17 research outputs found
Development of an Evaluation Framework Suitable for Assessing Humanitarian Workforce Competencies During Crisis Simulation Exercises
The need to provide a professionalization process for the humanitarian workforce is well established. Current competency-based curricula provided by existing academically affiliated training centers in North America, the United Kingdom, and the European Union provide a route toward certification. Simulation exercises followed by timely evaluation is one way to mimic the field deployment process, test knowledge of core competences, and ensure that a competent workforce can manage the inevitable emergencies and crises they will face. Through a 2011 field-based exercise that simulated a humanitarian crisis, delivered under the auspices of the World Health Organization (WHO), a competency-based framework and evaluation tool is demonstrated as a model for future training and evaluation of humanitarian providers. CranmerH, ChanJ, KaydenS, MusaniA, GasquetP, WalkerP, BurkleF, JohnsonK. Development of an evaluation framework suitable for assessing humanitarian workforce competencies during crisis simulation exercises. Prehosp Disaster Med. 2014;29(1):1-
Emergency care in 59 low- and middle-income countries: a systematic review
Abstract Objective: To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). Methods: We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards. Findings: We identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000 per year (IQR: 10 296–60 000), most of whom were young (median age: 35 years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. Conclusion: Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings
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Responding to chemical weapons violations in Syria: legal, health, and humanitarian recommendations
Abstract Background The repeated use of prohibited chemical weapons in the Syrian conflict poses serious health, humanitarian, and security threats to civilians, healthcare personnel, and first responders. Moreover, the use of chemical weapons constitutes a clear and egregious violation of international law—likely amounting to a war crime—for which continued impunity is setting a dangerous precedent in relation to current and future conflicts. This debate article calls upon concerned states, organizations, and individuals to respond urgently and unequivocally to this serious breach of international legal and humanitarian norms. Main Body Based on health, humanitarian, and legal findings, this article calls for concrete action to: 1) reduce the risk of chemical weapons being used in current and future conflicts; 2) review and support the preparedness equipment and antidote supplies of first responders, humanitarian organizations, and military forces operating in Syria; 3) support international mechanisms for monitoring and enforcing the prohibition on chemical weapons, including through criminal accountability; 4) support civilian victims of chemical weapons attacks, including refugees; and 5) re-commit to the complete elimination of chemical weapons in compliance with the Chemical Weapons Convention (1993), a comprehensive treaty that bans chemical weapons and requires their complete destruction. Conclusion All involved states and organizations should take urgent steps to ensure the protection of the most vulnerable victims of conflict, including victims of chemical weapons attacks in Syria, and to reinforce international law in the face of such serious violations
Attacks on Hospitals and Healthcare Workers in Syria:A Cry for International Health Neutrality
When the powerless lose interest in leading: Generalized sense of power predicts changes in the desire to lead
An immersive field-based simulation was used to examine how feeling powerless may erode one’s desire to lead. We studied current and prospective humanitarian aid professionals during a major field training exercise (a three-day simulated humanitarian crisis). Those with a lower generalized sense of power in their everyday lives (a) had higher levels of the stress hormone cortisol during the first night of the simulated crisis, (b) reported less assertiveness during the simulated crisis, and (c) left the simulated crisis with a relatively diminished desire to lead, despite not being deemed worse leaders by their teammates. In short, for those who felt they lacked power in their everyday lives, merely participating in the simulated crisis was sufficient to further undermine their desire to lead. These results suggest that feelings of power are a key leadership resource, without which one may be vulnerable to self-selection out of leadership.<p/
The generalized sense of power is a psychological resource: Evidence from a disaster response field training exercise
We examined whether the generalized sense of power—the belief that one is able to influence others in one's various social relationships—serves as a psychological resource that enables leadership in high-stakes, unfamiliar group challenges, such as emergencies or crises. We studied current and prospective humanitarian aid professionals (N = 180) during a major field training exercise: a three-day, immersive simulated humanitarian crisis. Individuals who entered the simulated crisis with a greater sense of power in their social relationships experienced lower stress (anxiety), behaved more assertively, and left the simulation with a relatively heightened desire to lead, despite not being deemed better leaders by their teammates. Lacking an initial sense of power was associated with experiences (e.g., feeling timid) that undermined the desire to lead. These results suggest that the psychological sense of power is a key leadership resource, without which one may be at risk of self-selecting out of leadership.</p