REALITIES OF CONFLICT/HEALTH IMPACTS OF CONFLICTS

Question 1

VERTICAL VS HORIZONTAL PH APPROACH

Answer 1

VERTICAL - DISEASE BASED/DISEASE-SPECIFIC, CURE-FOCUSED

HORIZONTAL - LOOKING AT THE HEALTHCARE SYSTEM AS A WHOLE, FOCUS ON A RANGE OF ISSUES, DRIVEN BY THE AFFECTED COMMUNITY

Question 2

WHAT IS HEALTH (BY WHO)

Answer 2

‘A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING AND NOT MERELY THE ABSCENCE OF DISEASE OR INFIRMITY’

Question 3

DEFINITION OF AN ARMED CONFLICT?

Answer 3

• THE DEFINITON SOMETIMES CONTENTIOUS, BECAUSE THERE ARE ARMED CONFLICT RULES THAT NEED TO BE OBEYED, SO SOMETIMES AVOIDANCE OF USING THE TERM

DEFINITION:
‘FIGHTING BETWEEN STATES OR PROTRACTED ARMED VIOLENCE BETWEEN GOVERNMENT AUTHORITIES AND ORGANISED ARMED GROUPS OR JUST BETWEEN ORGANISED ARMED GROUPS’

• CAN BE INTERNATIONAL AND NON-INTERNATIONAL (I.E. INTERNAL)
• SOME OVERLAP WITH ‘COMPLEX HUMANITARIAN EMEGENCIES’ (E.G. OUTBREAKS)

Question 4

SINCE COLD WAR, WHAT’S BEEN HAPPENING WITH CONFLICT GLOBALLY?

Answer 4

CW (1947-91)

LESS CONFLICTS, BUT THEY ARE LONGER AND MORE COMPLEX

Question 5

DURATION OF AN AVERAGE CONFLICT IN MODERN TIMES?

Answer 5

17 YRS

Question 6

CONFLICT CASUALTIES?

Answer 6

90% CIVILIANS

Question 7

% OF MORBIDITY AND MORTALITY INDIRECTLY RELATED TO CONFLICT (E.G. NOT DIRECT VIOLENT DEATHS, BUT DISEASES ETC)

Answer 7

90%

Question 8

HOW MANY PEOPLE IN THE WORLD TODAY ARE DISPLACED DUE TO AN ARMED CONFLICT?

Answer 8

65. 6 MILLION

43. 1 MIL IDPs AND 22.5 MIL REFUGEES

Question 9

MOST LONG-TERM REFUGEE SITUATIONS LAST MORE THAN:

Answer 9

20 YRS

Question 10

AVERAGE LENGTH OF TIME AS A REFUGEE?

Answer 10

26 YRS

Question 11

WHAT INFECTIOUS DISEASES ARE MOST CLOSELY ASSOCIATED WITH ARMED CONFLICTS?

Answer 11

• GASTROENTERITIS AND OTHER FOOD/WATER-BORNE INFECTIONS
• MALARIA AND OTHER VECTOR-BORNE INFECTIONS (VECTOR CONTROL MEASURES STOPPED, ABANDONED BUILDINGS IDEAL BREEDING SITE FOR VECTORS..)
• MEASLES, PERTUSSIS AND OTHER DROPLET-SPREAD INFECTIONS (E.G. MENINGITIS, DUE TO EXCESSIVE CROWDING)

(GASTROINTESTINAL DISEASES - CCA 44%, TROPICAL - CCA 20%)

Question 12

GASTROENTERITIS AND OTHER WATER/FOOD-BORNE INFECTIONS DURING CONFLICT - MOST NOTORIOUS AND MOST COMMON?

Answer 12

MOST:

NOTORIOUS: CHOLERA
COMMON: ROTAVIRUS

Question 13

GASTROENTERITIS AND OTHER WATER/FOOD-BORNE INFECTIONS DURING CONFLICT - DEATHS?

Answer 13

CAUSE OF 25-40% OF DEATHS IN IDP CAMPS, >80% OF THOSE DEATHS IN CHILDREN YOUNGER THAN 2

Question 14

ORAL REHYDRATION THERAPY FOR CHOLERA?

Answer 14

1L OF WATER, 8 TEASPOONS OF SUGAR, 1 TEASPOON OF SALT

Question 15

ORAL ROTA VIRUS VACCINE - PROBLEMS?

Answer 15

• USUALLY SPECIFICALLY DESIGNED FOR VERSIONS OF ROTAVIRUS THAT OCCUR IN DEVELOPED COUNTRIES, RATHER THAN DEVELOPING COUNTRIES, BECAUSE IT IS OFTEN MORE PROFITABLE

Question 16

1 IN HOW MANY MATERNAL DEATHS OCCU IN AREAS WHERE HELTH SERVICES ARE DISRUPTED BY CONFLICT?

Answer 16

1/3

Question 17

HOW MANY CHILDREN IN THE WORLD LIVE IN AREAS AFFECTED BY ARMED CONFLICT?

Answer 17

> 1 BILLION (1 IN 6)

Question 18

HOW MANY CHILD DEATHS OCCUR IN AREAS WHERE HEALTH SERVICES ARE DISRUPTED BY CONFLICT?

Answer 18

1/2

Question 19

MOST COMMON CHILD HEALTH PROBLEMS IN CONFLICT AFFECTED AREAS?

Answer 19

• DIARRHOEAL ILLNESSES
• ACUTE RESPIRATORY TRACT INFECTIONS
• MEASLES
• MALARIA
• MALNUTRITION

Question 20

CHRONIC DISEASES AND ARMED CONFLICT

Answer 20

ACUTE PROBLEMS WITH CHRONIC DISEASES CAN OCCUR:

• SICKLE CELL DISEASE (‘SICKLE CELL CRISIS’), OFTEN OCCUR WHEN ONE IS STRESSED, DEHYDRATED, MALNOURISHED ETC
• LACK OF MEDICATION FOR ASTHMA, DIABETES, EPILEPSY AND HEART DISEASE

LONG TERM IMPACT OF ARMED CONFLICT ON CVD AND CANCER IS UNPROVEN!!!!!!!!!!!!!!!!!!

Question 21

SOMETIMES, HEALTH INDICATORS IMPROVE DURING ARMED CONFLICTS (E.G. DURING AN ARMED CONFLICT IN NEPAL FROM 1996-2006, 16/19 HEALTH INDICATORS IMPROVED). THESE INDIRECT!!! BENEFITS POSSIBLY OCCUR DUE TO:

Answer 21

• HEALTHCARE SYSTEM SPARED BY BOTH SIDES FOR POLITICAL REASONS
• IMPROVED FOCUS AND CO-ORDINATION ON HEALTH AND HEALTHCARE SYSTEMS
• INTERNATIONAL HEALTHCARE ENGAGEMENT!!! WITH DISADVANTAGED GROUPS
• IMPROVED INFRASTRUCTURE IN REMOTE RURAL AREAS AFFECTED

(IMPROVEMENT IS EXCEPTION NOT A RULE!!!)