Humanitarian Crisis Research Articles

A Review of Drought Disturbance on Socioeconomic Development

Climate-change-intensified drought carries great challenges for socioeconomic development. This article aims to provide a comprehensive review of research on the effects of drought disturbance on socioeconomic development within the context of climate change. According to the co-citation analysis of approximately 3000 literature sources, it should be emphasized that challenges resulting from drought carry significant socioeconomic implications, including agriculture losses, increased financial burdens on governments, and escalating insurance claims. Drought can also trigger humanitarian and social crises, especially in resource-limited areas, resulting in shortages of food and water, population displacement, and health risks. Therefore, effective policies, informed by robust research and data, are crucial for addressing the complex challenges of droughts in a changing climate. Proactive strategies, including improved water management, early warning systems, and sustainable agricultural practices, are essential for a comprehensive response. Addressing the socioeconomic impacts of climate-induced drought requires a holistic, interdisciplinary approach, emphasizing collaboration among governments, communities, researchers, and international organizations. Implementing adaptive measures and risk reduction strategies enhances resilience and mitigates the adverse effects of drought on society and the economy.

Abstract 17321: Cardiometabolic Risk Increased in All Socioeconomic Status During the Venezuelan Humanitarian Crisis: The EVESCAM Cohort Study

Background: Social determinants of health (SDOH) significantly impact cardiovascular disease (CVD). Poverty is the most important underlying cause of preventable death, disease, and disability, and interacts with other SDOH. Venezuela was declared as suffering a humanitarian crisis, and besides the increase in poverty, other SDOHs such as traumatic stressors, violence, food insecurity, and treatment interruptions increased. This study aimed to estimate the changes in cardiometabolic risk factors (CMRF) in different socioeconomic statuses (SES) during the humanitarian crisis in Venezuela. Methods: Data from the EVESCAM Study was analyzed. The nationally-representative baseline assessment was conducted in 2014-2017 (N=3414) using a multi-stage stratified sampling and further follow-up on a subset of 35% of participants was undertaken in 2018-2020 (N=1257). Changes in CMRF and their prevalence among three SES (Low-SES N=657[52.3%], Middle-SES N=384[30.5%], and High-SES N=216[17.2%]) were compared. Results: There was a decrease in the prevalence of obesity (p=0.001), but an increase in the prevalence of dyslipidemia (total cholesterol ≥200mg/dL, and Low-Density Lipoprotein cholesterol ≥130mg/dL, P=0.001), low Mediterranean diet adherence (p=0.001), and depression (p=0.001) in all SES. Diabetes prevalence decreased only in middle-SES (p=0.01) and low-SES (p=0.03). Anxiety and hypertension did not change significantly. The prevalence of participants with high CVD risk (Globorisk score >20%) increased in all SES (P=0.001). Conclusion: There was an increase in multiple CMRF in all SES during the Venezuelan humanitarian crisis. This scenario could determine a particular pattern of morbidity determined by the interaction of several factors, including a shortage of basic goods, severe hyperinflation, and a breakdown of the healthcare infrastructure. Efforts are needed to improve the health and CVD risk of populations facing humanitarian crises.

The political economy of expedience: examining perspectives on military support to Sierra Leone’s Ebola response

The 2013–2016 West Africa Ebola Epidemic is the largest outbreak of Ebola in history. By September, 2014 the outbreak was worsening significantly, and the international president of Médecins Sans Frontières called for military assistance. In Sierra Leone, the British and Sierra Leonean militaries intervened. They quickly established a National Ebola Response Centre and a constituent network of District Ebola Response Centres. Thereafter, these inherently militarised centres are where almost all Ebola response activities were coordinated. In order to examine perspectives on the nature of the militaries’ intervention, 110 semi-structured qualitative interviews were conducted and analysed. Military support to Sierra Leone’s Ebola response was felt by most respondents to be a valuable contribution to the overall effort to contain the outbreak, especially in light of the perceived weakness of the Ministry of Health and Sanitation to effectively do so. However, a smaller number of respondents emphasised that the military deployments facilitated various structural harms, including for how the perceived exclusion of public institutions (as above) and other local actors from Ebola response decision making was felt to prevent capacity building, and in turn, to limit resilience to future crises. The concurrent provision of life-saving assistance and rendering of structural harm resulting from the militaries’ intervention is ultimately found to be part of a vicious cycle, which this article conceptualises as the ‘political economy of expedience’, a paradox that should be considered inherent in any militarised intervention during humanitarian and public health crises.

Epidemiological Implications of War: Machine Learning Estimations of the Russian Invasion’s Effect on Italy’s COVID-19 Dynamics

Background: The COVID-19 pandemic has profoundly transformed the global scenario, marked by overwhelming infections, fatalities, overburdened healthcare infrastructures, economic upheavals, and significant lifestyle modifications. Concurrently, the Russian full-scale invasion of Ukraine on 24 February 2022, triggered a severe humanitarian and public health crisis, leading to healthcare disruptions, medical resource shortages, and heightened emergency care needs. Italy emerged as a significant refuge for displaced Ukrainians during this period. Aim: This research aims to discern the impact of the Russian full-scale invasion of Ukraine on the COVID-19 transmission dynamics in Italy. Materials and Methods: The study employed advanced simulation methodologies, particularly those integrating machine learning, to model the pandemic’s trajectory. The XGBoost algorithm was adopted to construct a predictive model for the COVID-19 epidemic trajectory in Italy. Results: The model demonstrated a commendable accuracy of 86.03% in forecasting new COVID-19 cases in Italy over 30 days and an impressive 96.29% accuracy in estimating fatalities. When applied to the initial 30 days following the escalation of the conflict (24 February 2022, to 25 March 2022), the model’s projections suggested that the influx of Ukrainian refugees into Italy did not significantly alter the country’s COVID-19 epidemic course. Discussion: While simulation methodologies have been pivotal in the pandemic response, their accuracy is intrinsically linked to data quality, assumptions, and modeling techniques. Enhancing these methodologies can further their applicability in future public health emergencies. The findings from the model underscore that external geopolitical events, such as the mass migration from Ukraine, did not play a determinative role in Italy’s COVID-19 epidemic dynamics during the study period. Conclusion: The research provides empirical evidence negating a substantial influence of the Ukrainian refugee influx due to the Russian full-scale invasion on the COVID-19 epidemic trajectory in Italy. The robust performance of the developed model affirms its potential value in public health analyses.

Operationalizing strategies for expanding UHC for the vulnerable population in Nigeria

People living in vulnerable conditions have often been neglected or have a low coverage in health insurance which exacerbate poverty, vulnerability and social exclusion. This necessitates building and implementing insurance coverage that fully integrates social protection systems and community-based social care that prioritise the needs of the most vulnerable. To that end, we propose a decentralized system of sustainable financing and management of the vulnerable group fund that is performance driven with multi-stakeholder accountability systems premised on integrated data management. Integrating these elements will ensure that some of the existing gaps in the basic healthcare provision fund implementation in Nigeria are addressed with the following fundamental building blocks for the vulnerable group fund. These recommendations will help governments, resource partners and relevant stakeholders to consider in formulating strategies for operationalizing the vulnerable group funds and decreasing health inequalities among the population. In addition to implementation of this to accelerate universal health coverage and social protection, this will help to mitigate the currents challenges that exacerbate the inequality gaps, and build more resilient health and social protection systems, including the systems within humanitarian crises settings.

A comparison of total cost estimates between exclusive breast-feeding and breast milk substitute usage in humanitarian contexts.

Using a model-based analysis, we calculated the total costs associated with the exclusive breast-feeding (EBF) and breast milk substitute (BMS) usage for one infant for six months within select humanitarian contexts to (a) determine if there is a notable difference in costs and (b) use these results to inform future creation of data-informed humanitarian response standard operating procedures. The inputs and costing data were drawn from a mixture of local e-commerce vendors, peer-reviewed literature and personal communications with field-based humanitarian responders. To account for cost fluctuations, each input's costs along with low and high parameters are presented. All costs are presented in 2021 United States Dollars. Humanitarian responses within Indonesia and Jordan. Not applicable. There was a notable difference in the total cost of care in both selected locations across the study arms (Indonesia: $542; Jordan: $892). Given the reality of limited funding for comprehensive humanitarian response around the world and the necessity of prioritising certain interventions, humanitarian response organisations should consider the notable cost difference between EBF and BMS usage (along with the proven health benefits of EBF). This difference should play a role in informing the future creation of standard operating procedures while also ensuring that all infants within a humanitarian crisis receive appropriate feeding.

Volatility of World Oil Prices Towards Venezuela's Economic Crisis

The drop in world oil prices, especially in 2014, caused Venezuela to experience a crisis. This is because oil is the country's main commodity and 95% of Venezuela's exports come from oil commodities. This study uses a qualitative descriptive research method. By using the theory of International Political Economy, International Organization, and Price Liberalization, the author tries to find out the causes of the decline in world oil prices and efforts to stabilize world oil prices in this case OPEC and market mechanisms. The results of this study indicate that Venezuela's financial inability to deal with falling oil prices due to inappropriate government policies such as the Venezuelan Social Program has caused Venezuela to experience an economic crisis. This then causes further impacts in the form of a humanitarian crisis, namely poverty, hunger, unemployment, crime, and an increase in the number of Venezuelan refugees. The series of crises resulted in Venezuela becoming one of the countries that failed to overcome domestic crises.

The responsibility of bioethicists: The case study of Yemen.

In this article, we describe in detail the health and general living conditions resulting from the ongoing armed conflict in Yemen, including the historical and geopolitical underpinnings. In addition to mere reporting, we use Yemen as a case study to examine the responsibility of bioethicists in general. We find it unacceptable that bioethics neglects the largest humanitarian crisis taking place in the world at the moment as well as the largest Cholera outbreak in history. We argue that bioethicists should do more to address armed conflicts and their resulting basic human rights violations. We end with a few recommendations to prevent such neglect.

Effectiveness of resource management of Lebanese NGOs in response to COVID-19 and the Syrian crisis

Crises are appearing widely in different regions of the world. The Syrian war was considered one of the largest humanitarian crises where Lebanon hosted many displaced Syrians. Recently, the coronavirus outbreak coincided with a severe socio-political and economic crisis in the country. COVID-19 affected NGOs’ response to the community and refugees. Henceforth, the study examined NGO activities and strategies in response to the Syrian refugee crisis during and after COVID-19 to identify future effective practices. The paper is based on qualitative data. Forty representatives from NGOs in Lebanon participated in semi-structured interviews. They reported on (i) the influence of COVID-19 on NGOs’ activities, (ii) effective strategies for supporting Syrian refugees and the host community, and (iii) evaluation of NGOs’ achievements and failures to provide services for the community during COVID-19. Data disclosed that COVID-19 enhanced the need for different activities to support refugees and the host community but failed to procure funds and get the necessary support from the funding agencies. The paper suggested that both government and donor agencies should enhance support for NGOs during crisis times, with better communication among stakeholders being crucial. A resource dependency theory was developed and supported by stakeholder perspectives. Based on the research findings, implications, and future research suggestions are proposed.

Ukrainian War Refugee Children With Particularly Severe Viral Infections: A Case Series Report.

The humanitarian crisis in Ukraine in 2022 led to a massive migration of refugees to Poland. Immigrant children, living in overcrowded humanitarian hubs, were exposed to multiple stressful factors likely affecting their immune systems. This case series study aimed to describe a particularly severe course of common viral infections, in Ukrainian refugee children. We present 2 case series of Ukrainian refugee children: 5 hospitalized due to either adenovirus (AdV) and 8 with rotavirus (RV) infection, admitted within 3 months in each case series, recruited retrospectively. Most patients lived in humanitarian hubs and were neglected on admission (dehydrated, with poor hygiene and anxious). All RV infection cases had symptoms of severe gastroenteritis requiring intravenous rehydration. Metabolic acidosis was present in 6 children, and hypoglycemia in 4 participants. None of them were vaccinated against RV. All children with AdV infection had prolonged fever, dyspnea requiring oxygen therapy and hyperinflammation. In 2 AdV infection cases with no clinical improvement and increasing inflammatory markers, intravenous immunoglobulins and glucocorticosteroids were used. The combination of stressful factors and living in overcrowded hubs during the high prevalence of viral infections led to a particularly severe course of viral infections in Ukrainian refugee children.

The State of Ukraine's Protected Areas: an interim update on damages from the full-scale invasion

The Russian Federation’s full-scale invasion of Ukraine has become a humanitarian and political crisis. Since the very start of the invasion, it has also been an ecological disaster, with Russian troops utilising protected areas both in an attempt to access strategic Ukrainian settlements, but also as locations in which to conduct active warfare. The frontline has now crossed and retreated from many protected areas, many are still occupied and many are still the sites of active hostilities. This study found the most common damages to protected areas are: physical destruction of habitats and wildlife and wildlife behavioural changes from explosions; chemical and physical pollution from explosive materials; fires caused by shelling; damages to soil and plant cover from heavy military vehicles, equipment and defence infrastructure; and military exploitation of natural resources. Given the occupation, combat and mining with explosives, it will be years before Ukraine can account for the full extent of damage to its protected area system. This paper provides an interim assessment of the damages to protected areas so far and urges the conservation and policy communities to monitor the situation moving forward.

Заложник инфраструктурных противоречий на Кавказе: Нагорный Карабах после 2020 года

Introduction. The article defines the nodal intersections of international transport corridors in the South Caucasus. Nagorno-Karabakh, after the 2020 war, is isolated from the donor country, and the prospects for its existence are beginning to depend more and more on transport diplomacy in the region. Methods and materials. The study is based on the concept of F. Braudel on the territorial organization of space. To analyze the current regional situation around Nagorno-Karabakh after 2020, strategic documents, news reports, interviews, and statements by officials of the countries of the region and representatives of regional powers were used. Analysis. The transport isolation of Nagorno-Karabakh undertaken by Azerbaijan after 2020, while simultaneously developing transport infrastructure bypassing it and the central regions of Armenia, created conditions for a humanitarian crisis in the unrecognized state. During the negotiations with Armenia, the fate of the Karabakh population is becoming more closely associated with the development of transport infrastructure in the region, calling into question the participation of Armenia itself in the development of projects. This situation forces its Prime Minister to take unpopular measures, gradually yielding to Baku’s demands. Azerbaijan, having taken part in the implementation of European transport projects, is developing new ones with the participation of China, Russia, Turkey, and Iran. The unresolved conflict hinders the security of investments in the region. The speed of development of competing transport corridors does not create prerequisites for long-term projects to resolve the issue of Nagorno-Karabakh. Results. Thanks to Azerbaijan’s initiative, new transport geography is being formed in the South Caucasus, creating diversified corridors for Azerbaijan and Turkey, and at the same time increasing the Russian Federation and Iran’s dependence on the level of relations with these states. Taking into account Azerbaijan’s negotiations with Iran as well as Russia’s interest in the development of the North-South ITC, it can be assumed that tougher steps will be taken in the future with regard to the Nagorno-Karabakh as well as the Zangezur corridor.

Storytelling - Intervention method for children affected by war trauma

The war in Ukraine is the largest humanitarian crisis that Europe has faced in recent years, and our country, Romania, was directly involved in managing the situation created by the refuge of millions of Ukrainians (in particular, mothers and children) who left the country at the beginning of the armed conflict. This type of conflict has had a strong negative impact on children, especially Ukrainian children, and the thus generated trauma can affect the development of self-identity, of spirituality or of the world perspective due to its influence on cognitive processes involving the development of trust, intimacy, control, security, and power. Through our case study we capture the psychological effects of war on children, and the technique „ storytelling” as an effective method of intervention in treating war trauma in children.

Measles outbreak in Yemen amidst a humanitarian crisis: key challenges and recommendations

Measles outbreak in Yemen amidst a humanitarian crisis: key challenges and recommendations

Healing the unseen wounds: Sudan's humanitarian crisis traumatizing a nation.

Healing the unseen wounds: Sudan's humanitarian crisis traumatizing a nation.

Doing Refugee Right(s) with Technologies? Humanitarian Crises and the Multiplication of “Exceptional” Legal States

Abstract Like borders, refugee protection settings beyond the EU often serve as testing grounds for technologies. This article takes a socio-legal perspective to show how humanitarian experimentation in these contexts is made possible through different, interacting challenges to sovereignty. It argues that the understanding that actors or their positions are “exceptional” allows for and justifies data practices that would otherwise not be legally permissible. Examples of data practices in refugee protection settings are connected to work in geopolitics, science and technology studies, and sociology of law. The article shows how the position of the United Nations High Commissioner for Refugees (UNHCR) as negotiator on behalf of refugees and an emergency-driven techno-solutionism not only interacts with the already precarious legal context most people seeking refuge find themselves in. It coincides with the legal positioning of International Organisations and with citizenship-oriented conceptions of privacy, further constituting people seeking refuge as (digital) rights optional. This is problematic not least because of concerns about adequate data protection or the implications of bias. Data flows and algorithms are generative of the politics of contemporary societies, implying that the structural undermining of digital rights of people seeking refuge in the present can also hinder their access to rights in the future.

A41Implementation of virtual clinical experiences for Myanmar medical students: a pilot rollout of remote-synchronous simulation

Severe disruptions have plagued Myanmar’s undergraduate and postgraduate medical education – firstly with the Covid-19 pandemic and later with a military coup d’état in February 2021. In the wake of the current humanitarian and political crisis, many medical students partaking in civil disobedience have been driven underground for fear of retribution. Foregoing bedside teaching and crucial clinical learning opportunities in hospitals – for online education through teleconferencing and live broadcast via social media. To scale up these efforts the Global Health Education Group’s (GHEG) novel XR platform was piloted to provide remote clinical experiences streamed to Myanmar students with the help of diaspora doctors and virtual patients in the UK [1]. The pilot held over a 4-day period in February comprised 4 Virtual Clinical Experience (VCE) sessions each covering two simulated patient scenarios related to the following disciplines: Medicine, Surgery, Obstetrics and Gynaecology, and Paediatrics. Each session had an introductory, consultation, and debrief phase that ran for 1.5 – 2 hours altogether. This was held on GHEG’s newly developed Virtual CP platform [2], which enabled the students to view a live stream of the consultation with the patient-actor through the clinician’s smart glasses and provided the opportunity for real-time interaction. The sessions were successfully delivered to 400 students from across 5 Myanmar Universities. The student’s satisfaction was assessed using an anonymous feedback form that was disseminated; a total of 38 responses was obtained which was overwhelmingly positive. 76.3% of the respondents rated the session to be ‘helpful’ or ‘extremely helpful’ and 68.4% rated the session to be representative of a real clinical experience. On a scale out of 10, 57.8% of respondents rated the VCE platform a 6 and above on ease of use. Technical difficulties did arise affecting 68.4% of respondents, although free text feedback purported they were promptly addressed in subsequent sessions. Synchronous remote learning through virtual clinical experiences can be used to address the dearth of clinical opportunities afforded to medical students in Myanmar. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Public Health in Peril: Assessing the Impact of Ongoing Conflict in Gaza Strip (Palestine) and Advocating Immediate Action to Halt Atrocities

Background: The protracted Israel-Palestine conflict has once again escalated, resulting in a dire humanitarian crisis in Gaza Strip (Palestine). This brief report aims to provide an objective overview of the historical roots of the conflict, its impact on public health, and a call to action to end the ongoing atrocities. Methods: A literature search was conducted on PubMed, focusing on the period after the recent escalation in October 2023. Seven relevant papers were identified, serving as primary sources for this analysis. Results: We begin by presenting an unbiased historical account of the Israel-Palestine conflict and tracing its origins to the late 19th and early 20th centuries. This historical context forms the foundation for comprehending the current crisis and the urgent appeal for humanitarian intervention. The escalating violence has placed immense strain on the healthcare system in Gaza Strip (Palestine), resulting in overwhelmed hospitals, critically low medical supplies, and severe hardships for healthcare workers. Furthermore, the civilian population, especially children, bears the brunt of the conflict, with high casualties and long-term trauma. Urgent calls for a ceasefire, protection of civilians, and the immediate delivery of humanitarian aid are emphasized. Finally, the necessity of addressing these issues through an objective academic lens is emphasized to foster a deeper understanding of multifaceted conflict. Conclusion: The catastrophic impact of ongoing conflict in the Gaza Strip (Palestine) on public health is undeniable. Immediate action is imperative to halt atrocities, protect civilian lives, and support medical personnel in their life-saving mission. The call for an objective evaluation of the complex factors at play transcends historical grievances and political differences.

Map silences and chronic humanitarian crises: Spatial patterns of migrant mortality in South Texas, 2009–2020

Forensic and humanitarian interventions deployed to address migrant death in US southwestern border states have become increasingly prevalent over the past four decades. In this paper we address two persistent issues specific to the Texas-Mexico border context. First, we present the first comprehensive geospatial analysis of migrant deaths in South Texas, establishing a twelve-year (2009–2020) mortality profile. And second, we introduce the concept of necrosilences and its implications to both forensic and humanitarian work and usage of geospatial tools. We applied ANOVA, spatial statistics, and cluster analysis to test the relationships of migrant mortality point locations throughout South Texas, an area comprised of ten counties with some of the highest reported migrant deaths in the state. Our findings demonstrated that unidentified human remains that corresponded to migrants were found most consistently in jurisdictions inland from the Mexican border. Further, the map visualizations highlighted vast areas seemingly devoid of migrant deaths. These “empty” areas are emblematic of necrosilences. That is, instances where there is a lack of access or accounting rather than no death incidences. We conclude by discussing the importance of visualizing necrosilences.

Providing Remote Aid During a Humanitarian Crisis.

Humanitarian crises create opportunities for both in-person and remote aid. Durable, complex, and team-based care may leverage a telemedicine approach for comprehensive support within a conflict zone. Barriers and enablers are detailed, as is the need for mission expansion due to initial program success. Adapting a telemedicine program initially designed for critical care during the severe acute respiratory syndrome coronavirus 2 pandemic offers a solution to data transfer and data analysis issues. Staffing efforts and grouped elements of patient care detail the kinds of remote aid that are achievable. A multiprofessional team-based approach (clinical, administrative, nongovernmental organization, government) can provide comprehensive consultation addressing surgical planning, critical care management, infection and infection control management, and patient transfer for complex care. Operational and network security create parallel concerns relevant to avoid geolocation and network intrusion during consultation. Deliberate approaches to address cultural differences that influence relational dynamics are also essential for mission success.