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Published in: Emerging Themes in Epidemiology 1/2004

Open Access 01-12-2004 | Analytic perspective

The role of the applied epidemiologist in armed conflict

Authors: Sharon M McDonnell, Paul Bolton, Nadine Sunderland, Ben Bellows, Mark White, Eric Noji

Published in: Emerging Themes in Epidemiology | Issue 1/2004

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Abstract

Background

Applied epidemiologists are increasingly working in areas of insecurity and active conflict to define the health risks, suggest feasible means to reduce these risks and, monitor the capacity and reconstruction of the public health system. In 2001, The Carter Center and the United States Institute for Peace sponsored a conference within which "Violence and Health" was discussed and a working group on applied epidemiology formed. The group was tasked to describe the skills that are essential to effective functioning in these settings and thereby provide guidance to the applied epidemiology training programs.

Methods

We conducted a literature review and consultation of a convenience sample of practitioners of applied epidemiology with experience in conflict areas.

Results and conclusions

The health programs designed to prevent and mitigate conflict are in their early stages of implementation and the evaluation measures for success are still being defined. The practice of epidemiology in conflict must occur within a larger humanitarian and political context to be effective. The skills required extend beyond the normal epidemiological training that focuses on the valid collection and interpretation of data and fall into two general categories: (1) Conducting a thorough assessment of the conflict setting in order to design more effective public health action in conflict settings, and (2) Communicating effectively to guide health program implementation, to advocate for needed policy changes and to facilitate interagency coordination. These are described and illustrated using examples from different countries.
Literature
2.
go back to reference Levy BS, Sidel VW, : War and public health, updated edition. American Public Health Association Washington, DC, 2000. Levy BS, Sidel VW, : War and public health, updated edition. American Public Health Association Washington, DC, 2000.
3.
go back to reference Toole MJ, Waldman RJ: Refugees and displaced persons. War, hunger, and public health. JAMA. 1993, 270: 600-5. 10.1001/jama.270.5.600CrossRefPubMed Toole MJ, Waldman RJ: Refugees and displaced persons. War, hunger, and public health. JAMA. 1993, 270: 600-5. 10.1001/jama.270.5.600CrossRefPubMed
5.
go back to reference Foege WH: Arms and public health: a global perspective. In: War and public health Edited by: Levy BS, Sidel VW. New York: Oxford University Press in cooperation with the American Public Health Association, 1997, 3-11. Foege WH: Arms and public health: a global perspective. In: War and public health Edited by: Levy BS, Sidel VW. New York: Oxford University Press in cooperation with the American Public Health Association, 1997, 3-11.
6.
go back to reference Toole M, Galson S, Brady W: Are war and public health compatible? Lancet. 1993, 341: 1193-6. 10.1016/0140-6736(93)91013-CCrossRefPubMed Toole M, Galson S, Brady W: Are war and public health compatible? Lancet. 1993, 341: 1193-6. 10.1016/0140-6736(93)91013-CCrossRefPubMed
7.
go back to reference Murray CJ, Lopez AD: Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet. 1997, 349: 1436-42. 10.1016/S0140-6736(96)07495-8CrossRefPubMed Murray CJ, Lopez AD: Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet. 1997, 349: 1436-42. 10.1016/S0140-6736(96)07495-8CrossRefPubMed
8.
go back to reference Garfield RM, Neugut AI: Epidemiologic Analysis of warfare: A historical review. JAMA. 1991, 266: 688-92. 10.1001/jama.266.5.688CrossRefPubMed Garfield RM, Neugut AI: Epidemiologic Analysis of warfare: A historical review. JAMA. 1991, 266: 688-92. 10.1001/jama.266.5.688CrossRefPubMed
10.
go back to reference Waldman R, Williams HA: Public Health in Complex Emergencies: Toward a More Integrated Science. In Caring for Those in Crisis: Integrating Anthropology and Public Health in Complex Humanitarian Emergencies. Edited by: Williams HA. American Anthropological Association, 2001. Bulletin 21 Waldman R, Williams HA: Public Health in Complex Emergencies: Toward a More Integrated Science. In Caring for Those in Crisis: Integrating Anthropology and Public Health in Complex Humanitarian Emergencies. Edited by: Williams HA. American Anthropological Association, 2001. Bulletin 21
11.
go back to reference [No authors listed] Famine-affected, refugee, and displaced populations: recommendations for public health issues. MMWR Recomm. 1992, 41 (RR-13): 1-76. [No authors listed] Famine-affected, refugee, and displaced populations: recommendations for public health issues. MMWR Recomm. 1992, 41 (RR-13): 1-76.
12.
go back to reference Zwi A, Ugalde A: Towards an epidemiology of political violence in the Third World. Soc Sci Med. 1989, 28: 633-42. 10.1016/0277-9536(89)90210-4CrossRefPubMed Zwi A, Ugalde A: Towards an epidemiology of political violence in the Third World. Soc Sci Med. 1989, 28: 633-42. 10.1016/0277-9536(89)90210-4CrossRefPubMed
13.
go back to reference Armenian H, Acra A: From missionaries to the endemic war: public health action and research at the American University of Beirut). J Public Health Policy. 1988, 9: 261-72.CrossRefPubMed Armenian H, Acra A: From missionaries to the endemic war: public health action and research at the American University of Beirut). J Public Health Policy. 1988, 9: 261-72.CrossRefPubMed
14.
18.
go back to reference Thacker SM, Dannenberg AL, Hamilton DH: Epidemic Intelligence Service of the Centers for Disease Control and Prevention: 50 Years of Training and Service in Applied Epidemiology. Am J Epidemiol. 2001, 154: 985-992. 10.1093/aje/154.11.985CrossRefPubMed Thacker SM, Dannenberg AL, Hamilton DH: Epidemic Intelligence Service of the Centers for Disease Control and Prevention: 50 Years of Training and Service in Applied Epidemiology. Am J Epidemiol. 2001, 154: 985-992. 10.1093/aje/154.11.985CrossRefPubMed
19.
go back to reference White ME, McDonnell SM, Werker DH, Cardenas VM, Thacker SB: Partnerships in international applied epidemiology training and service, 1975–2001. Am J Epidemiol. 2001, 154: 993-9. 10.1093/aje/154.11.993CrossRefPubMed White ME, McDonnell SM, Werker DH, Cardenas VM, Thacker SB: Partnerships in international applied epidemiology training and service, 1975–2001. Am J Epidemiol. 2001, 154: 993-9. 10.1093/aje/154.11.993CrossRefPubMed
20.
go back to reference Hardeep SS, Thomas C, Nsubuga P, White ME: A Global Network for Early Warning and Response to Infectious Diseases and Bioterrorism: Applied Epidemiology and Training Programs, 2001. Am J Publ Health. 2003, 93: 640-1642. Hardeep SS, Thomas C, Nsubuga P, White ME: A Global Network for Early Warning and Response to Infectious Diseases and Bioterrorism: Applied Epidemiology and Training Programs, 2001. Am J Publ Health. 2003, 93: 640-1642.
21.
go back to reference White ME, McDonnell SM: Public health surveillance in low- and middle-income countries. In: Principles and Practice of Public Health Surveillance. Edited by: Tuetsch SM, Churchill E. New York: Oxford University Press, 2000, 287-315. White ME, McDonnell SM: Public health surveillance in low- and middle-income countries. In: Principles and Practice of Public Health Surveillance. Edited by: Tuetsch SM, Churchill E. New York: Oxford University Press, 2000, 287-315.
22.
go back to reference VanRooyen MJ, Hansch S, Curtis D, Burnham G: Emerging issues and future needs in humanitarian assistance. Prehospital Disaster Med. 2001, 16: 216-22.PubMed VanRooyen MJ, Hansch S, Curtis D, Burnham G: Emerging issues and future needs in humanitarian assistance. Prehospital Disaster Med. 2001, 16: 216-22.PubMed
23.
go back to reference Armenian HK: Perceptions from epidemiologic research in an endemic war. Soc Sci Med. 1989, 28: 643-7. 10.1016/0277-9536(89)90211-6CrossRefPubMed Armenian HK: Perceptions from epidemiologic research in an endemic war. Soc Sci Med. 1989, 28: 643-7. 10.1016/0277-9536(89)90211-6CrossRefPubMed
24.
go back to reference Goma Group : Public health impact of Rwandan refugee crisis: what happened in Goma, Zaire, in July. 1994. Goma Group : Public health impact of Rwandan refugee crisis: what happened in Goma, Zaire, in July. 1994.
25.
go back to reference Salama P, Buzard N, Spiegel P: Improving standards in international humanitarian response: The Sphere Project and beyond. JAMA. 2001, 286: 531-2. 10.1001/jama.286.5.531CrossRefPubMed Salama P, Buzard N, Spiegel P: Improving standards in international humanitarian response: The Sphere Project and beyond. JAMA. 2001, 286: 531-2. 10.1001/jama.286.5.531CrossRefPubMed
26.
go back to reference Weinberg J, Simmonds S: Public health, epidemiology and war. Soc Sci Med. 1995, 40: 1663-69. 10.1016/0277-9536(95)00022-YCrossRefPubMed Weinberg J, Simmonds S: Public health, epidemiology and war. Soc Sci Med. 1995, 40: 1663-69. 10.1016/0277-9536(95)00022-YCrossRefPubMed
27.
go back to reference Waldman RJ: Public health in times of war and famine: what can be done? What should be done? JAMA. 2001, 286: 588-90. 10.1001/jama.286.5.588CrossRefPubMed Waldman RJ: Public health in times of war and famine: what can be done? What should be done? JAMA. 2001, 286: 588-90. 10.1001/jama.286.5.588CrossRefPubMed
28.
go back to reference Bolton P, Weiss W: Communicating across cultures: Improving translation to improve complex emergency program effectiveness. Prehospital Disaster Med. 2001, 16: 252-6.PubMed Bolton P, Weiss W: Communicating across cultures: Improving translation to improve complex emergency program effectiveness. Prehospital Disaster Med. 2001, 16: 252-6.PubMed
30.
go back to reference Malison MD, Sekeito P, Henderson PL, Hawkins RV, Okware SI, Jones TS: Estimating health service utilization, immunization coverage, and childhood mortality: a new approach in Uganda. Bull World Health Organ. 1987, 65: 325-30.PubMedCentralPubMed Malison MD, Sekeito P, Henderson PL, Hawkins RV, Okware SI, Jones TS: Estimating health service utilization, immunization coverage, and childhood mortality: a new approach in Uganda. Bull World Health Organ. 1987, 65: 325-30.PubMedCentralPubMed
32.
go back to reference Haroon Haroon Ashraf : The people of Iraq face a grim future with or without a war. Lancet. 2003, 361: 626. 10.1016/S0140-6736(03)12620-7CrossRef Haroon Haroon Ashraf : The people of Iraq face a grim future with or without a war. Lancet. 2003, 361: 626. 10.1016/S0140-6736(03)12620-7CrossRef
34.
go back to reference Robin M, Coupland : FRCS, and Peter Herby, "Review of the legality of weapons, a new approach: The SIrUS Project ". IRRC; No. 835. 1999, 583. (Predicting medical effects of different weapons and warfare) Robin M, Coupland : FRCS, and Peter Herby, "Review of the legality of weapons, a new approach: The SIrUS Project ". IRRC; No. 835. 1999, 583. (Predicting medical effects of different weapons and warfare)
35.
go back to reference Monitoring access to food and household food security R.P. Sharma FAO. 1991. Assessment of the current world food security situation and outlook. FAO Committee on World Food Security, 16th Session, Rome, FAO. Article is adapted from Approaches to monitoring access to food and household food security, FAO Committee on World Food Security, 17th Session, Rome, 23–27. 1992, http://www.fao.org/docrep/U8050t/u8050t02.htm Monitoring access to food and household food security R.P. Sharma FAO. 1991. Assessment of the current world food security situation and outlook. FAO Committee on World Food Security, 16th Session, Rome, FAO. Article is adapted from Approaches to monitoring access to food and household food security, FAO Committee on World Food Security, 17th Session, Rome, 23–27. 1992, http://​www.​fao.​org/​docrep/​U8050t/​u8050t02.​htm
37.
go back to reference Ali MM, Shah IH: Sanctions and childhood mortality in Iraq. Lancet. 2000, 355: 9218-10.1016/S0140-6736(00)02289-3.CrossRef Ali MM, Shah IH: Sanctions and childhood mortality in Iraq. Lancet. 2000, 355: 9218-10.1016/S0140-6736(00)02289-3.CrossRef
38.
go back to reference McMichael AJ, Beaglehole R: The changing global context of public health. Lancet. 2000, 356: 495-99. 10.1016/S0140-6736(00)02564-2CrossRefPubMed McMichael AJ, Beaglehole R: The changing global context of public health. Lancet. 2000, 356: 495-99. 10.1016/S0140-6736(00)02564-2CrossRefPubMed
39.
go back to reference Villaveces A, Cummings P, Espitia VE, Koepsell TD, McKnight B, Kellermann AL: Effect of a ban on carrying firearms on homicide rates in 2 Colombian cities. JAMA. 2000, 283: 1205-9. 10.1001/jama.283.9.1205CrossRefPubMed Villaveces A, Cummings P, Espitia VE, Koepsell TD, McKnight B, Kellermann AL: Effect of a ban on carrying firearms on homicide rates in 2 Colombian cities. JAMA. 2000, 283: 1205-9. 10.1001/jama.283.9.1205CrossRefPubMed
40.
go back to reference MMWR 1995- Patterns of homicide– Cali Colombia, 1993–1994. MMWR Morb Mortal Wkly Rep. 1995, 44: 734-7. MMWR 1995- Patterns of homicide– Cali Colombia, 1993–1994. MMWR Morb Mortal Wkly Rep. 1995, 44: 734-7.
42.
go back to reference Horton R: Violence and medicine: the necessary politics of public health. Lancet. 2001, 358: 1472-3. 10.1016/S0140-6736(01)06566-7CrossRefPubMed Horton R: Violence and medicine: the necessary politics of public health. Lancet. 2001, 358: 1472-3. 10.1016/S0140-6736(01)06566-7CrossRefPubMed
44.
go back to reference Lewer N: Conflict Resolution and Mediation for Public Health Professionals'. In: Public Health and War. Edited by: Levy B, Sidel V. Oxford University Press, Oxford, 1997. Lewer N: Conflict Resolution and Mediation for Public Health Professionals'. In: Public Health and War. Edited by: Levy B, Sidel V. Oxford University Press, Oxford, 1997.
45.
go back to reference Tangermann R, Hull HF, Jafari H, Nkowane B, Everts H, Aylward RB: Eradication of poliomyelitis in countries affected by conflict. Bull World Health Organ. 2000, 78: 330-8.PubMedCentralPubMed Tangermann R, Hull HF, Jafari H, Nkowane B, Everts H, Aylward RB: Eradication of poliomyelitis in countries affected by conflict. Bull World Health Organ. 2000, 78: 330-8.PubMedCentralPubMed
Metadata
Title
The role of the applied epidemiologist in armed conflict
Authors
Sharon M McDonnell
Paul Bolton
Nadine Sunderland
Ben Bellows
Mark White
Eric Noji
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Emerging Themes in Epidemiology / Issue 1/2004
Electronic ISSN: 1742-7622
DOI
https://doi.org/10.1186/1742-7622-1-4

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