Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-27T17:49:19.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Complex Emergencies: Expected and Unexpected Consequences

Published online by Cambridge University Press:  28 June 2012

Michael J. Schull  and
Leslie Shanks
Michael J. Schull*
Affiliation:
Médecins Sans Frontières (Canada) Clinical Epidemiology Unit, Sunnybrook and Women's College Health Sciences Centre, Toronto, Canada
Leslie Shanks
Affiliation:
Médecins Sans Frontières (Canada)
*
Clinical Epidemiology Unit, G-147, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada, M4N 3M5
Get access Rights & Permissions [Opens in a new window]

Abstract

Complex emergencies emerged as a new type of disaster following the end of the Cold War, and have become increasingly common in recent years. Human activity including civil strife, war, and political repression often coexist with and contribute to natural phenomena such as famine. They frequently result in high mortality, population displacement, and the disruption of civil society and its infrastructure. This article reviews the context of recent complex emergencies, and their expected health consequences, such as diarrhea, measles, malnutrition and outbreaks of infectious disease, and the disruption of mechanisms of disease control and surveillance. However, the complex nature of these emergencies also may have unexpected consequences, such as hindering understanding of their causes or limiting the attention paid to them by the public. This paper discusses the context and consequences of complex emergencies from the health standpoint, and explores some of their unexpected effects.

Keywords

agencies, humanitariancivil strifecomplex emergenciesconsequences, healthcontroldefinitionsdisasterdiseases, infectiousdisplacementeffectsinternally displaced personsmediamorbiditymortalityrefugeesrepression, politicalsurveillancewar
Type
Part 1. Complex Emergencies: Lessons Learned
Information
Prehospital and Disaster Medicine , Volume 16 , Special Issue 4: Complex Emergencies , December 2001 , pp. 192 - 196
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Noji, E: The nature of disaster: General characteristics and public health effects. In: Noji, E (ed), The Public Health Consequences of Disasters. New York: Oxford University Press, 1997. pp 3–20.Google Scholar
2.Bole, S: The new ethical boundaries. In: Leaning, J (ed), Humanitarian Crises: The Medical and Public Health Response. Cambridge: Harvard University Press, 1999. pp 179–194.Google Scholar
3.Spiegel, PB: Health issues affecting displaced populations. Refuge 2000;18(5):1–3.CrossRefGoogle Scholar
4.Burkle, FM: Lessons learnt and future expectations of complex emergencies. BMJ 1999;319(7207):422–426.CrossRefGoogle ScholarPubMed
5.Toole, MJ, Waldman, RJ: The public health aspects of complex emergencies and refugee situations. Annul Rev Public Health 1997;18:283–312.Google Scholar
6.Médecins Sans Frontières: Refugee Health: An Approach to Emergency Situations. 1st ed, London: Macmillan. 1997.Google Scholar
7.Toole, MJ: Refuge for the selected few. Lancet 2001;357(9266):1426–1427.CrossRefGoogle ScholarPubMed
8.Legros, D, Brown, V: Documenting violence against refugees. Lancet 2001;357(9266):1429.CrossRefGoogle ScholarPubMed
9.Rostrup, M, Ford, N: Aid and safety for Guinea's refugees. Lancet 2001;357(9262):1123.CrossRefGoogle ScholarPubMed
10.Regal, J: Crisis medicine. In: Jean, F (ed), Populations in Danger. London: John Libby and Company Ltd, 1999: pp 139–143.Google Scholar
11.Biberson, P: Epidemics in the wake of conflict. In: Jean, F (ed), Populations in Danger. London: John Libby and Company Ltd, 1999. pp 135–137.Google Scholar
12.Beaumont, P: Hope of cure for sleep that kills millions. The Guardian 18 August 2001.Google Scholar
13.Boelart, M: Nutrition Guidelines. 1st ed. Paris: Medecins Sans Frontieres. 1995.Google Scholar
14.Sphere Project:Humanitarian Charter and Minimum Standards in Disaster Response. Oxford: Oxfam Publishing, 2000.Google Scholar
15.Médecins Sans Frontières: Angola: Warring parties' neglect adds to humanitarian emergencies. Press release 02 July, 2001. http://www.msf.org/countries/page.cfm?articleid=lF42A872-8DD0-4EDE-A383376FF1106DE2.Google Scholar
16.Davis, A: Exploring the limits of Humanitarian aid. Médecins Sans Frontières–Holland Annual Report 1999. Amsterdam: Médecins Sans Frontières 2000. pp 5–11.Google Scholar
17.Shanks, L, Ford, N, Schull, M, de Jong, K: Responding to rape. Lancet 2001;357(9252):304.Google Scholar
18.Bouchet-Saulnier, F: Between Humanitarian Law and Principles. Médecins Sans Frontières International Activity Report 2000. Brussels: Médecins Sans Frontières, 2001. http://www.msf.org/content/page.cfm?articleid=6589C8A5-DC2C-11D4-B2010060084A6370.Google Scholar
19.Bedell, R, Coppens, K, Lefkow, L, Nolan, H, Shanks, L, Schull, MJ: Humanitarian medicine, gender and the law: Utility, inadequacy and irrelevance. J Women's Health and Law 1999;1(2):109–124.Google Scholar
20.Munslow, B, Brown, B: Complex emergencies: The institutional impasse. Third World Quarterly 1999;20(1):207–221.CrossRefGoogle Scholar
21.Marschner, A: A scientific approach to temoignage. Médecins Sans Frontières International Activity Report 1999. Brussels: Médecins Sans Frontières, 2000. http://www.msf.org/content/page.cfm?articleid=0F722 DE2-BF6A-11D4-852200902789187E.Google Scholar
22.Chodos, R: In dubious battle. Canadian Forum Magazine 2000;[January-February]:10–15.Google Scholar
23.Neier, A, Leaning, J: Human rights challenges. In: Leaning, J (ed), Humanitarian Crises: The Medical and Public Health Response. Cambridge: Harvard University Press, 1999: pp 195–210.Google Scholar
24.International Panel of Eminent Personalities: International Panel of Eminent Personalities to Investigate the 1994 Genocide in Rwanda and the Surrounding Events. Chapter 15. 2001. Assembly of Heads of State and Government of the Organization of African Unity. http://www.oau-oua.org/Document/ipep/ipep.htm.Google Scholar
25.Office of the Secretary General: Report of the Independent Inquiry into the Actions of the United Nations during the 1994 Genocide in Rwanda. 15 December 1999. United Nations. http://www.un.org/News/ossg/rwanda_report.htm.Google Scholar