Recognizing the Public Health Impact of Genocide

Willis, Brian; Levy, Barry S.

doi:10.1001/jama.284.5.612

Cited by 12 publications

(8 citation statements)

References 14 publications

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“…The second is the most frequently advocated approach and calls for surveillance of sociopolitical risk factors (“Early Warning”), triggering intercession by the world community when genocide seems imminent (“Prevention”) (American Public Health Association 2001; Gellert 1995; Willis and Levy 2000). In a comparative disease‐prevention model, this approach could be considered as analogous to the emergency treatment of ischemic heart disease, where crescendo angina (“Early Warning”) is treated with thrombolysis (“Prevention”).…”

Section: Discussionmentioning

confidence: 99%

To Prevent, React, and Rebuild: Health Research and the Prevention of Genocide

Adler¹,

Smith²,

Fishman³

et al. 2004

Health Services Research

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Objective. To develop an approach to the primary prevention of genocide, based on established public health-based violence prevention methods derived from a variety of high-risk settings. Data Sources.(1) Peer-reviewed literature in the fields of public health, violence/ injury prevention, medicine, economics, sociology, psychology, history, and genocide studies, (2) demographic and health data bases made available by governments and international organizations, (3) reports on recent episodes of genocide published by international and nongovernmental organizations, (4) newspaper and journalistic accounts of recent and past genocides, (5) archival testimonies of genocide victims and perpetrators, and (6) court transcripts of international genocide prosecutions. Study Design. The research was conducted as a medical-historical policy analysis synthesizing data within the following framework: (1) Assessment of current violence and injury prevention models for suitability in the prevention of extreme, populationwide violence, (2) analysis of morbidity and mortality data to quantify the impact of genocide on the health of populations, (3) making an inventory of the known societal risk factors for genocidal violence, (4) identification of the theorized, modifiable attitudinal risk factors for genocidal behavior within a population health model, and (5) assessment of existing projects targeting primary violence and injury prevention in high risk jurisdictions, for future adaptation within a structured, public health approach. Principal Findings. Mortality rates due to genocidal violence are far in excess of other public health emergencies including malaria and HIV/AIDS. The immediate and longrange health consequences of genocide include the sequelae of infectious diseases, organ system failure, and psychiatric disorders, conferring an increased burden of disease on affected populations for multiple subsequent generations. The impact of genocide on local health economies is catastrophic, and the opportunity costs of diverting scarce global health dollars toward ameliorating genocide related outcomes are substantial. Structural risk factors for genocide within societies include: totalitarian government, exclusionary ideologies, armed conflict, economic hardship, and inaction of bystander nations. Proposed psychological risk factors for genocidal behavior include: moral exclusion, authority orientation, action in self-interest, desensitization, and compartmentalized thinking. Violence and injury prevention models, incorporating what is currently known about the societal and behavioral risk factors for genocide in high-risk populations, may be modified to address the primary prevention of catastrophic violence on a population-wide scale. A number of existent global peace building 2027 initiatives may serve as models for the design of future prevention initiatives in high-risk, pre-genocide jurisdictions. Conclusions. Our analysis suggests that genocide is one of the most pressing threats to the health of populations in the ...

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Section: Discussionmentioning

confidence: 99%

To Prevent, React, and Rebuild: Health Research and the Prevention of Genocide

Adler¹,

Smith²,

Fishman³

et al. 2004

Health Services Research

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“…Systematic rape during the genocide served as a vector for HIV transmission [22]. The exodus of Rwandans into refugee camps in the Democratic Republic of the Congo without adequate food, water, and sanitation gave rise to epidemics of infectious disease (such as cholera) that resulted in a crude mortality rate of 20 to 35 per 10,000 people each day [23]. Increased incidences of both malaria and tuberculosis have lasted far beyond the formal end of the genocide [24].…”

Section: Structural Violence and Riskmentioning

confidence: 99%

Poverty, Global Health, and Infectious Disease: Lessons from Haiti and Rwanda

Alsan

Westerhaus

Herce

et al. 2011

Infectious Disease Clinics of North America

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Poverty and infectious diseases interact in complex ways. Casting destitution as intractable, or epidemics that afflict the poor as accidental, erroneously exonerates us from responsibility for caring for those most in need. Adequately addressing communicable diseases requires a biosocial appreciation of the structural forces that shape disease patterns. Most health interventions in resource-poor settings could garner support based on cost/benefit ratios with appropriately lengthy time horizons to capture the return on health investments and an adequate accounting of externalities; however, such a calculus masks the suffering of inaction and risks eroding the most powerful incentive to act: redressing inequality.

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“…Acts of genocide are humanitarian emergencies and, human rights and health are inseparable. [2][3][4] The health outcomes of genocide extend beyond the devastating impact of the crude mortality rate. Genocide often causes shortages of food, water and shelter along with poor sanitation and living conditions.…”

Section: Introductionmentioning

confidence: 99%

“…This results in long-term health sequelae which include infectious diseases and malnutrition. 2,5,6 It is important to realise that health professionals can have a role in the prevention and mitigation of genocide. 7,8 Genocide prevention is currently not listed as a core learning outcome in the UK undergraduate medical curriculum 9 and is covered rarely within the undergraduate medical course.…”

Section: Introductionmentioning

confidence: 99%

Developing and evaluating an e-learning package for medical students on genocide and public health

et al. 2013

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Objective: This paper describes the development and evaluation of an e-learning package on the topic of genocide and public health aimed at undergraduate medical students. Methods: An e-learning package was designed based on pedagogical principles and was evaluated in a sample of second-year medical students. Students were asked to rate the usability of the e-learning package (design, interactivity, pace, suitability as a learning mode for the topic). The effectiveness of the e-learning package in relation to achieving learning outcomes was tested via baseline and postlearning activity questionnaires. Results: Out of 253 second-year medical students, 96(38%) participated in the evaluation of which 45% gave a score of 9 out of 10 for the e-learning package design, 97% preferred it as a learning mode over traditional lecture based teaching and 95% agreed that the package increased understanding of the topic. Immediately following the learning activity 93.75% of second-years agreed that genocide was a public health issue as opposed to 23.96% at baseline. 96% agreed that health professionals had a role in genocide prevention but only 32% agreed that they had a personal role in genocide prevention. Conclusions:The evaluation of the e-learning package suggested that learners found it well-designed and a preferred learning mode as compared to traditional lecture based teaching. There was some evidence of positive changes in knowledge and attitudes relating to genocide prevention and the role of public health immediately following the learning activity.

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Recognizing the Public Health Impact of Genocide

Cited by 12 publications

References 14 publications

To Prevent, React, and Rebuild: Health Research and the Prevention of Genocide

To Prevent, React, and Rebuild: Health Research and the Prevention of Genocide

Poverty, Global Health, and Infectious Disease: Lessons from Haiti and Rwanda

Developing and evaluating an e-learning package for medical students on genocide and public health

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