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PubMedDate not supplied

Motivations, concerns, and expectations of Scandinavian health professionals volunteering for humanitarian assignments.

International nongovernmental organizations (NGOs) involved in humanitarian assistance employ millions of volunteers. One of the major challenges for the organizations is the high turnover rate among their personnel. Another is recruiting the right persons. As part of a series of studies investigating factors that affect the recruitment process and the success of assignment, this qualitative study examined health professionals' motivations for volunteering, their various concerns, and their expectations about themselves and the organizations for which they would work. The findings from focus group interviews with potential humanitarian volunteers were considered within the framework of Hertzberg's theory of motivations and Maslow's hierarchy of needs. The study has significant implications for personnel policy and practice in the humanitarian sector. Recruitment officers should have the self-actualized person, as described by Maslow, in mind when interviewing candidates. This perspective would make it easier for them to understand the candidates' thoughts and concerns and would lead to more effective interventions. Program officers should have satisfiers and dissatisfiers, as identified by Herzberg, in mind when planning programs. The probability that personnel will leave humanitarian work is lower if they perceive working conditions as good.

Adult↗
PubMedDate not supplied

Refugee women's health: collaborative inquiry with refugee women in Rwanda.

A collaborative capacity building experience in a Rwandan refugee camp with refugee women from the Democratic Republic of Congo (DRC) is described in this article. In service to the American Refugee Committee, I taught 13 refugee women how to plan and facilitate focus group sessions with the larger community of refugee women. The facilitators then conducted 18 focus group sessions gathering data from 100 refugee women. Thematic results included the health implications of poverty, the struggle to survive, the overburden of daily work, ambivalence about family planning, and the lack of freedom to express themselves.

Adult↗
PubMed2002

[Conclusion: challenges and stakes in humanitarian action in the XXIth century].

The authors in the special issue devoted to humanitarian action use their own experience, analysis, and thought as a basis for identifying the challenges and stakes facing humanitarian action in the twenty-first century. They present their thoughts on the relevance of humanitarian intervention, on the need to combine emergency aid with development assistance, and on the development of governmental humanitarian action. In today's world there is a compelling obligation for communities with resources and means to undertake humanitarian action in the name of human dignity. Adopting a code of conduct, respecting minimal standards, and evaluating the outcome are now universally accepted principles, but the modalities of applying these principles are still subject to discussion especially with regard to standards and accreditation. The importance of adequate training and preparation for humanitarian action has also been established. Currently most humanitarian operations involve numerous actors from different organizations that may be national or international as well as governmental, intergovernmental, or non-governmental. A major portion of this issue is devoted to the relationship between military forces and humanitarian organizations. The need to coordinate action in the field is emphasized. Humanitarian actions are increasingly complex operations carried out in fast-changing situations by numerous players. As a result it has become more and more important that actors in the field know each other in order to work together efficiently and thus better reach their common goal of relieving and preventing human suffering in accordance with ethical principles.

Altruism↗
PubMed1999

Humanitarianism, pluralism and ombudsmen: do the pieces fit?

A variety of codes and standards for humanitarian assistance have been put forth in recent years. Many NGOs have agreed to abide by these codes. There is uncertainty, however, about if and how these codes are actually being put into practice. Have we moved from words to action? One response to this concern has been a proposal to establish a humanitarian ombudsman. This paper analyses two choices facing an eventual ombudsman: whether to attempt to take punitive actions to enforce the codes and standards, or whether instead to facilitate agencies' own internal efforts to improve accountability to their beneficiaries. It proposes a pluralistic approach, wherein a variety of methods, structures and local perceptions are accepted as potentially appropriate, but where a clear moral stance is still maintained. Some suggestions are outlined for how flexible forms of policy analysis may be used to combine an acceptance of the validity of a vast range of humanitarian actions while still retaining a strong stance against practices that may harm beneficiaries or feed the causes of conflict. Realism about each agency's room for manoeuvre is essential, especially local institutions. A modest but principled stance will involve helping actors to consider the impact of their work on conflict and to find ways to improve the quality of their interventions as perceived by beneficiaries.

Altruism↗
PubMed2004

Birthing Sphere.

This paper tells the story of the initiation and first year of Sphere. It traces the history of how the project was started and its relationship to other major events of that time, principally the multi-donor Rwanda evaluation. The paper describes how the basic structure of the Sphere standards was agreed upon and discusses why some sectors were eventually left out of the standards. Tensions and public disagreements between the agencies that created Sphere are discussed, along with the manner in which the chosen working processes contributed to the successful publication of the Sphere standards. We show how the process of policy formulation, which led up to the publication of the first edition of the Sphere standards, was as dependent upon the ability of the project team to work opportunistically as it was upon the application of agency principles. Finally the paper reflects upon the success of Sphere and lessons that can be learned from this early Sphere process.

Altruism↗
PubMedDate not supplied

A nurse's experience on a disaster-preparedness team.

Taking steps to coordinate international, regional and national efforts to minimize damages caused by natural disasters, the United Nations has declared the 1990s the International Decade for Natural Disaster Reduction. To make nurses aware of how they can join these efforts, INR has dedicated this special issue on the subject, an issue that would not be complete without a description of the invaluable work contributed by Marie Farrell and other members of the EURO disaster-preparedness team who are often the first persons on the scene after a disaster in the European Region.

Disaster Planning↗
PubMedDate not supplied

IMERT deployment to Baton Rouge, Louisiana in response to Hurricane Katrina, September 2005.

An Illinois volunteer emergency response team was deployed to assist in the disaster care efforts following Hurricane Katrina. The team joined local care providers to establish a field hospital on the campus of Louisiana State University in Baton Rouge, Louisiana. The team worked to support local providers, establish order, and assist more than 3000 evacuees. The challenges and lessons learned from this deployment are identified.

Disaster Planning↗
PubMedDate not supplied

After Hurricane Floyd passed: investigating the social determinants of disaster preparedness and recovery.

In September 1999, Hurricane Floyd struck eastern North Carolina. Investigators from the health promotion study "Health Works for Women/Health Works in the Community" responded by initiating a focused research study, "Health Works After the Flood." Participatory research involving a multilevel design and qualitative methods was applied to investigate how community preparedness, response, and recovery are affected by social factors such as social capital, social cohesion, and collective efficacy. This article presents evidence from qualitative research conducted for "Health Works After the Flood" and links these findings to observations regarding current conceptualizations of social capital and related concepts.

Community Networks↗
PubMed1996

Social contract and deterring famine: first thoughts.

The links between certain kinds of political systems and protection against famine are investigated in this paper. The starting-point is a critique of Amartya Sen's observation that famines are unknown in countries with a free press and competitive elections. This holds true only in India because of a unique political history in which freedom from famine became a right, upon which political legitimacy was founded: an anti-famine 'social contract'. The rise and decline of anti-famine systems in Africa is charted. Major reasons for decay include neo-liberalism and the international humanitarian system, both of which undermine relationships of domestic political accountability that underpin effective famine prevention. A number of politically regressive tendencies in 'actually existing humanitarianism' are identified that work against any nascent anti-famine social contracts in Africa. This is possible because famine prevention has not been established as a right in Africa.

Africa↗
PubMedDate not supplied

Cruse control.

Linda Cruse has been nominated as Good Housekeeping magazine's Inspirational Woman the Year. Working in remote parts of Asia, she uses all her nursing experience to help 'forgotten' communities and to make a difference.

Attitude of Health Personnel↗
PubMedDate not supplied

Emergency medical services in the reconstruction phase following a major earthquake: a case study of the 1988 Armenia earthquake.

STUDY OBJECTIVE: To use the clinical activities of an ambulance service as a tool to assess the residual and unmet medical needs of a city in the aftermath of a major earthquake and to apply that assessment to the development of a training curriculum for the prehospital personnel. METHODS: The researchers conducted structured interviews with health care workers at all levels of the emergency health care delivery system in Gyumrii, Armenia, and carried out a retrospective frequency analysis of 29,010 ambulance runs for an 11-month period from February through December 1992. Runs first were assigned into the broad categories of: 1) Adult Medical; 2) Pediatric Medical; or 3) Trauma, and then, according to diagnosis. The runs then were classified further as: 1) Primary Care; 2) Basic Life Support (BLS); or 3) Advanced Life Support (ALS). RESULTS: Adult Medical calls represented 24,684 (85%), Pediatric Medical calls 459 (1.6%), and Trauma calls 3,867 (13%). Only 12% of all ambulance calls resulted in transport to a medical facility, although this percentage was higher in children. Thirty percent of Adult Medical patients were diagnosed by the emergency medical providers as having exclusively a psychiatric problem. CONCLUSION: In the late aftermath of a devastating earthquake, the ambulance service in Gyumrii, Armenia has been delivering a substantial proportion of non-emergency, primary care services. They have adopted this unconventional role to compensate for the deficit in health care facilities and personnel created by the disaster. The training program that the investigators developed reflected the actual work activities of the prehospital personnel demonstrated in their assessment.

Adult↗
PubMed1997

[Experiences as a surgeon in a mobile hospital of the German Red Cross--German Referral Hospital/Benaco (Tanzania)].

The German Red Cross Society participated in the international aid activities for the refugees of Ruanda. Among other duties the German Red Cross became responsible for the medical care of the refugee camp population of Benaco, Tanzania. From 1994 until 1997 the German Red Cross used its so-called Module Hospital. This is a transportable hospital, which can be installed within a few days. The technical facilities of this hospital are well adapted to the conditions of medical work in developing countries. The authors, who are surgeons, report about their experiences in this sort of emergency surgery.

Developing Countries↗
PubMed2002

Disasters, psychiatry, and psychodynamics.

The unique experience of Disaster Psychiatry Outreach, a voluntary organization devoted to providing psychiatric assistance to people affected by disasters, provides a valuable substrate for exploring the role of psychodynamics in the human experience of disaster and trauma. This article offers a theoretical framework for such an experience that takes into account personal meaning, ego psychology and defenses, and grief work and suggests how to employ this framework in the setting of a disaster by way of examples from the events of Sept. 11. A useful clinical construct for future disaster work known as the "trauma tent" is ultimately proposed, as are novel applications of psychodynamics toward the prevention and mitigation of manmade and natural disasters.

Community-Institutional Relations↗
PubMedDate not supplied

Faculty workload assessment: a case study.

BACKGROUND: Because of the increasing work demands posed by the new supervisory requirements of IL 372, coupled with budget constraints resulting from decreasing external grant funding and shrinking practice revenues, departments must weigh workplace needs against faculty resources. Following a period of faculty shortage, the Department of Family Medicine at East Carolina University expected to achieve balance in staffing its department's clinical services, teaching obligations, and scholarly activities once additional faculty were hired. While relief from work obligations was noted once new hires were in place, there remained inadequate faculty to meet all the identified demands of the department. METHODS: To deal with this dilemma, a new approach was created to assess workforce availability and workload demands. Instead of assuming faculty availability based on an average daily or monthly schedule, an actual assessment of faculty availability and workload demands was performed. The method calculated the actual availability and work demands using weeks per year as the unit of measure, i.e., I half day per week of precepting requires 5.2 faculty weeks per year, and an average full-time faculty member is available 45 work weeks per year when vacation, national holidays, and departmental/educational leave time is accounted for. By calculating total weeks of departmental work demands and comparing to faculty availability, a true number of faculty members needed by a department can be accurately determined. RESULTS: During the period in question at East Carolina University, a comparison of work demands and faculty availability revealed that the department needed 2.8 additional faculty to cover the existing work requirements. If time were provided for leadership/management, research, and other administrative activities, then the actual need was for 8.25 additional faculty members. CONCLUSIONS: To meet the increasing time demands on faculty in academic medical centers, departments need to have an accurate accounting of both workforce availability and work demands. The faculty workload assessment model described in this report can be used to generate such an accounting.

Curriculum↗
PubMed1994

The impact of disaster support work.

Limited available evidence suggests that disaster support work may have negative effects. This study attempts to examine the impact of disaster-related stress on helpers offering psychological support to victims of two major disasters, and to identify potential moderating factors. Sixty-seven social workers were surveyed, measures being taken of psychological symptomatology and wellbeing, personality variables, social support, life events, and various aspects of disaster support work. Comparison with normative data suggested that subjects were experiencing significant levels of stress. Two major sources of disaster-related stress were identified: role-related difficulties and contact with clients' distress. Approximately one third of the variance in helper response could be explained by variables reflecting coping style, prior life events and the aforementioned aspects of disaster support work. Follow-up data at 12 months demonstrated persisting high levels of stress.

Adaptation, Psychological↗
PubMed1994

From dialysis to basic paediatric nephrology: an unorthodox project applied in Yerevan, Armenia.

Following the earthquake in December 1988, a long-term project was developed: starting from haemodialysis, it was extended to basic nephrology and urology, with a programme for schooling and psychosocial care. Medical training had first priority. The programme relied on robust and often second-hand equipment and voluntary work. The approach chosen (an inverse help programme, from sophisticated to basic medicine) strongly stimulated motivation and proved to be practicable.

Adolescent↗
PubMed1999

Trauma and reconstruction in a large group of refugees.

The study is a continuation of a research which the expert team started in refugee and displaced persons' settlements in Croatia. By studying a group of refugees in its entirety we could not avoid noticing its extremely regressive position. Faced with the refugees' numerous existential problems we took the role of good, caring and tender mother (a good object) who will protect her children, give them security, meet their essential needs. Looking at the group dynamics, in the light of Melanie Klein's theory, we noticed the existence of schizo-paranoid and depressive position in the group, manifesting itself through the gap occuring as defense from its self-destructiveness, i.e. as the protection of introjected object which has be saved from destruction because the true "good object" was destroyed. Through the analysis of schizo-paranoid and depressive position of large group of refugees the aim of our work was to enable the group to gradually overcome the schizo-paranoid position and transfer into a more mature phase of development, thus creating a favorable atmosphere for maturation and self-protection.

Adaptation, Psychological↗