This study explores the perceived influence of climate change on the health of Hamer pastoralists and their livestock in south-western Ethiopia. A combination of focus group discussions and key ...informant interviews were conducted with Hamer communities as well as local health workers, animal health workers and non-governmental organisation (NGO) staff. Thematic framework analysis was used to analyse the data. Reductions in rangeland, erratic rainfall, recurrent droughts and loss of seasonality were perceived to be the biggest climate challenges influencing the health and livelihoods of the Hamer. Communities were travelling greater distances to access sufficient grazing lands, and this was leading to livestock deaths and increases in ethnic violence. Reductions in suitable rangeland were also precipitating disease outbreaks in animals due to increased mixing of different herds. Negative health impacts in the community stemmed indirectly from decreases in livestock production, uncertain crop harvests and increased water scarcity. The remoteness of grazing lands has resulted in decreased availability of animal milk, contributing to malnutrition in vulnerable groups, including children. Water scarcity in the region has led to utilisation of unsafe water sources resulting in diarrhoeal illnesses. Further, seasonal shifts in climate-sensitive diseases such as malaria were also acknowledged. Poorly resourced healthcare facilities with limited accessibility combined with an absence of health education has amplified the community’s vulnerability to health challenges. The resilience and ambition for livelihood diversification amongst the Hamer was evident. The introduction of camels, increase in permanent settlements and new commercial ideas were transforming their livelihood strategies. However, the Hamer lack a voice to express their perspectives, challenges and ambitions. There needs to be collaborative dynamic dialogue between pastoral communities and the policy-makers to drive sustainable development in the area without compromising the values, traditions and knowledge of the pastoralists.
Background Myanmar has had a long history of civil wars with its minority ethnic groups and is yet to see a sustainable peace accord. The conflicts have had a significant impact on health in Myanmar, ...with ethnic populations experiencing inequitable health outcomes. Consequently, to meet the health needs of ethnic people, Ethnic Health Organisations and Community-Based Health Organisations (EHO/CBHOs) created their own health system. The EHO/CBHO and Government health systems, provided by the Myanmar Ministry of Health and Sports (MoHS), remain parallel, despite both stakeholders discussing unification of the health systems within the context of ongoing but unresolved peace processes. EHO/CBHOs discuss the 'convergence' of health systems, whilst the MoHS discuss the integration of health providers under their National Health Plan. Methods A qualitative study design was used to explore the challenges to collaboration between EHO/CBHOs and the MoHS in Kayin state, Myanmar. Twelve health workers from different levels of the Karen EHO/CBHO health system were interviewed. Semi-structured, in-depth interviews were digitally recorded, transcribed, and coded. Data was analysed thematically using the Framework method. Topic guides evolved in an iterative process, as themes emerged inductively from the transcripts. A literature review and observation methods were also utilised to increase validity of the data. Results The challenges to collaboration were identified in the following five themes: (1) the current situation is not 'post conflict' (2) a lack of trust (3) centralised nature of the MoHS (4) lack of EHO/CBHO health worker accreditation (5) the NHP is not implemented in some ethnic areas. Conclusions Ultimately, all five challenges to collaboration stem from the lack of peace in Myanmar. The health systems cannot be 'converged or 'integrated' until there is a peace accord which is acceptable to all actors. EHO/CBHOs want a federal political system, where the health system is devolved, equitable and accessible to all ethnic people. External donors should understand this context and remain neutral by supporting all health actors in a conflict sensitive manner. Keywords: Myanmar, Kayin/Karen state, Devolved healthcare, Access to healthcare, Universal health coverage, Health as a bridge to peace, Ethnic health system, Indigenous health, Health system strengthening
Humanitarianism under attack Munslow, Barry
International health,
09/2019, Letnik:
11, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Attacks on humanitarianism are threefold. First, in conflict zones, over the past decade attacks on humanitarian health facilities and personnel are increasingly documented, along with a decline in ...respect for core humanitarian principles by state and non-state actors, and this will continue. Second, growing instrumentalisation, a failure to adequately fund the sector, antimigrant/refugee populism on the rise and the protracted nature of many crises are provoking a shift away from humanitarian to development healthcare aid over the next decade, intended to keep refugees far away from developed countries by encouraging their integration into immediate neighbouring states. This undermines humanitarian healthcare emergency response capacity. Third, the climate crisis will massively increase humanitarian healthcare needs among the most vulnerable over the next decade and challenge the sector to respond across all its programmes, not least as it absorbs a renewed youthful agency elsewhere in climate protest.
Malnutrition plays a significant role in under-five mortality rates following disasters. Older people play an important role in childcare in non-Western societies, which often increases in ...displacement contexts. Until now, policy, in general, and nutrition programmes, in particular, have focused on the mother-child dyad.
To gather information on possible barriers to older carers accessing nutritional services for the children they care for and explore ways to overcome these obstacles.
A qualitative approach was taken to explore the experiences of the carers themselves. Focus group discussions provided data, which were analysed using grounded theory.
Data collected showed older people have similar needs to other caregivers in emergency settings, needs that are often amplified by age. Moreover, many barriers to accessing services were elicited, including targeting and advertising of nutritional programmes, alongside physical and psychosocial barriers to assessing existing support. Participants generated potential solutions to each identified barrier.
As older people in Haiti were often the sole carers of under-fives, there is a need to recognise their importance in this role and support them within. More generally, in any emergency setting, organisations need take into account all stakeholders in child nutrition when planning and implementing programmes.
First published in 1984, this collection of twelve case studies examines the emergence of a free wage-labour force in all regions of the third world. Although the struggle and conflict through which ...the proletariat has achieved a degree of class consciousness is not neglected, the more dominant theme is that of the process and techniques which have created a working class on the capitalist periphery.
Asia's economic development successes will create new policy areas to address, as the advances made through globalisation create greater climate change challenges, particularly the impact on urban ...health. Poverty eradication and higher standards of living both increase demand on resources. Globalisation increases inequalities and those who are currently the losers will carry the greatest burden of the costs in the form of the negative effects of climate change and the humanitarian crises that will ensue. Of four major climate change challenges affecting the environment and health, two-urban air pollution and waste management-can be mitigated by policy change and technological innovation if sufficient resources are allocated. Because of the urban bias in the development process, these challenges will probably register on policy makers' agenda. The second two major challenges-floods and drought-are less amenable to policy and technological solutions: many humanitarian emergency challenges lie ahead. This article describes the widely varying impact of both globalisation and climate change across Asia. The greatest losers are those who flee one marginal location, the arid inland areas, only to settle in another marginal location in the flood prone coastal slums. Effective preparation is required, and an effective response when subsequent humanitarian crises occur.
This special issue of Third World Quarterly makes a case for redirecting attention and resources away from the 'war on terror' and focussing as a matter of urgency on the causes and consequences of ...global climate change. Global climate change must be recognised as an issue of national and international security. Increased competition for scarce resources and migration are key factors in the propagation of many of today's chronic complex humanitarian emergencies. The relentless growth of megacities in natural disaster hotspots places unprecedented numbers of vulnerable people at risk of disease and death. The Earth's fragile ecosystem has reached a critical tipping point. Today's most urgent need is for a collective endeavour on the part of the international community to redirect resources, enterprise and creativity away from the war on terror and to earnestly redeploy these in seeking solutions to the far greater and increasingly imminent threats that confront us as a consequence of global climate change.
This special issue of Third World Quarterly makes a case for redirecting attention and resources away from the 'war on terror' and focussing as a matter of urgency on the causes and consequences of ...global climate change. Global climate change must be recognised as an issue of national and international security. Increased competition for scarce resources and migration are key factors in the propagation of many of today's chronic complex humanitarian emergencies. The relentless growth of megacities in natural disaster hotspots places unprecedented numbers of vulnerable people at risk of disease and death. The Earth's fragile ecosystem has reached a critical tipping point. Today's most urgent need is for a collective endeavour on the part of the international community to redirect resources, enterprise and creativity away from the war on terror and to earnestly redeploy these in seeking solutions to the far greater and increasingly imminent threats that confront us as a consequence of global climate change.
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