Editorial: Health and conflict transformation
Dear reader,
The phrase ‘days of tranquillity’ may remind us of the past holiday season, maybe of a nice resort or just some days without emails. But quite a few of you will undoubtedly also be familiar with ‘days of tranquillity’ as the practice in quite a number of conflicts over the past decades to negotiate a few days of ceasefire with the various warring factions to allow immunisation of children. The primary goal to negotiate these ceasefires is to promote health, but often there is a more hidden hope that the ceasefire may last beyond the immunisation days and that therefore health may promote peace. Days of tranquillity are often mentioned in discussions around ‘Health as a Bridge for Peace’, a concept based on the notion of health providing neutral space to bring warring parties or different ethnic groups together (1). The various conflicts in Central America in the 80’s and the former Yugoslavia in the 90’s led to elaboration of the concept of Health as a Bridge to Peace and was even formally accepted by the World Health Assembly as a ‘multidimensional policy and planning framework which supports health workers in delivering health programmes in conflict and post-conflict situations and at the same time contributes to peace-building’ (2). By and large, it proved difficult to operationalise the concept and there was the critique that activities may place health in the political, peace-building sphere, thereby politicising health (3).
In more recent conflict we have seen the relation between health and peace being increasingly used by the military, in their efforts to win hearts and minds (4), frequently resented by the NGO community who saw humanitarian space decreasing as a result. Also donor agencies have started to frame provision of health and other basic services more and more in the realm of contributing to enhanced state legitimacy and state-building (5). This has led, for instance, to various ‘3D programmes’, combining defence with diplomacy and development.
But also others, including a range of NGOs, are interested in the notion if their health programmes can fulfil a wider role beyond direct health promotion in contributing to conflict transformation. In particular in those countries, that are ‘in transition’, somewhere in between peace and conflict, with a mix of humanitarian needs, recovery efforts, unstable political and security conditions, and poorly functioning government. After all, conflicts are bad for health, so it would be exciting if strengthening health systems could both stimulate better health outcomes and address root causes that led to the conflict.
Can this be done? Is there any evidence that it works? What are the challenges? How do we measure results? Is it ‘what’ we do or rather ‘how’ we implement activities? Many of these questions are still unanswered and in particular we lack empirical evidence. Does this work ‘on the ground’? With MMI we are therefore organising an expert meeting, 11th October 2012 in Amsterdam, to explore these issues. The meeting will be firmly rooted in experiences from the field and we aim to discuss the value of the different approaches and how we can take this agenda forward.
Egbert Sondorp, Senior Health Advisor, KIT Amsterdam
Co-organiser of the MMI event on “Health systems strengthening
and conflict transformation in fragile states” (see below)
References
- MacQueen G, Santa Barbara J. Mechanisms of Peace through Health. In: Arya N, Santa Barbara J, editors. Peace through Health: How health professionals can work for a less violent world Sterling, VA: Kumarian Press; 2008. p. 30-2.
- http://www.who.int/hac/techguidance/hbp/about/en/
- Sondorp E, Bornemisza O. Health in peace-building: The need to develop guidelines for health professionals, Health Diplomacy Monitor, 2011; Vol 2: issue 2, 2-4
- Bricknell M, Gadd R. Roles for international military medical services in stability operations (reconstruction and development) JR Army Med Corps. 2007;153(3):160-4
- OECD-DAC. Service delivery in fragile situations: key concepts, findings and lessons. Paris: OECD-DAC; 2008.
MMI Network events, Amsterdam, October 2012
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MMI workshop on 10 October 2012
Getting evidence into NGO practice and policy
At this workshop, members of the Medicus Mundi International Network and other NGOs working in the field of international health cooperation will be learning from HealthNet TPO (The Netherlands) and Memisa (Belgium) how they deal with the challenge of getting evidence into their practice. As main programme element of the second part of the meeting, NGOs and representatives of research and teaching institutions discuss the feasibility of a project initiated by the MMI Network to create a “marketplace” for NGOs and young researchers.
- Workshop announcement and programme: download as PDF
- More information: www.bit.ly/mmi-amsterdam2012
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MMI events on 10 October 2012
Assembly highlight: admission of new Network members
The research workshop will be followed by an Extraordinary General Assembly of the MMI Network. The highlight of the Assembly will be the admission of three new Network members. The three membership applications are good news for the Medicus Mundi International Network. The designated new Network members will certainly strengthen the Network and its programs. The Assembly will also discuss Network events in the coming year and hopefully adopt the Network’s budget for the year 2013. After the Assembly, the MMI Board will discuss recent developments, and the day will be closed by a dinner in town.
The candidates:
- medico international, Germany: www.medico.de
- Community Working Group on Health, Zimbabwe: www.cwgh.co.zw
- Health Poverty Action, UK: www.healthpovertyaction.org
Assembly and Board meeting:
- More information and registration form: www.bit.ly/mmi-amsterdam2012
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Expert meeting on 11 October 2012
Health systems strengthening and conflict transformation in fragile states
The objective of this expert meeting organized by the Medicus Mundi International Network together with Cordaid and the Royal Tropical Institute (KIT) is to facilitate learning and information sharing on health sector initiatives that aim to improve health outcomes, contribute to longer term, sustainable health system strengthening and conflict transformation in fragile states, in order to inform programming, policy, advocacy and further research.
- Updated meeting announcement with programme: download as PDF
- Online registration (please register now): http://mmi2012.eventbrite.com
- More information: www.bit.ly/mmi-amsterdam2012
MMI Network: News, events, resources
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Network news: Doctors with Africa Cuamm
Medici con l’Africa. The movie
In August 2012 Carlo Mazzacurati presented “Medici con l’Africa” at the Venice Film Festival, a documentary shot in Mozambique, reporting on the work of volunteers from DWA Cuamm: “This work was produced in a fast, impulsive way, with no strategy either before or during the shootings. My idea was to tell a world that I didn’t know, while I was discovering it, in real time. The film is the story of a group of people who are engaged in bringing health to Africa and about their special way of doing it. I think that the result is a collective portrait, where individuality is fundamental, but where a very strong common spirit exists and makes perseverance and the ability to make sacrifices coexist with sweetness and irony. I’ve been influenced by their particular style and I, too, have tried to make the movie as ‘light’ as possible on a topic as tragic as the health in sub-Saharan Africa.” (Carlo Mazzacurati)
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Network report: Wemos/MMI
WHO is too precious an institution for global health to fail!
“’Health is too big to fail’. With these words the WHO Director General (DG) Margaret Chan addressed the 62nd regional committee meeting on 11th September in Malta. Indeed, the DG was present and outspoken during this meeting of WHO Europe. She indicated with her interventions that she is truly at the helm of the organization, steering it to a renewed leadership position in the dense landscape of global health actors and initiatives.” Remco van de Pas, Wemos, represented the MMI Network at the meeting and reports back.
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Network Event: Medicus Mundi Switzerland
Mother and child health
Basel, 6 November 2012
This year’s Swiss Health Cooperation Symposium organized by the Network Medicus Mundi Switzerland will focus on mother and child health. Announcements are available in German and French only.
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Network event: ACHAP
Increasing burden of non-communicable diseases (NCDs) in Africa:
the challenge of sustainability in scaling up FBOs response
Lusaka, 25-28 February 2013
The Africa Christian Health Associations’ Platform (ACHAP) will hold their 6th Biennial Christian Health Associations Conference on February 25-28, 2013 in Lusaka, Zambia. The conference will be hosted by the Churches Health Association of Zambia (CHAZ) in collaboration with ACHAP Secretariat. The conference will create an opportunity for Christian Health Associations to take stock of their contribution to the non-communicable diseases prevention and management in various countries and discuss opportunities for strengthening capacity, partnerships and health systems for quality, accessible, integrated and sustainable services for NCD prevention and control through the faith based health networks in Africa.
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Network reporting: various MMI members
Annual reports 2011
The following Network members recently published their annual reports:
- The annual report of Medicus Mundi Italia is available in Italian.
- The annual report of AGEH is available in German.
More annual reports of Network members: collection
International Health Policy: MMI updates
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Health systems strengthening
Health services, health financing
Universal health coverage
- Health systems frameworks in their political context: framing divergent agendas. J. van Olmen et al.
http://www.biomedcentral.com/1471-2458/12/774/abstract - Understanding health systems, health economies & globalization: need for social science perspectives. SF Murray et al.
http://www.globalizationandhealth.com/content/8/1/30/abstract - Why differentiating between health system support and health system strengthening is needed. Grace Chee et al. (pdf)
http://onlinelibrary.wiley.com/doi/10.1002/hpm.2122/pdf - Improving data use in decision making: An intervention to strengthen health systems. Tara Nutley, August 2012
http://www.cpc.unc.edu/measure/publications/SR-12-73 - An alternative framework for analyzing financial protection in health. Jennifer Prah Ruger
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001294
- Universal Health Coverage. Lancet themed issue
http://www.thelancet.com/themed-universal-health-coverage - Universal health scare – planned Indian insurance scheme will give a greater role to private players. Varshney et al.
http://www.downtoearth.org.in/content/universal-health-scare - Healthy Mexicans, ill Indians. K. Srinath Reddy
http://www.financialexpress.com/news/column-healthy-mexicans-ill-indians/993929/0 - Health: Global South leads the way towards universal healthcare coverage. IRIN report
http://irinnews.org/Report/96280/HEALTH-Global-South-leads-the-way-towards-universal-healthcare-coverage - The impact of health insurance in Africa and Asia: a systematic review. Ernst Spaan et al.
http://www.who.int/bulletin/volumes/90/9/12-102301/en/index.html
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Human resources for health
- America’s health worker mismatch: It is irrational & immoral to recruit from countries w. critical shortage. K Tulenko
http://www.nytimes.com/2012/09/14/opinion/americas-health-worker-mismatch.html - Task-shifting: experiences and opinions of health workers in Mozambique and Zambia. Paulo Ferrinho et al.
http://www.human-resources-health.com/content/10/1/34/abstract - Experiences of leadership in health care in sub- Saharan Africa. Leslie Curry et al.
http://www.human-resources-health.com/content/10/1/33/abstract - WHO Office for South-East Asia: Critical shortage of trained health workers hampering the delivery of health services
http://www.searo.who.int/LinkFiles/2012_PR_1549.pdf - Action towards achieving a sustainable health workforce: Implementing the WHO Code of Practice in Europe
www.medicusmundi.org/en/contributions/news/2012/action-towards-achieving-a-sustainable-health-workforce-and-strengthening-health-systems - Why health workers count for universal health coverage. Policy briefing, September 2012
http://www.healthworkerscount.org/2012/09/why-health-workers-count-for-universal-health-coverage - Task sharing, not task shifting: Team approach is best bet for HIV. David J. Olson
http://www.capacityplus.org/task-sharing-not-task-shifting
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Access to medicines and vaccination
- Time for governments to shape vision on medical innovation and access to essential medicines. Interview with M-P Kieny
http://www.hip3.org - India’s patent laws under pressure. Peter Roderick and Allyson M Pollock
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961513-X/fulltext
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Women’s and children’s health
- Levels and trends in child mortality. UNICEF, WHO, World Bank, UN Population Division, September 2012
http://www.who.int/maternal_child_adolescent - Committing to Child Survival: A Promise Renewed – Progress Report 2012. Unicef, September 2012
http://www.apromiserenewed.org/383.htm - Women, abortion and the new technical and policy guidance from WHO. Mahmoud F Fathalla and Rebecca J Cook
http://www.who.int/bulletin/volumes/90/9/12-107144/en/index.html - A “how to” guide for improving maternal and newborn health? Gary Darmstadt et al. (Gates Foundation)
http://www.impatientoptimists.org/Posts/2012/08/A-quotHow-Toquot-Guide-For-Improving-Maternal-and-Newborn-Health - Time is ripe for breakthrough on child mortality. M. Tran. With slides: tackling child mortality
http://www.guardian.co.uk/global-development/2012/aug/28/breakthrough-child-mortality-unicef-official - More than mothers: aligning indicators with women’s lives. Stephanie R Psaki and Funmilola OlaOlorun
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960757-5/fulltext
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Equity and human right to health
Social, economic and political determinants of health
- WHO European review of social determinants of health and the health divide
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961228-8/abstract - Why all matters are health matters. Interview with Sir Michael Marmot
http://www2.macleans.ca/2012/08/14/sir-michael-marmot-on-why-all-matters-are-health-matters/ - Where do the World’s poor live? Andy Sumner, Institute of Development Studies, June 2012
http://www.ids.ac.uk/files/dmfile/Wp393.pdf - The air that we breathe: Addressing the risks of global urbanization on health. PLoS Medicine editorial
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001301
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Global health governance and policy
Beyond 2015, MDGs and SDGs
- WHO Reform: “non-Member State stakeholders” (!) consultation on the draft Twelfth General Programme of Work of the WHO
http://www.who.int/about/who_reform/stakeholder_consultation/en/ - The draft of the 12th WHO general programme of work contains a strong analysis of the current global health agenda
http://www.euro.who.int/__data/assets/pdf_file/0010/170758/RC62wd17-Eng.pdf - Governance for health in the 21st century. Ilona Kickbusch and David Gleicher, WHO Europe 2012
http://www.euro.who.int/en/what-we-publish/abstracts/governance-for-health-in-the-21st-century - The global health regime. Issue brief on global health challenges & lack of coherence. US Council on Foreign Relations
http://www.cfr.org/health-science-and-technology/global-health-regime/p22763 - Global advocacy in an era of resource constraints and shifting global priorities. Eduard Grebe
http://bit.ly/S4FGpz - Future Global Priorities or Beyond 2015. Gorik Ooms at AIDS 2012 conference
http://www.globalhealthobserver.org/2012/gorik-ooms-future-global-priorities-2015/ - Health at the Rio+20 negotiations. Sudhvir Singh et al.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961538-4/fulltext - Why non-communicable diseases must be part of any new development goals. Johanna Ralston and Ann Keeling
http://www.guardian.co.uk/global-development/poverty-matters/2012/sep/11/non-communicable-diseases-development-goals - What have the MDGs achieved? We don’t really know… Heretical thoughts from Matthew Lockwood
http://www.oxfamblogs.org/fp2p/?p=11498 - One world, one health: beyond the Millennium Development Goals. Ben Marais et al.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961450-0/fulltext - Incorporating the principles of a Framework Convention on Global Health (FCGH) into the post-2015 development goals
http://www.jalihealth.org/documents/FCGHandpost-2015incorporation8-13-12.pdf - Post-2015 health Millennium Development Goals. Research reports and studies. Julian Schweitzer et al., ODI, July 2012
http://www.odi.org.uk/resources/details.asp?id=6444&title=millennium-development-goals-mdgs-health-post2015
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NGO debate
- Impact evaluations everywhere: What’s a small NGO to do? William Savedoff
http://blogs.cgdev.org/globaldevelopment/2012/09/impact-evaluations-everywhere-whats-a-small-ngo-to-do.php - Global health initiatives, civil society, NGOs and the evolution of accountability. INCO-GHIs consortium at PHA3
http://www.globalhealthobserver.org/2012/ghis-cso-ngos-evolution-accountability/
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