Red Cross Research Articles

Word-of-mouth among blood service employees who also donate blood: a qualitative investigation of advantages and challenges for dual-role donors

BackgroundDespite word-of-mouth (WOM) and electronic WOM (eWOM) influencing people’s willingness to donate blood, no research has explored this behavior among blood service employees who are also donors. This underexplored segment is highly important, as they are generally committed to both the organization and the cause and are likely more informed on the topic of blood donation than the average donor.MethodsThis study comprised six online focus groups with 26 Australian Red Cross Lifeblood employees who are also donors. Questions covered a range of blood donation and WOM topics, including when they became blood donors, if they had engaged in WOM about blood donation, what they had talked about and with whom, and what were audience reactions. Thematic analysis was then used to explore how responses related to the employees’ motivations, opportunities, and abilities to engage in WOM and eWOM about blood donation.ResultsWhile most employee-donors saw alignment in their employee and donor roles, advocating for blood donation was not considered a necessary part of either role. Educating others about blood donation was a common goal of employee-donor WOM and eWOM, and almost all employees engaged in reactive WOM, triggered by events (e.g., recent donations) or questions about their work. Employee-donors in donor-facing roles (e.g., communications and collections staff) felt more aware of the importance of encouraging others to donate blood and were also more likely to be proactive in their WOM activity. Along with these perceived advantages of having a dual role, employee-donors also identified some disadvantages, such as unrealistic expertise expectations and negative audience responses that can be difficult to navigate.ConclusionsBeing an employee-donor is a double-edged sword. For example, increased opportunities to talk about blood donation and access to more information can be offset by having to respond to more challenging questions/comments and expectations, while appropriately representing their employer. More research is needed among those in employee-donor roles within the healthcare and/or non-profit sectors, to determine whether these are issues faced more broadly, and how those in dual roles can be most effectively supported to engage in positive WOM and eWOM.

Mykola Motsakov — in the field of the Red Cross

The article represents a life and a professional path of zemstvo doctor Mykola Petrovych Motsakov. His contribution to the development of the medical service in Katerynoslav has been presented: he worked in the community of mourning sisters, was the first chief doctor in the field of the Red Cross. He died prematurely in the prime of his life in the line of duty. Excerpts from the diary of Princess Vera Urusova about his mother have been provided. The presented material will contribute to the popularization of the figure of the Ukrainian zemstvo doctor.

Uniform or demand-driven allocation? Optimal management of social donations distribution in response to sudden outbreaks

PurposeThis study aims to address challenges in the distribution of social donations during epidemic emergencies, focusing on issues such as uneven distribution and material stacking. The goal is to propose optimized strategies that enhance equity and efficiency in the allocation of donated resources.Design/methodology/approachFirstly, the satisfaction function is constructed from two perspectives of the designated hospital and the Red Cross. On this basis, the fairness perception level of the two is portrayed. Then, we set the time weights, and construct a multi-objective programming model by combining the resource constraints in the social donation distribution process. The combined algorithm of NSGA-II and TOPSIS is also designed for model solving. Finally, an example of social donation distribution of the Red Cross Society of China Wuhan Branch is conducted for numerical analysis.FindingsNumerical analysis reveals that timely transmission of demand information favors a demand-oriented distribution strategy for optimal efficiency. However, in scenarios with poor demand information transmission, an equal distribution of social donations proves to be a more effective strategy. Equal distribution ensures rapid allocation while minimizing perceived unfairness at designated hospitals, ultimately improving overall satisfaction levels and emergency response effectiveness.Practical implicationsThe findings provide practical insights for emergency response planners. These include translating the developed methods into guiding principles, establishing real-time monitoring systems, enhancing training for relevant departments, and implementing evaluation mechanisms. Practitioners can utilize this knowledge to optimize the efficiency of social donation distribution during sudden outbreaks.Social implicationsThe equitable distribution of social donations ensures efficient resource allocation and minimizes perceived unfairness, contributing to improved social satisfaction levels. This has broader implications for community resilience and support during emergencies.Originality/valueThis research contributes to the field by proposing a comprehensive model for optimizing social donation distribution in emergencies. The integration of fairness perception, time weights, and a multi-objective planning approach, along with the application of the combined algorithm of NSGA-II and TOPSIS, adds novelty and practical value to the existing literature. The study serves as a decision-making reference for enhancing emergency response theories in sudden event.

Establishing Quality Assurance for HIV-1 Rapid Test for Recent Infection in Thailand through the Utilization of Dried Tube Specimens.

The present study focuses on establishing the quality assurance of laboratories for recent infections (RTRI) in Thailand. We developed a cold-chain independent method, using fully characterized plasma obtained from the Thai Red Cross Society, and prepared as dried tube specimens (DTS). Twenty microliters of HIV-seronegative, recent, and long-term infected samples were aliquoted into individual tubes and dried at room temperature, 20-30 degrees Celsius, in a biosafety cabinet overnight to ensure optimal preservation. The DTS external quality control and external quality assessment were tested for homogeneity and stability following the ISO/Guide 35 guidelines. The DTS panels were distributed to 48 sites (FY 2022) and 27 sites (FY 2023) across 14 and 9 provinces, respectively, in Thailand. The results from participating laboratories were collected and evaluated for performance. The results were scored, and acceptable performance criteria were defined as the proportion of panels correctly tested, which was set at 100%. The satisfactory performance ranged from 96% to 100% and was not significantly different among the 13 health regions. The developed and implemented DTS panels can be used to monitor the quality of RTRI testing in Thailand.

Through the Lens of the ICJ: Bridging the Gap between Human Rights and Humanitarian Norms in Global Child Soldiering

Recently in June 2022, the United Nations Special Representative of the Secretary-General for Children and Armed Conflict expressed that the ongoing use and recruitment of children in armed conflict globally warrants "international concern". Notwithstanding the existence of proscriptive norms in terms of international humanitarian law (IHL) and international human rights law (IHRL), international legal violations are nevertheless committed by states and non-state actors. A systematic analysis of the respective normative systems identifies a lacuna between specific provisions thereof. Consequently, violations are committed in armed conflicts for the purposes of IHRL but not IHL, it is contended that this inconsistency in the law perpetuates ongoing child soldiering. It is further contended that this inconsistency establishes a genus of children who are legally unprotected as they fall between the cracks of international law. Based on recent progressive jurisprudence of the International Court of Justice, an approach which will bridge the lacuna between these norms is proposed. Contrary to the view of the International Committee of the Red Cross and with due consideration for the lex specialis principle, it is proposed that the IHL and IHRL instruments should apply in a complementary fashion, as opposed to the separate legal regimes under which they have developed.

Investigating the Response Time to Disasters in the Red Crescent Society by Province and Type of Disasters: A Descriptive Study

Investigating the Response Time to Disasters in the Red Crescent Society by Province and Type of Disasters: A Descriptive Study

The Role of the International Red Cross and Red Crescent Movement in Promoting the Culture of Peace and Cooperation in the Middle East in 2000-2022

The Role of the International Red Cross and Red Crescent Movement in Promoting the Culture of Peace and Cooperation in the Middle East in 2000-2022

How Can Practitioners Support Citizen Volunteers in Disaster Risk Reduction? Insight from “Good and Ready” in Aotearoa New Zealand

Global and national policy frameworks emphasize the importance of people’s participation and volunteers’ role in disaster risk reduction. While research has extensively focused on volunteers in disaster response and recovery, less attention has been paid on how organizations involved in disaster risk management can support volunteers in leading and coordinating community-based disaster risk reduction. In 2019, the New Zealand Red Cross piloted the Good and Ready initiative in Auckland, Aotearoa New Zealand, with the objective to empower local people in resilience building with a focus on volunteers and community participation. This research examined the positive and negative outcomes of Good and Ready and investigated volunteers’ experiences in the disaster resilience initiative. It involved the codesign of a questionnaire-based survey using participatory methods with Good and Ready volunteers, the dissemination of the survey to gather volunteers’ viewpoints, and a focus group discussion with participatory activities with Red Cross volunteers. The findings highlight that a key challenge lies in finding a balance between a program that provides flexibility to address contextual issues and fosters communities’ ownership, versus a prescriptive and standardized approach that leaves little room for creativity and self-initiative. It pinpoints that supporting volunteers with technical training is critical but that soft skills training such as coordinating, communicating, or facilitating activities at the local level are needed. It concludes that the sustainability of Good and Ready requires understanding and meeting volunteers’ motivations and expectations and that enhancing partnerships with local emergency management agencies would strengthen the program.

A Plain Song about the Red Cross

A Plain Song about the Red Cross

Implementing Prehospital Ultrasound at the Saudi Red Crescent Authority: Perceived Barriers and Training Needs.

This study examines the inherent barriers to implementing prehospital ultrasound within the Saudi Red Crescent Authority (SRCA) in Saudi Arabia. A qualitative study was conducted to explore the perceived barriers, mode of transportation, ultrasound familiarity, and self-efficacy level of relevant stakeholders in implementing the prehospital ultrasound in SRCA. Data was collected via surveys and interviews with 24 SRCA paramedics/EMTs, 4 SRCA station administrators, and two hospital physicians to further examine the inherent barriers of implementing the prehospital ultrasound. Thematic analysis revealed the main barriers were costs of ultrasound equipment, environmental factors affecting image capture, and lack of training in ultrasound skills and interpretation. Administrators and physicians also noted concerns about machine portability and technical maintenance. Stakeholders agreed ultrasound could improve trauma diagnosis if barriers were addressed through extensive training and protocols. In prehospital care setting, the two main modes of transportation are "stay and play", involving on-scene interventions before transport, and "load and go", prioritizing rapid transport to the hospital, with the choice depending on various factors. An overwhelming 96% of paramedics/EMTs preferred a 'stay and play' approach to stabilize patients before transport, while 75% of administrators preferred 'load and go' for rapid transport to hospitals. 62.5% of paramedics were familiar with ultrasound, but only 20.8% had previously used it. This study provides important insights into stakeholder perspectives on the implementation of prehospital ultrasound within the Saudi Red Crescent Authority. The findings can guide efforts to implement appropriate ultrasound use through tailored training programs and enhanced coordination across groups, aimed at improving trauma outcomes.

Interactive Voice Response Technology as a Data Collection Tool Compared to a Household Survey: What We Learned

The COVID-19 pandemic profoundly affected all aspects of life, including the Canadian Red Cross’s (CRC) operations. To continue delivering projects and evaluations under restrictions, the CRC adapted its methods. This adaptation is exemplified by the Adolescent Sexual and Reproductive Health and Rights project in Mali, launched during global lockdowns. Typically, such projects use standardized monitoring frameworks with pre–post-intervention measurements and household surveys for data collection. However, the pandemic made household surveys impractical. The CRC employed interactive voice response (IVR) technology to gather data, a method commonly used by telecommunications companies for short surveys. This study explores how the CRC used IVR for a more extended 45-minute questionnaire on sensitive topics like adolescent girls’ reproductive health. The article discusses the benefits and drawbacks of IVR compared to traditional household surveys, detailing the challenges faced and solutions implemented. Ultimately, the authors compare the effectiveness of both methods, offering insights into ensuring data quality in constrained circumstances. The evaluators’ perspectives on the two methodologies underscore the adaptability required to maintain robust data collection and project monitoring during unprecedented times.

The history of the establishment of organs for fact-finding in the resolution of international disputes

The paper traces the historical background of the formation and development of the institution of international fact-finding. As a result of the progressive development of international law, the institution of international investigation emerged at the turn of the 19th and 20th centuries, first receiving its international legal consolidation in the Hague Convention on the peaceful settlement of international disputes of 1899. The history of establishing fact-finding bodies by states, which acted as parties to disputes based on factual issues, both at the universal and regional levels, is examined. The practice of resorting to investigation procedures within international intergovernmental organizations such as the League of Nations, the UN, ILO, ICAO, the World Bank, the EU, and others is considered. In the modern period of international law, the fact-finding procedure has gained quite extensive use and is implemented in a more primitive form, especially within the activities of the United Nations. The UN establishes international commissions (composed mainly of individuals who are not citizens of the parties to the dispute or participants in the situation) authorized, as often happens, not only to establish facts (conduct investigations) but also endowed with broad competence to provide conclusions on legal issues and recommendations for dispute resolution or situation. The UN also uses the international investigation procedure in conjunction with other international mechanisms for dispute resolution. Referring to international bodies for fact-finding, as one of the means of peaceful settlement of international disputes, was first provided for by the Hague Conventions on the peaceful settlement of international disputes of 1899 and 1907. Therefore, the existence of various nature international investigating commissions - from "pure" fact-finding in the Tigre case to investigations regarding the Red Cross and the Letellier and Moffitt case, which were close to arbitration.

Dengue virus transmission risk in blood donation: Evidence from Thailand.

Individuals infected with dengue virus (DENV) often show no symptoms, which raises the risk of DENV transfusion transmission (TT-DENV) in areas where the virus is prevalent. This study aimed to determine the evidence of DENV infection in blood donors from different geographic regions of Thailand. A cross-sectional study was conducted on blood donor samples collected from the Thai Red Cross National Blood Center and four regional blood centers between March and September 2020. Screening for DENV nonstructural protein 1 (NS1), anti-DENV immunoglobulin G (IgG), and IgM antibodies was performed on residual blood from 1053 donors using enzyme-linked immunosorbent assay kits. Positive NS1 and IgM samples indicating acute infection were verified using four different techniques, including quantitative real-time (q) RT-PCR, nested PCR, virus isolation in C6/36 cells, and mosquito amplification. DENV IgG seropositivity was identified in 89% (938/1053) of blood donors. Additionally, 0.4% (4/1053) and 2.1% (22/1053) of Thai blood donors tested positive for NS1 and IgM, respectively. The presence of asymptomatic dengue virus infection in healthy blood donors suggests a potential risk of transmission through blood transfusion, posing a concern for blood safety.

Supporting parents with acutely ill children: Environment scan and user evaluation of mobile applications (the SuPa kids project)

BackgroundChildren are one of the biggest users of emergency departments in the UK, sometimes utilising services when experiencing acute illnesses that can be managed at home. mHealth can be an efficacious way for parents/guardians to manage acute illnesses. It has also become a ubiquitous resource to promote public health interests within a resource constrained health system. However, to be effective, co-design is necessary with concepts such as usefulness, ease of use, trustworthiness and security underpinning the utility of mHealth interventions for acute childhood illness. ObjectiveThe objective of this study was to conduct an environmental scan of mHealth apps for parental assessment and management of acute childhood illnesses in 0- to 5-year-olds, review the content and functionality of each identified app against the list of desired attributes identified in previous research and synthesise publicly available reviews from end users to demonstrate the quality of current apps in the marketplace and identify areas for improvement. MethodApp characteristics were mapped to an a priori defined list of desirable attributes. End user reviews were mapped to a modified Technology Acceptance Model framework that included overarching themes of: Perceived Usefulness (PU), Perceived Ease of Use (PEU), Perceived Trustworthiness (PT) and Perceived Security (PS) using reflexive thematic analysis. ResultsOverall, 15 apps were included in the analysis (Table 2). Fourteen of the 15 apps were available on both the iOS and Android platforms. ‘Baby Illness, Prevention, Cure’ was only available on the Android store. All apps were free to download and did not restrict access to information or features via in-app purchases. Baby and child first aid (British Red Cross) was the earliest app to be released (2014). This app was updated annually, with the most recent update being 2022. The most recent apps to be released (2018) were ‘AskFirst’ (formerly Ask NHS), ‘Essex Child Health’ and ‘The Lullaby Trust Baby Check’, updated in 2022, 2020 and 2019, respectively. No individual app met all the desirable attributes highlighted by parents in previous research. Both ‘Healthier Together’, and ‘The Lullaby Trust Baby Check’ included all but one desirable attributes (video), as did the ‘’CATCH (Common Approach to Children’s Health), which did not utilise a traffic light system. Apps that were locality specific were not rated by users (Berkshire Child Health, Cheshire Child Health, Child Health Guide Newham, Child Health HMR, Oldham Child Illness and Walsall Healthy Child). All other apps were rated from 2/5 to 5/5 stars. When considering localities, the ‘CATCH’ app was only supported in Halton, Cheshire, Knowsley, Liverpool, St Helens and Vale Royal. Further investigation evidenced no correlation between inclusion of the desirable attributes and app rating. ConclusionOverall, this research has highlighted several aspects of best practise when developing mHealth apps for the management of acute childhood illnesses, for increasing PU, PEU, PT and PS; and also, places importance on co-design.

International Law in the Perspective of International Relations

Before discussing the meaning of international law, it is important to know that law is divided into two large groups, private law and public law. However, the terms these two large groups are better known as international law and international private law. The difference between the two is in the objects they regulate. International law is the law that regulates relations between countries and other legal subjects. International law can be defined as the law that regulates international scale entities. Initially, the definition of international law was only defined as law that regulates behavior and relations between countries. However, in its development, the meaning of international law has expanded to include the relationship between states and international organizations, the relationship between international organizations and other organizations, the relationship between states and individuals in special contexts, and so on. There are six subjects of international law, namely : states, international organizations, the international red cross, the vatican holy see, rebels and individuals. International Law includes a set of rules and principles established through international treaties, the practices of states, as well as legal decisions and interpretations by international institutions. Its aim is to regulate the behavior of states in maintaining peace, managing conflict, promoting cooperation, and protecting human rights. International Law covers various aspects, including the law of war (also known as international humanitarian law), refugee law, maritime law, environmental law, international trade law, international investment law, human rights law, diplomatic law.

Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town

Background: Juvenile onset recurrent respiratory papillomatosis (JoRRP) is an incurable condition caused by human papilloma virus (HPV) types 6 and 11, often requiring repeated surgeries and in severe cases, tracheostomy. This imposes a significant socioeconomic burden on patients and families. Gardasil®, a proven prophylactic HPV vaccine, is emerging as a potential adjuvant therapy. We studied its response on JoRRP patients at our center.Methods: We conducted a retrospective review at Red Cross War Memorial Children’s Hospital from January 2015 to June 2022 on histologically confirmed JoRRP cases. Age at diagnosis, baseline and post-dosing Derkay-Coltrera (DC) scores (disease severity measure), inter-surgical intervals and tracheostomy, were collected.Results: Twenty-five of 30 confirmed cases were included. Average age at diagnosis was 60 months (about 5 years old), with HPV Type 6 in 40% and Type 11 in 48% of patients. All patients received at least one Gardasil® dose, 84% received a second dose and 64% a third dose. Total population DC score decreased from an average of 17 (range: 4-34) pre-first dose to 8 (range: 0-16) after three doses, indicating a 50% reduction. Surgical intervals modestly increased. More significant improvements were seen in patients with aggressive forms of the disease.Conclusion: This is the first study in Southern Africa highlighting Gardasil® as adjuvant therapy. Despite our limited sample size, new cases observed a linear reduction in DC scores and tracheostomy rates.Contribution: This suggests that Gardasil® as adjuvant therapy has the potential to reduce disease severity and extend surgical intervals.

Colposcopic Detection of CIN in Patients with Clinically Abnormal Cervix at a Tertiary Care Center in Bangladesh

Background: Cervical cancer poses a significant public health challenge globally, especially in regions like Bangladesh where access to effective screening programs is limited. Early detection and management of cervical intraepithelial neoplasia (CIN) play crucial roles in preventing the progression to cervical cancer. This study investigates the diagnostic accuracy of colposcopy, compared with histopathological findings, in detecting various grades of CIN and cervical cancer. Methods: This retrospective observational study reviewed hospital records of 200 VIA-positive cases from January 2021 to December 2023 at the Obstetrics and Gynecology Department of Holy Family Red Crescent Medical College Hospital Dhaka, Bangladesh. Colposcopic examinations were conducted, followed by histopathological evaluations of biopsied tissues to confirm the presence and grade of CIN. Data on demographic characteristics, clinical findings, and outcomes were analyzed using descriptive statistics. Result: Of the participants, 44% had normal colposcopic findings, while the prevalence of CIN I, CIN II, CIN III, and cervical cancer was 22.5%, 17%, 11%, and 4%, respectively. Histopathological correlation confirmed 46% as normal, with discrepancies noted in higher-grade lesion diagnosis. The study highlighted the high sensitivity but variable specificity of colposcopy in detecting and grading cervical lesions. Conclusion: Colposcopy serves as a valuable diagnostic tool in the early detection of cervical abnormalities. However, discrepancies in lesion grading underscore the need for integrating colposcopy with histopathological evaluations to enhance diagnostic accuracy and optimize patient management.

Ventriculoperitoneal shunt failures at Red Cross War Memorial Children’s Hospital

IntroductionVentriculoperitoneal shunt (VP shunt) insertion is one of the mainstays of treatment of hydrocephalus and although very effective, a high rate of shunt failure persists globally. The purpose of the study was to quantify the ventriculoperitoneal shunt failure rate at Red Cross War Memorial Children’s Hospital (RCWMCH) and assess potential factors contributing to shunt failures.MethodsA retrospective review of VP shunts done at RCWMCH between August 2015 through December 2019 was performed. Operative notes, discharge summaries and patient folders were reviewed to collect information about patient age, aetiology of hydrocephalus, index vs revision shunt, shunt system and other noticeable variables. Overall shunt failure was recorded. Univariate and multivariate models were used to determine causal relationship.ResultsFour hundred and ninety-four VP shunt operations were performed on 340 patients with 48.8% being index shunts and 51.2% revision shunts. The average patient age was 3.4 months. The total VP shunt failure rate over the study period was 31.2%, with a 7.3% infection rate, 13.6% blockage and 3.6% disconnection rate. The most common aetiologies were post-infectious hydrocephalus 29.4%, myelomeningocele 19.7% and premature intraventricular haemorrhage 14.1%. Orbis-sigma II (OSVII), distal slit valves and antibiotic-impregnated catheters were used most frequently. Failure rates were highest in the revision group, 34.7% compared to 27.3% in index shunts. Sixty-five percent (65%) of the head circumferences measured were above the + 3 Z score (> 90th centile).ConclusionVP shunt failure occurs most commonly in revision surgery, and care should be taken at the index operation to reduce failure risk. Surgeon level, duration of surgery, aetiology of hydrocephalus and shunt system used did not influence overall failure rates. A closer look at larger head circumferences, their effect on shunt systems and the socio-economic factors behind late presentations should be investigated further in the future.

Utilization of emergency medical service and its associated factors among patients visited public hospitals at Hawassa City, Sidama Region, Ethiopia, 2023

BackgroundThe burden of emergency medical conditions is borne mostly by poorer nations, with a 6 % increase in deaths of adults and children due to emergency conditions between 1990 and 2015. Emergency medical service is crucial to improve outcomes of those injuries and other time-sensitive illnesses. However, access to emergency medical services in Hawassa City is still limited and its’ utilization is influenced by different factors. MethodsA facility-based cross-sectional study was conducted among 422 randomly selected clients who visited the emergency service in public hospitals of Hawassa City. A structured interviewer-administered questionnaire adapted by reviewing previous literature was used. The collected data by using the Kobo toolbox was exported into a statical package for social science software for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were used. A binary logistic regression model at a 95 % confidence interval was used to declare an association between dependent and independent variables using the odds ratio. ResultsAll 422 participants completed the interview with a response rate of 100 %. The mean age of the study participants was 33.73 years with a 14.67 standard deviation. One quarter (24.9 % (95 % CI: 21.1–29.4)) of the study participants have utilized emergency medical services. Urban residence (AOR = 3.48, 95 % CI: 1.69–7.16), ever utilized ambulance service (AOR = 2.37, 95%CI: 1.21–4.67), having Red Cross Association ambulance number (AOR = 2.64, 95%CI: 1.20–5.83) and awareness on presence of free government ambulance (AOR = 3.74, 95%CI: 1.46–9.59) were the predictors of the outcome variable. Conclusionutilization of emergency medical services in the study area was relatively low when compared with other studies. urban residence, ever utilization of ambulance service, awareness of the presence of free government ambulances, and having a Red Cross Association ambulance number were predictors of utilization of emergency medical service.

Establishing a practical test for the end of non-international armed conflict

Abstract When do non-international armed conflicts (NIACs) end? Determining the existence of a NIAC requires a detailed, fact-intensive inquiry. Since the International Criminal Tribunal for the Former Yugoslavia's seminal decision in the Tadić case, international courts and tribunals have evaluated the existence of NIACs under the Tadić test's two-pronged inquiry into intensity and organization. Although that decision also pronounced that international humanitarian law (IHL) continues to apply until a “peaceful settlement is achieved,” neither international tribunals nor scholars have articulated a comparably widely accepted and well-developed test for determining the end of NIACs. At the same time – and especially since 9/11 – States have increasingly relied on IHL to meet the threat posed by non-State actors, broadening the scope of conflict-related liabilities in armed conflict without conferring the privileges or immunities otherwise inherent in IHL. This one-sided approach twists the purpose of IHL and places members of organized armed groups into legal black holes without temporal limitations, as States resist the termination of “armed conflict” irrespective of the continuing intensity of violence or the level of organization of non-State actors. Ultimately, the current approach gives States broad discretion without appropriate safeguards, which undermines the proper application of human rights and humanitarian principles within conflict and prevents the establishment of a sustainable peace. This paper argues that the most appropriate test for ascertaining the end of a NIAC is one that combines objective consideration of the diminution of organized and intense hostilities below the Tadić threshold with the likelihood that hostilities will not again rise above that threshold. It thus draws from but does not fully endorse the preferred approach of the International Committee of the Red Cross (ICRC), which focuses on the lasting termination of hostilities,1 while abjuring a general temporal limitation. Although commendable for its effort to avoid the legal uncertainty that attends the revolving conflict classification problem, the ICRC's approach unfortunately tends to encode existing uncertainty surrounding the termination of NIACs and to indistinctly prolong the application of IHL to erstwhile conflict situations. In contrast, the authors suggest that a test for the end of NIAC based on a specific period (five months following the diminution of organized and intense hostilities below the Tadić threshold), subject to an evaluation of the risk that those hostilities may resume, better balances certainty of legal application with the promotion of a return to peace. The authors will employ the facts of diverse case studies, including the FARC in Colombia, the LTTE in Sri Lanka, numerous armed groups in Mali, and the United States with Al-Qaeda, to build a legal standard that courts can use to determine IHL's continuing applicability to an erstwhile armed conflict.