Sporadic Violence Research Articles

“There is a fear that you will be attacked just for the act of working in health”: a survey of experiences of violence against healthcare in Colombia

BackgroundColombia has experienced decades of conflict between the government and non-state actors. Attacks on healthcare have been a grave but regular facet of that violence. In response, the Misión Médica (MM) program was developed to support, protect, and defend healthcare. Sporadic violence continues, with many recent attacks perpetrated not by armed actors but by residents. Given the history of conflict and ongoing violence, we sought to capture the perspectives of both healthcare workers (HCWs) and community members (CMs) regarding the characteristics and impacts of attacks on health in Colombia to gain insight into how to better prevent violence and mitigate its impacts.MethodsA cross-sectional survey was conducted from January to March 2021 in seven departments in Colombia in regions that witnessed attacks on healthcare. Questionnaires were administered to HCWs and CMs via purposive sampling, probing their experiences with attacks on health with both closed and open-ended questions. The categorical responses were stratified by health worker vs. non-health worker and descriptively analyzed. Narrative responses were analyzed via a hybrid deductive/inductive thematic approach.ResultsSeventy-three individuals participated in the study (36 HCWs and 37 cm). Approximately 77% of HCWs believed that attacks on healthcare impacted health outcomes while 68% of CMs did not see a direct connection between violence against healthcare and poor health outcomes. Awareness of the MM program was significantly different between HCWs (83.3%) and CMs (37.8%). The survey responses explored the characteristics of attacks on health, compounded impacts of violence on the health system, personal impacts, and perspectives on mitigation efforts.ConclusionsThe study demonstrates that: (1) attacks on healthcare are context-dependent and require a local lens for mitigation and management; (2) both HCWs and CMs have critical perspectives that must be considered, (3) the impacts of violence against healthcare are complex and compounded and (4) that awareness of the legal protections of the Geneva Conventions must be combined with education on the health impacts for robust protection strategies. Critically, Both CMs and HCWs experience fear and psychosocial ramifications of these attacks, suggesting the need for stronger protections and resources to support the health workforce and the local community.

Challenging Communal Boundaries in Late Ottoman Thrace: Jews and Muslims in Dimetoka (Didymoteicho)

This article turns to microhistory to explain the targeting of Jews by their Muslim opponents following the Second Balkan War (July 1913) and the return of Ottoman rule to Dimetoka. It explores intercommunal tensions between Jews and Muslims over boundaries and representation in the public sphere that surfaced following the 1908 revolution and the project to construct a new building for the Jewish school in part of the town that was situated outside the boundaries of the traditional Jewish neighborhood. This article argues that the humiliation triggered by Ottoman defeat in the Balkan Wars, the atrocities against Muslim civilians at the hands of Bulgarian soldiers and irregulars, and calls to avenge the Muslims' suffering following the Ottoman retaking of Eastern Thrace provided legitimacy for retaliation against non-Muslims. Existing prewar tensions between Muslims and Jews in Dimetoka, combined with desires for revenge, made the latter into victims of sporadic violence and an economic boycott.

Ethnic Conflict in the Indian Subcontinent: Assessing the Impact of Multiple Cleavages

As majoritarian electoral politics and religious conservatism are rising in the major multi-ethnic South Asian countries, such as India and Pakistan, the events of mob lynching, ethnic clashes and targeting non-plural and minority communities are becoming more frequent. This article analyses which cleavages of marginalisation make some ethnic groups prone to violent social movements vis-a-vis others. Theoretically, through social constructivism and horizontal inequality, the study argues that socioeconomic condition, religion and language are the three broad cleavages that influence political behaviour of ethnic groups. Explicating the theory about underlying versus facilitating conditions of ethnic–civil conflicts, this article examines the prerequisites of ethnic conflicts. Thereafter, it evaluates which single cleavages and combinations of the aforementioned cleavages increase the probability of conflict occurrence in the Indian subcontinent. The argument is empirically evaluated on a sample of 60 ethnic groups of the Indian subcontinents over the period of 1947–2013. We find that groups affected by reinforcing cleavages of religious and economic marginalisation, and religious, economic and lingual marginalisation have engaged in active violence over the period of our study. Additionally, the reinforcing cleavages of language and economy, and language and religion are associated with sporadic violence. Apart from the combined effects, we find that the ethnic groups facing economic disadvantage alone can also engage in violence.

Civil War and Citizens' Demand for the State: An Empirical Test of Hobbesian Theory

How does violence during civil war shape citizens' demand for state-provided security, especially in settings where non-state actors compete with the state for citizens' loyalties? I draw on Hobbesian theory to argue that in post-conflict countries, citizens who were more severely victimized by wartime violence should substitute away from localized authorities and towards centralized ones, especially the state. I test the theory by combining two original surveys with existing NGO and media data on wartime violence in Liberia. I show that citizens who were more severely affected by violence during the Liberian civil war were more likely to demand state-provided security in the post-conflict period, both in absolute terms and relative to non-state alternatives. More sporadic collective violence in the post-conflict period does not reverse this substitution effect. Also consistent with Hobbesian theory, citizens who were more severely victimized were more fearful of threats to peace almost a decade later.

Trading Under World Trade Organisation Terms Only: Consequences for the Irish Border

In 1998, the Good Friday Agreement brought a stop to the Northern Ireland conflict, a first and foremost border conflict. Assisted by their membership within the European Union (EU) and the requirements of the European integration, the United Kingdom (UK) and the Republic of Ireland initiated a peace process with the border within the island of Ireland as a point of cooperation at its centre. Twenty years after the signature of the Good Friday Agreement, peace has been achieved between Northern Ireland and Ireland but has remained fragile. Sporadic violence has emerged since 1998 and the implementation of the Agreement has sometimes faced difficulties. The consequences of the Brexit vote may compromise the cooperation spirit embraced by the two countries. Most importantly, it may question the invisible character of the border. Despite repeated commitments from both the EU and the UK to avoid the return of border control infrastructures and thus the re-introduction of a hard border between the North and the South of Ireland, the vexed issue of the Irish border has still not received a common EU-UK answer. Indeed, the backstop proposed by the EU in March 2018 remains the most contentious sticking point of the Brexit negotiations. Looking at World Trade Organisation (WTO) law, this paper examines what would happen to the Irish border in the absence of a deal. By exiting the EU Customs Union and the EU Single Market, borders between the EU and the UK will therefore be governed by the WTO Most-Favoured Nation (MFN) clause. The paper explains that exchanging goods on an MFN-basis with the EU will have drastic consequences on the Irish border. It illustrates the possible return to border controls at the Irish border by using the example of the EU REACH Regulation applicable to both chemical products manufactured in the EU and imported into the EU. Hence, as the paper argues, only a backstop which is part of a withdrawal agreement can prevent a hard border. Yet importantly, any backstop for the Irish border should also pass muster with the WTO rules. This constraint requires the EU and the UK to remain particularly cautious if and when they agree on a specific backstop.

Attitudes to immigrants in South Africa: personality and vulnerability

ABSTRACTWhile many countries across the world face increasing numbers of immigrants, the literature on attitudes to foreigners and immigrants focuses on Western countries. This article tests broad insights from Western countries in a specific non-Western context – South Africa, a country marked by sporadic violence against some immigrant groups. This provides an important validity check. Data from the 2013 South African Social Attitudes Survey and the 2013 World Value Survey are used to model attitudes to immigrants. In line with research on Western countries, individual personality is associated with differences in attitudes; people in vulnerable positions and those who lack a personal support mechanism are more likely to oppose immigrants. When implemented to reflect the specific context, research on attitudes to immigrants appears to generalise to non-Western contexts.

Revisiting the Notion of ‘Intensity’ Inherent in Common Article 3: An Examination of the Minimum Threshold Which Satisfies the Notion of ‘Intensity’ and a Discussion of the Possibility of Applying a Method of Cumulative Assessment

Summary The 2016 ICRC Commentaries reveal an appreciation that the intensity of violence test which is included in the Common Article 3 understanding of the notion of ‘intensity’ has arrived at a point at which situations formerly regarded as instances of ‘sporadic violence’ have become so violent as to be reclassified as armed conflict not of an international character in that the situation resembles ‘protracted armed violence’. The difficulty lies in determining whether a lower intensity situation is sufficiently violent to constitute a Common Article 3-type non-international armed conflict. The minimum threshold test in relation to the notion of ‘intensity’ in Common Article 3 pertinently is concerned with the relationship between the terms ‘duration’ and ‘intensity’. At what point has a violent situation lasted long enough to exceed our understanding of the meaning of ‘sporadic’ and, thus, has become a non-international armed conflict? Is the method of assessing the level of violence in the context of Common Article 3 limited to a bilateral approach or is an aggregate assessment framework permissible as an application in border-line low-intensity non-international armed conflicts? These questions illustrate the importance of gaining a comprehensive understanding of the phrase ‘protracted armed violence’.

Natchez Country: Indians, Colonists, and the Landscapes of Race in French Louisiana

With Natchez Country: Indians, Colonists, and the Landscapes of Race in French Louisiana George Edward Milne contributes an ambitious and compelling monograph on French and Natchez relations in Louisiana. He examines the development of French and Natchez societies in the Natchez homelands along the Mississippi River from 1682 to 1733. Using a wide variety of archaeological and documentary sources, Milne analyzes how Natchez and French people understood their worlds and each other, and how both peoples pursued their respective political and economic agendas. After they had worked for decades to coexist in Louisiana, in 1729 the Natchez massacred their French neighbors and drove the survivors from their territory. Ultimately Milne’s insightful volume argues that by the late 1720s the Natchez people had come to understand themselves as fundamentally different from and incompatible with their French neighbors, and they relied on a racial ideology to articulate their desire to rid themselves of these “impudent immigrants” (79).As Milne chronicles the interactions of the French and the Natchez, he devotes roughly equal attention to the efforts of the Natchez elite to expand and control their chiefdom and to French colonizers’ efforts to establish lucrative settlements in the Lower Mississippi Valley. Although Milne provides a thorough analysis of the influences of Atlantic networks in Louisiana, he devotes less attention to the Natchez villages’ relationships with their Indian neighbors. Given that Choctaw involvement in the 1729 Natchez War was a decisive factor in the conflict, further analysis of Indigenous relationships would have enhanced Milne’s astute discussion of Natchez diplomacy.Milne’s volume offers an insightful reinterpretation of the sporadic violence and conflicts that shaped Natchez-French relationships in the Lower Mississippi Valley. Through his analysis of the tensions between the politically elite Grand Village and the outlying and subordinate towns, Milne highlights how divisions within the Natchez polity shaped the conflicts among Natchez peoples and their French neighbors. Rather than approach the series of violent conflicts between the French and Natchez towns in the years before the 1729 massacre as individual wars, Milne suggests that these clashes are better understood as moments of crisis and as points at which the Natchez elite sought to eliminate their political rivals. Milne also illustrates how seemingly chaotic acts, like the mutilation of French cattle and horses that wandered into Natchez farmlands, were part of a larger, complex political dialogue between the two nations and a way in which the Natchez attempted to assert control and reinforce borders in their lands.Most significant, Milne persuasively argues that the Natchez massacre represents a critical turning point in Native American and colonial relations, as the Natchez used race to explain the difference between their people and the French. Unlike previous scholars, who have argued that the Natchez massacre of 1729 resulted from land pressure or the diplomatic failings of a single French commander, Milne points to Natchez anxiety about the influx of enslaved Africans into their homelands and to their increasing perception of Europeans as threats to their society. As he explains, their interactions with Europeans and enslaved Africans led the Natchez to begin to call themselves “red men,” a term that Milne argues helped them conceive of themselves as a unified people and assert sovereignty in the face of European encroachment. Milne’s contribution to our understanding of French and Native relations and to the emergence of racial ideologies among both European and Indian peoples is sure to be of interest to all scholars of early America.

Rashi’s Glosses Belaaz: Navigating Hebrew Scripture under Feudal Lanterns

Amid sporadic anti-Jewish violence whipped by a crusading frenzy, Rabbi Shlomo Yitzhaki (“Rashi”) composed a commentary on the Hebrew Bible that was destined to become a vast navigational aid for God’s scriptural plan. Many of Rashi’s glosses invited medieval Jews on a spiritual pilgrimage that would dispel their sense of subjugation to temporal Christian powers. From the advent of Christianity, Jewish communities increasingly steered a course between Jewish autonomy and welfare, on one hand, and accommodation of Christian and feudal strictures, on the other. Wondering whether the cataclysmic destruction of the Second Temple in 70 c.e. signaled God’s abandonment of his people, medieval Jews’ scriptural interpretations intensified the themes of survival and internal social cohesion. To guide medieval Jewry through a middle ground between a characteristically triumphant scriptural landscape and the dispiriting Christian counterpart, Rashi frequently incorporated into his glosses French terms he transliterated into Hebrew characters. This incorporation of French was both purposeful and well-informed. As a minority community in Rashi’s Troyes, Jews lived two distinct experiences: in one, they spoke vernacular French with Christian neighbors, while, in the other, they prayed and studied the Pentateuch and Prophets in Hebrew. In this setting, the laazim communicated to Jewish readers in a specialized language akin to a password or a special handshake. Yet the glosses, because they were enveloped in Hebrew commentaries and disguised in Hebrew letters, would have eluded French-speaking Christians who could not have identified fragments of their own language hiding in plain sight.

Mao’s Golden Mangoes and the Cultural Revolution ed. by Alfreda Murck (review)

Reviewed by: Mao’s Golden Mangoes and the Cultural Revolution ed. by Alfreda Murck Richard King (bio) Alfreda Murck, editor. Mao’s Golden Mangoes and the Cultural Revolution. Zurich: Verlag Scheidegger & Spiess, 2013. 248 pp. Hardcover $35.00, isbn 978-3-85881-732-7. In August 1968, Communist Party Chairman Mao Zedong received a gift of man-goes from the visiting foreign minister of Pakistan, and passed the fruit on to the Workers’ Propaganda Team that had recently been sent to Qinghua University to quell the violent confrontations between Red Guard factions that were ravaging the campus. In doing so, Mao signalled his disaffection with the Red Guards, the youth vanguard he had unleashed against the state apparatus at the beginning of the Cultural Revolution, and declared his support for the proletariat and the military as forces of order and stability. The suppression of the Hundred Day War at Qinghua was a pivotal moment in the Cultural Revolution: the truculent and charismatic student leader Kuai Dafu, previously the darling of the Cultural Revolution Group appointed by Mao, was summarily removed and incarcerated, and the high school graduates of the Red Guard generation were dispatched within months to new challenges in villages and frontier farms. The Pakistani mangoes, exotic and virtually unheard of in 1960s China, briefly played an important role in Cultural Revolution discourse, as the physical expression of Mao’s love and concern for his people at a time when the Mao cult was at its most frenzied. The mangoes were transported nationwide, despite their deterioration in the summer heat; they were replicated in wax and placed in glass vitrines for presentation and display; paintings and photographs of the fruit became objects of veneration; and they appeared as an auspicious motif on the ubiquitous Mao badges, on quilts, on household goods, and on floats at public ceremonies. The events surrounding Mao’s golden mangoes can serve as a microcosm of the political maneuverings, the personality cult, the mass hysteria, the sporadic violence, and the devotional iconography of the early Cultural Revolution. They also remind us of the ephemeral nature of such obsessions: within a year, mango fever had subsided, its [End Page 143] artifacts no longer treasured. Half a century later, the art historian and curator Alfreda Murck dived into the dumpster of history (and the curio markets of Beijing) to retrieve the memorabilia of mango fever and mount an exhibition of her collection at the Museum Reitberg in Zurich. The volume under review contains the catalogue for that exhibition, prefaced by an introduction and six short essays placing the event in its historical, social, and cultural context. The essays in the first section of the book comprise a history of the student unrest at Qinghua, a memoir of mango celebration in a factory, analysis of the National Day Parade of October 1, 1968, a review of the role of food images in the history of Chinese art, a summary of a 1976 film attempt to revive mango fever, and a tracking of the changing images of the peasant and worker in contemporary China. Three of the essays are particularly notable here: (1) Xiaowei Zheng’s “Qinghua University and Chinese Politics during the Cultural Revolution” is a summary of events at Qinghua—a longer version can be found in The Chinese Cultural Revolution as History, edited by Joseph W. Esherick, Paul G. Pickowicz, and Andrew C. Walder (Stanford, 2006)—with valuable material from the author’s interviews with Kuai Dafu and other participants. The essay is illustrated with photographs, including one of Kuai’s most notorious stunts, the public humiliation of Wang Guangmei, leader of an earlier “work-team” at Qinghua and wife of State Chairman Liu Shaoqi. (2) Daniel Leese’s “Designing Spectacles: The 1968 Beijing National Day Parade” is a careful exposition of that tightly scripted procession (with a mango-themed display on float three) and an analysis of what this and other public events reveal about contemporary policies and the stratification of power within the leadership and among the classes that formed the ranks of the revolution. (3) Adam Yuet Chau’s “Political Awakening through the Magical Fruit: The Film Song of the Mango is amply...

Kosovo and the UN

Kosovo's declaration of independence from Serbia was followed by sporadic violence on the ground, and sharply divided the international community. Russia, China, India and a majority of the world's nations opposed what was characterised as ethnic separatism. The United States and much of the European Union supported Kosovo's independence as the last step in the non-consensual break-up of the former Yugoslavia. UN Secretary-General Ban Ki-moon sought to defuse the crisis with a package of measures including the drawdown of the UN mission that had administered Kosovo since 1999, Security Council support for the deployment of a European Union rule-of-law mission, and a status-neutral framework within which recognising and non-recognising countries could cooperate while Kosovo's transition continued. Almost three years later, Kosovo's new institutions have progressed significantly; Serbia is governed by moderates focused on that country's European future, and the international military and civil presences are being reduced.

Foreword

Winning the peace has typically proved far harder than winning the war. 1 The delicate transition from war to peace is frequently characterized by enduring tensions, sporadic violence, and the ever present threat of a return to war. Various estimates suggest indeed that the risk of conflict recurrence is between 20 to 50 per cent in the first five years after a conflict has ended. Such a feeling of failure is obviously not independent of the particularly high – even disproportionate for some – expectations that the ambitious concept of peacebuilding encourages. Post-conflict peacebuilding is aimed at addressing the deep-rooted, structural causes of a violent conflict in a comprehensive manner. It is both a multifaceted and long-term process; the ultimate objective being to reconcile security, development, and justice. The means of facilitating a sustainable peace are well known. They demand an unfailing determination from the international community, the mobilization of resources over the long term, and a better understanding of the true needs of the war-torn societies. One cannot, however, help but notice that the concept of post-conflict peacebuilding is still struggling to move from rhetoric to reality. Its popularity in diplomatic circles certainly owes much to the broad and equivocal nature of this concept which still lacks of a common understanding among the broad variety of stakeholders. The ever-present gap between theory and practice is also a reminder of the extent to which building sustainable peace is a complex and perilous task involving a wide range of activities and actors.

Commoners, Kings, and Subaltern: Political Factionalism and Structured Inequality in Lesotho

Conflict studies continue to focus on ethnicity because violence often arises among culturally heterogeneous populations. Conflicts also occur, however, in culturally homogeneous settings such as Lesotho. In Lesotho, sporadic violence has resulted not from ethnic conflicts, but from contests between interest groups vying to control the state and concomitant perquisites. Particular models for state control are legitimized by global interests seeking to promote formation of labor and commodity markets. As a result, the political system in Lesotho has fractured into multiple parties which struggle to promote specialized interests, while expressions of civil society are commonly suppressed. This article concludes that without freedom to develop institutions of civil society, sporadic violence will remain a problem for Lesotho. The lessons learned from analysis of conflict in a culturally homogenous state such as Lesotho also shed light on the ways that factors other than ethnicity contribute to conflict in culturally heterogeneous populations.

Timor-Leste in 2006: The End of the Post-Independence Honeymoon

Sporadic sociopolitical violence plagued Timor-Leste for much of 2006, a manifestation in many ways of the festering wounds associated with Indonesia's war and occupation. This violence spurred both international military intervention in an attempt to restore order and also a change in government, aggravating an already difficult socioeconomic situation.

Voices of commemoration: The discourse of celebration and confrontation in Northern Ireland

Anniversaries and commemorations are commonly sources of group solidarity and identity reaffirmation. In particular, the communal marking of historical anniversaries can be seen as a mode of community celebration, commemoration, and display. Such events play a significant role in reinforcing the history, culture, and identity of the group, as well as strengthening feelings of commonality and solidarity between community members. In this paper, however, we want to look at situations in which community commemorations also function as sources of exclusion and division. In Northern Ireland, historical anniversaries and displays (particularly Protestant Orange marches) are both a central means of cultural/communal expression, and a source of division, sectarianism, and sporadic violence (Bryan 2000; Jarman 1997). Moreover, notwithstanding constitutional devolution and the ongoing peace process, research suggests that attitudes to symbolic community displays remain strongly partisan. Here, we apply an empirical discursive framework to better understand the meaning of such commemorations at the level of grass-roots community identification in Northern Ireland. Drawing on focus group data from working-class urban groupings (both Protestant/unionist and Catholic/nationalist), we examine how such anniversaries are constructed and negotiated in `real-life' talk and interaction; and hence how they come to function simultaneously as points of solidarity and division within the community as a whole.

Terrorism: The International Response of the Courts

Terrorism:The International Response of the Courts* Michael Kirby, The Honorable Justice (bio) I. A Century of Terrorism The events of September 11, 2001 in the United States, of October 12, 2002 in Bali, and during 2004 in Madrid, Breslan, and Jakarta, have brought home to the world the challenge that acts of terrorism present when combined with new means of causing destruction and of enlivening the capacity of the global media to cover the suffering. However, terrorism is not new. The last century was a century of terrorism. It was not always so perceived. Yet from the early days-from the anarchists and communists in 1901 through the colonial unrest that followed, right up to the new century we have entered-that was the reality. The Great War began in 1914 with an act of terrorism. The reality struck home within the British Isles in the Easter Rebellion in Dublin in 1916. Not a year of the century was free from acts of terror. Mahatma Gandhi deployed a very skillful combination of passive resistance, sporadic violence, and political showmanship, ultimately to lead India, the jewel in the Crown, out of British rule. Mohammed Ali Jinnah did the same with Pakistan, obliging the division of the subcontinent that has since witnessed unrest and terrorist acts as a consequence. Over many decades (most of them in prison on Robben Island), Nelson Mandela led the African National Congress (ANC), modeled on that of India. For decades the ANC was branded a "terrorist" organization. What did these three leaders have in common? All were lawyers.1 All [End Page 313] were gifted communicators. Gandhi and Mandela, at different times, were even prisoners in the same jail, near where the Constitutional Court of South Africa now proudly stands in the center of Johannesburg. Other "terrorist" movements were led by people who refined their skills on the battlefield-Mao Tse Tung, General Giap, Ho Chi Minh, Colonel Boumédienne, Gamel Abdel Nasser. As the old European empires crumbled, terrorists struck at their quarry. They did so against the new autocratic Nazi and Soviet empires and were repaid with fearsome reprisals. They did so against the relatively benign British Empire in Palestine, Kenya, Malaya, Aden, Cyprus, and elsewhere. They attacked the faded glories of France in Algeria and Vietnam. The new empires that took the place of the old were then themselves attacked, as in East Timor, Chechnya, Kosovo, and West Irian. Terrorists mounted separatist campaigns in Northern Ireland and Quebec. Successive coups in Fiji deployed unconstitutional and violent means. Bougainville, the Solomons, and East Timor came uncomfortably close to collapse. Indonesia has repeatedly fallen victim to suicide bombers of Jemaah Islamiah. Russia has suffered repeated violence, much of it apparently caused by Chechnyn separatists. In my youth, I followed the Cyprus campaign of General Grivas. He was a commander of no more than 250 EOKA terrorists with extreme nationalist sympathies, demanding union with Greece. Those few ultimately drove 28,000 British troops from the island by destroying their political capability to wage war.2 The fate of the French in Algeria was similar. The same has not proved true in Northern Ireland. Whereas the "colons" in Algeria constituted only 2 percent of the population, the overwhelming majority of the Muslims in that country had a common interest in forcing their increasingly desperate and violent French rulers to leave.3 Eventually they succeeded. In Northern Ireland, there always were, and still are, substantial numbers in both communities who found continuing connection with the United Kingdom acceptable and terrorism unacceptable.4 The story of Uruguay is particularly instructive. Before 1974, it was one of the few longstanding, stable constitutional democracies of Latin America. In 1967 it adopted a new and stronger constitution. That document incorporated [End Page 314] impeccable rule of law and human rights principles. But then Uruguay suffered a serious economic downturn which threatened its welfare laws. At the same time, it had to grapple with a challenge from a small, determined band of terrorists known as the Tupamaros. The Tupamaros resorted to indiscriminate acts of violence and cruelty that shook Uruguayan society. The citizens, and especially the military, began to demand solutions. Coups had...

Progress Toward Global Eradication of Dracunculiasis, January-June 2003

In 1986, the World Health Assembly (WHA) called for the elimination of dracunculiasis (Guinea worm disease), a parasitic infection in humans caused by Dracunculus medinensis. At the time, an estimated 3.5 million cases were occurring annually in 20 countries in Africa and Asia, and 120 million persons were at risk for the disease. Because of slow mobilization in countries with endemic disease, the 1991 WHA goal to eradicate dracunculiasis globally by 1995 was not achieved. In 2004, WHA established a new target date of 2009 for global eradication; despite considerable progress, that target date also was not met. This report updates both published and previously unpublished data and updates progress toward global eradication of dracunculiasis since January 2009. At the end of December 2009, dracunculiasis remained endemic in four countries (Ethiopia, Ghana, Mali, and Sudan). The number of indigenous cases of dracunculiasis worldwide had decreased 31%, from 4,613 in 2008 to 3,185 in 2009. Of the 766 cases that occurred during January--June 2010, a total of 745 (97%) were reported from 380 villages in Sudan. Ghana, Ethiopia, and Mali each are close to interrupting transmission, as indicated by the small and declining number of cases. The current target is to complete eradication in all four countries as quickly as possible. Insecurity (e.g., sporadic violence or civil unrest) in areas of Sudan and Mali where dracunculiasis is endemic poses the greatest threat to the success of the global dracunculiasis eradication program.

Netukulimk Past and Present: Míkmaw Ethics and the Atlantic Fishery

Míkmaq began to sell their furs to Europeans more than four centuries ago, while contending directly and often violently with Europeans for the control of Atlantic fishing grounds. Although Míkmaq were slowly displaced and reduced to destitution by settlers, they continued to hunt, fish and trap on a reduced scale and remained largely independent until the 1960s, when new federal licensing regimes for fishing contributed to a surge of Míkmaw nationalism. Since 1985, Canadian courts have repeatedly vindicated Míkmaw treaty hunting, fishing and trading rights, including offshore rights, culminating in a 1999 Canadian Supreme Court ruling affirming their right to secure a “moderate livelihood” by fishing commercially. Ottawa continues to try to regulate the Míkmaw fishery, however, and this resulted in sporadic violence during the 2000 and 2001 fishing seasons. Meanwhile, commercial groundfish and herring stocks in the region have collapsed, and salmon are threatened with extinction. This ecological and economic disaster has been the focus of a public relations war over responsible fishing between federal bureaucrats and Míkmaq. For the Míkmaq, netukulimk symbolizes their capacity to do a better job of conservation. The Department of Fisheries and Oceans Canada (DFO) has responded by asserting its “scientific” superiority. This article reviews the evidence for responsible Míkmaw use of living resources through the early nineteenth century, when Míkmaq became demographically and economically marginalized, and the evidence for overfishing and mismanagement of Atlantic fisheries in the twentieth century. Although the conditions that made Míkmaq fishing self-regulating no longer exist, the federal management regime is even more of a threat to the survival of fish stocks and fishing communities.

Poverty as a cause of wars?

During this last century war has taken more lives and wrought more damage than in all of human history. Its persistence - with over a hundred armed conflicts on the scale of ‘war’ raging in the last decade - prompts a search for causes, since diagnosis comes before a cure. Many fingers point to the stress of poverty as a major contributing factor, but both anecdotal and modelling approaches reveal that poverty has not been and is not now a significant proactive or enabling factor: if poverty were to become a thing of the past there would be no assurance that wars would be eliminated or even significantly reduced. Poverty is associated with societal stress and with sporadic and endemic societal violence, but stress does not lead to war or play a major role in enabling the rise to power of war prone leaders and their associated elites unless other factors are at play. The causal factors conducive to war making are varied but all are characterised by tribal, religious, and ethnic rivalries that political leaders exploit to mobilise support for war, and/or by the lust for money or hegemonic power of the political leadership. It is exceptionally difficult to prevent the rise of leaders who, for various self-serving reasons, are able to gain power and are prone to pursue policies leading to war. The way to thwart these ambitions is to create conditions, nationally and internationally, that are inimical to the rise to power of such leaders and, if they do gain power, to make the realisation of their war bent policies too costly to them. At the national level of governance the essential elements of policies to create such war inhibiting conditions are education, especially at the primary level, a free independent media, and a guaranteed protection of political and civil rights - in a phrase, democratic governance. At the international level of governance the support calls for financial and other forms of assistance that would enable national governments to carry through the democracy enhancing programmes and projects related to education and to political and civil rights, and measures to strengthen democratic control of the system of international institutions and to constrain the exercise of national sovereignty in those areas where doing so enhances ‘the global common good’, one key element of which is the radical diminution of international and intrastate wars. Economic and social rights are the other aspects that comprise the concept of ‘human rights’, and, though they are mutually reinforcing, for tactical reasons the struggle to achieve these rights should be pursued on a separate track from the struggle to gain political and civil rights that appear to face less formidable obstacles and could thus, in the short and medium term, progress sufficiently to have a significant impact in reducing the occurrence and intensity of wars.

Growing Pains: Status of Emergency Me dicine in Nicaragua

Nicaragua is one of the poorest nations in the Western Hemisphere. The health of the population suffers as a result of poor nutrition, epidemic diseases, natural and manmade disasters, sporadic violence, urban industrial growth, and inadequate government funding for even basic medical equipment and supplies. Within this environment, emergency services development has been recognized as an important and cost-effective public health intervention. In recent years, government and nongovernmental agencies working together have had a dramatic positive impact on the quality of emergency care provided. [Gaitan M, Mendez W, Sirker NE, Green GB: Growing pains: Status of emergency medicine in Nicaragua. Ann Emerg Med March 1998;31:402-405.]