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Challenges for communicable disease surveillance and control in southern Iraq, April-June 2003. Letter from Basrah.
JAMA. 2003 Aug 6; 290(5):654-658.The recent war in Iraq presents significant challenges for the surveillance and control of communicable diseases. In early April 2003, the World Health Organization (WHO) sent a team of public health experts to Kuwait and a base was established in the southern Iraqi governorate of Basrah on May 3. We present the lessons learned from the communicable disease surveillance and control program implemented in the Basrah governorate in Iraq (population of 1.9 million) in April and May 2003, and we report communicable disease surveillance data through June 2003. Following the war, communicable disease control programs were disrupted, access to safe water was reduced, and public health facilities were looted. Rapid health assessments were carried out in health centers and hospitals to identify priorities for action. A Health Sector Coordination Group was organized with local and international health partners, and an early warning surveillance system for communicable disease was set up. In the first week of May 2003, physicians in hospitals in Basrah suspected cholera cases and WHO formed a cholera control committee. As of June 29, 2003, Iraqi hospital laboratories have con firmed 94 cases of cholera from 7 of the 8 districts of the Basrah governorate. To prevent the transmission of major communicable diseases, restoring basic public health and water/sanitation services is currently a top priority in Iraq. Lack of security continues to be a barrier for effective public health surveillance and response in Iraq. (author's)
New York, New York, Women's Commission for Refugee Women and Children, 2004 Jan. 43 p. (Watch List on Children and Armed Conflict)This paper is a call to action urging the UN Security Council members, the UN system, regional bodies, civil society, and national governments to respond with the resources and remedies proportionate to the grave state of affairs for children in armed conflicts around the globe. It outlines three essential Action Areas where progress must be made to begin to close the gap between international commitments to protect children and the harsh reality that children experience: gross violations of their rights---with impunity. (excerpt)
In: Nutrition: a foundation for development, compiled by United Nations. Administrative Committee on Coordination [ACC]. Sub-Committee on Nutrition [SCN]. Geneva, Switzerland, United Nations, Administrative Committee on Coordination [ACC], Sub-Committee on Nutrition [SCN], 2002. 4 p.. (Nutrition: a Foundation for Development, Brief 9)In the past 15 years food insecurity, malnutrition, and disinvestments in health systems have contributed to increasing national crises and made countries more vulnerable to systemic shocks. Over this period the world has experienced an alarming increase in costly humanitarian disasters that have tragically affected millions of people each year. Shocks have included violent internal conflicts; natural traumas such as droughts and hurricanes; economic shocks; and the surging HIV/AIDS epidemic. The greatest numbers of affected people have been those uprooted by war and natural disasters, which doubled from 20 million in 1985 to 40 million in 1994 and remained over 35 million in 1999, and those living with HIV/AIDS, which increased from only a few million in the early 1980s to 34 million in 2000. Besides causing terrible suffering and death, these crises have caused many developing countries to suffer serious economic and food production setbacks. Global expenditures for humanitarian crisis interventions have grown while official development investment has stagnated or declined, adding to the drag on development. For instance, from 1985 to 2000 the World Food Programme shifted the balance of its program toward emergency response and away from sustainable development of food security and nutrition. It is now time to invest in nutrition as a tool for crisis prevention, mitigation, and management for three reasons: 1. Good nutrition relieves the social unrest underlying violent conflict; 2. Good nutrition decreases the human vulnerability that transforms systemic shocks into humanitarian disasters; and 3. Good nutrition lowers the death rate and promotes timely return to equitable and durable development in the aftermath of crises. (excerpt)
Integration of the human rights of women and a gender perspective: Violence against women. Report of the Special Rapporteur on violence against women, its causes and consequences, Yakin Erturk. Addendum. Mission to El Salvador (2-8 February 2004).
[Geneva, Switzerland], United Nations, Commission on Human Rights, 2004 Dec 20. 29 p. (E/CN.4/2005/72/Add.2)This report contains my findings as the Special Rapporteur on violence against women, its causes and consequences, following my visit to El Salvador on official mission, from 2 to 8 February 2004. It addresses the diverse forms of violence against women in the country and identifies key measures and initiatives needed to ensure the protection and promotion of the rights of women and the elimination of violence against women. Although women's rights were not central to the civil war that ravaged El Salvador between 1980 and 1992 or to the peace negotiations thereafter, women's high level of participation in the opposition forces gave them experience and political consciousness that enabled them to challenge discriminatory practices in the society. As a result, in the post-conflict era notable progress related to gender equality, particularly at the legislative level, was achieved. Other encouraging developments include the establishment of the Salvadoran Institute for the Advancement of Women (ISDEMU), a human rights programme within the National Civil Police (PNC) and other institutional initiatives designed to protect women against violence. Despite the achievements, the failure of authorities to investigate, prosecute and punish those responsible for gender-based violence has contributed to an environment of impunity that has resulted in little confidence in the justice system. Impunity for crimes, the socio-economic disparities and the machista culture foster a generalized state of violence, subjecting women to a continuum of multiple violent acts, including murder, rape, domestic violence, sexual harassment and commercial sexual exploitation. (excerpt)
WHO ethical and safety recommendations for researching, documenting and monitoring sexual violence in emergencies.
Geneva, Switzerland, WHO, 2007.  p.Sexual violence in humanitarian emergencies, such as armed conflict and natural disasters, is a serious, even life-threatening, public health and human rights issue. Growing concern about the scale of the problem has led to increased efforts to learn more about the contexts in which this particular form of violence occurs, its prevalence, risk factors, its links to HIV infection, and also how best to prevent and respond to it. Recent years have thus seen an increase in the number of information gathering activities that deal with sexual violence in emergencies. These activities often involve interviewing women about their experiences of sexual violence. It is generally accepted that the prevalence of sexual violence is underreported almost everywhere in the world. This is an inevitable result of survivors' well-founded anxiety about the potentially harmful social, physical, psychological and/or legal consequences of disclosing their experience of sexual violence. In emergency situations, which arecharacterized by instability, insecurity, fear, dependence and loss of autonomy, as well as a breakdown of law and order, and widespread disruption of community and family support systems, victims of sexual violence may be even less likely to disclose incidents. (excerpt)