A case study of four South African War (1899-1902) Black concentration camps

Abstract: On 11 October 1899, the South African War commenced between the British Empire and the South African Republic and Orange Free State Republic. This conflict saw the targeting of civilians by all sides throughout the conflict and a harbinger of 20th century “Total War”, when civilians and their resources were harnessed to support military objectives. Set against the prior use of concentration camps in Cuba and the Philippines, the war was followed by a genocidal campaign undertaken by Imperial Germany against the Herero people in German South West Africa in 1906. Although civilian internment in South Africa was not genocidal by design and purpose, it caused a high loss of life and lasting bitterness amongst Boer descendants. Black concentration camps, however, were far more lethal to their internees and designed along a completely different model. Their role was to coerce labour while supporting the British war effort in defeating the Republican forces. Through a work or starve policy, combined with withholding food, medical support and shelter, many perished from systemic neglect. Yet the memory of this experience of the black concentration camps has entered historical discourse only recently, in the last three decades. The area of study, examined by this article, is those black concentration camps established during 1901 to 1902, at Klip River Station, Witkop, Meyerton and Vereeniging, in the former South African Republic (ZAR). Contemporary tangible evidence of these camps remains fleeting. However, this article identifies where these camps existed and how they were integrated into the British military’s counter-guerrilla warfare strategy. This in turn enables further research into these camps that may conclusively establish their historic locations

The Trauma Registry Compared to All Patient Refined Diagnosis Related Groups (APR DRG)

Background Literature has shown there are significant differences between administrative databases and clinical registry data. Our objective was to compare the identification of trauma patients using All Patient Refined Diagnosis Related Groups (APR-DRG) as compared to the Trauma Registry and estimate the effects of those discrepancies on utilization. Methods Admitted pediatric patients from 1/2012–12/2013 were abstracted from the trauma registry. The patients were linked to corresponding administrative data using the Pediatric Health Information System database at a single children’s hospital. APR-DRGs referencing trauma were used to identify trauma patients. We compared variables related to utilization and diagnosis to determine the level of agreement between the two datasets. Results There were 1942 trauma registry patients and 980 administrative records identified with trauma-specific APR-DRG during the study period. Forty-two percent (816/1942) of registry records had an associated trauma-specific APR-DRG; 69% of registry patients requiring ICU care had trauma APR-DRGs; 73% of registry patients with head injuries had trauma APR-DRGs. Only 21% of registry patients requiring surgical management had associated trauma APR-DRGs, and 12.5% of simple fractures had associated trauma APR-DRGs. Conclusion APR-DRGs appeared to only capture a fraction of the entire trauma population and it tends to be the more severely ill patients. As a result, the administrative data was not able to accurately answer hospital or operating room utilization as well as specific information on diagnosis categories regarding trauma patients. APR-DRG administrative data should not be used as the only data source for evaluating the needs of a trauma program

Exploring water indices and associated parameters: A case study approach

In the past 20 years, over 50 water indices have been developed to characterize human-water systems within the frameworks of water scarcity, water poverty, water vulnerability, and water security. This study compares existing water indices in Bangladesh and Sri Lanka to better understand which parameters (or lack thereof) contribute to the usefulness of water indices. Drawing on knowledge about human-water interactions in Bangladesh and Sri Lanka, this exploration of indices at the parameter level highlights missing parameters, inadequate consideration of complex relationships between parameters, and inconsistencies in index nomenclature and units. This study reveals both the benefits and shortcomings of water indices and provides recommendations for researchers and water managers to consider when selecting indices to assess and support their water policy goals

Traces of forced labour – a history of black civilians in British concentration camps during the South African War, 1899-1902

Philosophiae Doctor - PhDDuring the South African War of 1899-1902 captured civilians were directed by the British army into military controlled zones and into refugee camps which became known as concentration camps. Established near towns, mines and railway sidings these camps were separated along racial lines. The British forced black men, women and children through the violence of war into agricultural and military labour as a war resource, interning over 110,000 black civilians in concentration camps. Unlike Boer civilians who were not compelled to labour, the British forced black civilians into military labour through a policy of no work no food. According to recent scholarly work based only on the written archive, at least 20,000 black civilians died in these camps. This project uses these written archives together with archaeological surveys, excavations, and oral histories to uncover a history of seven such forced labour camps. This approach demonstrates that in constructing an understanding and a history of what happened in the forced labour camps, the written archive alone is limited. Through the work of archaeology which uncovers material evidence on the terrain and the remains of graves one can begin to envisage the scale an extent of the violence that characterized the experience of forced laborers in the 'black concentration camps' in the South African War

Retrospective Evaluation of the Epidemiology and Practice Variation of Dexmedetomidine Use in Invasively Ventilated Pediatric Intensive Care Admissions, 2007-2013

OBJECTIVES: The study assessed dexmedetomidine utilization and practice variation over time in ventilated pediatric intensive care unit (PICU) patients; and evaluated differences in hospital outcomes between high- and low-dexmedetomidine utilization hospitals. STUDY DESIGN: This serial cross-sectional analysis used administrative data from PICU admissions in the pediatric health information system (37 US tertiary care pediatric hospitals). Included admissions from 2007 to 2013 had simultaneous dexmedetomidine and invasive mechanical ventilation charges, <18 years of age, excluding neonates. Patient and hospital characteristics were compared as well as hospital-level severity-adjusted indexed length of stay (LOS), charges, and mortality. RESULTS: The utilization of dexmedetomidine increased from 6.2 to 38.2 per 100 ventilated PICU patients among pediatric hospitals. Utilization ranged from 3.8 to 62.8 per 100 in 2013. Few differences in patient demographics and no differences in hospital-level volume/severity of illness measures between high- and low-utilization hospitals occurred. No differences in hospital-level, severity-adjusted indexed outcomes (LOS, charges, and mortality) were found. CONCLUSION: Wide practice variation in utilization of dexmedetomidine for ventilated PICU patients existed even as use has increased sixfold. Higher utilization was not associated with increased hospital charges or reduced hospital LOS. Further work should define the expected outcome benefits of dexmedetomidine and its appropriate use

Narco wars: an analysis of the militarisation of U.S. counter-narcotics policy in Colombia, Mexico and on the U.S. border

The U.S. War on Drugs has been underway for several decades. Since it was declared by the Nixon Administration narcotics have been understood as a growing security threat to the American public, their health, economy and society. Illicit drugs have gradually become a securitised issue. From the Nixon Administration onward, the law enforcement and eventually military assets of the United States government were increasingly deployed in an effort to counter this drug threat. While initially regarded as a minor issue, as the potency and addictive qualities of illicit drugs increased during the 20th Century, so too did the concerns of influential actors from the political and public spheres. Nixon's actions did not represent the high-water mark of U.S. counter-narcotics. There was growing violence on American streets linked to the drug trafficking cartels out of Colombia, especially in Southern Florida where traffickers battled each other for lucrative drug markets. In response to this national security threat, the Reagan Administration – followed by the successor Bush and Clinton Administrations – gradually increased the involvement of the U.S. military in counter-narcotics policy. This occurred both at home in the form of greater militarisation of police forces, and abroad in support of several Latin American countries’ security forces. In 2000, drug-related instability in Colombia resulted in the launch of the Plan Colombia initiative, a dedicated package of American financial and security assistance, with counter-narcotics the primary purpose. In 2008, as drug-related violence in Mexico reached epidemic proportions and threatened to spillover across the American border, the U.S. launched the Merida Initiative in an attempt to aid Mexican counter-narcotics efforts. This thesis uses qualitative research methods to examine the militarisation of U.S. foreign counter-narcotics policy by analysing the case studies of Colombia and Mexico and their American-backed efforts. It also examines domestic policy, by considering the historical development of U.S. counter-narcotics, the progressive militarisation of law enforcement as a consequence of the drug war, and the security situation on the southern border with Mexico. This empirical research is facilitated by the development of a militarisation analytical framework, which builds upon the securitisation framework. Based on the findings of the case studies, the processes that drive militarisation are explored, and the framework itself is further developed and refined. The research possibilities for counter-narcotics policy and future direction for militarisation research are also explored in the Conclusion. Ultimately, this thesis offers a detailed analysis of militarisation in U.S. foreign and domestic counter-narcotics policy, the processes behind this, and develops a militarisation framework applicable to any security situation, contributing to the overall securitisation debate

Cross-sectional comparison of critically ill pediatric patients across hospitals with various levels of pediatric care

BACKGROUND: Inpatient administrative data sources describe the care provided to hospitalized children. The Kids' Inpatient Database (KID) provides nationally representative estimates, while the Pediatric Health Information System (PHIS, a consortium of pediatric facilities) derives more detailed information from revenue codes. The objective was to contextualize a diagnosis and procedure-based definition of critical illness to a revenue-based definition; then compare it across hospitals with different levels of pediatric care. METHODS: This retrospective, cross-sectional study utilized the 2009 KID, and 2009 inpatient discharges from the PHIS database. Patients <21 years of age (excluding neonates) were included to focus on pediatric critical illness. Critical illness was defined as: (1) critical care services (CC services) using diagnosis and procedures codes and (2) intensive care unit (ICU) care using revenue codes. Demographics, invasive procedures, and categories of critical illness were compared using Chi square and survey-weighted methods. The definitions of critical illness were compared in PHIS hospitals. CC services populations identified in General Hospitals, Pediatric Facilities, and Freestanding Children's hospitals (from KID) were compared to those in PHIS hospitals. RESULTS: Among PHIS hospitals, critically ill discharges identified by CC services accounted for 37.7% of ICU care. CC services discharges were younger and had greater proportion of respiratory illness and invasive procedure use. Critically ill patients identified by CC services in PHIS hospitals were statistically similar to those in Freestanding Children's hospitals. Pediatric Facilities and General Hospitals had more adolescents with more traumas. CC services patients in general hospitals had lower use of invasive procedures and predominance of trauma, respiratory illness, mental health issues, and general infections. Freestanding children's hospitals discharged 22% of the estimated 96,700 CC services cases. Similar proportions of critically ill patients were seen in Pediatric Facilities (31%) and General Hospitals (33%). CONCLUSION: The CC services definition captured a more severely ill fraction of critically ill children. Critically ill discharges from PHIS hospitals can likely be extrapolated to Freestanding Children's hospitals and Pediatric Facilities. General Hospitals, which provide a significant amount of pediatric critical care, are different. Studies utilizing administrative data can benefit from multiple data sources, which balance the individual strengths and weaknesses

Work or starve: dry harts forced labour camp, November 1901-December 1902

Abstract: Camps interning black civilians during the South African War (1899-1902) are known as concentration camps, yet this is not the full picture of what transpired during the conflict. Rather, by mid-1901, the concentration camps established for black civilians in South Africa during late 1900 and early 1901 were incorporated into the newly formed Native Refugee Department, which fell under direct command of the British Army. At this point, the camps were mostly closed and the internees relocated to Boer farms cleared of civilians. There, departmental camps were established with a completely different function to that of the concentration camp system. These camps, established by the Native Refugee Department, operated as forced labour camps wherein women, children and elderly men were compelled into forced labour, growing crops for the British military in exchange for food. If they refused, they were starved to death on the ‘let die’ basis. Able-bodied men in turn sought work with the military or the mines to support their dependants. Dry Harts Forced Labour Camp forms the focus of this article. A combination of sources was used to reconstruct this history; archaeological surveys, the fragmentary written archive, and accessing local oral history and memory at the site during 2001-2008. Through this research, a narrative emerges. What is learned is that the fight for land, the creation of forced labour, civilian displacement and the horror of Total War are not, as some scholars advocate, a shared experience with the Boer population at the hands of a common enemy, commensurate with mutual suffering or black participation in the war. The experience of civilians inside Dry Harts Forced Labour Camp was fundamentally different to that of the Boers interned in camps. Theirs’ was not so-called black participation, rather it was a standalone experience of land, labour, war and displacement

Traces and memory of African forced labour camps during the South African War (1899-1902)

Abstract: On 11 October 1899 hostilities commenced between the former British Empire and the two Boer republics, namely the South African Republic and Orange Free State Republic. The South African War (1899-1902) was a conflict that saw the targeting of civilians by all sides throughout the conflict and was a harbinger of 20th century Total War, where both civilians and their resources would be harnessed to support military operations. Set against the backdrop of concentration camps in Cuba and the Philippines, it was soon followed by genocidal campaigns by Imperial Germany against the Herero people in German South West Africa in 1906 (Nault, 2012)..