases in 2015. Other conditions such as diarrheal diseases and malaria had a lower overall global burden, but were more prevalent in low-income countries. The analysis also showed that emergency diseases affect men much more than women, and half of all the emergency disease burden was among people younger than 45 years old.
Countries with the lowest mortality and morbidity burden of medical emergencies included Bahrain, Israel and Kuwait, while Chad, Niger and Mali had the highest burdens. China, India and the United States, the three most populous countries studied, were ranked globally at 64th, 144th and 47th out of 195, respectively, in terms of the lowest burden of emergency diseases……”

Ethical Challenges in Humanitarianism during Violent Situations

Reality Makes Our Decisions: Ethical Challenges in Humanitarian Health in Situations of Extreme Violence

Report and recommendations: a collaboration among Center for Public Health and Human Rights, Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health | International Rescue Committee | Syrian American Medical Society

“…….The ethical principles include respect for persons (i.e., respect for human dignity and for individuals’ autonomous choices), beneficence (the promotion of others’ well-being), non-maleficence “do no harm”, and justice (in both fair distribution of resources and fair processes for decision-making). These four principles, can be adapted to the provision of health care to communities, though how the principles are weighed and applied might differ…..”

NYT

NYT

“……A recent United Nations report found about a quarter of the country’s population is in dire need of food and basic supplies — and the need is expected to grow. The International Monetary Fund estimates the Venezuelan economy will shrink by 25 percent this year as infrastructure continues to crumble.

Around 5,500 Venezuelans flee the country daily in what has become one of the world’s biggest refugee crises, according to the United Nations…..”

NYT

NBC

“…..In 2017, more than 280,000 children were found to be malnourished and at risk of dying. The situation in the country has only declined drastically and the statistics are likely far worse now. Alarmingly, the government denies there are any problems; it doesn’t even allow health statistics to be officially kept.

Still, we know that newborns in Syria, which is still wracked by war, are more likely to survive than those born to Venezuelan mothers; maternal mortality rose 66 percent from 2015 to 2016. The average person in the nation lost 24 pounds in 2017.Reports indicate that nearly 80 percent of hospitals lack regular access to water, 53 percent of the nation’s operating rooms are shuttered and more than 70 percent of emergency rooms cannot regularly provide services to patients….”

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…..”

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...…..”

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……”