Humanitarian Assistance/disaster Relief Research Articles

401 Global Neurosurgery Advances from Trenches to Bedside: Lessons from Neurosurgical Care in War, Humanitarian Assistance, and Disaster Response

INTRODUCTION: War has influenced the development of neurosurgery. Armed conflict and mass casualty events, including Humanitarian Assistance Disaster Relief (HADR) missions, require military surgeons to innovate to meet extreme demands. Neurosurgeons serving in the military have provided a pragmatic template for global neurosurgeons to emulate in humanitarian disaster responses METHODS: We performed a narrative review of the literature examining the influence of wars and mass casualty disasters on contemporary global neurosurgery practices. RESULTS: Wartime innovations that influenced global neurosurgery include the development of triage systems and modernization with airlifts, implementation of ambulance corps, early operation on cranial injuries in hospital camps near the battlefield, use of combat body armor, and the rise of damage control neurosurgery. Workforce shortages during wars and disasters have promoted task-shifting and task-sharing in low-resource settings that catalyzed the establishment of the physician associate profession in the United States (US). Neurosurgical care has been utilized by the US as a form of "soft power" during natural and humanitarian disasters. Low-and middle-income countries (LMICs) face similar challenges in developing trauma systems and obtaining advanced technology, including neurosurgical equipment like battery-powered computed tomography scanners. These challenges— ubiquitous in low-resource settings— have underpinned innovations in triage and wound care, rapid evacuation to tertiary care centers, and minimizing infection risk. CONCLUSIONS: War and mass casualty disasters have catalyzed significant advancements in neurosurgical care both in the pre-hospital and inpatient settings. Most of these innovations originated in the military with subsequent spread to the civilian sector as military neurosurgeons and civilian neurosurgeons, who are military reservists, returned from the battlefront or other low-resource locations. LMICs have, by necessity, responded to challenges arising from resource shortages by developing innovative, context-specific care paradigms and technologies.

Simplifying humanitarian assistance/disaster relief analytic models using activity-based intelligence

PurposeThe purpose of this paper is to propose an effective knowledge elicitation method and representation scheme that empowers humanitarian assistance/disaster relief (HA/DR) analysts and experts to create analytic models without the aid of data scientists and methodologists while addressing the issues of complexity, collaboration, and emerging technology across a diverse global network of HA/DR organizations.Design/methodology/approachThe paper used a mixed-methods research approach, with qualitative research and analysis to select the model elicitation method, followed by quantitative data collection and evaluation to test the representation scheme. A simplified analytic modeling approach was created based on emerging activity-based intelligence (ABI) analytic methods.FindingsUsing open source data on the Syrian humanitarian crisis as the reference mission, ABI analytic models were proven capable in modeling HA/DR scenarios of physical systems, nonphysical systems, and thinking.Practical implicationsAs a data-agnostic approach to develop object and network knowledge, ABI aligns with the objectives of modeling within multiple HA/DR organizations.Originality/valueUsing an analytic method as the basis for model creation allows for immediate adoption by analysts and removes the need for data scientists and methodologists in the elicitation phase. Applying this highly effective cross-domain ABI data fusion technique should also supplant the accuracy weaknesses created by traditional simplified analytic models.

The Association Between Service Members' Participation in Humanitarian Aid and Disaster Relief and Mental Health Symptoms and Treatments.

There is a scarcity of research establishing a relationship between mental illness and the U.S. military service members who participate in the field of military humanitarian assistance/disaster relief (HA/DR). One of the few studies in this area showed that participation in military HA/DR was not associated with depressive symptoms, however, the study was limited by sample size. This study examined (1) the relationship between participation in military HA/DR and mental health symptoms and military stress and (2) the relationship between HA/DR and mental health treatment and therapy. Data from the 2011 Health Related Behaviors Survey was used. The analytic sample consisted of U.S. military service members who participated in HA/DR (the Haiti earthquake and Deepwater Horizon oil spill in the Gulf) (n = 573) compared to those who participated in non-HA/DR deployments from 2007 to 2011 (n = 986). Multivariate models were used to examine the relationship between the independent variables and dependent variables while controlling for a set of variables that may confound the relationship between the two. The logistic regression model found that participating in HA/DR deployments decreased the likelihood of service members reporting post-traumatic stress disorder (PTSD) symptoms by 3% (p < 0.1) and depressive symptoms by 1% (p < 0.05). Furthermore, participation decreased the likelihood of having a prescription for antidepressants during and/or 3 months after deployment by 1% (p < 0.05). Additional results showed that junior enlisted and senior enlisted members were more likely to report symptoms of PTSD than senior officers (p < 0.05). Marines were more likely to seek treatment and therapy for depression than U.S. Coastguard members (p < 0.1). Results showed that participation in HA/DR was associated with significant reductions in PTSD symptoms, depressive symptoms, and the use of antidepressants by service members. Further research needs to understand the mechanism of these associations for better planning and implementation of HA/DR and delivery of care to service members who participate in these missions.

Contrasting the Impacts of Combat and Humanitarian Assistance/Disaster Relief Missions on the Mental Health of Military Service Members

We study the differential impacts of combat and humanitarian assistance/disaster relief (HA/DR) missions on the mental health of U.S. Marine Corps members. The deployment experiences of any individual Marine are plausibly random conditional on the observable characteristics which are used to assign Marines into units. Leveraging this exogenous variation, we compare the incidence of post-traumatic stress disorder (PTSD) and suicide deaths among Marines who deployed to either Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) or HA/DR missions between 2001 and 2011. We find that the hazard of PTSD is close to eight times higher among Marines returning from OEF/OIF compared to those never deployed, and just 1.33 times higher among those returning from HA/DR (and never participated in OEF/OIF). Those returning from OEF/OIF missions are 1.81 times more likely than those never deployed to die by suicide when they were still active duty, and the hazard increases to almost 3 after they have left the military. In contrast, we find no difference in the hazards of suicide death between those that deployed to only HA/DR missions and non-deployed Marines.

Multi-criteria logistics modeling for military humanitarian assistance and disaster relief aerial delivery operations

Given that it is not always feasible to reach an affected area via land or sea within the first week following a natural disaster, aerial delivery provides the primary means to rapidly supply the affected population. Further, it is often the case that high density delivery of humanitarian aid supplies are taken over by non-friendly groups within the affected population. By using direct airdrop systems to deliver large quantities of individually wrapped food and water items, dispersion among the affected disaster relief population will occur more quickly. In this paper, we proffer a multiple criteria decision analysis (MCDA) framework to optimize the military humanitarian assistance/disaster relief (HA/DR) aerial delivery supply chain network. The model uses stochastic, mixed-integer, weighted goal programming to optimize network design, logistics costs, staging locations, procurement amounts, and inventory levels. The MCDA framework enables decision-makers to explore the trade-offs between military HA/DR aerial delivery supply chain efficiency and responsiveness, while optimizing across a wide range of real-world, probabilistic scenarios to account for the inherent uncertainty in the location of global humanitarian disasters as well as the amount of demand to be met.

Medium Navy: A Trilateral Capability Building for HA/DR in Asia Pacific

Navies should invest not only for defense but also for responding effectively and efficiently to “Humanitarian Assistance/Disaster Relief (HA/DR) Operations”. Asia Pacific is one of the most vulnerable regions to disasters which require urgent HA/DR operation by navies. For this reason, capability building is emerging as a new area for HA/DR operations as region's navies’ short term goals. Considering wide area of the region, foreign HA/DR contribution is crucial to handle with widespread human, material, economic or environmental losses and impacts of disasters. This study examines the response of navies to Indian Ocean and Japan earthquake. The lessons taken from these disasters initiated the regional and foreign commitment with their navies to prepare for such tragic events. In this regard, this study recommends a trilateral HA/DR path for medium navies: 3Bs, Build HADR Platforms + Build Logistic Centers + Build Cooperation.

Waves of Change: Evolution in the US Navy's Strategic Approach to Disaster Relief Operations between the 2004 and 2011 Asian Tsunamis

The US military response to the 2004 Indian Ocean tsunami had a powerful strategic influence on Indonesia, and led the US Navy to make far-reaching changes in its strategic approach to humanitarian assistance/disaster relief (HA/DR) operations. These changes emerged because the positive benefits of military-delivered relief were so clearly demonstrated and the experiences validated specific concepts that have since guided the US Navy toward becoming a humanitarian partner. Current force structures were demonstrated to be adaptable to HA/DR, close cooperation with diverse partners was affirmed as a key element of successful maritime operations, and seabasing was shown as an operational construct exceptionally well suited for HA/DR. As a result of the changes, the naval response to the tsunami that struck Japan in 2011 took place in a very different strategic context.

Medical Support to Sri Lanka in the Wake of Tsunamis: Planning Considerations and Lessons Learned

When massive tsunamis affected the coast of Sri Lanka and other Indian Ocean littorals, elements of the Third Force Service Support Group and assigned Navy, Air Force, Army, and Coast Guard units from the U.S. Pacific Command were "task organized" to form Combined Support Group-Sri Lanka (CSG-SL), charged to conduct humanitarian assistance/disaster relief (HA/DR) operations. The specific mission was to provide immediate relief to the affected population of Sri Lanka and the Maldives, to minimize loss of life, and to mitigate human suffering. A 30-person health care team deployed to the northern province of Jaffna and provided medical assistance to that chronically underserved and acutely overstressed region. For a 12-day period, the team served as the principal medical staff of an under-resourced government hospital and conducted mobile primary care clinics at nearby welfare camps housing > 7,000 internally displaced persons made homeless by the tsunamis. By every measurable standard, CSG-SL accomplished its assigned HA/DR task in Sri Lanka, including the medical mission. In doing so, the medical team learned many important lessons, including five of particular value to planners of similar relief operations in the future. This article discusses the context in which CSG-SL planned and executed the medical aspects of its HA/DR operations in Sri Lanka, and it describes the most significant medical lessons learned.

A Knowledge Management Framework for the Support of Decision Making in Humanitarian Assistance/Disaster Relief

The major challenge in current humanitarian assistance/disaster relief (HA/DR) efforts is that diverse information and knowledge are widely distributed and owned by different organizations. These resources are not efficiently organized and utilized during HA/DR operations. We present a knowledge management framework that integrates multiple information technologies to collect, analyze, and manage information and knowledge for supporting decision making in HA/DR. The framework will help identify the information needs, be aware of a disaster situation, and provide decision-makers with useful relief recommendations based on past experience. A comprehensive, consistent and authoritative knowledge base within the framework will facilitate knowledge sharing and reuse. This framework can also be applied to other similar real-time decision-making environments, such as crisis management and emergency medical assistance.

A Framework for Designing a Global Information Network for Multinational Humanitarian Assistance/Disaster Relief

Large-scale Humanitarian Assistance/Disaster Relief (HA/DR) operations, particularly in developing countries, require the intervention and aid of various agencies from all over the world in a concerted and timely manner. As a result, HA/DR operations involve dynamic information exchange, planning, coordination and above all negotiation. Although a number of studies have reported the benefits of using information and communication technologies to support negotiation activities, it remains unclear how such technologies could be adapted to large-scale HA/DR operations. This paper examines negotiational issues involved in a multinational HA/DR environment and presents a framework that would help in developing a Global Information Network (GIN). The proposed framework can be used to assess and characterize individual disaster situations so that the GIN functional and design requirements can be accurately identified early. Future implications to GIN architecture are also discussed.