Global & Disaster Medicine

Archive for the ‘Conflict’ Category

Charting an Ethical Course in Providing care Within Global Areas of Conflict

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…..”


Guernica: 4/26/1937


Political Instability in Venezuela and Malaria Resurgence

CDC

Jaramillo-Ochoa R, Sippy R, Farrell DF, Cueva-Aponte C, Beltrán-Ayala E, Gonzaga JL, et al. Effects of Political Instability in Venezuela on Malaria Resurgence at Ecuador–Peru Border, 2018. Emerg Infect Dis. 2019;25(4):834-836. https://dx.doi.org/10.3201/eid2504.181355

Probable migration route of imported malaria cases described in study of effects of political instability in Venezuela on malaria resurgence at the Ecuador–Peru Border, 2018. A) Locations of the 4 countries along the migration route in South America; B) El Oro Province and Tumbes Region on the Ecuador–Peru border. The city of Huaquillas, Ecuador, is 70 km southwest of Machala, the location of the single autochthonous malaria case in this country. Huaquillas is the primary border crossing from Ec



Probable migration route of imported malaria cases described in study of effects of political instability in Venezuela on malaria resurgence at the Ecuador–Peru border, 2018. A) Locations of the 4 countries along the migration route in South America; B) El Oro Province and Tumbes Region on the Ecuador–Peru border. The city of Huaquillas, Ecuador, is 70 km southwest of Machala, the location of the single autochthonous malaria case in this province. Huaquillas is the primary border crossing from Ecuador into Peru. Tumbes, the source of the 3 autochthonous cases in Peru, is the capital of Tumbes Region and is 22 km from the border. Dashed line in panel B broadly denotes the migration route taken from Venezuela through Colombia and Ecuador to Peru. Note the proximity of these countries and additional potential malarial resurgence through migration to Central America, the Caribbean, and the United States.


Hezbollah’s Precision Missile Project : February 2019 Document

Precision Missiles : Document

European countries have been critical of Iranian missile tests but a more urgent and alarming regional threat is Iran’s project to upgrade Hezbollah missiles into precision guided missiles. These would enable the Lebanese group to accurately target critical Israeli infrastructure and constitutes a significant threat to Israel’s security.

• The Hezbollah Precision Missile project is a test case that could be replicated. After infrastructure has been put in place, evidence suggests that missiles can be converted into precision guided missiles in just a few hours at a cost of $5,000- $10,000. Iran has already attempted to utilise this technology for its Houthi allies in Yemen, a move which could put US bases in the Gulf under significant risk.

• Iran sought originally to deliver advanced precision missiles to Hezbollah in Lebanon via Syria, with these efforts intensifying during the Syrian civil war. Israel declared that the supply of such weapons was a ‘red-line’ and has carried out air strikes to prevent them reaching Hezbollah by targeting storage facilities, weapons convoys, and research and production facilities in Syria.

• As a result, Iran launched a new initiative to fit GPS guidance packs onto ‘dumb’ medium range Zelzal 2 missiles, of which Hezbollah is thought to possess 14,000 and which are already located in Lebanon. Relevant components are transported from Iran to factories in Syria and Lebanon, either by land, or by air via Damascus, using civilian aircraft.

• Once in the factory, an existing section of the Zelzal 2 is removed and replaced with a new section which includes a GPStype navigation system; a command and guidance system; and a control system (for applying guidance commands and steering the missile). This transforms the Zelzal 2 into something similar to a Fateh 110 missile.

• It is not clear how many precision missiles Hezbollah currently has, with estimates ranging from the low 20 to 200. But even a small number of missiles could do serious damage to Israel – which is a small, densely populated country with all its key industrial and critical infrastructure sites concentrated in a small number of locations. Hezbollah has already threatened to attack power stations, air force bases, the Haifa oil refinery, the nuclear reactor close to Dimona, and the ‘Kirya’ Ministry of Defence and IDF Headquarters in central Tel Aviv.

• Israel has been developing missile defence systems since the 1980s. Yet whilst the country’s capabilities are arguably the most comprehensive and capable in the world, they cannot provide hermetic protection. And with limited batteries available, Israel may be forced to make a choice between protecting critical infrastructure or population centres.

• Israeli decision makers face a dilemma over how best to counter Hezbollah’s Precision Missile project. Israel could launch a preemptive strike inside Lebanon to destroy missile factories, but this could trigger a wider conflagration with Hezbollah. In light of this, Israel is currently focused on issuing public warnings to Hezbollah and the Government of Lebanon including revealing secret intelligence to maximise impact.

• The US and key European states including the UK, France and Germany can play an important role preventing an escalation in Lebanon. One option would be to publicly warn Hezbollah and the Lebanese Government that they are aware of the precision project and to make clear that the project is a direct violation of UN Security Council Resolution 1701. If these warnings fail to make an impact then they should consider initiating tough sanctions against those involved in the project from Hezbollah and the IRGC.


Kashmir: An attack on a convoy of Indian soldiers killed 37 and wounded five

CNN

 


Maduro has blocked a bridge on the Colombia-Venezuela border meant to be one of three collection points for the delivery of international aid.


Colombia: A car bomb exploded in front of a Bogotá police academy Thursday morning, killing at least 21 people and wounding another 68.

NYT


A review of injuries associated with drone attacks in Gaza

The Lancet Planetary Health

“……drone strikes were associated with more proximal amputations that needed more surgical operations after initial life-saving emergency surgery than traumatic amputations caused by other types of explosive weapons. …..”

 


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…..”


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