Risk Management and Healthcare Policy
Volume 9, 2016
https://www.dovepress.com/risk-management-and-healthcare-policy-archive56

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Original Research
Video
Haiti’s progress in achieving its 10-year plan to eliminate cholera: hidden sickness cannot be cured
Koski-Karell V, Farmer PE, Isaac B, Campa EM, Viaud L, Namphy PC, Ternier R, Ivers LC
Risk Management and Healthcare Policy 2016, 9:87-100
Published Date: 24 May 2016
Abstract:
Since the beginning of the cholera epidemic in Haiti 5 years ago, the prevalence of this deadly water-borne disease has fallen far below the initial rates registered during its explosive outset. However, cholera continues to cause extensive suffering and needless deaths across the country, particularly among the poor. The urgent need to eliminate transmission of cholera persists: compared to the same period in 2014, the first 4 months of 2015 saw three times the number of cholera cases. Drawing upon epidemiology, clinical work (and clinical knowledge), policy, ecology, and political economy, and informed by ethnographic data collected in a rural area of Haiti called Bocozel, this paper evaluates the progress of the nation’s 10-year Plan for the Elimination of Cholera. Bocozel is a rice-producing region where most people live in extreme poverty. The irrigation network is decrepit, the land is prone to environmental shocks, fertilizer is not affordable, and the government’s capacity to assist farmers is undermined by resource constraints. When peasants do have rice to sell, the price of domestically grown rice is twice that of US-imported rice. Canal water is not only used to irrigate thousands of acres of rice paddies and sustain livestock, but also to bathe, wash, and play, while water from wells, hand pumps, and the river is used for drinking, cooking, and bathing. Only one out of the three government-sponsored water treatment stations in the research area is still functional and utilized by those who can afford it. Latrines are scarce and often shared by up to 30 people; open defecation remains common. Structural vulnerabilities cut across all sectors – not just water, sanitation, health care, and education, but agriculture, environment, (global and local) commerce, transportation, and governance as well. These are among the hidden sicknesses that impede Haiti and its partners’ capacity to eliminate cholera.

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Review
Critical role of ethics in clinical management and public health response to the West Africa Ebola epidemic
Folayan MO, Haire BG, Brown B
Risk Management and Healthcare Policy 2016, 9:55-65
Published Date: 12 May 2016
Abstract:
The devastation caused by the Ebola virus disease (EVD) outbreak in West Africa has brought to the fore a number of important ethical debates about how best to respond to a health crisis. These debates include issues related to prevention and containment, management of the health care workforce, clinical care, and research design, all of which are situated within the overarching moral problem of severe transnational disadvantage, which has very real and specific impacts upon the ability of citizens of EVD-affected countries to respond to a disease outbreak. Ethical issues related to prevention and containment include the appropriateness and scope of quarantine and isolation within and outside affected countries. The possibility of infection in health care workers impelled consideration of whether there is an obligation to provide health services where personal protection equipment is inadequate, alongside the issue of whether the health care workforce should have special access to experimental treatment and care interventions under development. In clinical care, ethical issues include the standards of care owed to people who comply with quarantine and isolation restrictions. Ethical issues in research include appropriate study design related to experimental vaccines and treatment interventions, and the sharing of data and biospecimens between research groups. The compassionate use of experimental drugs intersects both with research ethics and clinical care. The role of developed countries also came under scrutiny, and we concluded that developed countries have an obligation to contribute to the containment of EVD infection by contributing to the strengthening of local health care systems and infrastructure in an effort to provide fair benefits to communities engaged in research, ensuring that affected countries have ready and affordable access to any therapeutic or preventative interventions developed, and supporting affected countries on their way to recovery from the impact of EVD on their social and economic lives.

Vulnerable Children and Youth Studies
An International Interdisciplinary Journal for Research, Policy and Care
Volume 11, Issue 2, 2016
http://www.tandfonline.com/toc/rvch20/current

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Original Articles
An art therapy intervention for symptoms of post-traumatic stress, depression and anxiety among Syrian refugee children
pages 89-102
Nilay Ugurlu, Leyla Akca & Ceren Acarturk
DOI:10.1080/17450128.2016.1181288
Published online: 26 Apr 2016
ABSTRACT
This study first examined the prevalence of psychological symptoms among Syrian refugee children (N = 64) and assessed the effect of an art therapy intervention on post-traumatic stress, depression and anxiety symptoms. The Stressful Life Events (SLE) Questionnaire was used to measure stressful and traumatic experiences. The main outcome measures were UCLA Post-Traumatic Stress Disorder Parent version, Child Depression Inventory and State-Trait Anxiety Scale. After the baseline assessment, a five-day art therapy intervention, which is based on Skills for Psychological Recovery, was implemented. Findings of the study indicated that 60.3% (N = 35) of Syrian children who participated had high risk to develop post-traumatic stress disorder (PTSD) according to the SLE scale. The 23.4% of the children had PTSD symptoms while the 17.6% showed severe depression symptoms. Moreover, the 14.4% of the children showed severe levels of state anxiety symptoms and the 31.1% showed severe levels of trait anxiety symptoms. Findings of the study indicated that trauma, depression and trait anxiety symptoms of children were significantly reduced at the post-assessment. However, for state anxiety scores, significant differences between pre- and post-assessments did not appear. Therefore, it could be said that art therapy may be an effective method to reduce post-traumatic stress disorder, depression and trait anxiety symptoms among refugee children.

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ARTICLE
The health of children whose mothers are trafficked or in sex work in the U.S.: an exploratory study
pages 127-135
Brian Willis, Diane Vines, Sara Bubar & Maria Ramirez Suchard
DOI:10.1080/17450128.2016.1189019
Published online: 30 May 2016
ABSTRACT
The goal of this exploratory study was to identify health problems experienced by children whose mothers are trafficked or in sex work in the U.S. and the proportion of the children who experience these health problems. Participants were adult survivors of sex trafficking and adult women in sex work. They were asked about the health of children whose mothers were trafficked or in sex work but not about their own children. This approach allows participants to discuss sensitive issues but without having to share potentially negative information about their own children. Participants were asked to identify the common and serious health problems among the children based on their observations, to rank the problems in order of seriousness, to estimate the percentages of the children who experience certain health problems, and to identify the causes of death among the children. There were numerous reports of birth defects, fetal alcohol syndrome, blindness, neonatal abstinence syndrome, and physical and sexual abuse. Nearly a third of respondents (31%) knew of the death of a child whose mother was trafficked or in sex work, and 11% reported they knew of the death of a child due to physical abuse. The majority of respondents (89%) reported that some daughters are trafficked into prostitution. The median estimate of the percentage of daughters who are trafficked was 50%. Children born to trafficked adolescents and adult female sex workers in the U.S. are potentially at high risk for many serious and fatal health problems. The magnitude of these health problems is poorly understood but warrant urgent attention.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 28 May 2016

This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

David R. Curry
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: The Sentinel_ week ending 28 May 2016