Abstract
BackgroundApplied epidemiologists are increasingly working in areas of insecurity and active conflict to define the health risks, suggest feasible means to reduce these risks and, monitor the capacity and reconstruction of the public health system. In 2001, The Carter Center and the United States Institute for Peace sponsored a conference within which "Violence and Health" was discussed and a working group on applied epidemiology formed. The group was tasked to describe the skills that are essential to effective functioning in these settings and thereby provide guidance to the applied epidemiology training programs.MethodsWe conducted a literature review and consultation of a convenience sample of practitioners of applied epidemiology with experience in conflict areas.Results and conclusionsThe health programs designed to prevent and mitigate conflict are in their early stages of implementation and the evaluation measures for success are still being defined. The practice of epidemiology in conflict must occur within a larger humanitarian and political context to be effective. The skills required extend beyond the normal epidemiological training that focuses on the valid collection and interpretation of data and fall into two general categories: (1) Conducting a thorough assessment of the conflict setting in order to design more effective public health action in conflict settings, and (2) Communicating effectively to guide health program implementation, to advocate for needed policy changes and to facilitate interagency coordination. These are described and illustrated using examples from different countries.
Highlights
In 2004 it is estimated that there are 95 violent conflicts worldwide [1,2]
The examination included specific training and reference materials developed to support Health as a Bridge for Peace [16,17]. The leaders expanded their workgroup to include other experts representing the Training in Epidemiology and Public Heal th Network (TEPHINET- a consortium of applied epidemiology training programs in 40 countries), the US Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), foundations, schools of public health, and numerous private organizations [20,21]
This paper presents the results of the literature review, as well as the answers provided by members of the group at the meeting and subsequently by members of the expanded workgroup via phone interviews about the implications of these recommendations for training field epidemiologists
Summary
The profound consequences to the wellbeing of communities from these conflicts are disproportionately distributed. Ninety percent of those who die in war are civilians, half are female, and more children will die or be disabled than soldiers [2,3,4,5,6,7,8,9]. As war became endemic in certain areas, primarily civil and geographically less demarcated, the international public health community was pressured to provide prevention and primary health services to the indigenous population as well [12,13]. The group was tasked to describe the skills that are essential to effective functioning in these settings and thereby provide guidance to the applied epidemiology training programs
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