A Lecture on Communicable Diseases in Post Humanitarian Crisis Regions
During this International Diploma in Humanitarian Assistance (IDHA) program from June 2, 2019, through June 29, 2019, the Institute of International Humanitarian Affairs welcomes an abundance of students, professors and professionals alike. Students include humanitarians from around the world with a minimum of 5 years of experience in the field along with professors, lecturers, and others whose diverse experience in the humanitarian world brings a wide range of expertise and perspective to every lecture and discussion that takes place throughout the program. This summer, Mark Little M.D., and Course Director of this year’s IDHA program delivered a lecture on communicable diseases in post-humanitarian crisis regions.
The goal of Dr. Little’s lecture was to investigate what communicable diseases are and how they occur, particularly in a humanitarian crisis. As noted in class, a communicable disease is an infectious disease that is from one person to another. Dr. Little spent his lecture investigating the four major causes of death in a humanitarian crisis, their case definitions, risk factors, and methods of treatment.
The four major causes of death in a humanitarian crisis are:
1) acute lower respiratory illness
Following an in-depth analysis of these four causes of death, Dr. Little spoke briefly on other diseases, such as HIV, AIDS, and Tuberculosis, which all plague emergency zones as well.
Acute lower respiratory illness, such as Bronchitis, Bronchiolitis, and Pneumonia, interfere with normal breathing. These diseases are particularly dangerous for children, older adults, and individuals with pre-existing immune system disorders. Dr. Little stated that every minute, two children die from Pneumonia. Although the severity of this illness has been known for quite some time, standardized treatment was only normalized recently. Dr. Little recognizes that standardized treatment through access to health care services, early diagnosis, use of antibiotics, and standardized case management is incredibly useful in preventing death. This reflection took place in light of a case study, Dr. Little shared with his audience on the standardized approach in Malawi, where 47,000 admitted children had Pneumonia. This approach led to a 30–37% reduction in death rates due to acute lower respiratory illnesses. Key preventive measures include vaccination, nutrition, handwashing, and reductions in indoor air pollution.
Diarrhea is a symptom of infection and is not a disease in and of itself. In the field, doctors use case definitions such as acute dysentery and cholera to insinuate diarrhea in a report. Globally, there are 1.7 billion cases of childhood diarrhea a year, resulting in nearly 530,000 childhood deaths a year. Diarrhea is highly contagious and can transmit through both direct or indirect contact. Population movement, overcrowding, poor sanitation, lack of health care, and malnutrition are major risk factors for infection. Diarrhea is both preventable and treatable. Often, diseases like diarrhea, are preventable through safe drinking water and adequate sanitation and hygiene.
Measles is a highly contagious disease, as well. One case of measles is considered a medical emergency. The 21st century has witnessed a significant decrease in measles cases globally due to the vaccine. Between 2000 and 2013, there was a 75% decrease in cases reported, with the prevention of approximately 15.6 million deaths during that time. However, there is now an increase in measles worldwide as a direct result of a breakdown in public health systems. Little mentioned the current outbreak of 700 plus cases in Brooklyn, New York, as evidence of the renewal of the disease. Little took a moment to outline his position as a pro-vaccinator and emphasized that vaccination is the most effective preventive measure of measles. In addition, Dr. Little showed a series of photos of children with measles, encouraging students to remember the images so they can report a case on sight when in the field.
The fourth communicable disease Little spoke about was Malaria. There are between 350 and 450 million cases of Malaria a year, resulting in over one million deaths a year, 90% of which are in Africa. Little outlined strategies during an epidemic such as free diagnosis and treatment, mobile clinics, referral of severe cases, and mass treatment of fever cases. He encouraged surveillance of the outbreak as well, emphasizing the importance of reporting cases and deaths.
Although Dr. Little spoke at length about the diseases themselves, how to recognize their symptoms, and how to treat patients, he recognized a more systematic approach to health as well. He cites an instance early in his career in which a field agent expressed his discomfort for more medical staff and implored for more water engineers in the area. The individual’s message was understood to mean that developing countries could avoid medical epidemics more feverishly with stronger public health systems rather than an influx of doctors. Public health systems are an essential preventive measure and are often considered more effective in preventing disease than an effort to treat all individuals after infection.
Likewise, Little emphasized preventative measures to avoid malnutrition, which is a significant risk factor for all communicable diseases. For children, breastfeeding is an important measure in improving nutrition and health since breastfeeding is predicted to save nearly 1 million lives per year. It is this knowledge and more that Dr. Little’s lectures bring to the IDHA.
Written by Charles Beauregard, Refuge Press Intern, Summer 2019
About the IIHA
The Institute of International Humanitarian Affairs (IIHA) prepares current and future aid workers with the knowledge and skills needed to respond effectively in times of humanitarian crisis and disaster. Our courses are borne of an interdisciplinary curriculum that combines academic theory with the practical experience of seasoned humanitarian professionals. The IIHA also publishes on a wide range of humanitarian topics and regularly hosts a number of events in the New York area, including the annual Humanitarian Blockchain Summit and Design for Humanity Summit.
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