Global & Disaster Medicine

August 19: World Humanitarian Day (WHD)

WHO 

Civilians are #NotATarget.

Humanitarian Health Workers are #NotATarget.

ICRC/Albert Gonzalez Farran

Health Cluster partners and humanitarians everywhere are coming together to mark World Humanitarian Day (WHD). Every year on 19 August we pay tribute to aid workers who risk their lives in humanitarian service, and to rally support for people affected by crises around the world.

Violence against health workers providing care in conflict is prohibited by international law, and has therefore been globally condemned – yet the scale and gravity of violence remains extreme. These attacks can take many forms, including looting, sexual assault, arson and bombings. Whilst attacks against health workers remain under-reported, WHO found that in 2016 there were 302 reported attacks in 20 countries facing emergencies, resulting in 418 deaths and 561injuries to health workers. 74% of these attacks were bombings.

As well as destroying human life, such attacks inhibit the ability of humanitarian agencies to respond to health emergencies, increasing the vulnerability of civilians in conflict.

This WHD we demand that leaders:

  • Do not target health workers, facilities, or patients.
  • Respect the right of all wounded and sick persons to receive medical care.
  • Adopt and promote the UN Secretary-General’s recommendations on the protection of medical care in armed conflict.

Learn more


Thirteen of the newly reported Saudi cases are linked to a hospital MERS-CoV outbreak

WHO

Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

Disease outbreak news
17 August 2017

Between 4 July and 12 August 2017, the national IHR Focal Point of Saudi Arabia reported 26 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection including six deaths, and two deaths among previously reported cases.

Details of the cases

Detailed information concerning the cases reported can be found in a separate document (see link below).

Among the 26 newly reported cases, 13 are associated with a cluster in a hospital in Al Jawf Region, Saudi Arabia. The initial case was a 51-year-old reported on 2 August 2017. To date, 12 cases have been identified through contact tracing. These cases include eight health care workers (all asymptomatic) in the hospital where the initial case was treated, one hospital contact (a 70-year-old male) and three household contacts. Follow up of health care workers, hospital and household contacts are ongoing.

Globally, 2066 laboratory-confirmed cases of infection with MERS-CoV including at least 720 related deaths have been reported to WHO.

Public health response

The Ministry of Health of Saudi Arabia evaluates each case and their contacts and implements measures to limit further human-to-human transmission and bring Middle East Respiratory Syndrome (MERS) outbreaks under control. The measures taken by Ministry of Health officials in Saudi Arabia include:

  • Risk stratification and active tracing for contacts in healthcare and in communities. High risk contacts (e.g. unprotected exposure to a case or engagement in an aerosol generating procedure) are tested by PCR regardless of having symptoms. Health care workers are exempted from work until they are cleared by infection control experts.
  • Trained hospital epidemiologists have been deployed to sites within 24 hours of identifying an outbreak.
  • Enforcement of strict adherence to environmental disinfection and terminal cleaning of affected areas.
  • Enforcement of visual triage for respiratory diseases in emergency department and outpatient departments and ensuring the 24/7 availability of trained nurses for early detection of patients with respiratory symptoms, and proper documentation on triage forms.
  • Extensive training of all health care workers on case definition for early detection, implementation of isolation precautions, proper selection, donning and doffing of personal protective equipment (PPE), hand hygiene and environmental cleaning and disinfection.
  • Ensuring availability of infection prevention supplies including hand sanitizer, PPEs, surface disinfectants, portable HEPA filters and fumigation machines.
  • Ensuring that all health care workers are fit tested for high efficiency respirators.
  • Implementing the policy of not allowing health care personnel working in a facility affected by an outbreak to travel or work in Hajj premises or in any healthcare facility until they are medical cleared.

WHO risk assessment

MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, in addition to avoiding close contact with suspected or confirmed human cases of the disease, people with these conditions should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.


No O2: The government hospital, part of the larger Baba Raghav Das Medical College in Gorakhpur, considered a beacon to millions of people, is now a symbol of India’s swamped, mismanaged and often corrupt public health care system.

NY Times

 


A daily exodus of villagers fleeing armed conflict, hunger and sexual violence in South Sudan has pushed the number of refugees sheltering in Uganda to over one million.

NY Times

“…..As many as 85 percent of those reaching Uganda recount horrific tales of seeing armed groups burning villagers alive in their houses, shooting people in front of their families, raping women and girls, and seizing boys to serve as conscripts….”

 


While flooding is a natural disaster, the scale of the human tragedy in Freetown is very much man-made.

Amnesty International

‘…..“The authorities should have learned lessons from previous similar incidents and put in place systems to prevent, or at least minimise, the consequences of these disasters. Devastating floods are now an annual occurrence in the country’s capital. Yet, due to a lack of regulation and insufficient consideration for minimum standards and environmental laws, millions of Sierra Leoneans are living in dangerously vulnerable homes.”
The right to adequate housing under international law requires that every home be ‘habitable’, which includes providing protections against disasters such as this. However, poor regulation and failures to ensure environmental factors are part of urban planning in Sierra Leone often result in structures being built that are both unsafe and situated in dangerous locations…..’

 


2 killed and 6 others hospitalized in a stabbing attack in the Finnish city of Turku

CNN

 

 


Fatal Terror Attack in Barcelona

https://nyti.ms/2v5sV9z

https://nyti.ms/2vIOakV

NY Times, 8/18/17

 

 


Barcelona: Police shoot dead 5 men in car also attacking pedestrians several hours after the Las Ramblas van attack

Washington Post

  • The 5 suspects in the nearby seaside resort of Cambrils tried to mow down pedestrians in the early hours of the morning
  • 1 a.m. on Friday, police responded to an attack near the boardwalk of the beach town of Cambrils, 60 miles southwest of Barcelona
  • An Audi had plowed into a crowd.
  • The police exchanged fire with the men in the car, killing four immediately while a fifth later died of his injuries. Six others were injured, including a police officer.
  • More than a hundred people from at least 24 nationalities were hurt and the death toll could rise above 13.

 


Barcelona, Spain: AT LEAST 13 DEAD, 100 HURT IN SPAIN TERROR ATTACK

CNN


With some 400 bodies recovered from the mudslides and flood that devastated Sierra Leone’s capital, Freetown, the dead are being buried in mass graves.

NY Times

 


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