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Oxford Handbook of Humanitarian Medicine

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Oxford Handbook of Humanitarian Medicine

Edited by

Amy S. Kravitz

Medical

Officer, United

States Agency for International Development (USAID), Washington, DC, USA

Associate Editor

Alexander van Tulleken Institute of International Humanitarian Affairs, USA

Oxford Handbook of Humanitarian Medicine

Published and forthcoming Oxford Handbooks

Oxford Handbook for the Foundation Programme 5e

Oxford Handbook of Acute Medicine 3e

Oxford Handbook of Anaesthesia 4e

Oxford Handbook of Cardiology 2e

Oxford Handbook of Clinical and Healthcare Research

Oxford Handbook of Clinical and Laboratory Investigation 4e

Oxford Handbook of Clinical Dentistry 6e

Oxford Handbook of Clinical Diagnosis 3e

Oxford Handbook of Clinical Examination and Practical Skills 2e

Oxford Handbook of Clinical Haematology 4e

Oxford Handbook of Clinical Immunology and Allergy 3e

Oxford Handbook of Clinical Medicine – Mini Edition 9e

Oxford Handbook of Clinical Medicine 10e

Oxford Handbook of Clinical Pathology

Oxford Handbook of Clinical Pharmacy 3e

Oxford Handbook of Clinical Specialties 10e

Oxford Handbook of Clinical Surgery 4e

Oxford Handbook of Complementary Medicine

Oxford Handbook of Critical Care 3e

Oxford Handbook of Dental Patient Care

Oxford Handbook of Dialysis 4e

Oxford Handbook of Emergency Medicine 4e

Oxford Handbook of Endocrinology and Diabetes 3e

Oxford Handbook of ENT and Head and Neck Surgery 2e

Oxford Handbook of Epidemiology for Clinicians

Oxford Handbook of Expedition and Wilderness Medicine 2e

Oxford Handbook of Forensic Medicine

Oxford Handbook of Gastroenterology & Hepatology 2e

Oxford Handbook of General Practice 4e

Oxford Handbook of Genetics

Oxford Handbook of Genitourinary Medicine, HIV, and Sexual Health 2e

Oxford Handbook of Geriatric Medicine 3e

Oxford Handbook of Infectious Diseases and Microbiology 2e

Oxford Handbook of Integrated Dental Biosciences 2e

Oxford Handbook of Humanitarian Medicine

Oxford Handbook of Key Clinical Evidence 2e

Oxford Handbook of Medical Dermatology 2e

Oxford Handbook of Medical Imaging

Oxford Handbook of Medical Sciences 2e

Oxford Handbook for Medical School

Oxford Handbook of Medical Statistics

Oxford Handbook of Neonatology 2e

Oxford Handbook of Nephrology and Hypertension 2e

Oxford Handbook of Neurology 2e

Oxford Handbook of Nutrition and Dietetics 2e

Oxford Handbook of Obstetrics and Gynaecology 3e

Oxford Handbook of Occupational Health 2e

Oxford Handbook of Oncology 3e

Oxford Handbook of Operative Surgery 3e

Oxford Handbook of Ophthalmology 4e

Oxford Handbook of Oral and Maxillofacial Surgery 2e

Oxford Handbook of Orthopaedics and Trauma

Oxford Handbook of Paediatrics 2e

Oxford Handbook of Pain Management

Oxford Handbook of Palliative Care 3e

Oxford Handbook of Practical Drug Therapy 2e

Oxford Handbook of Pre-Hospital Care

Oxford Handbook of Psychiatry 3e

Oxford Handbook of Public Health Practice 3e

Oxford Handbook of Rehabilitation Medicine 3e

Oxford Handbook of Reproductive Medicine & Family Planning 2e

Oxford Handbook of Respiratory Medicine 3e

Oxford Handbook of Rheumatology 4e

Oxford Handbook of Sport and Exercise Medicine 2e

Handbook of Surgical Consent

Oxford Handbook of Tropical Medicine 4e

Oxford Handbook of Urology 4e

Oxford Handbook of Humanitarian Medicine

Edited by

Amy S. Kravitz

Medical

Officer, United

States Agency for International Development (USAID), Washington, DC, USA

Associate Editor

Alexander van Tulleken Institute of International Humanitarian Affairs, USA

1

Great Clarendon Street, Oxford, OX2 6DP, United Kingdom

Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries

© Oxford University Press 2019

The moral rights of the authors have been asserted

Impression: 1

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above

You must not circulate this work in any other form and you must impose this same condition on any acquirer

Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America

British Library Cataloguing in Publication Data

Data available

Library of Congress Control Number: 2018949667

ISBN 978–0–19–956527–6

Printed and bound in China by C&C Offset Printing Co., Ltd.

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breast-feeding

Links to third party websites are provided by Oxford in good faith and for information only. Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work.

Foreword

Now seen as a branch of clinical practice which deals collectively with human misfortunes that affect health beyond the individual, Humanitarian Medicine embraces the predicaments of groups of people with shared experiences in facing calamities: calamities that are either immediately apparent—or waiting to strike.

Despite intense media exposure and ostensible political support by disinterested parties, in truth many campaigns in Humanitarian Medicine have proved social misfits lacking loyal and authoritative parents; judged retrospectively as they must be, their effects signal bitter political failure.

With the Oxford Handbook of Humanitarian Medicine, Dr Amy Kravitz and her contributors have authored a unique and original guide: not simply to the practical relief of critical and fast-emerging ‘ground’ emergencies with plague, pestilences, starvation, torture and war-related human disasters of every possible kind, but to essential strategic measures. The authors succinctly explore the need to predict, to resource, as well as develop tailormade advocacy for political and economic solutions to the unique conflation of forces that can drive populations ineluctably to doom.

This handbook goes beyond simple therapy; it seeks to promote, provide, and instruct. Within the ethical framework of conventional medicine, it offers support those who holistically improve well-being and health of populations while conforming to the Charter of the United Nations, the Universal Declaration of Human Rights, the Red Cross and Crescent Conventions, and other accepted canons of practice. Naturally there is a complex political dimension in this field; and the practitioner of Humanitarian Medicine must at all costs operate systematically with discretion to avoid neo-colonial dominance and dependence at all costs. At the same time, there is really no place for the ‘parachute mentality’ related to theatrical international emergencies apparently promulgated in global media. Usually local conditions of healthcare are fractured and, after military intervention and colonization, wayward and permanently starved of resources. Not only is diplomacy and sharing of resources and responsibility between multiple agencies crucial; but the need for ethical refinement and disinterested investment, is paramount.

After the immediate crisis has resolved, resources for sustaining parachute missions quickly recede and many humanitarian workers withdraw from the penumbra of conflict. In this first-edition of the wide-ranging Oxford Handbook, Dr Kravitz and her glittering team of experienced coauthors and practitioners show not only how to move to the best standards of care but to settle realistically for what can be sustainably offered for the public health of the entire residual population. This extraordinary book

1

Great Clarendon Street, Oxford, OX2 6DP, United Kingdom

Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries

© Oxford University Press 2019

The moral rights of the authors have been asserted

Impression: 1

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above

You must not circulate this work in any other form and you must impose this same condition on any acquirer

Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America

British Library Cataloguing in Publication Data

Data available

Library of Congress Control Number: 2018949667

ISBN 978–0–19–956527–6

Printed and bound in China by C&C Offset Printing Co., Ltd.

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breast-feeding

Links to third party websites are provided by Oxford in good faith and for information only. Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work.

Foreword

Now seen as a branch of clinical practice which deals collectively with human misfortunes that affect health beyond the individual, Humanitarian Medicine embraces the predicaments of groups of people with shared experiences in facing calamities: calamities that are either immediately apparent—or waiting to strike.

Despite intense media exposure and ostensible political support by disinterested parties, in truth many campaigns in Humanitarian Medicine have proved social misfits lacking loyal and authoritative parents; judged retrospectively as they must be, their effects signal bitter political failure.

With the Oxford Handbook of Humanitarian Medicine, Dr Amy Kravitz and her contributors have authored a unique and original guide: not simply to the practical relief of critical and fast-emerging ‘ground’ emergencies with plague, pestilences, starvation, torture and war-related human disasters of every possible kind, but to essential strategic measures. The authors succinctly explore the need to predict, to resource, as well as develop tailormade advocacy for political and economic solutions to the unique conflation of forces that can drive populations ineluctably to doom.

This handbook goes beyond simple therapy; it seeks to promote, provide, and instruct. Within the ethical framework of conventional medicine, it offers support those who holistically improve well-being and health of populations while conforming to the Charter of the United Nations, the Universal Declaration of Human Rights, the Red Cross and Crescent Conventions, and other accepted canons of practice. Naturally there is a complex political dimension in this field; and the practitioner of Humanitarian Medicine must at all costs operate systematically with discretion to avoid neo-colonial dominance and dependence at all costs. At the same time, there is really no place for the ‘parachute mentality’ related to theatrical international emergencies apparently promulgated in global media. Usually local conditions of healthcare are fractured and, after military intervention and colonization, wayward and permanently starved of resources. Not only is diplomacy and sharing of resources and responsibility between multiple agencies crucial; but the need for ethical refinement and disinterested investment, is paramount.

After the immediate crisis has resolved, resources for sustaining parachute missions quickly recede and many humanitarian workers withdraw from the penumbra of conflict. In this first-edition of the wide-ranging Oxford Handbook, Dr Kravitz and her glittering team of experienced coauthors and practitioners show not only how to move to the best standards of care but to settle realistically for what can be sustainably offered for the public health of the entire residual population. This extraordinary book

has much to offer directly for those who wish to learn and engage with the innumerable complexities of Humanitarian Medicine: its weight lies in its focused but comprehensive treatment and the profound vision needed strategically to resolve every human disaster.

Timothy M. Cox Professor of Medicine Emeritus Director of Research Honorary Consultant Physician

Addenbrooke’s

Hospital, Cambridge

Preface

Welcome to the first edition of the Oxford Handbook of Humanitarian Medicine (OHHM).

This book was conceived as a way to share the accumulated experiences and wisdom of the most experienced humanitarian practitioners from across disciplines. It includes clinical guidance aimed at conflict, displacement, and low-resource settings, by authors who have first-hand experience. OHHM goes beyond the clinical domain, however, to include detailed information on important socioeconomic and political drivers, as well as the voices of allied disciplines such as logistics, epidemiology, law, and security.

Humanitarian medicine is, by nature, variable and nuanced. There can be no guide to definitively tell a reader exactly what to do in complicated situations of conflict or natural disaster, especially where additional socioeconomic and political intricacies are often present. It is our hope, however, that this book helps to provide the framework and guidance necessary for the humanitarian practitioner to make the best decisions possible in these challenging settings.

Humanitarian medicine is a practice that is needed now more than ever. The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) estimates that at least 128 million people in 33 countries will need humanitarian assistance in 2017—the highest level in history. Protracted conflicts and man-made crises have caused complex humanitarian emergencies and have contributed to unprecedented levels of displacement. The Office of the United Nations High Commissioner for Refugees (UNHCR) reports an estimated 65.5 million people forcibly displaced worldwide in 2016, another all-time record-breaking high. In other words, nearly 1% of the global population is currently internally displaced, a refugee, or an asylum seeker. Indeed, this is a critical time in the humanitarian sphere. The increase in needs has grown faster than available funding and has stretched the capacity of the humanitarian sector to the limit.

Concurrently, there have been increased violations against international humanitarian and human rights law, and lack of respect for the protection of civilians, humanitarian and medical workers, and civilian infrastructure. Médecins Sans Frontières (MSF), for example, reports the bombing of more than 60 of their health structures since 2015, and the indiscriminate and disproportionate targeting of civilians. No longer is conflict fought on a battlefield. Despite the clear violations of international law, perpetrators have not been held accountable and have largely escaped consequences.

Humanitarian response is guided by medical ethics and the principles outlined in international humanitarian law: humanity, neutrality, impartiality, and independence. When nations and warring parties disregard the international obligations and the protections in place for impartial provision of healthcare, humanitarian action itself is threatened. This message, a component of the #NotATarget campaign, launched by MSF in 2015, was also part of the 2017 agenda for the United Nations World Humanitarian Day, and in an affiliated petition ‘demanding that global leaders do more to ensure

the rules of war are upheld and civilians are protected in armed conflicts’. At present, however, there lacks much substantive commitment by global leaders to support the rhetoric.

At this critical time when the global community is at a crossroads, today’s geopolitical context portends uncertainty. The global governance no longer has any appearance of solidarity, and the traditions of humanitarianism that once ran deep in world politics are often reduced to strategic interests. The view has turned decidedly inward, and the moral responsibilities of world leaders are no longer assumed.

Those practising humanitarian medicine, indeed the readers of this book, are holding onto those general principles of humanity. Their work goes beyond the therapeutic acts of relieving suffering and saving lives, as by also bearing witness and demanding accountability, they help to restore dignity for those impacted by crises.

It is truly a privilege to bring this book to print. On behalf of the all the dedicated humanitarians in the world, and those countless million whose voices are often unheard, we hope that this book serves to both inform and inspire. Now more than ever, it is critical.

Amy S. Kravitz January, 2017

Acknowledgements

First, I thank Alex van Tulleken, my co-editor. We joined forces many years ago with a similar vision, and I am so proud that we are coming out the other end together. Without his clarity of vision and initiative in getting this project off the ground, this book never would have been a reality. I am also deeply grateful, of course, to Michael Hawkes. Through the years, and what must amount to thousands of emails and phone calls, his unwavering support and guidance has been the foundation upon which this book was built.

I am also grateful to those who have supported me and my work over the years. The list is too long to include, but I would be remiss to not extend a personal thanks to Mr Allan McRobie and Professor Timothy Cox. Their mentorship, support, and encouragement have had a profound impact on my life, and I am deeply grateful to have had the good fortune to cross their paths.

Last, but certainly not least, I thank my family for their support with this project. At times, ‘the book’ evoked a sentiment similar to that of a visiting houseguest who refused to leave, and I am grateful to Alvaro for never considering if it was time to kick them out. Now with two small boys who grew at an exponentially faster pace than I could muster this book to do, I dedicate this book to them, in the hopes that one day they can see the value in perseverance and be proud to have been part of this journey.

Amy S. Kravitz 2018

I owe a huge debt of gratitude to a number of people. Anton Bilton for his tremendously generous support almost a decade ago; John Fraser and all the Fraser MacCallum family; Brendan Cahill and Helen Hamlyn; Andrew Cavey; and my own family, especially my son Julian.

Two people deserve a special mention. First, Michael Hawkes at OUP for his patience, dedication, and for sticking with the project for almost a decade. Finally, and most importantly, I have to thank Amy Kravitz who understood the vision of the book from our first conversation. Ours is not a normal partnership: she has worked tirelessly with the contributors, without help from me, for the last 3 years of this project and she has shaped every aspect of the content. It is hard to exaggerate how difficult this book was to create and it owes existence to her determination and brilliance. I am lucky to have been able to work alongside her.

Alexander van Tulleken 2018

The editors would also like to extend a tremendous thanks to Dr Raghu Venugopal. We appreciate all of his input, and are very grateful for his assistance with persuading some of the most experienced and dedicated humanitarians to take time from their work to contribute to this book. Without his assistance, this book would not be what it is today.

We would like to specifically thank Dr Tammam Aloudat for his contributions to the book. In addition to co-authoring two chapters, he also develop a third chapter which although ultimately was not able to be included, did help to inform the introduction of OHHM. His thoughtful contributions are most appreciated.

We would also like to extend our sincere appreciation to Dr Sydney Wong, Dr Sandrine Tiller, Dr Ester Casas, and Dr Aditya (Adi) Nadimpalli. Each of them went above and beyond what we could reasonably expect to help provide expert reviews of the manuscript. We thank them for their time and input.

We would like to thank Dr Benjamin Black as well for his excellent assistance in reviewing the manuscript.

Last, but certainly not least, we would like to thank Dr Jennifer Turnbull Jennifer is not only an author in OHHM, but also helped in numerous other ways, including by serving as co-editor for the following three chapters: Chapter 1, ‘Introduction to humanitarian medicine’; Chapter 3, ‘Health priorities in displacement’; and Chapter 17, ‘Approach to paediatric care’. We thank her not only for her skilful editorial assistance, but also for her perseverance and commitment in helping to bring this book to print (even while balancing a newborn!).

These are the people who personify the ideal image of the humanitarian doctor—dedicated, determined, and brilliant.

Contributors

Tammam Aloudat

(Chapter 3: Health priorities in displacement; Chapter 46: Chronic non-communicable diseases)

Deputy Medical Director, Medical Department, Médecins

Sans Frontières, Geneva, Switzerland

Elizabeth Ashley (Chapter 29: Malaria)

Director of Clinical Research, Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, University of Oxford, UK

Anne Aspler

(Chapter 25: Oedema)

Emergency Medicine, University of Toronto, Canada

Nathalie Avril

(Chapter 3: Health priorities in displacement)

Nutrition Advisor, Médecins Sans Frontières Operational Centre, Geneva, Switzerland

Marco Baldan

(Chapter 49: Medical management of the surgical abdomen)

General Surgeon, Delegate Regional Surgeon for the Near and Middle East, International Committee of the Red Cross, Beirut, Lebanon

Aaron L. Berkowitz

(Chapter 39: Neurology)

Director, Global Neurology Program, Brigham and Women’s Hospital, Boston, MA, USA

Associate Professor of Neurology, Harvard Medical School, Boston, MA, USA

Health and Policy Advisor in Neurology, Partners in Health, Boston, MA, USA

Catherine Berry (Chapter 34: Global impact of antimicrobial resistance)

Clinical Advisor, Médecins

Sans Frontières-UK, Chancery Exchange, London, UK

Massey Beveridge

(Chapter 49: Medical management of the surgical abdomen; Chapter 50: Wound care and minor surgical procedures; Chapter 51: Burns)

Adjunct Assistant Professor of Surgery, University of Toronto, Canada

Axel Bex (Chapter 40: Urology)

Urologic Surgeon, Division of Surgical Oncology, Department of Urology, Netherlands Cancer Institute, Amsterdam, Netherlands

Benjamin Oren Black

(Chapter 42: Obstetric care)

Obstetrician and Gynaecologist, London, UK Obstetric Technical Lead, UK-Med and UK

Emergency Medical Team, UK Association member, Médecins Sans Frontières-UK, London, UK

Laurent Bonnardot

(Chapter 45: Ear, nose, and throat)

ENT and Emergency Physician, Médecins Sans Frontières, Paris, France

Marie Claude Bottineau (Chapter 43: Neonatology)

Pediatrician and Neonatology, MSF International Pediatrics

Working Group Leader, MSF-CH Women & Children Health Pool Leader, Médecins sans Frontières

Operational Centre, Geneva, Switzerland

Françoise Bouchet-Saulnier

(Chapter 3: Health priorities in displacement; Chapter 9: International Law for Healthcare Workers)

Doctor of Law and Magistrate, International Legal Director of Médecins sans Frontières, Paris, France

Philippa Boulle

(Chapter 3: Health priorities in displacement; Chapter 37: Respiratory illness; Chapter 46: Chronic non-communicable diseases)

Chronic Non-Communicable Disease Advisor; Chronic Conditions Team Leader, Médecins sans Frontières, Geneva, Switzerland

Vincent Buard (Chapter 27: Diarrhoea and vomiting)

General Practitioner, Médecins Sans Frontières (MSF), Angers, France

Jorge Castilla Echenique (Chapter 4: Health systems design)

Senior Health Advisor, Emergency Operations, WHO Health Emergencies Programme, World Health Organization, Geneva, Switzerland

Vanessa Cavallera (Chapter 6: Mental health in humanitarian emergencies)

Independent Consultant

Kevin Chan (Chapter 19: Fever; Chapter 28: Malnutrition)

Chair, Pediatrics, Memorial University and Clinical Chief, Children’s Health, Eastern Health, St. John’s, Newfoundland, Canada

Bernard Chomilier

(Chapter 12: Medical logistics in humanitarian settings)

Logistics Expert, retired

Christine Chomilier (Chapter 12: Medical logistics in humanitarian settings)

Logistics Expert, retired

Iza Ciglenecki

(Chapter 3: Health priorities in displacement)

Operational Research Coordinator, Médecins Sans Frontières Operational Centre, Geneva, Switzerland

Gustavo Fernandez (Chapter 3: Health priorities in displacement)

Migration Senior Project Manager, Médecins Sans Frontières Operational Centre, Geneva, Switzerland

Deputy Head, Humanitarian Representation Team, Humanitarian Representative in Geneva, Médecins sans Frontières International

Sheri Fink

(Chapter 1: Introduction to humanitarian medicine)

Fellow, FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA

Christos Giannou

(Chapter 15: Mass casualty triage)

Honorary Lecturer, Queen

Mary & Barts, Blizard Institute, University of London, UK

Former Head Surgeon, International Committee of the Red Cross, retired

Sarah Giles (Chapter 45: Ear, nose, and throat)

Assistant Clinical Professor, Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. Member, Médecins sans Frontières, Canada

P. Gregg Greenough (Chapter 7: Epidemiology)

Assistant Professor, Global Health & Population, Harvard T.H. Chan School of Public Health; Faculty, Harvard Humanitarian Initiative, Cambridge, MA, USA

Andre Griekspoor

(Chapter 4: Health systems design)

Senior Humanitarian Policy Adviser, Emergency Operations, WHO Health Emergencies Programme, World Health Organization, Geneva, Switzerland

Monique Gueguen

(Chapter 54: Blood transfusion)

Medical Laboratory Advisor, Médecins sans Frontières, Paris, France

Jan Hajek

(Chapter 30: Neglected tropical diseases)

Clinical Assistant Professor, Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, Canada

Ingo Hartlapp (Chapter 38: Gastrointestinal Illness)

Senior Physician, Specialist for Internal Medicine/ Gastroenterology/Infectiology/ Oncology, Würzburg University Hospital, Germany

Member, Médecins sans Frontières Telemedicine Program, Germany

Laura Hawryluck (Chapter 18: Shock)

Associate Professor Critical Care Medicine, University of Toronto, Canada

Physician Lead, Critical Care Rapid Response Team, University Health Network, Toronto, Canada

Member, Médecins Sans Frontières Telemedicine Program, Canada

Laurent Hiffler (Chapter 17: Approach to paediatric care)

Paediatric Advisor, MSF Operational Center, Barcelona, Athens, Dakar, Senegal

Chris Houston (Chapter 10: Security)

Senior Program Officer (Humanitarian), Grand Challenges Canada

Board member, Médecins sans Frontières, Canada

Module Lead, Global Health Education Initiative, Postgraduate Medical Education, University of Toronto, Canada

Tim Jagatic

(Chapter 32: Clinical suspicion of Ebola)

Physician, Médecins Sans Frontières, Ontario, Canada

Kiran Jobanputra

(Chapter 3: Health priorities in displacement)

Head of Manson Unit, Médecins Sans Frontières, London, UK

Lynne Jones (Chapter 6: Mental health in humanitarian emergencies)

Fellow, FXB Center for Health and Human Rights, Harvard University, Boston, MA, USA

Honorary Consultant Child and Adolescent Psychiatrist, Cornwall Partnership NHS Foundation Trust, Cornwall, UK and South London and Maudsley NHS Foundation Trust, London, UK

Jaap Karsten (Chapter 17: Approach to paediatric care)

Médecins Sans Frontières, Amsterdam, The Netherlands

Saleem Kassam

(Chapter 36: Cardiac conditions)

Consultant, Director, Cardiac Catheterization Laboratory, Rouge Valley Health System, Toronto, Canada

Vice President, Médecins Sans Frontières, Canada

Jocelyn T.D. Kelly

(Chapter 5: Gender-based violence in humanitarian crises)

Director, Women in War Program, Harvard Humanitarian Initiative, Cambridge, MA, USA

Hyo Jeong Kim

(Chapter 4: Health systems design)

Technical Officer, Emergency Operations, WHO Health Emergencies Programme, Geneva, Switzerland

Cara Kosack

(Chapter 53: Laboratory; Chapter 54: Blood transfusion)

Leader, Diagnostic Network, Médecins sans Frontières, Amsterdam, The Netherlands

Alena Koscalova

(Chapter 3: Health priorities in displacement)

Tropical Medicine Adviser, Médecins sans Frontières, Operational Centre, Geneva, Switzerland

Amy S. Kravitz

(Chapter 1: Introduction to humanitarian medicine)

Medical Officer, United States Agency for International Development (USAID), Washington, DC, USA

W. Ted Kuhn (Chapter 55: Ultrasound)

Former Director, International Medicine, Co-director, Ultrasound Fellowship, Medical College of Georgia, Augusta University, GA, USA

Kenneth Lavelle

(Chapter 11: Medical care under fire: a perspective from the international medical organization Médecins Sans Frontières)

Deputy Director of Operations, Médecins Sans Frontières, Geneva, Switzerland

Matthew Lyon (Chapter 55: Ultrasound)

Executive Director, Center for Ultrasound Education, Medical College of Georgia, Augusta University, GA, USA

Anna MacDonald (Chapter 23: Lymphadenopathy)

Emergency Physician, St Michael’s Hospital, North York General Hospital, Toronto, Canada

Peter Maes (Chapter 56: Water, sanitation, and hygiene; Chapter 57: Medical waste management)

Water, Hygiene and Sanitation Unit Coordinator, Water, Hygiene & Sanitation Unit, Médecins Sans Frontières – O.C. Brussels, Belgium

Olivier Malard (Chapter 45: Ear, nose, and throat)

ENT – Head and Neck Surgery Department, Centre Hospitalier Universitaire de Nantes, France

William Mapham (Chapter 44: Ophthalmology)

Ophthalmologist, Stellenbosch University, South Africa

Daniel Martinez Garcia (Chapter 17: Approach to paediatric care)

Paediatric Advisor, Medical Department, Médecins Sans Frontières, OCG Women & Child Health Unit, Geneva, Switzerland

James Maskalyk (Chapter 26: Patient with unintentional weight loss)

Emergency Physician, Assistant Professor, University of Toronto, Canada

Pierre Maury (Chapter 3: Health priorities in displacement)

Médecins Sans Frontières, Geneva, Switzerland

Camille Michel (Chapter 11: Medical care under fire: a perspective from the international medical organization Médecins Sans Frontières)

Legal Advisor for International Humanitarian Law and Medicolegal Issues, Médecins Sans Frontières, Geneva, Switzerland

Rose Leonard Molina (Chapter 5: Gender-based violence in humanitarian crises)

Assistant Professor of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA

Faculty Physician, Division of Global and Community Health, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA

Associate Scientist, Division of Women’s Health, Brigham and Women’s Hospital, Boston, MA, USA

Peter Moons (Chapter 16: Medical triage; Chapter 27: Diarrhoea and vomiting)

Consultant Paediatrician, Academic Pediatric Center Suriname, Paramaribo, Suriname

Lily Muldoon (Chapter 20: Anaemia)

Emergency Medicine Resident, Department of Emergency Medicine, University of California San Francisco, CA, USA

Veronique Mulloni

(Chapter 3: Health priorities in displacement)

Water, Hygiene and Sanitation Technical Referent, Technical Support to the Operations, Médecins Sans Frontières, Geneva, Switzerland

Aditya Nadimpalli

(Chapter 37: Respiratory illness)

Primary Care Ultrasound Fellow, School of Medicine, University of South Carolina, Columbia, SC, USA

Thomas Nierle

(Chapter 11: Medical care under fire: a perspective from the international medical organization Médecins Sans Frontières)

Former President, Médecins Sans Frontières, Geneva, Switzerland

David Nott (Chapter 48: Major trauma)

Consultant Surgeon, Imperial College, London, UK

Dirk-Jan Omtzigt

(Chapter 8: Understanding economic effects of humanitarian intervention)

Analyst, UNOCHA Regional Office for Southern and Eastern Africa

Joseph O’Neill (Chapter 21: Pain; Chapter 24: Cough and breathlessness; Chapter 47: Palliative care)

Palliative Medicine, University of Maryland/Shore Regional Health, Easton, MD, USA

James Orbinski (Humanitarianism Today) Professor and Director, Dahdaleh Institute for Global Health Research, York University, Toronto, Canada

Susan Ann O’Toole (Chapter 42: Obstetric care) Obstetrician-Gynaecologist, Collingwood, ON, Canada

AnneMarie Pegg (Chapter 35: Response to epidemic disease)

Clinical Lead, Epidemic Response and Vaccination, Médecins Sans Frontières, Paris, France

Associate Clinical Faculty, University of Calgary, Department of Family Medicine, Calgary, Canada

Max Ritzenberg (Chapter 20: Anaemia)

Clinical Instructor, Department of Emergency Medicine, Faculty Affiliate, Institute for Global Health Sciences, University of California, San Francisco, CA, USA

Patrick Robitaille (Chapter 2: Responders and responses)

Independent Consultant

David Rowley (Chapter 52: Orthopaedics and limb injuries)

Emeritus Professor, University of Dundee, UK

Monica Rull (Chapter 3: Health priorities in displacement)

Operations Health Coordinator Médecins Sans Frontières, Geneva, Switzerland

Margaret Salmon (Chapter 20: Anaemia)

Director and Innovator at InnovationsCZ, Attending: Valley Emergency Physicians, San Francisco, CA

Peter Saranchuk

(Chapter 31: Tuberculosis and HIV in humanitarian contexts)

TB/HIV Adviser, Southern Africa

Medical Unit (SAMU), Médecins Sans Frontières, Cape Town, South Africa

Medical Technical Advisor, Seva Foundation, Berkeley, USA

Practicing Clinician, Bridges Community Health Centre, Fort Erie, Canada

Elisabeth Sauvaget (Chapter 45: Ear, nose, and throat)

Chief of ENT – Head and Neck surgery department, Hôpital Saint Joseph, Paris, France

Laura Sauve (Chapter 19: Fever)

Pediatric Infectious Diseases

Specialist, BC Children’s Hospital; Clinical Assistant Professor, Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, Canada

Jennifer Scott

(Chapter 5: Gender-based violence in humanitarian crises)

Director, Division of Global and Community Health, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA

Associate Scientist, Division of Women’s Health, Brigham and

Women’s Hospital, Boston, MA, USA

Instructor, Harvard Medical School, Boston, MA, USA

Norman Sheehan (Chapter 10: Security)

Risk Management Consultant

Jonathan Spector (Chapter 43: Neonatology)

Executive Director, Global Health, Novartis Institutes for BioMedical Research, Cambridge, MA, USA

Craig Spencer (Chapter 32: Clinical suspicion of Ebola)

Director of Global Health in Emergency Medicine, New York-Presbyterian/ Columbia University Medical Center, New York, NY, USA

Assistant Professor of Medicine and Population and Family Health, Columbia University Medical Center, New York, NY, USA

Miroslav Stavel (Chapter 18: Shock)

Staff Paediatrician and Neonatologist, Royal Columbian Hospital, New Westminster, Canada

Marianne Stephen (Chapter 41: Reproductive health)

Specialist Registrar Obstetrics and Gynaecology; Field Doctor, Médecins Sans Frontières

Ana Maria Tijerino (Chapter 3: Health priorities in displacement)

Mental Health Advisor, MSFCH –Médecins Sans Frontières, Geneva, Switzerland

Sandrine Tiller (Chapter 2: Responders and responses)

Strategic Adviser, Médecins Sans Frontières, London, UK

Michelle Tubman (Chapter 22: Jaundice)

Attending Physician, Emergency Medicine, Alberta Health Services, Edmonton, Canada

Clinical Lecturer, Department of Emergency Medicine, University of Alberta, Edmonton, Canada

Jennifer Turnbull (Chapter 15: Mass casualty triage; Chapter 28: Malnutrition; co-editor of Chapter 1: Introduction to humanitarian medicine; Chapter 3: Health priorities in displacement

Attending Physician, Division of Pediatric Emergency Medicine, McGill University Health Centre, Montreal Children’s Hospital, Canada

Assistant Professor, Department of Pediatrics, McGill University, Montreal, Canada

Rafael Van den Bergh (Chapter 56: Water, sanitation, and hygiene; Chapter 57: Medical waste management)

Senior Operational Research and Technical Support Officer, LUX-OR, Médecins Sans Frontières Operational Centre, Brussels, Belgium

Joos Van den Noortgate (Chapter 56: Water, sanitation, and hygiene; Chapter 57: Medical waste management)

Responsible Innovation & Training, Water, Hygiene & Sanitation Unit, Médecins Sans Frontières Operational Centre, Brussels, Belgium

Peter Ventevogel

(Chapter 6: Mental health in humanitarian emergencies)

Senior Mental Health Officer, UNHCR, Geneva, Switzerland

Raghu Venugopal (Chapter 14: Approach to clinical care in humanitarian contexts); Chapter 27: Diarrhoea and vomiting)

Médecins Sans Frontières Telemedicine Coordinator

Assistant Professor of Medicine, University of Toronto, Canada

Attending Physician, Department of Emergency Medicine, University Health Network, Toronto, Canada

Isabelle Voiret (Chapter 3: Health priorities in displacement)

Médecins Sans Frontières, Geneva, Switzerland

Rod Volway (Chapter 13: Working for international organizations)

Humanitarian Development

Professional

David A. Warrell

(Chapter 33: Venomous animal bites and stings and marine poisoning

Emeritus Professor of Tropical Medicine and Honorary Fellow of St Cross College, University of Oxford, UK

Inka Weissbecker (Chapter 6: Mental health in humanitarian emergencies)

Senior Global Mental Health and Psychosocial Support Advisor, International Medical Corps, Washington, DC, USA

Andrew James Willis (Chapter 7: Epidemiology) Epidemiologist, Médecins Sans Frontières, Montreal, Canada

ESymbols and abbreviations

cross-reference

M website

± with or without

i increased

d decreased

~ approximately

ACT artemisinin-based combination therapy

AEC antiepileptic drug

AFB acid-fast bacilli

AIDS acquired immunodeficiency syndrome

ALT alanine transaminase

AMI acute myocardial infarction

AP Additional Protocol

ART antiretroviral therapy

AST aspartate transaminase

ATFC ambulatory therapeutic feeding centre

ATLS® Advanced Trauma Life Support®

AVPU alert, voice, pain, unresponsive

BCG bacillus Calmette–Guérin

BEmONC basic emergency obstetric and newborn care

BMI body mass index

BPD biparietal diameter

BPH benign prostatic hyperplasia

bpm beats per minute

CAD coronary artery disease

CCm cryptococcal meningitis

CDC Centers for Disease Control and Prevention

CEmONC comprehensive emergency obstetric and newborn care

CFR case-fatality rate

CHB chronic hepatitis B

CHC chronic hepatitis C

CHF congestive heart failure

CHW community health worker

CMV Cytomegalovirus

CNS central nervous system

COPD chronic obstructive pulmonary disease

CrAg cryptococcal antigen

CS caesarean section

CSF cerebrospinal fluid

CVP central venous pressure

DHMT district health management team

DIC disseminated intravascular coagulation

DKA diabetic ketoacidosis

DPT diphtheria, pertussis, and tetanus

DR-TB drug-resistant tuberculosis

DST drug susceptibility testing

DVT deep vein thrombosis

EBV Epstein–Barr virus

EC emergency contraception

ECG electrocardiography/electrocardiogram

EEG electroencephalography

EHEC enterohaemorrhagic Escherichia coli

EP ectopic pregnancy

EPI Expanded Programme on Immunization

EPTB extrapulmonary tuberculosis

ETAT Emergency Triage, Assessment, and Treatment

EU European Union

EWARS early warning alert and response system

FAST focused assessment with sonography in trauma

FEV1 forced expiratory volume in 1 second

FGC female genital cutting

FGM female genital mutilation

FNA fine-needle aspiration

FVC forced vital capacity

G6PD glucose-6-phosphate dehydrogenase

GAM global acute malnutrition

GBV gender-based violence

GCS Glasgow Coma Scale

GFR glomerular filtration rate

GI gastrointestinal

GN glomerulonephritis

GNI gross national income

HAT human African trypanosomiasis

Hb haemoglobin

HbA1c glycated haemoglobin

HBsAG hepatitis B virus surface antigen