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May 17, 2017 · Health threats are so varied that one of the Middle East's main teaching hospitals, the American University of Beirut Medical Center, has introduced a conflict-medicine programme to equip...
- How Should Relief Organizations Fund Care of Patient-Asylees Who Have Cancer? 457
- How Should Military Health Care Workers Respond When Conflict Reaches the Hospital? 478
- Survivor-Centered Approaches to Conflict-Related Sexual Violence in International Humanitarian and Human Rights Law 495
- Why We Need Stricter Oversight of Research Involving Human Subjects Affected by Conflict 518
- Traumatic Imagination in Traditional Stories of Gender-Based Violence 530
- How Should Relief Organizations Fund Care of Patient-Asylees Who Have Cancer?
- Abstract
- Three Approaches to Covering Costs of Care
- Balancing Care of Refugees and Members of Host Populations
- Conclusion
- Editor’s Note
- Case
- Treating Injuries vs Conducting Research
- Research Feasibility
- Conclusion
- Editor’s Note
- How Should Access to Military Health Care Facilities Be Controlled in Conflict?
- Abstract
- Case
- Commentary
- General Duties
- Specific Responsibilities
- Conclusion
- Editor’s Note
- How Should Military Health Care Workers Respond When Conflict Reaches the Hospital?
- Abstract
- Case
- Conflicting Obligations During Crises
- Conclusions
- Conflict of Interest Disclosure
- Abstract
- Case
- Onward
- Everyone Is Harmed When Clinicians Aren’t Prepared
- Abstract
- Colonialism and Conquest Permeate Medicine and Science
- Conflict as Endemic Disease
- Local Determinants of Health and Healing
- Survivor-Centered Approaches to Conflict-Related Sexual Violence in International Humanitarian and Human Rights Law
- Acknowledgements
- Why We Need Stricter Oversight of Research Involving Human Subjects Affected by Conflict
- Results
- Traumatic Imagination in Traditional Stories of Gender-Based Violence
- Abstract
- Representing the Unrepresentable
- Traumatic Imagination and Traditional Storytelling
- What Does Ethics Demand of Health Care Practice in Conflict Zones?
- Abstract
- Introduction
- Threats of Violence and Decision Making
- Conclusion
Farrah J. Mateen, MD, PhD and Paul B. Spiegel, MD, MPH
Hunter Jackson Smith, MD, MPH, MBE, Joseph Procaccino, JD, MFS, and Megan Applewhite, MD, MA
Klearchos A. Kyriakides, PhD, MPhil and Andreas K. Demetriades, MBBChir, MPhil Original Research
Anushka Ataullahjan, PhD, Samantha Lo, MSc, Mohammad Haaris Aziz, MBBCh, Nadia Amin Somani, and Zulfiqar A. Bhutta, PhD, MBBS Medicine and Society
Ayesha Ahmad, PhD, Lida Ahmad, MA, Shazana Andrabi, MA, Lobna Ben Salem, PhD, Peter Hughes, MBBS, Jenevieve Mannell, PhD, Sharli Anne Paphitis, PhD, and Gamze Senyurek, MA
Farrah J. Mateen, MD, PhD and Paul B. Spiegel, MD, MPH
Several clinical and ethical dilemmas arise when caring for refugees with complex, costly, and chronic conditions in low- and middle-income countries where they often first seek asylum. This commentary responds to a case involving a patient asylee with a malignant brain tumor and considers these questions: (1) Should refugee care costs be allocated...
Costs of caring for refugees and other forcibly displaced persons are largely determined by context. Whose treatment is paid for, in what amounts, and by whom differ by asylum location.9,10 Some governments and organizations working with refugees approach asylee care by specifying a maximum coverage amount per patient. Covering refugee cancer care ...
Concerns about equity12 also require us to consider access to these same potentially lifesaving interventions in the host country population (ie, the nationals living in the country where the refugees are residing). Host country populations can be just as poor and underresourced as some refugee populations. In some circumstances, refugees may have ...
Cancer care for refugees will continue to be challenging, as the pace of science leads to many options for care for those with resources. Thus, refugees and host populations in low- and middle-income countries with limited resources have fewer specialized care options. Although we do not answer each of the questions we posed about coverage of care ...
The case to which this commentary is a response was developed by the editorial staff.
Dr P is a physician and researcher from an East African country that has been immersed in violence and civil conflict for years. He and his colleagues work in the region with an international nonprofit organization that both provides health care services and aims to strengthen the evidence available to guide practitioners during humanitarian crises...
Dr P and his colleagues are trying to decide how to allocate their limited time, energy, and resources between treating acute, conflict-related injuries and addressing unmet needs of children with acute and chronic infectious diseases through research. Some of the clinicians believe evidence from research is needed to determine whether existing pol...
Even if ethical issues can be resolved satisfactorily, the feasibility of the research must be investigated carefully. Humanitarian organizations and individuals working in conflict zones might be overstretched and underresourced to the extent that conducting research might not be feasible.8 The case of Dr P described challenges of transporting sam...
The ethical and practical challenges of conducting research in conflict settings should not lead to it being abandoned; creative approaches should be explored to manage time, find resources, and adapt protocols as needed. Before designing studies, it is essential for researchers to engage involved communities, even those in conflict, to understand ...
This composite case was developed from interviews conducted as part of the
Martin Bricknell, PhD, David Whetham, PhD, Richard Sullivan, PhD, and Peter Mahoney, PhD
This commentary on a case analysis examines the principles that govern decisions about which patients might be admitted to an international military hospital during humanitarian or combat operations. It explores the balance between duties under the Geneva Conventions and other international humanitarian laws, the requirement to be able to provide m...
MM commands a military field hospital, physically based on a semi-trailer truck convoy that follows combat troops into disputed territory as part of a United Nations (UN) peacekeeping and security mission to implement and maintain a fragile truce between local government forces and opposition forces. In the disputed territory, the humanitarian cris...
This case scenario might seem to present a simple question about the procedures to be adopted by the guard force controlling the checkpoint at the entrance to the hospital site. However, these procedures will need to comply with policies for the peacekeeping force on the use of military resources for humanitarian relief, the duties of medical perso...
Military field hospitals are normally designed, staffed, and equipped to provide health care for military personnel and other specifically designated groups termed the population at risk (PAR). In a UN peacekeeping mission, the PAR might include other UN personnel, such as police and civilian workers. However, it is inevitable that military medical...
Although a military hospital is responsible for its own local security, it might be situated within a wider military compound that is guarded by combatants. To ensure safety, there needs to be a system at the main entrance for the clinical assessment of patients seeking care to confirm their status under the MRoE. Unfortunately, ambulances and sick...
Conflict and other humanitarian crises might require health care workers to make very difficult decisions that have substantial ethical implications. Many issues, such as the care of nonmilitary patients with predictable health emergencies (eg, severe trauma, obstetric crises, severe burns), can be anticipated and mitigated by policy, procedures, a...
The case to which this commentary is a response was developed by the editorial staff.
Hunter Jackson Smith, MD, MPH, MBE, Joseph Procaccino, JD, MFS, and Megan Applewhite, MD, MA
Military clinicians face unique ethical challenges in conflict zones, particularly if conflict reaches a health care setting. Although the ethical challenges of rationing and triaging while fulfilling obligations to individual patients are not dissimilar to those civilian clinicians encountered during the COVID-19 pandemic, military clinicians must...
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
Clinical and other professional groups, as well as donors and international agencies supporting humanitarian health responses, need to provide support to those who confront confounding, painful, high-stakes decisions.
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G hassan Abu Sittah is a plastic and reconstructive surgeon and associate professor of surgery in London, and co-director of the Conflict Medicine Program at the Global Health Institute, American University of Beirut. Omar Dewachi and Nabil Al-Tikriti interviewed him in December 2020 about his work, his insights into the past decade of turmoil ...
Ghassan S. Abu-Sittah, MBChB heads the Division of Plastic and Reconstructive Surgery at the American University of Beirut Medical Center in Lebanon and founded the Conflict Medicine Program of the Global Health Institute at the American University of Beirut. Call for Editorial Fellows. Work with us to create a theme issue! Learn More. Email Signup
ABOUT CMP. Launched in May 2016, the Conflict Medicine Program (CMP) at the Global Health Institute is the first of its kind to be established within a civilian academic institution. The CMP combines academic expertise with AUB’s strategic location in the MENA that offers direct access to conflict zones and populations impacted by conflict.
May 29, 2020 · Conclusions: This systematic mapping provides a comprehensive database of evidence about HCWs in conflict and post-conflict settings on a global scale that is often needed to inform policies and strategies on effective workforce planning and management and in reducing emigration. It can also be used to identify evidence for policy-relevant ...
The First Global Congress on Conflict Medicine (May 12, 2017) Beirut, Lebanon – The Middle East Medical Assembly (MEMA) 2017, at the American University of Beirut (AUB) comes this year with a new direction holding the first global congress on conflict medicine, focusing on the management of conflict related
