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1.
PLoS One ; 16(12): e0261787, 2021.
Article in English | MEDLINE | ID: covidwho-1595484

ABSTRACT

BACKGROUND: The Spanish Civil War (1936-1939) is an example of a historic event involving nurses, with the participation of professional and volunteer nurses from Spain and other countries. In this context, nurses were trained over short periods of time and recruited to work at hospitals serving the two warring camps. OBJECTIVES: To identify the characteristics of the training received by volunteer nurses on both sides in the Spanish Civil War and compare it with previous experiences in the history. DESIGN: Historical research. METHODS: Heuristic and hermeneutical analysis of nurse training manuals and news articles from 1936 to 1939. Spanish primary sources were consulted at the Red Cross Documentation Centre Archive in Madrid, the General Military Archive in Ávila, the Municipal Newspaper Archive in Madrid, and the archives of Spanish daily newspapers ABC and La Vanguardia. The following variables were analysed: duration, entry requirements, and theoretical content of the training courses. Consolidated Criteria for Reporting Qualitative Research (COREQ) has been used. FINDINGS: Both sides in the conflict offered a varied training programme, which was supported by official institutions and private initiatives. The courses lasted between one week and two months. Entry requirements were influenced by education level, age, moral conduct, health status, and social and political background. Training content focused on the techniques needed in conflict settings and covered specific moral values. CONCLUSIONS: Despite the different social and political characteristics of the two warring factions, the variety of training programmes on offer, the entry requirements, and the theoretical content of volunteer nurse training were similar on both sides. At the end of the Spanish Civil War, volunteer nurses on the Republican side suffered reprisals or had to go into exile. We now know that some countries involved in World War II provided training courses for volunteer nurses. It would therefore be interesting to ascertain whether Spanish volunteer nurses contributed their experience to these courses.


Subject(s)
Armed Conflicts , Volunteers , Spain , World War II
6.
Global Health ; 17(1): 83, 2021 07 22.
Article in English | MEDLINE | ID: covidwho-1388780

ABSTRACT

BACKGROUND: Yemen has been left in shambles and almost destroyed by its devastating civil war, and is now having to deal with the spread of coronavirus. The Yemeni people have been are left to fend for themselves and faced many problems such as hunger, the ongoing war, infections, diseases and lack of equipment even before the COVID-19 pandemic. All together it is a humanitarian crisis. Only around 50% of the hospitals and healthcare facilities are in full working condition, and even those that are functioning are operating at nowhere near full potential. Healthcare staff and facilities lack necessary essential equipment and money. CONCLUSION: As, sadly, is common in conflict-affected regions, the violence has brought with it a secondary disaster of infectious disease outbreaks. Yemen is not only battling COVID-19 amid a catastrophic war, but also has to deal with other diseases such as cholera, diphtheria and measles. A number of key measures are needed to support the current efforts against this deadly epidemic and its potential subsequent waves as well as to prevent further epidemics in Yemen.


Subject(s)
Armed Conflicts , COVID-19/epidemiology , Relief Work , Humans , Yemen/epidemiology
7.
Int J Environ Res Public Health ; 18(16)2021 08 19.
Article in English | MEDLINE | ID: covidwho-1369765

ABSTRACT

The present study investigated predictors of psychological coping with adversity responses during the COVID-19 pandemic and an armed conflict. Two paired samples that represented the Israeli population that was exposed to both adversities were compared. Respondents rated five different psychological coping responses associated with the two adversities, such as anxiety or individual resilience. Perceived security, pandemic, economic, and political risks, as well as level of morale, were rated. Two major findings were disclosed by two path analyses. Morale improved the predictions of the varied coping responses in both the pandemic and conflict and was the best predictor of four out of five responses and the second-best predictor of the fifth response. Contrary to previous studies, our findings revealed that the concept of a single major predictor of coping responses under distress is an overgeneralization. In both cases, the coping responses were better explained by other perceived risks rather than by the risk of the investigated adversity. Rather than assume that a perceived security threat accounts for low levels of public moods, it is vital to study the antecedents of coping responses and to empirically examine additional potential predictors.


Subject(s)
COVID-19 , Pandemics , Adaptation, Psychological , Armed Conflicts , Humans , Morale , SARS-CoV-2 , Stress, Psychological/epidemiology
12.
Clin Dermatol ; 39(1): 5-8, 2021.
Article in English | MEDLINE | ID: covidwho-1300685

ABSTRACT

Pandemics have ravished the globe periodically, often associated with war, at times commencing as fever and rash, beginning in recorded history in the crowded walled city of Athens during the Peloponnesian War as described in great detail by the Athenian historian and military general Thucydides in 430 BCE. As the world now faces the first major pandemic of the 21st century, we focus on the "plague" commencing in Athens in 430 BCE and the 2 pandemics of the more recent century, which killed more than one million, the Spanish flu of 1918 and the Asian flu of 1957. The latter linked with successful vaccine development thanks to the heroic efforts of microbiologist Maurice Hilleman. We now look back and then forward to the viral infection coronavirus disease 2019 now devastating the world.


Subject(s)
Influenza Pandemic, 1918-1919/history , Influenza, Human/history , Pandemics/history , Armed Conflicts/history , Asia , Greece , History, Ancient , Humans , Influenza, Human/epidemiology , Influenza, Human/virology
14.
Front Public Health ; 9: 667364, 2021.
Article in English | MEDLINE | ID: covidwho-1285357

ABSTRACT

Background: Since the Arab uprising in 2011, Libya, Syria and Yemen have gone through major internal armed conflicts. This resulted in large numbers of deaths, injuries, and population displacements, with collapse of the healthcare systems. Furthermore, the situation was complicated by the emergence of COVID-19 as a global pandemic, which made the populations of these countries struggle under unusual conditions to deal with both the pandemic and the ongoing wars. This study aimed to determine the impact of the armed conflicts on the epidemiology of the novel coronavirus (SARS-CoV-2) within these war-torn countries and highlight the strategies needed to combat the spread of the pandemic and its consequences. Methods: Official and public data concerning the dynamics of the armed conflicts and the spread of SARS-COV-2 in Libya, Syria and Yemen were collected from all available sources, starting from the emergence of COVID-19 in each country until the end of December 2020. Datasets were analyzed by a set of statistical techniques and the weekly resolved data were used to probe the link between the intensity levels of the conflict and the prevalence of COVID-19. Results: The data indicated that there was an increase in the intensity of the violence at an early stage from March to August 2020, when it approximately doubled in the three countries, particularly in Libya. During that period, few cases of COVID-19 were reported, ranging from 5 to 53 cases/day. From September to December 2020, a significant decline in the intensity of the armed conflicts was accompanied by steep upsurges in the rate of COVID-19 cases, which reached up to 500 cases/day. The accumulative cases vary from one country to another during the armed conflict. The highest cumulative number of cases were reported in Libya, Syria and Yemen. Conclusions: Our analysis demonstrates that the armed conflict provided an opportunity for SARS-CoV-2 to spread. The early weeks of the pandemic coincided with the most intense period of the armed conflicts, and few cases were officially reported. This indicates undercounting and hidden spread during the early stage of the pandemic. The pandemic then spread dramatically as the armed conflict declined, reaching its greatest spread by December 2020. Full-blown transmission of the COVID-19 pandemic in these countries is expected. Therefore, urgent national and international strategies should be implemented to combat the pandemic and its consequences.


Subject(s)
COVID-19 , Pandemics , Armed Conflicts , Humans , Libya/epidemiology , SARS-CoV-2 , Syria/epidemiology , Yemen/epidemiology
15.
Lancet Glob Health ; 9(8): e1068-e1076, 2021 08.
Article in English | MEDLINE | ID: covidwho-1281651

ABSTRACT

BACKGROUND: The effects of the COVID-19 pandemic on mental health have been understudied among vulnerable populations, particularly in fragile and conflict-affected settings. We aimed to analyse how the pandemic is related to early changes in mental health and parenting stress among caregivers, many of whom are internally displaced persons (IDP), in a conflict-affected setting in Colombia. METHODS: For this cohort study, we used longitudinal data from a psychosocial support programme in which 1376 caregivers were randomly assigned across four sequential cohorts. Recruitment of participants took place in March, 2018, for cohort 1; July, 2018, for cohort 2; March, 2019, for cohort 3; and July, 2019, for cohort 4. Participants completed assessments at baseline, 1-month, and 8-month follow-ups. The 8-month assessment occurred before the COVID-19 pandemic for participants in cohorts 1 and 2 (n=573), whereas those in cohorts 3 and 4 (n=803) were assessed during the early stages of the pandemic, 2-5 weeks after the national lockdown began on March 25, 2020. Primary caregiver anxiety and depression were measured with a scale adapted from the Symptoms Checklist-90-Revised and parenting stress was measured with the short form of the Parenting Stress Index. We estimated how mental health changed by comparing prepandemic and postpandemic 8-month outcomes using lagged-dependent variable models. FINDINGS: Results showed that the likelihood of reporting symptoms above the risk threshold increased by 14 percentage points for anxiety (95% CI 10-17), 5 percentage points for depression (0·5-9), and 10 percentage points for parental stress (5-15). The deterioration in mental health was stronger for IDP, participants with lower education or pre-existing mental health conditions, and for those reporting a higher number of stressors, including food insecurity and job loss. INTERPRETATION: Maternal mental health significantly worsened during the early stages of the pandemic. Considering the vulnerability and pre-existing mental health conditions of this population, the estimated effects are substantial. Policies in fragile and conflict-affected settings targeting IDP and other vulnerable people will be important to mitigate further mental health and socioeconomic problems. FUNDING: Saving Brains-Grand Challenges Canada, Fundación Éxito, Fundación FEMSA, United Way Colombia, Universidad de los Andes. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.


Subject(s)
COVID-19/psychology , Maternal Health/statistics & numerical data , Mental Health/statistics & numerical data , Mothers/psychology , Pandemics , Adult , Armed Conflicts , COVID-19/epidemiology , Cohort Studies , Colombia/epidemiology , Female , Humans , Mothers/statistics & numerical data , Vulnerable Populations
16.
Int J Infect Dis ; 106: 79-82, 2021 May.
Article in English | MEDLINE | ID: covidwho-1279593

ABSTRACT

The first case of COVID-19 in Yemen was confirmed on 10 April 2020. Having faced with a six-year long conflict that has destroyed half of its healthcare facilities and displaced millions, predictions of infections and mortality in Yemen suggested a looming healthcare catastrophe. Difficulty in implementing coordinated lockdowns and preventive measures due to the daily labor working nature of the majority of the population, provided the perfect breeding ground for the SARS-CoV-2 virus. However, official figures of infections and mortality are very low and there have not been confirmed reports of excess mortality. This could indicate that Yemen is silently marching towards forced herd immunity. Seroprevalence studies will provide useful insight into the COVID-19 transmission trajectory in Yemen, which can serve as a guide in planning vaccine distribution strategies and allocating the limited funds wisely.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Health Resources/supply & distribution , Immunity, Herd , Armed Conflicts , COVID-19/immunology , Communicable Disease Control/methods , Humans , SARS-CoV-2/immunology , Yemen/epidemiology
19.
PLoS One ; 16(4): e0250651, 2021.
Article in English | MEDLINE | ID: covidwho-1206199

ABSTRACT

In recent times, many alarm bells have begun to sound: the metaphorical presentation of the COVID-19 emergency as a war might be dangerous, because it could affect the way people conceptualize the pandemic and react to it, leading citizens to endorse authoritarianism and limitations to civil liberties. The idea that conceptual metaphors actually influence reasoning has been corroborated by Thibodeau and Boroditsky, who showed that, when crime is metaphorically presented as a beast, readers become more enforcement-oriented than when crime is metaphorically framed as a virus. Recently, Steen, Reijnierse and Burgers replied that this metaphorical framing effect does not seem to occur and suggested that the question should be rephrased about the conditions under which metaphors do or do not influence reasoning. In this paper, we investigate whether presenting the COVID-19 pandemic as a war affects people's reasoning about the pandemic. Data collected suggest that the metaphorical framing effect does not occur by default. Rather, socio-political individual variables such as speakers' political orientation and source of information favor the acceptance of metaphor congruent entailments: right-wing participants and participants relying on independent sources of information are those more conditioned by the COVID-19 war metaphor, thus more inclined to prefer bellicose options.


Subject(s)
COVID-19/psychology , Social Behavior , Thinking/physiology , Adult , Armed Conflicts/psychology , Female , Humans , Italy , Language , Male , Metaphor , Pandemics/prevention & control , Problem Solving , SARS-CoV-2/pathogenicity
20.
BMJ Glob Health ; 5(Suppl 1)2021 02.
Article in English | MEDLINE | ID: covidwho-1203975

ABSTRACT

BACKGROUND: While much progress was made throughout the Millennium Development Goals era in reducing maternal and neonatal mortality, both remain unacceptably high, especially in areas affected by humanitarian crises. While valuable guidance on interventions to improve maternal and neonatal health in both non-crisis and crisis settings exists, guidance on how best to deliver these interventions in crisis settings, and especially in conflict settings, is still limited. This systematic review aimed to synthesise the available literature on the delivery on maternal and neonatal health interventions in conflict settings. METHODS: We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to conflict, women and children, and maternal and neonatal health. We searched websites of 10 humanitarian organisations for relevant grey literature. Publications reporting on conflict-affected populations in low-income and middle-income countries and describing a maternal or neonatal health intervention delivered during or within 5 years after the end of a conflict were included. Information on population, intervention, and delivery characteristics were extracted and narratively synthesised. Quantitative data on intervention coverage and effectiveness were tabulated but no meta-analysis was undertaken. RESULTS: 115 publications met our eligibility criteria. Intervention delivery was most frequently reported in the sub-Saharan Africa region, and most publications focused on displaced populations based in camps. Reported maternal interventions targeted antenatal, obstetric and postnatal care; neonatal interventions focused mostly on essential newborn care. Most interventions were delivered in hospitals and clinics, by doctors and nurses, and were mostly delivered through non-governmental organisations or the existing healthcare system. Delivery barriers included insecurity, lack of resources and lack of skilled health staff. Multi-stakeholder collaboration, the introduction of new technology or systems innovations, and staff training were delivery facilitators. Reporting of intervention coverage or effectiveness data was limited. DISCUSSION: The relevant existing literature focuses mostly on maternal health especially around the antenatal period. There is still limited literature on postnatal care in conflict settings and even less on newborn care. In crisis settings, as much as in non-crisis settings, there is a need to focus on the first day of birth for both maternal and neonatal health. There is also a need to do more research on how best to involve community members in the delivery of maternal and neonatal health interventions. PROSPERO REGISTRATION NUMBER: CRD42019125221.


Subject(s)
Armed Conflicts , COVID-19 , Child Health , Delivery of Health Care , Maternal Health , Africa South of the Sahara/epidemiology , Betacoronavirus , Child , Female , Humans , Infant Health , Infant, Newborn , Pandemics , Pregnancy , SARS-CoV-2
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