Fragile Environments

This article describes a public-private partnership (PPP) between the Peter C. Alderman Foundation and Ugandan government institutions that demonstrated the feasibility of delivering low cost, evidence-based mental health care to massively traumatized populations in northern Uganda through PPPs. [adapted from author]

This guide is intended to help health-care personnel adapt their working methods to the exigencies of armed conflicts and other emergencies. [from author]

In a district hospital in conflict-torn Somalia, the authors assessed the impact of introducing telemedicine on the quality of paediatric care, and the added value as perceived by local clinicians. [from abstract]

The main objective of this study is to explore the knowledge, attitudes, behaviors and the response capacity of primary care medical staff related to public health emergencies in Guangdong Province, China. [adapted from abstract]

This update describes the development of a platform for delivery of essential health services in a post-conflict setting using integrated mobile teams of health workers consisting of MOH doctors, nurses, midwives, community health workers, and technicians, as well as community nutrition volunteers. [adapted from author]

This contribution looks at some of the roles of non-state providers (NSPs) in providing health services in fragile states that are coming out of conflict, and the relationships of NSPs with state agencies. [from author]

This account from one of the highly-qualified nurses and midwives who returned to Somaliland after the civil war relates what has been done to train a new generation of nurses and midwives, to improve standards of patient care, to develop relevant training programs and to foster regulation of the health sector. [from author]

The patterns of abuse recorded in this report and the evidence garnered from other sources provide a compelling picture of how the Syrian authorities are blocking access to health care for people wounded during conflict and preventing healthcare professionals from treating such patients freely and without fear. [from author]

This call to action advocates for the recognition of the economic and social value of volunteers in public health disaster situations and the development of policies to protect them.

This film tells the story of Mirta Nubia Rosero, the only health worker in a remote village in south-western Colombia. After five decades of conflict, unexploded landmines and remnants of war lie hidden in the ground. [from publisher]

This short film shows the human face of the conflict affected health care. Entire villages have been destroyed and health-care centres looted in western Cote d’Ivoire, and mobile clinics provide the only health care for many villages in the area. [adapted from publisher]

Four decades of conflict in southern Colombia have made health care a rare commodity on the Rio Caguan, a remote tributary of the Amazon. In this video, Abdi Ismail explains his work taking mobile health clinics along the river to thousands of villagers who would otherwise be cut off from medical care. [from publisher]

This unique video footage, shot in Libya, starkly reveals the danger that health-care workers are exposed to as they treat the war-wounded close to the front line. [from publisher]

Violence, both actual and threatened, against the wounded and the sick, and against health-care facilities and personnel, is a crucial yet overlooked humanitarian issue. This brochure provides a brief overview of the stark reality of violence against health care. [adapted from publisher]

In this issue of the Red Cross Red Crescent Magazine, contributors outline the global challenges of delivering health care during conflict or other situations of violence and health care after natural disasters. [from publisher]

Thousands of wounded and sick people can be denied effective health care when hospitals are damaged by explosive weapons or forcibly entered by fighters, when ambulances are hijacked and when health-care personnel are threatened, kidnapped, injured or killed. This study is based on an analysis of reports collected over a two and- a-half year period describing 655 violent incidents affecting health care in 16 countries. [from summary]

This report discusses issues related to violence against health workers, patients and hospitals during armed conflict and the impact it has on health workers and the subsequent lack of available health care for those in need.

This document outlines the important role health workers play in areas suffering from severe crises and makes the case for investing in HRH as central to health system recovery and improved health outcomes. [adapted from author]

The nature of armed conflict is changing, putting health workers increasingly in harm’s way. This article outlines the issue and a new campaign that aims to raise awareness and improve conditions on the ground for health workers and facilities in conflict zones. [adapated from author]

Health workers along with other community members and service providers are central to preparing for, and responding to, public health emergencies (PHEs). This policy note presents key considerations for dealing with HRH and PHEs. [from author]

This policy note outlines the importance of the health workforce in public health emergencies (PHEs), highlights the causes of PHEs and the subsequent impacts on the health worker and health system, and raises questions around health workforce performance in PHEs. The focus is on developing country contexts. [from introduction]

The purpose of this paper is to present a comprehensive, engaging, and visible framework of HRH system development. This has been further developed from the lessons distilled from Japanese experiences of supporting HRH system development in three fragile and post-conflict health systems: Afghanistan, the Democratic Republic of Congo, and Cambodia. [from author]

This presentation discusses the impact of public health emergencies on the health workforce and planning needs for addressing it.

The aim of this statement is to draw attention to the vital role that the community-based health workforce plays in all phases of emergency risk management; promote the scale-up of the community-based health workforce; and encourage governments and supporting partners to reinforce the community-based health workforce by strengthening and preparing existing health systems. [from author]

This study looks at how violence affects the delivery of health care including attacks on patients, health-care workers and facilities, and on medical vehicles. It first looks at the general disruption to health care that occurs during conflict and civil strife, before looking more closely at specific types of violence. [adapted from author]

This article highlights some challenges from the recent experience with surgical team after the Haiti earthquake and proposes some ways forward to support an effective surgical humanitarian response to future major disasters. [adapted from author]

This paper illustrates the process, successes, ongoing challenges and current strategies Liberia has used to increase and improve HRH since the end of a 14-year cival war, particularly the nursing workforce. [adapted from abstract]

This report links the high rates of maternal mortality with the health worker crisis in fragile states1. It explores the causes of maternal death, highlighting where and why these deaths are occurring. It also contrasts the need to fund health workers and strengthen health systems with the present aid allocations to health. [from author]

This paper captures the professional, personal and national effects conflict is having on health workers and the inadequate protection they currently work under. It explores the context in which health staff are working in some of the world’s most fragile countries. It outlines the high rates of death and disease and the vital role health workers play in not only addressing these needs, but in meeting global health targets. [from introduction]

All disasters are a health issue with national health workers at the heart of every response. This research into the role of national and international health workers after the 2010 earthquake in Haitie signals a need to rethink how the humanitarian community works with national health system and stresses how a strong health system offers vital protection from disaster-related risks.