No discipline has been impacted more by war and armed conflict than health care has. Health systems and health care providers are often the first victims, suffering increasingly heinous acts that cripple the essential health delivery and public health infrastructure necessary for the protection of civilian and military victims of the state at war. This commentary argues that current instructional opportunities to prepare health care providers fall short in both content and preparation, especially in those operational skill sets necessary to manage multiple challenges, threats, and violations under international humanitarian law and to perform triage management in a resource-poor medical setting. Utilizing a historical framework, the commentary addresses the transformation of the education and training of humanitarian health professionals from the Cold War to today followed by recommendations for the future. (Disaster Med Public Health Preparedness. 2019;13:383-396)

Risk communication plays a very important role in the prevention of public health crisis events and has been considered by the World Health Organization (WHO) to be 1 of the main functions of an emergency public health crisis. However, it is a relatively new research field in China, so many people have mistaken understandings of risk communication. This article will describe the concept and importance of risk communication and briefly introduce the role of risk communication in public health crisis management. It also provides information for the prevention of public health crisis events in the future.

The toll of civilian deaths in current wars and conflicts has been building for decades. Civilian populations, particularly since WWII, have suffered most of the consequences of armed violence and today represent the most at-risk population. This is attributed to the rise of religious and ethnic hatreds, the collapse of State structures, the battle for control of natural resources, the vast availability of weapons, the proliferation of acts of terrorism, and the spread of so-called asymmetric conflicts. Protections provided to innocent civilians under International Humanitarian Law and the Geneva Conventions have been ignored. This commentary captures the experience of the immediate care and transportation provided to military casualties of the Battle of Solferino in 1859 with civilian casualties recently documented in a Stanford-led study during the “golden hour” after injury in 13 conflicts from 1990 to 2017. Despite many advances in triage and management of war injuries over the intervening decades, the common thread of these 2 scenarios is that transport times and early resuscitation capacity and capabilities, first recognized in the 19th century wars and now accepted as global norms and markers for survival from trauma, are as unavailable today to civilians caught up in war and conflict as they were to soldiers in the 19th century.

For more than 75 years, the United Nations Charter has functioned without the benefit of Chapter VII, Article 43, which commits all United Nations member states “to make available to the Security Council, on its call, armed forces, assistance, facilities, including rights of passage necessary for the purpose of maintaining international peace and security.” The consequences imposed by this 1945 decision have had a dramatic negative impact on the United Nation’s functional capacity as a global body for peace and security. This article summarizes the struggle to implement Article 43 over the decades from the onset of the Cold War, through diplomatic attempts during the post–Cold War era, to current and often controversial attempts to provide some semblance of conflict containment through peace enforcement missions. The rapid growth of globalization and the capability of many nations to provide democratic protections to their populations are again threatened by superpower hegemony and the development of novel unconventional global threats. The survival of the United Nations requires many long overdue organizational structure and governance power reforms, including implementation of a robust United Nations Standing Task Force under Article 43. (Disaster Med Public Health Preparedness. 2018;13:655–662)

What began in 2013 as the eruption of a political struggle between forces loyal to President Salva Kiir, a member of the Dinka ethnic group, and then–vice president Riek Machar, a Nuer, has splintered into a multifaction conflict. A dizzying array of armed groups have entered the fray, many unmotivated by political leverage that conventionally brings parties to a conflict to the negotiating table. Two years and tens of thousands of deaths after the 2015 signing of the Agreement on the Resolution of the Conflict in South Sudan, with no substantive progress toward meetings its terms, it is unrealistic to think that Intergovernmental Authority on Development’s recently announced High-Level Revitalization Forum will be sufficient to address the drivers of this conflict. Current policy proposals are poorly designed to address escalating intercommunal conflict and cattle raiding, both devastating forms of violence. As measures at the international level continue to be pursued, the conflict resolution strategy should also include a more comprehensive approach incorporating local actors in order to build momentum toward long-term stability. In this article, we highlight gaps in the current dialogue around a political solution in South Sudan, as well as domains that must be part of the next push for peace. (Disaster Med Public Health Preparedness. 2019;13:663–671)

The intensely active 2017 Atlantic basin hurricane season provided an opportunity to examine how climate drivers, including warming oceans and rising seas, exacerbated tropical cyclone hazards. The season also highlighted the unique vulnerabilities of populations residing on Small Island Developing States (SIDS) to the catastrophic potential of these storms. During 2017, 22 of the 29 Caribbean SIDS were affected by at least one named storm, and multiple SIDS experienced extreme damage. This paper aims to review the multiplicity of storm impacts on Caribbean SIDS throughout the 2017 season, to explicate the influences of climate drivers on storm formation and intensity, to explore the propensity of SIDS to sustain severe damage and prolonged disruption of essential services, to document the spectrum of public health consequences, and to delineate the daunting hurdles that challenged emergency response and recovery operations for island-based, disaster-affected populations. (Disaster Med Public Health Preparedness. 2019;13:5–17)