Breastfeeding in emergencies with assessment of recent humanitarian crises and the Covid-19 pandemic.

The world is becoming a place where the number of emergencies and humanitarian crises is increasing rapidly due to economic inequality and the gap between developed and underdeveloped countries, as well as climate changes leading to disruption of the natural balance and development of natural disasters. The most vulnerable groups of the population including women and children always are affected by disasters. The younger the child, the more vulnerable he/she is, especially if not naturally fed or having a mother or parents. Various humanitarian organizations have been involved in a number of crises, with the World Health Organization and UNICEF and other United Nations-related organizations leading the way. In the care of mothers, infants and young children, most important is to ensure appropriate nutrition because otherwise it can result in life-threatening health conditions. The lack of protection, support and promotion of natural nutrition (breastfeeding) and its disruption and undermining by uncritical and uncontrolled donations and distribution of infant formula are the biggest challenge due to the lack of information of mothers, those who provide support in emergencies from both governmental and non-governmental sector, without cross-sectoral cooperation, thus causing uncoordinated and sometimes harmful interventions. Therefore, it is recommended that governments issue guidelines on infant and young child nutrition prior to the occurrence of an emergency, and crisis management regulations in which the issue of infant and young child nutrition will be given due consideration.Copyright © 2020 Croatian Paediatric Society. All rights reserved.

Menstrual hygiene management during times of complex humanitarian crisis: Listening to the voices of rural adolescent girls of Assam

Menstrual hygiene management (MHM) is an integral component of the reproductive health and hygiene of adolescent girls. Despite being a vital issue that has a multifaceted effect on the well-being of girls, it is often overlooked in the household and community environment. In a disaster-prone zone, the situation further aggravates at the time of emergency situation. The first section of the chapter examines the knowledge, perception, and practices of MHM prior to the coronavirus (COVID-19) pandemic. The second section explores the impact of the COVID-19 pandemic and annual flood on menstrual hygiene practices. The first phase of extensive primary survey using mixed sampling method was done in Biswanath district of Assam in 2019. Furthermore, the second phase of the survey was conducted in 2020 to investigate the impact of a biological and climatic disaster. Poor menstrual hygiene practices are the outcome of knowledge gap, unfavorable cultural milieu, and inadequate resources. In general, menstrual hygiene needs of adolescent girls are neglected in rural settings. Respondents' ability to deal with their menses is severely altered during unprecedented crisis situation. Humanitarian agencies also overlook gender-specific needs of hygiene and sanitation facilities, thus amplifying existing vulnerabilities in the relief camps. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

THE FOURTH ETHICAL COMMENT TOWARDS COVID-19 (three years later). TRUST AND FAITH: SOCIAL AND MORAL PROFILE OF VACCINATION.

The summarizing up the semantic and systemic results should comprise the next phase to provide insights into COVID-19 pandemic and consider it as a modern epidemic and humanitarian crisis on global level. The journal <<Infection and Immunity>> regularly and consistently present the results of ethically viewed legal framework of the pandemic and the administrative regulation of the public health system. Analysis and ethical assessment of the situation covers a wide range of issues, including the provision and operational adaptation of the regulatory framework, the problems of medical care, the processes and conditions for developing diagnostics, treatment and prevention, as well as all aspects related to the organization and implementing vaccination. Three previous ethical comments presented in 2020-2022 during the pandemic were devoted to these issues. Current study within the framework of the <<fourth ethical commentary>> follows directly from the data obtained while evaluating and analysing real-world experience on vaccination in the context of a regional cluster - the CIS member states, presented in the previous article. The perceived need and obvious significance of the study is to highlight objective factors of vulnerability in the vaccination during the COVID-19 pandemic and identify the response spectrum to form trust/or distrust to vaccination in various sectors of society, depending on a set of social and moral factors, including those coupled to a religious denomination. The data obtained are of paramount importance to find the moral ways to support and stabilize a responsible attitude with the aim to protect moral, social and physical health in emergency situations.Copyright © 2023 Saint Petersburg Pasteur Institute. All rights reserved.

Unmuting leadership: the impact of Zelensky's social media strategy at the inset of the Ukrainian War

Since the start of the war in Ukraine in February 2022, President Zelensky has used his social networks to request international support. This research analyzes the audiovisual discourse of the hegemonic networks during the first 40 days of the humanitarian war crisis in the context of risk communication. The contribution of this research relates to the unveiling of a new era where social media platforms are no longer the underdog of traditional media. This paper analyzes the visual content of President Zelensky's most followed social media profile, Instagram. This paper builds on previous work examining the political leaders of the most affected European countries during the first days of the COVID-19 pandemic in 2020 and how they enhanced the use of their social media profiles in order to communicate about the crisis. In contrast to the use of social media during the COVID-19 pandemic, the audiovisual narrative created by the president of Ukraine optimized the social network's resources and achieved an impactful and authentic approach to leadership during the first 40 days of crisis. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Humanitarian management strategy for interstate movement of migrant workers in India during COVID-19 pandemic: an optimization based approach.

India faced a unique situation during the ongoing COVID-19 pandemic when millions of migrant workers, in different states had to be transported to their home states as workplaces shut down. The governments in respective states faced challenges of minimizing economic impact while ensuring that the risk of infection was also kept under control. This paper develops models based on various secondary data from governmental and relevant non-governmental sources, trying to minimize the economic impact while keeping the rate of infection low and determining whether the migrant workforce should be allowed to stay in their workplace state or allowed to return to their home state. We found that the number of days of lockdown had a significant impact on the results. Fewer days of lockdown resulted in workers remaining in their work state as the preferred outcome, while a higher number of days of lockdown implied that people traveled to their home state and remain there. The proportion of workers who were willing to return to their work state played an important role on the results too. Beyond the threshold percentages of migrant workers returning to their work state, it became optimal for the government to encourage the workers to travel to their home state. However, this was mostly visible for moderate number of lockdown days as the effects on results were dominated by the impact from the number of lockdown days for too high or too low number of lockdown days. There is also an important trade-off between the budget and infection rate 'R' for the governments to consider. Minimizing the risk of infection requires an additional budget.

Intergenerational trauma: A silent contributor to mental health deterioration in Afghanistan.

Multiple theories, including family systems, epigenetics, attachments, and many others, have proposed mechanisms for trauma transmission from generation to generation. Intergenerational trauma is today one of the most important psychosocial issues affecting Afghans' mental health and psychology, with the potential to affect subsequent generations. A variety of factors have impacted the mental health of the Afghan population over the years, including years of conflict, socioeconomic instability, natural disasters, chronic drought conditions, economic turmoil, and food insecurity, all of which have been exacerbated by recent political turbulence and the The Coronavirus pandemic COVID-19 pandemic that has further increased the susceptibility to intergenerational trauma among the Afghan population. International bodies must play a role in addressing intergenerational trauma among Afghans. Breaking the chain in future generations will be possible by resolving political issues, providing adequate health facilities, financial support, and eliminating stigmas associated with mental health issues.

Vulnerability and Humanitarian Emergencies: Fate of Rohingya Women Amid Covid-19

While populations as a whole suffer during complex humanitarian crisis, women become especially vulnerable. This gendered nature of vulnerability in crisis situations has recently received attention from academics and humanitarians alike, the dominant narrative failing to take into account that social and legal systems making women vulnerable since birth and emergencies only exacerbate their plight: vulnerability is not episodic, it is a fundamental part of a woman's life. Through the study of vulnerability and security, this study explores the experience of the already relegated Rohingya refugee women during COVID-19. By drawing on Martha Fineman's theoretical framework exploring the inevitability of vulnerability, the chapter seeks to shift perceptions and mindsets over gendered vulnerabilities. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Could Emergency Diseases Surveillance Systems Be Transitioned to Routine Surveillance Systems? A Proposed Transition Strategy for Early Warning, Alert, and Response Network.

In humanitarian emergencies, traditional disease surveillance systems either do not exist to begin with or come under stress due to a huge influx of internal or external migrants. However, cramped camps with an unreliable supply of safe water and weak sanitation systems are the ideal setting for major disease outbreaks of all kinds. The Early Warning, Alert and Response Network (EWARN) has been supported by the WHO since the late 1990s to ensure health system capacity to identify and control risks early before they become major epidemics. These systems have been proven to be an excellent asset in reducing morbidity and mortality in humanitarian crises around the world. However, there is also a global challenge of transitioning them back to a regular or national monitoring system in their respective countries. This article is the result of in-country consultations arranged by the Eastern Mediterranean office of the World Health Organization. In these consultations, the unique local conditions and limitations of different countries were discussed to identify a way forward for transitioning these emergency disease surveillance systems into regular systems. After these discussions, different options were presented which could be further modified according to local needs. As there has not been any documented evidence of a successful transition of any emergency surveillance system, it is difficult to discuss or determine the gold standard for transition. As with any public health program being practiced in the field, local decision-making with some broad guidelines will be the best approach available. This article provides these guidelines and practical steps which could be further modified according to country needs.

The On-Going Humanitarian Crisis of Mass Human Migration due to Complex Disasters

Documented Risks Facing Migrants During Travel and at Border Detention Points Type of Risk Environmental Exposure Physical Injury during Transit due to Terrain Temperature Extremes Drowning Minimal or No Water for Consumption Starvation/Food Insecurity Insect Pests and Dangerous Animals or Plants Infection Parasitic Infection (example: infectious diarrhea) Endemic Diseases (example: Malaria, hepatitis) Skin and Tissue Infection (example: cellulitis) Disease due to Crowding (example: tuberculosis) Transport Accidents and Injury Traffic and Boating Accidents Heat and Cold Exposure in Unsafe Vehicles Economic Exploitation Robbery Extortion and Kidnapping Exploitation by Border Vendors/Employers Forced Drug and Contraband Trafficking Physical Harm Rape and Assault Placed into Human Trafficking Forced Prostitution Sport Murder Lack of Health Care Access An important factor in understanding and addressing current migration patterns is recognizing the push and pull factors that convince people and families to migrate. Environmental degradation of agricultural and habitat land, social violence for control of limited resources by gangs and cartels, corrupt governments, and cultural discrimination, as well as a rapidly changing world economy are inter-related push factors for migration.

The contributions of religious leaders in addressing food insecurity during the COVID-19 pandemic in the Philippines: A realist evaluation of the Rapid Emergencies and Disasters Intervention (REDI).

To address the unintended consequences of public health measures during the COVID-19 pandemic (e.g., emergency food insecurity, income loss), non-governmental organizations (NGOs) have partnered with diverse actors, including religious leaders, to provide humanitarian relief in resource-constrained communities. One such example is the Rapid Emergencies and Disasters Intervention (REDI), which is an NGO-led program in the Philippines that leverages a network of volunteer religious leaders to identify and address emergency food insecurity among households experiencing poverty. Guided by a realist evaluation approach, the objectives of this study were to identify the facilitators and barriers to effective implementation of REDI by religious leaders during the COVID-19 pandemic and to explore the context and mechanisms that influenced REDI implementation. In total, we conducted 25 virtual semi-structured interviews with religious leaders actively engaged in REDI implementation across 17 communities in Negros Occidental, Philippines. Interviews were audio recorded, transcribed, and thematically analyzed. Three main context-mechanism configurations were identified in shaping effective food aid distribution by religious leaders, including program infrastructure (e.g., technical and relational support from partner NGO), social infrastructure (e.g., social networks), and community infrastructure (e.g., community assets as well as a broader enabling environment). Overall, this study contributes insight into how the unique positionality of religious leaders in combination with organizational structures and guidance from a partner NGO shapes the implementation of a disaster response initiative across resource-constrained communities. Further, this study describes how intersectoral collaboration (involving religious leaders, NGOs, and local governments) can be facilitated through an NGO-led disaster response network.

For the Parent, by the Parent: Creating a Program to Empower Parents of Refugee Background Using Novel Participatory Approaches

BACKGROUND: With more than 28 million individuals of refugee or asylum-seeking background globally, the current situation has been described as one of the largest humanitarian crises of all time. Families of refugee background have complex, multigenerational mental health and developmental needs that are not accounted for in current programming frameworks. Difficulties in resettlement have been further compounded by COVID-19-related lockdowns, straining parental mental health and placing children at an increased risk for developmental or behavioural problems. Providing appropriate support services and educational resources that address the multigenerational concerns of families of refugee background will address these challenges, allowing for improved parental mental health, family cohesion, and developmental outcomes for children. OBJECTIVE(S): To gather data about the experiences, resources, referral pathways and barriers that impact the experience of parents of refugee background in the Greater Toronto Area (GTA) and to develop a novel, multi-dimensional parenting program model using Community-Based Participatory Research (CBPR) principles. DESIGN/METHODS: This was a qualitative community-based participatory study using a formative research framework, in accordance with COREQ guidelines. In-depth interviews (IDIs) were conducted with parents of refugee background and care providers that work closely with this population. Data were recorded, transcribed, and coded using deductive and inductive coding methods by two independent coders. RESULT(S): A total of 20 IDIs were conducted (7 parents and 13 care providers). The main topics that were identified to be incorporated into the program include features of child development, how to address resettlement issues, child advocacy, and parenting in the Canadian context. Participants felt that tackling the language barriers, addressing the overlapping responsibilities of the mothers attending the sessions, providing incentives, increasing awareness of the program, and using an anti-racist and anti-oppressive approach is key to the program's success. Participants emphasized the need for trauma-informed mental health support within the program model. CONCLUSION(S): This study describes the key considerations for a novel parenting program for families of refugee background, by engaging them as key stakeholders in the program design process. Future iteration of this project would involve a pilot and evaluation of the program.

The primary care of the future: What can primary care in Europe learn from the innovations and challenges of the COVID-19 pandemic?

The organisational and financial diversity that characterizes European primary care has made it possible to respond extraordinarily to the COVID-19 pandemic with innovative solutions: reorganisation of the scope of services, digitization, new professional roles and inclusion of new professions in primary care, and the use of additional fees for service. Telemedicine has transformed patient care. Humanitarian crises (immigration and refugees) still require new solutions in Europe. Palliative care in primary care has been transformed. The new virtual medical education must be evaluated. The reduction of bureaucracy is a clear need, as is coordination with preventive medicine and public health services. Solo practice versus primary care teams, access to the prescription of certain drugs, over-prescription, preventive activities, and migration of physicians constitute future challenges for European primary care. Copyright © 2022 The Author(s)

European union initiatives supporting middle eastern countries incombating the COVID-19 pandemic

The EU has been supporting Middle Eastern countries- including Iraq, Iran, and Yemen in their ight against COVID-19 since day one of the global out-break, using a whole range of multidimensional tools in the broader context of pursuing its lagship efective multilateralism policies combined with the com-prehensive approach promoted by the EU Global Strategy. From an unprece-dented network of air-bridges to various forms of assistance addressing diferent aspects of humanitarian crises, very oten exacerbated by diverse, complicated internal and regional challenges, the EU's robust engagement and initiatives have resulted in the overall strengthening of its position as a reliable and trustworthy strategic partner in mutually beneicial co-operation for the broader neighbour-ing region as well as a major global player capable of providing meaningful sup-port in an efective Team Europe spirit despite objective limitations resulting from the course of the pandemic. he aim of this chapter is to analyse speciic initiatives undertaken by the European Union in the context of supporting the eforts of Iraq, Iran, and Yemen in their ight against the pandemic. © Peter Lang GmbH Internationaler Verlag der Wissenschaften Berlin 2022. All rights reserved.

The impact of violence on healthcare workers' mental health in conflict based settings amidst COVID-19 pandemic, and potential interventions: A narrative review.

Healthcare workers (HCWs) have faced an increased amount of mental health struggles amidst the COVID-19 pandemic. However, those in conflict-based settings with fragile healthcare systems meet additional challenges. This study reviews violence, conflict and mental health among HCWs in five countries: Syria, Palestine, Yemen, Afghanistan and Lebanon. Our study reports that HCWs are targeted by violence, bombings, mistreatment and different forms of abuse, including verbal and physical. With the additional burdens of the pandemic including prolonged working hours, limited resources and insufficient humanitarian aid, the healthcare workers fall victim to increased levels of burnout and mental illnesses. The situation leads to dire consequences on their personal lives and professional development, compelling them to quit their job or country all together. Although healthcare workers remain resilient in these conflict-based settings, immediate interventions are required to prevent violence against them and cater to their rapidly declining mental health.

Unraveling the Jeopardy: Child health in Afghanistan.

A humanitarian crisis started in Afghanistan after the United States and international Allies withdrew in August 2021, causing numerous challenges and have especially impacted children. Children in Afghanistan have been affected by a long history of suffering from violence, war, and poverty. The US withdraw and COVID-19 pandemic have caused an economic crisis causing high rates of child malnutrition and prevented them from receiving healthcare and education. In the long run, the impacts of the current situation will significantly affect the child growth, education, and psychological health. There is a need for international organizations to intervene now to ensure children do not further suffer and have the option for a bright future. In turn, ensuring a brighter future for Afghanistan.

Migratory crisis in northern Chile. Information frames of the regional press

The article analyzes the migratory crisis that occurred in the Tarapacá Region in Chile during the COVID-19 pandemic, considering the perspective of the informative frames that are used by the regional media. The study was developed from a qualitative research perspective, through a content analysis of the news on the displacement of the migrant population to the north of Chile, published by four Chilean regional newspapers during 2020. The results show that the main frame of the information related to the problem examined is that of attribution of responsibility, concluding that the role of national, regional and local government authorities becomes the main focus of attention of the news on the humanitarian and health effects of the crisis. © 2022, Universidad Autonoma de Baja California. All rights reserved.

Shadow of Pandemic: An Analysis of Maternal and Neonatal Outcomes before, during, and after the First and Second COVID-19 Waves

Objective: India reported its first case of coronavirus in Kerala on 30th January, 2020. On March 24, 2020, the Government of India announced the first complete lockdown of the entire nation for 21 days for the containment of the virus. The immediate effect of the lockdown was that the cases and COVID-19-related deaths were significantly controlled. Besides the direct effects, the indirect impact of the pandemic and pandemic-control policies on healthcare services, communities, and the global economy may also affect vulnerable groups like pregnant women. The objective is to explore trends in maternal or neonatal outcomes during this pandemic by comparing the same in pre-pandemic, pandemic, and post-pandemic phases. Materials and Methods: This was a retrospective analysis of maternal and neonatal outcomes over the period from January 2020 to August 2021. The monthly statistics from the pre-pandemic period (2018 and 2019) were combined and then analyzed against the statistics from 2020 and 2021 using the Fisher’s exact test or Chi-squared analysis as appropriate. Results: There was positive correlation between the monthly number of COVID-19-related deaths with the monthly number of stillbirths (p = 0.153). The diagnosis of antenatal complications such as hypertension in pregnancy occurred at the same rate pre-pandemic as in the months during the pandemic. There was a strong positive correlation between maternal mortality and the number of COVID-19-related deaths (p = 0.016). Conclusion: Women’s healthcare is often adversely affected in humanitarian disasters, and our study highlights the importance of planning for powerfully built maternal services in any emergency services.

Evaluating an e-learning program to strengthen the capacity of humanitarian workers in the MENA region: the Humanitarian Leadership Diploma.

BACKGROUND: The Middle East and North Africa (MENA) region is consistently plagued with humanitarian crises while having little response capacity. Despite their obvious growing need, there exist limited educational opportunities for humanitarian workers to develop their capacity in humanitarian topics. The present study evaluates an online training program, the Humanitarian Leadership Diploma (HLD), which targeted humanitarian workers across the MENA region. METHODS: A mixed-methods design was used, comprising short and long-term quantitative and qualitative data, targeting individual and organizational-level outcomes. A total of 28 humanitarian workers across the MENA region enrolled in the program starting September 2019 until October 2020, 18 of which completed the full diploma. Short-term quantitative data such as knowledge assessments, course evaluations, and reflective commentaries were collected from all learners, whereas long-term qualitative data was collected only from those who completed the full diploma and from peers at their organizations, 6 months after completion. Data was triangulated, analyzed using qualitative content analysis, and reported as themes. RESULTS: The program was overall successful given multiple factors reported by participants such as enhanced knowledge, high satisfaction, and improved practice, with some important challenges being identified. Themes under the strengths category related to (1) online learning, (2) significance of diploma, (3) course content, (4) instructors, (5) transfer of learning into practice, and (6) personal development. Themes under the challenges category related to (1) barriers to applying changes in behavior and performance, (2) engagement and interaction, and (3) pedagogical approach. CONCLUSION: This is one of very few evaluations of locally developed and delivered online learning programs for humanitarian actors in the MENA region. The findings are especially important as they may inform researchers and humanitarian actors looking to design and deliver similar programs in the MENA region or other fragile settings. Key recommendations are discussed in the manuscript, and include to combine synchronous and asynchronous approaches, design concise course materials, limit theoretical pedagogical approaches, ensure topics are contextualized to the region, and consider continuous engagement strategies for learners.

Applying Charismatic Leadership to Support Learner Engagement in Virtual Environments: Teaching and Learning in a Time of Crisis

The institutional spaces of education and health were transformed as a result of COVID-19. The shift to emergency remote education can occur in many contexts, more than once, and with differing degrees of severity. During these periods of disruption, educators are affected and are met with professional challenges. These challenges include maintaining curriculum flexibility in response to rapidly change teaching modalities while maintaining effective delivery of educational programing. Whether in a traditional setting or online classroom, evidence from classical leadership theory can ease this transition allowing the educator to keep the learner engaged, especially in virtual learning environments. [ FROM AUTHOR] Copyright of Pedagogy in Health Promotion is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)