4. Central African Republic
Clashes throughout 2018 in the capital Bangui and a number of major towns illustrate the deadly threat posed by armed groups – a mix of pro-government militias, ex-rebels, bandits and local “self-defence” units – that control much of the countr...y. MINUSCA, the UN peacekeeping force, has failed to neutralise these groups and, as a result, is mistrusted by the general public. Likewise, the national army, slowly being deployed in parts of the country, has been unable to constrain the armed groups’ predatory activities. The humanitarian situation remains dire, with more than one million people internally displaced or fleeing to neighbouring countries and 2.5 million in need of assistance, according to the UN.
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This document describes recommended measures for dealing with medical and other staff employed either in patient care or in outbreak control during the 2014 Ebola outbreak.
This module should always be used together with the
mhGAP Intervention Guide for Mental, Neurological
and Substance Use Disorders in Non-specialized Health
Settings (WHO, 2010), which outlines relevant general
principles of care and management of a range of other
mental, neurological and substa...nce use disorders.
(www.who.int/mental_health/publications/mhGAP_
intervention_guide/en/index.html)
In the future, this module may be integrated with other
products in the following ways:
– This module may be integrated – in its full form –
into future iterations of the existing mhGAP Intervention
Guide.
– The module will be integrated –in a simplified structure –
into a new product, the WHO-UNHCR mhGAP Intervention
Guide for Humanitarian Settings (planned for 2014).
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Gender-based violence, including rape is a problem throughout the world, occurring in every society, country and region. Refugees and internally displaced people are particularly at risk of this violation during every phase of an emergency situation. The systematic use of sexual violence as a method... of warfare is well documented and constitutes a grave breach of international humanitarian law.
The Arabic Version can be downloaded here: http://reliefweb.int/report/syrian-arab-republic/guidelines-health-staff-caring-gender-based-violence-survivors-including
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An applied approach to the training of trainers who, in turn,
train teams to implement psychosocial and mental health
interventions in developing countries affected by emergencies.
The film
On
the
Road
to
Peace
of
Mind,
used in conjunction with this guidebook, presents an applied Traini...ng of Trai-
ners
(TOT) approach. They are designed to educate trainers to prepare teams to provide psychosocial and mental
health assistance for populations in developing countries affected by wars, conflict, natural disasters and other emer-
gencies. The film and guidebook offer a practical framework for the training of trainers that enables psychosocial
and mental health workers to train others. Through modifications for local culture and context, the framework
presented can be used in training programmes on the road to peace of mind around the globe.
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UNAIDS calls on governments to live up to their commitment to develop nationally owned and led social protection systems for all, including floors; and scale up and progressively enhance coverage, adequacy and comprehensiveness, thereby improving the responsiveness and quality of interventions to ad...dress the needs and vulnerabilities of people living with HIV.
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Focusing on preventing and mitigating COVID-19 related risks, the standards aim to protect the health and safety of personnel, while ensuring that organizations continue to deliver on their mandates. Attention is paid to non-discrimination and ensuring that all personnel, regardless of nationality o...r contractual type is equally covered and protected by the minimum standards in the COVID-19 context. It is acknowledged that the implementation of such standards may entail additional costs for organizations, for which a dialogue with donors may be warranted.
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According to WHO, around 22% of adults in conflict settings have mental health conditions.
This is almost triple to non-conflict settings. There is no generally accepted estimate for children but it is clear that children who are refugees, IDPs or who live in conflict settings have high levels of m...ental health issues.
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March 2021. “A Decade of Destruction: Attacks on health care in Syria,” highlights with chilling detail how this 10-year war strategy has turned hospitals from safe havens into no-go zones where Syrian civilians now fear for their lives.
The impact of attacks on health care in Fragile, Conflict-affected and Vulnerable (FCV) settings goes well beyond endangering health providers. Reduced capacity, interrupted services and loss of health care resources deprive vulnerable populations of urgently needed care, undermine health systems an...d jeopardize long-term public health goals.
As the world struggles with the COVID-19 pandemic, protecting health care where health systems are the most vulnerable has become more important than ever. Ensuring the right to access health care for everyone, everywhere is not only at the core of WHO’s commitment to achieve better health but also a stepping stone to a reaching the Sustainable Development Goals or SDGs.
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The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services. This means that 1.8 billion people use facilities that l...ack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
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WHO issued an updated appeal (May 2022) detailing its resource needs for Ukraine and refugee-receiving and hosting countries for March-August for Ukraine and March-December 2022 for other countries.
The needs are an estimated US$ 147.5 million: US$ 80 million for health response in Ukraine and ano...ther US$ 67.5 million is needed to address the health needs of Ukrainian people affected by the conflict in refugee-receiving and hosting countries.
With the funds sought, WHO aims to ensure, until August, that up to 6 million people can access essential health services including trauma care in Ukraine.
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KEY MESSAGES
Always talk to a GBV specialist first to understand what GBV services are available in your area. Some services may take the form of hotlines, a mobile app or other remote support.
Be aware of any other available services in your area. Identify services provided by humanitarian pa...rtners such as health, psychosocial support, shelter and non-food items. Consider services provided by communities such as mosques/ churches, women’s groups and Disability Service Organizations.
Remember your role. Provide a listening ear, free of judgment. Provide accurate, up-to-date information on available services. Let the survivor make their own choices. Know what you can and cannot manage. Even without a GBV actor in your area, there may be other partners, such as a child protection or mental health specialist, who can support survivors that require additional attention and support. Ask the survivor for permission before connecting them to anyone else. Do not force the survivor if s/he says no.
Do not proactively identify or seek out GBV survivors. Be available in case someone asks for support.
Remember your mandate. All humanitarian practitioners are mandated to provide non-judgmental and non-discriminatory support to people in need regardless of: gender, sexual orientation, gender identity, marital status, disability status, age, ethnicity/tribe/race/religion, who perpetrated/committed violence, and the situation in which violence was committed. Use a survivor-centered approach by practicing:
Respect: all actions you take are guided by respect for the survivor’s choices, wishes, rights and dignity.
Safety: the safety of the survivor is the number one priority.
Confidentiality: people have the right to choose to whom they will or will not tell their story. Maintaining confidentiality means not sharing any information to anyone.
Non-discrimination: providing equal and fair treatment to anyone in need of support.
If health services exist, always provide information on what is available. Share what you know, and most importantly explain what you do not. Let the survivor decide if s/he wants to access them. Receiving quality medical care within 72 hours can prevent transmission of sexually transmitted infections (STIs), and within 120 hours can prevent unwanted pregnancy.
Provide the opportunity for people with disabilities to communicate to you without the presence of their caregiver, if wished and does not endanger or create tension in that relationship.
If a man or boy is raped it does not mean he is gay or bisexual. Gender-based violence is based on power, not someone’s sexuality.
Sexual and gender minorities are often at increased risk of harm and violence due to their sexual orientation and/or gender identity. Actively listen and seek to support all survivors.
Anyone can commit an act of gender-based violence including a spouse, intimate partner, family member, caregiver, in-law, stranger, parent or someone who is exchanging money or goods for a sexual act.
Anyone can be a survivor of gender-based violence – this includes, but isn’t limited to, people who are married, elderly individuals or people who engage in sex work.
Protect the identity and safety of a survivor. Do not write down, take pictures or verbally share any personal/identifying information about a survivor or their experience, including with your supervisor. Put phones and computers away to avoid concern that a survivor’s voice is being recorded.
Personal/identifying information includes the survivor’s name, perpetrator(s) name, date of birth, registration number, home address, work address, location where their children go to school, the exact time and place the incident took place etc.
Share general, non-identifying information
To your team or sector partners in an effort to make your program safer.
To your support network when seeking self-care and encouragement.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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Ahead of World Malaria Day, the WHO Global Malaria Programme published a new operational strategy outlining its priorities and key activities up to 2030 to help change the trajectory of malaria trends, with a view to achieving the global malaria targets. The strategy outlines 4 strategic objectives ...where WHO will focus its efforts, including developing norms and standards, introducing new tools and innovation, promoting strategic information for impact, and providing technical leadership of the global malaria response.
In recent years, progress towards critical targets of the WHO Global technical strategy for malaria 2016-2030 has stalled, particularly in countries that carry a high burden of the disease. In 2022 there were an estimated 608 000 malaria-related deaths and 249 million new malaria cases globally, with young children in Africa bearing the brunt of the disease.
Millions of people continue to miss out on the services they need to prevent, detect, and treat malaria. Additionally, progress in global malaria control has been hampered by resource constraints, humanitarian crises, climate change and biological threats such as drug and insecticide resistance.
“A shift in the global malaria response is urgently needed across the entire malaria ecosystem to prevent avoidable deaths and achieve the targets of the WHO global malaria strategy,” notes Dr Daniel Ngamije, Director of the Global Malaria Programme. “This shift should seek to address the root causes of the disease and be centred around accessibility, efficiency, sustainability, equity and integration.”
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