Global health with justice ALTHOUGH the title of Gostin's latest book, Global health law, may suggest a dry legal tome, it is, in fact, a highly readable exploration of the major issues and debates in the field of international health policy and governance. For those new to the field, Gostin offers an insightful overview of the overarching legal and policy regime and key institutional actors. However, the book is not a neutral primer in the basics of health law. Rather, Gostin's ultimate goal is prescriptive: he sets forth in Chapter 1 his vision for "global health with justice" as requiring a more equitable distribution of health resources than the current status quo. In turn, much of the book is devoted to making the case for the political, legal and institutional reform that would be necessary to achieve this end.
The effects of the 1994 Rwandan Genocide against the Tutsi are widespread and long‐lasting, but little is known about how posttraumatic consequences differ regarding gender. In the present study, we estimated the associations between trauma exposure and posttraumatic stress symptoms (PTSS) in a Rwandan community sample and examined whether the associations differed by gender. The sample comprised 498 adults (75.2% women) living in Rwanda's Huye District in 2011. We used a validated self‐report checklist to assess the eight most frequent traumatic experiences during the Genocide. The PTSD Checklist–Civilian version (PCL‐C) was used to assess PTSS. Associations between trauma exposure and PTSS were estimated using structural equation modeling (SEM), with additional SEMs stratified by gender. The prevalence of exposure to each traumatic event ranged from 15.1% to 64.5%, with more severe PTSS among individuals who reported personal physical injury, β = .76, 95% CI [0.54, 0.98]; witnessing sexual/physical violence against a loved one, β = .51, 95% CI [0.20, 0.81]; a close relative/friend's death, β = .54, 95% CI [0.24, 0.83]; property destruction, β = .35, 95% CI [0.048, 0.51]; or a family member's death due to illness, β = .21, 95% CI [0.00, 0.41]. Men who saw people killed and women who witnessed sexual/physical violence against a close family member reported elevated PTSS. The psychiatric impact of the Rwandan Genocide continues into the 21st century. Increased attention should be paid to the long‐term and demographic patterns of distress and disorder, especially in the absence of widespread clinical mental health services.
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