Articles

The blast wounded of Raqqa, Syria: observational results from an MSF-supported district hospital

In June 2017, the U.S.-backed Syrian Democratic Forces (SDF) launched a military operation to retake the city of Raqqa, Syria, from the so-called Islamic State. The city population incurred mass numbers of wou...

Authors: Jennifer OKeeffe, Larissa Vernier, Vanessa Cramond, Shazeer Majeed, Antonio Isidro Carrion Martin, Maartje Hoetjes and Mohana Amirtharajah

Essential newborn care practice at four primary health facilities in conflict affected areas of Bossaso, Somalia: a cross-sectional study

Newborn mortality is increasingly concentrated in contexts of conflict and political instability. However, there are limited guidelines and data on the availability and quality of newborn care in conflict sett...

Authors: Ribka Amsalu, Catherine N. Morris, Kingsley Chukwumalu, Michelle Hynes, Shehryar Janjua, Alexia Couture, Aimee Summers, Amy Cannon, Erin N. Hulland and Sabine Baunach

“What’s happening in Syria even affects the rocks”: a qualitative study of the Syrian refugee experience accessing noncommunicable disease services in Jordan

Humanitarian actors and host-countries in the Middle East and North Africa region are challenged with meeting the health needs of Syrian refugees and adjusting the response to contemporary humanitarian conditi...

Authors: Zahirah Zahrah McNatt, Patricia Elaine Freels, Hannah Chandler, Muhammad Fawad, Sandy Qarmout, Amani Saleh Al-Oraibi and Neil Boothby

Examining intersections between violence against women and violence against children: perspectives of adolescents and adults in displaced Colombian communities

Research examining the interrelated drivers of household violence against women and violence against children is nascent, particularly in humanitarian settings. Gaps remain in understanding how relocation, dis...

Authors: Jennifer J. Mootz, Lindsay Stark, Elizabeth Meyer, Khudejha Asghar, Arturo Harker Roa, Alina Potts, Catherine Poulton, Mendy Marsh, Amy Ritterbusch and Cyril Bennouna

Reproductive health in humanitarian settings in Lebanon and Iraq: results from four cross-sectional studies, 2014–2015

Reproductive health is an important component of humanitarian response. Displaced women need access to family planning, antenatal care, and the presence of a skilled birth attendant at delivery. Since the begi...

Authors: Marta A. Balinska, Robin Nesbitt, Zeina Ghantous, Iza Ciglenecki and Nelly Staderini

Predictors of posttraumatic growth among conflict-related sexual violence survivors from Bosnia and Herzegovina

Conflict-related sexual violence (CRSV) was committed on a large scale against women across Bosnia and Herzegovina (BiH) during the 1990’s war, and research has shown both negative and positive psychosocial ou...

Authors: Kimberley Anderson, Amra Delić, Ivan Komproe, Esmina Avdibegović, Elisa van Ee and Heide Glaesmer

Nutritional profile of Syrian refugee children before resettlement

The year 2015 marked the highest number of refugees globally and included record numbers of Syrians moving to neighboring countries. Half of the Syrians were children aged ≤18 years. Our study sought to examin...

Authors: Sweetmavourneen Pernitez-Agan, Kolitha Wickramage, Catherine Yen, Elizabeth Dawson-Hahn, Tarissa Mitchell and Dominik Zenner

‘We just been forced to do it’: exploring victimization and agency among internally displaced young mothers in Bogotá

Armed conflict in Colombia has a history of 50 years that continues to this day. According to the Victims Record of Colombia, from 1985 to 2013 2.683.335 women have been victims of the armed conflict. Women ha...

Authors: Yazmin Cadena-Camargo, Anja Krumeich, Maria Claudia Duque-Páramo and Klasien Horstman

Localisation and cross-border assistance to deliver humanitarian health services in North-West Syria: a qualitative inquiry for The Lancet-AUB Commission on Syria

In a growing number of humanitarian crises, “remote management” is negotiated across borders and implemented by humanitarian agencies through “local actors” to deliver assistance. However, the narrative descri...

Authors: Diane Duclos, Abdulkarim Ekzayez, Fatima Ghaddar, Francesco Checchi and Karl Blanchet

Diphtheria outbreak in Yemen: the impact of conflict on a fragile health system

War in Yemen started three years ago, and continues unabated with a steadily rising number of direct and indirect victims thus leaving the majority of Yemen’s population in dire need of humanitarian assistance...

Authors: Fekri Dureab, Maysoon Al-Sakkaf, Osan Ismail, Naasegnibe Kuunibe, Johannes Krisam, Olaf Müller and Albrecht Jahn

Precarious hope and reframing risk behavior from the ground up: insight from ethnographic research with Rwandan urban refugees in Yaoundé, Cameroon

Theoretical and methodological research on risk-taking practices often frames risk as an individual choice. While risk does occur at individual level, it is determined by aspirations which are connected to oth...

Authors: Kelly Ann Yotebieng, Nathan Fakult, Paschal Kum Awah and Jennifer L. Syvertsen

Prevalence and associated factors of stunting and thinness among adolescent Somalian refugee girls living in eastern Somali refugee camps, Somali regional state, Southeast Ethiopia

Adolescence is a critical time of life stage with a continuum of physical, cognitive, behavioral and psychosocial changes. It is also a period of physical growth, reproductive maturation and cognitive transfor...

Authors: Melaku Tadege Engidaw and Alemayehu Digssie Gebremariam

Serious psychological distress and disability among older persons living in conflict affected areas in eastern Ukraine: a cluster-randomized cross-sectional household survey

Older persons are often unable to leave conflict areas; however, little is known about the mental and physical health among this population. Our objective was to determine the prevalence of and whether there w...

Authors: Aimee Summers, Eva Leidman, Isabel Maria Pereira Figueira Periquito and Oleg O. Bilukha

Deaths, injuries and detentions during civil demonstrations in Sudan: a secondary data analysis

Since December 2018, the latest wave of anti-government protests in Sudan has led to deaths, injuries and detentions. We estimated the number of people killed and described patterns of deaths, injuries and det...

Authors: Maysoon Dahab, Nada Abdelmagid, Ahmed Kodouda and Francesco Checchi

Migration patterns & their associations with health and human rights in eastern Myanmar after political transition: results of a population-based survey using multistaged household cluster sampling

Myanmar transitioned to a nominally civilian government in March 2011. It is unclear how, if at all, this political change has impacted migration at the household level.

Authors: Parveen K. Parmar, Charlene Barina, Sharon Low, Kyaw Thura Tun, Conrad Otterness, Pue P. Mhote, Saw Nay Htoo, Saw Win Kyaw, Nai Aye Lwin, Cynthia Maung, Naw Merry Moo, Eh. Kalu Shwee Oo, Daniel Reh, Nai Chay Mon, Xinkai Zhou and Adam K. Richards

The long-term health consequences of genocide: developing GESQUQ - a genocide studies checklist

Genocide is an atrocity that seeks to destroy whole populations, leaving empty countries, empty spaces and empty memories, but also a large health burden among survivors is enormous. We propose a genocide repo...

Authors: Jutta Lindert, Ichiro Kawachi, Haim Y. Knobler, Moshe Z. Abramowitz, Sandro Galea, Bayard Roberts, Richard Mollica and Martin McKee

Gender disparities and psychological distress among humanitarian migrants in Australia: a moderating role of migration pathway?

The role of migration pathway (refugees vs. asylum seekers) is seldom addressed in extant literature that looks at gender and mental health of humanitarian migrants. The aim of this study is to assess the rela...

Authors: Yara Jarallah and Janeen Baxter

Treating Syrian refugees with diabetes and hypertension in Shatila refugee camp, Lebanon: Médecins Sans Frontières model of care and treatment outcomes

Médecins Sans Frontières (MSF) has been providing primary care for non-communicable diseases (NCDs), which have been increasing in low to middle-income countries, in the Shatila refugee camp, Beirut, Lebanon, ...

Authors: Maysoon Kayali, Krystel Moussally, Chantal Lakis, Mohamad Ali Abrash, Carla Sawan, Anthony Reid and Jeffrey Edwards

“The more children you have, the more praise you get from the community”: exploring the role of sociocultural context and perceptions of care on maternal and newborn health among Somali refugees in UNHCR supported camps in Kenya

Maternal and neonatal survival are key components of population health and may be particularly vulnerable in humanitarian contexts of civil unrest and displacement. Understanding what factors contribute to poo...

Authors: Stephanie Gee, Josep Vargas and Angel M. Foster

The nursing profession: a critical component of the growing need for a nuclear global health workforce

Instability in the global geopolitical climate and the continuing spread of nuclear weapons and increase in their lethality has made the exchange of nuclear weapons or a terrorist attack upon a nuclear power p...

Authors: Tener Goodwin Veenema, Frederick M. Burkle Jr and Cham E. Dallas

Host country responses to non-communicable diseases amongst Syrian refugees: a review

Since the beginning of the Syrian conflict in 2011, Jordan, Lebanon and Turkey have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs).

Authors: Chaza Akik, Hala Ghattas, Sandra Mesmar, Miriam Rabkin, Wafaa M. El-Sadr and Fouad M. Fouad

Utilization of primary health care services among Syrian refugee and Lebanese women targeted by the ICRC program in Lebanon: a cross-sectional study

The Syrian crisis has put tremendous strain on the Lebanese health system, particularly in the historically underserved border region. The ICRC Primary Health Care program has focused on refugee and host commu...

Authors: Claudia Truppa, Enrica Leresche, Arlan F. Fuller, Ariana S. Marnicio, Josyann Abisaab, Nicole El Hayek, Carla Zmeter, Warda S. Toma, Hilda Harb, Randa S. Hamadeh and Jennifer Leaning

Social norms and beliefs about gender based violence scale: a measure for use with gender based violence prevention programs in low-resource and humanitarian settings

Gender-based violence (GBV) primary prevention programs seek to facilitate change by addressing the underlying causes and drivers of violence against women and girls at a population level. Social norms are con...

Authors: Nancy Perrin, Mendy Marsh, Amber Clough, Amelie Desgroppes, Clement Yope Phanuel, Ali Abdi, Francesco Kaburu, Silje Heitmann, Masumi Yamashina, Brendan Ross, Sophie Read-Hamilton, Rachael Turner, Lori Heise and Nancy Glass

Cost-effectiveness of birth-dose hepatitis B vaccination among refugee populations in the African region: a series of case studies

Hepatitis B affects 257 million people worldwide. Mother-to-child hepatitis B virus (HBV) transmission is a preventable cause of substantial morbidity and mortality and poses greatest risk for developing chron...

Authors: Joseph Michael Reardon, Siobhán M. O’Connor, Joseph D. Njau, Eugene K. Lam, Catherine A. Staton and Susan T. Cookson

Internet searching produces misleading findings regarding violent deaths in crisis settings: short report

Donor and agency priorities are influenced by a variety of political, social, and media-related forces that can have a profound impact on response and resource provision. We have attempted to assess how well i...

Authors: Mary Grace Flaherty and Leslie F. Roberts

Construct validity and factor structure of sense of coherence (SoC-13) scale as a measure of resilience in Eritrean refugees living in Ethiopia

There is a scarcity of adapted measures to study resilience and mental health of people in humanitarian settings in Africa. The aim of this study was to identify the factor structure and other psychometric pro...

Authors: Berhanie Getnet and Atalay Alem

Approaches to protect and maintain health care services in armed conflict – meeting SDGs 3 and 16

The escalation of conflict in the Middle East coincides with an emerging trend of attacks on healthcare. Protection of health personnel, health services and humanitarian workers is no longer respected. This co...

Authors: Philippa Druce, Ekaterina Bogatyreva, Frederik Francois Siem, Scott Gates, Hanna Kaade, Johanne Sundby, Morten Rostrup, Catherine Andersen, Siri Camilla Aas Rustad, Andrew Tchie, Robert Mood, Håvard Mokleiv Nygård, Henrik Urdal and Andrea Sylvia Winkler

Integration of health services, access and utilization by refugees and host populations in West Nile districts, Uganda

Prolonged civil war and unrest has dominated the short history of South Sudan resulting in the long-term displacement of millions of people since the 1990s. Since December 2013, over one million South Sudanese...

Authors: Henry Komakech, Lynn Atuyambe and Christopher Garimoi Orach

Access to care for non-communicable diseases in Mosul, Iraq between 2014 and 2017: a rapid qualitative study

During June 2014 to April 2017, the population of Mosul, Iraq lived in a state of increasing isolation from the rest of Iraq due to the city’s occupation by the Islamic State group. As part of a study to devel...

Authors: Louisa M. Baxter, Manal Shams Eldin, Ali Al Mohammed, Malika Saim and Francesco Checchi

Shortcomings in addressing attacks on health care

Authors: Dilshad Jaff

Healthcare needs and health service utilization by Syrian refugee women in Toronto

Access to healthcare is an important part of the (re)settlement process for Syrian refugees in Canada. There is growing concern about the healthcare needs of the 54,560 Syrian refugees who were admitted to Can...

Authors: Sepali Guruge, Souraya Sidani, Vathsala Illesinghe, Rania Younes, Huda Bukhari, Jason Altenberg, Meb Rashid and Suzanne Fredericks

What influenced provision of non-communicable disease healthcare in the Syrian conflict, from policy to implementation? A qualitative study

There has been increasing focus on tackling the growing burden of non-communicable diseases (NCD) in crisis settings. The complex and protracted crisis in Syria is unfolding against a background of increasing ...

Authors: Sylvia Garry, Francesco Checchi and Beniamino Cislaghi

Are public hospitals reforming efficiently in West Bank?

The structure, function, and capacity of the health care system in the Occupied Palestinian Territories (OPT) had been largely shaped by the complex political history of the country. Since the establishment of...

Authors: Wasim I. M. Sultan and José Crispim

Bibliometric analysis of peer-reviewed literature on Syrian refugees and displaced people (2011–2017)

The Syrian conflict has created the worst humanitarian crisis of our time with approximately half of Syria’s pre-war population killed or forced to flee their homes. The current study aimed to analyze peer-rev...

Authors: Waleed M. Sweileh

SMS-based smartphone application for disease surveillance has doubled completeness and timeliness in a limited-resource setting – evaluation of a 15-week pilot program in Central African Republic (CAR)

It is a challenge in low-resource settings to ensure the availability of complete, timely disease surveillance information. Smartphone applications (apps) have the potential to enhance surveillance data transm...

Authors: Ziad El-Khatib, Maya Shah, Samuel N Zallappa, Pierre Nabeth, José Guerra, Casimir T Manengu, Michel Yao, Aline Philibert, Lazare Massina, Claes-Philip Staiger, Raphael Mbailao, Jean-Pierre Kouli, Hippolyte Mboma, Geraldine Duc, Dago Inagbe, Alpha Boubaca Barry…

Health status of returning refugees, internally displaced persons, and the host community in a post-conflict district in northern Sri Lanka: a cross-sectional survey

Although the adverse impacts of conflict-driven displacement on health are well-documented, less is known about how health status and associated risk factors differ according to displacement experience. This s...

Authors: Rachel Burns, Kolitha Wickramage, Anwar Musah, Chesmal Siriwardhana and Francesco Checchi

Mental health and psychosocial problems among conflict-affected children in Kachin State, Myanmar: a qualitative study

In Kachin State, Myanmar, collapse of a ceasefire in 2011 has resulted in widespread exposure to conflict and ongoing internal displacement. Such exposures are known risk factors for mental health and psychoso...

Authors: Catherine Lee, Amanda J. Nguyen, Tara Russell, Yasmina Aules and Paul Bolton

A cross-sectional assessment of diabetes self-management, education and support needs of Syrian refugee patients living with diabetes in Bekaa Valley Lebanon

Patients with diabetes require knowledge and skills to self-manage their disease, a challenging aspect of treatment that is difficult to address in humanitarian settings. Due to the lack of literature and expe...

Authors: James A. Elliott, Debashish Das, Philippe Cavailler, Fabien Schneider, Maya Shah, Annette Ravaud, Maria Lightowler and Philippa Boulle

"I prefer dying fast than dying slowly", how institutional abuse worsens the mental health of stranded Syrian, Afghan and Congolese migrants on Lesbos island following the implementation of EU-Turkey deal

In 2015 and early 2016, close to 1 million migrants transited through Greece, on their way to Western Europe. In early 2016, the closure of the “Balkan-route” and the EU/Turkey-deal led to a drastic reduction ...

Authors: Christos Eleftherakos, Wilma van den Boogaard, Declan Barry, Nathalie Severy, Ioanna Kotsioni and Louise Roland-Gosselin

Population trends related to injury from explosive munitions in Lao PDR (1964–2008): a retrospective analysis

The presence of landmines and explosive remnants of war (ERW) including unexploded ordnance (UXO) poses a serious public health risk for populations living in conflict-affected and contaminated areas. Current ...

Authors: Stacey E. Pizzino, Samuel Hundessa, Vinu Verghis, Mark Griffin and Jo Durham

Facilitators and barriers in implementing the Minimum Initial Services Package (MISP) for reproductive health in Nepal post-earthquake

Following the Nepal earthquake in April 2015, UNFPA estimated that 1.4 million women of reproductive age were affected, with approximately 93,000 pregnant and 28,000 at risk of sexual violence. A set of priori...

Authors: Anna Myers, Samira Sami, Monica Adhiambo Onyango, Hari Karki, Rosilawati Anggraini and Sandra Krause

Adaptation and testing of an assessment for mental health and alcohol use problems among conflict-affected adults in Ukraine

In Ukraine, a large number of internally displaced persons (IDPs) and veterans experience social and psychological problems as a result of the ongoing conflict between Ukraine and Russia. Our purpose was to de...

Authors: S. Benjamin Doty, Emily E. Haroz, Namrita S. Singh, Sergiy Bogdanov, Judith K. Bass, Laura K. Murray, Karis L. Callaway and Paul A. Bolton

Armed conflict, alcohol misuse, decision-making, and intimate partner violence among women in Northeastern Uganda: a population level study

Relations among and interactions between exposure to armed conflict, alcohol misuse, low socioeconomic status, gender (in)equitable decision-making, and intimate partner violence (IPV) represent serious global...

Authors: Jennifer J. Mootz, Florence Kyoheirwe Muhanguzi, Pavel Panko, Patrick Onyango Mangen, Milton L. Wainberg, Ilana Pinsky and Kaveh Khoshnood

Living in Mosul during the time of ISIS and the military liberation: results from a 40-cluster household survey

In June 2014, an estimated 1500 fighters of the Islamic State of Iraq and Syria (ISIS) seized control of Mosul, Iraq’s second city. Although many residents fled, others stayed behind, enduring the restrictive ...

Authors: R. Lafta, V. Cetorelli and G. Burnham

Barriers to cardiovascular disease secondary prevention care in the West Bank, Palestine – a health professional perspective

Non-communicable diseases (NCDs) - including cardiovascular disease (CVD), cancer and diabetes - have become a significant global burden on health. Particularly concerning are CVD rates, causing approximately ...

Authors: Jane Collier and Hanna Kienzler

Tuberculosis contact-tracing among Syrian refugee populations: lessons from Jordan

In response to the influx of displaced Syrians since 2011, the Jordanian National Tuberculosis Program (NTP) implemented a specific Tuberculosis (TB) reduction strategy, including contact-tracing (CT). Contact...

Authors: Edouard Hosten, Mandana Mehta, Emmanuel Andre, Khaled Abu Rumman and Dimitri Van der Linden

Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan

Tackling the high non-communicable disease (NCD) burden among Syrian refugees poses a challenge to humanitarian actors and host countries. Current response priorities are the identification and integration of ...

Authors: Manuela Rehr, Muhammad Shoaib, Sara Ellithy, Suhib Okour, Cono Ariti, Idriss Ait-Bouziad, Paul van den Bosch, Anais Deprade, Mohammad Altarawneh, Abdel Shafei, Sadeq Gabashneh and Annick Lenglet

Small and light arms violence reduction as a public health measure: the case of Libya

The conflict environment in Libya is characterized by continued pervasive insecurity amidst the widespread availability of small arms and light weapons (SALW). After the First Civil War, armed brigades took th...

Authors: Gemma Bowsher, Patrick Bogue, Preeti Patel, Peter Boyle and Richard Sullivan

Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen

Unstable settings present challenges for the effective provision of antiretroviral treatment (ART). In this paper, we summarize the experience and results of providing ART and implementing contingency plans du...

Authors: Cecilia Ferreyra, Daniel O’Brien, Beatriz Alonso, Abdulbasset Al-Zomour and Nathan Ford

Performance-based financing in three humanitarian settings: principles and pragmatism

Performance based financing (PBF) has been increasingly implemented across low and middle-income countries, including in fragile and humanitarian settings, which present specific features likely to require ada...

Authors: Maria Paola Bertone, Eelco Jacobs, Jurrien Toonen, Ngozi Akwataghibe and Sophie Witter