Chronic Health Crises and Emergency Medicine in War-torn Yemen, Exacerbated by the COVID-19 Pandemic

Alsabri, Mohammed; Alsakkaf, Luai M.; Alhadheri, Ayman; Cole, Jennifer; Burkle, Frederick M.

doi:10.5811/westjem.2021.10.51926

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…30 Regions affected by war and conflict require healthcare providers and infrastructure adapted to emergency medicine, trauma and acute care surgery, and mental health care. 31,32 However, these war-torn regions often lack the resources and infrastructure to provide specialized training due to destruction, loss of equipment and supplies, and disrupted supply chains, typically relying on assistance from humanitarian organizations like the International Committee of the Red Cross (https://www.icrc.org/en) and Doctors Without Borders (https://www.msf.org/). The resulting limited skilled healthcare workforce and infrastructure significantly exacerbate existing health disparities.…”

Section: Disruption and Challenges In Achieving Career Dreamsmentioning

confidence: 99%

The Silent Casualties: War's Impact on Medical Students and Medical Education

Takoutsing,

Găman,

Puyana

et al. 2023

Int J Med Stud

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The field of medicine has made significant contributions to the global economy. This contribution is evident in the advancements in medical technology, groundbreaking research, and the development of a highly skilled workforce, including medical students. These advancements have opened up numerous economic opportunities, leading to job creation and, consequently, fostering economic growth. 13 Beyond economic development, medical students play a pivotal role in promoting social development by addressing health disparities and improving access to equitable healthcare. 14 In addition, initiatives for international medical education-such as those offered by the International Federation of Medical Students-are essential for fostering cross-cultural communication and understanding. Future medical professionals can broaden their viewpoint and acquire varied cultural ideas through these possibilities. This not only makes it easier to promote peace inside and between countries, but it also makes a big difference in helping to create a society that is just and equal. 15 However, medical students face a wide range of challenges during their training. These challenges encompass financial, academic, physical, and emotional aspects. 16 War and conflicts further exacerbate these challenges, having a profound and often detrimental impact on medical education and the lives of future physicians. 17

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Section: Disruption and Challenges In Achieving Career Dreamsmentioning

confidence: 99%

The Silent Casualties: War's Impact on Medical Students and Medical Education

Takoutsing,

Găman,

Puyana

et al. 2023

Int J Med Stud

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“…The crisis in Yemen has been described as the world's largest, but the extent to which it has affected population mortality across the country remains unclear, depriving response actors and other stakeholders of critical evidence for benchmarking the war's impacts and the adequacy of response efforts [2]. While a credible estimate of people killed by war injuries (about 110,000 as of end 2022 [3]) has been established based on media and civil society report monitoring, the death toll indirectly attributable to the conflict could be substantial, as suggested by the occurrence over the past few years of repeated phases of food insecurity [4,5], reduced health service functionality [6,7], forced displacement [8] and large-scale epidemics [9]. Against this backdrop, the COVID-19 pandemic would plausibly have resulted in a further mortality increase [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Population mortality before and during armed conflict in Yemen: geospatial and statistical analysis of cemetery data

Checchi,

Besson,

Ali

et al. 2023

Preprint

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Since 2014, Yemen is affected by crisis conditions due to armed conflict. Evidence on the impact of this large-scale crisis on mortality is lacking. We analysed archive very high-resolution satellite imagery from a sample of Yemeni subdistricts to quantify changes in burial incidence attributable to the crisis. We identified possible cemeteries through remote and ground sources in 24 sampled subdistricts. After initial triage and extensive steps to improve the interpretability of archive imagery spanning the period 2011 to 2021, a pool of crowd workers, supervised by expert analysts and aided by an automated algorithm, annotated surface area and grave counts in sequential images from a set of analysis-eligible cemeteries. We complemented these longitudinal observations with data on different predictors including three crisis proxies (incidence of insecurity events, price of staple cereal, internal displacement), and fitted statistical models to compare predicted burials under observed and assumed counterfactual (no crisis) conditions. We identified 561 potential cemeteries within 24 sampled subdistricts, but excluded most due to inability to geolocate them or see the cemetery and/or graves in available imagery, yielding an effective sample of 110 image observations across 35 cemeteries in 10 subdistricts. Burial rate generally decreased between 2014-2018 and rose sharply thereafter. Alternative regression models suggested that most cemeteries would have experienced lower burial rate under non-crisis conditions, with a crisis to non-crisis ratio of about two overall. The incidence of insecurity events appeared positively associated with burial rate. This unprecedented-scale geospatial analysis of cemeteries suggests an increase in burial rates attributable to crisis conditions in a non-representative, disproportionately urban sample of Yemen. The study identifies key challenges of such an analysis. We discuss possible methodological ways forward to further explore the feasibility and validity of this option for mortality estimation in settings with insufficient vital events registration and limited ground access.

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“…Access to health information, different age groups, gender, minority groups, socioeconomic and schooling levels[ 10 ], inadequate housing quality, absence of potable water and electricity, overcrowding, and bad sanitary conditions can influence the infection heterogeneity[ 11 ]. Such conditions are visualized in populations that daily coexist with armed conflicts, in regions historically more vulnerable with low access to health services, provisions, high rates of infectious and chronic diseases, and factors able to add to the COVID-19 pandemic and potentiate its impact on health[ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Syndemic aspects between COVID-19 pandemic and social inequalities

Apolonio¹,

Júnior²,

Cuzzuol³

et al. 2022

WJM

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Although the coronavirus disease 2019 (COVID-19) pandemic has reached all over the world population, it has demonstrated a heterogeneous impact on different populations. The most vulnerable communities which coexist daily with the social inequalities like low access to hygiene and personal protection products, crowded residences, and higher levels of chronic diseases have a higher risk of contact and the spread of infection, beyond unfavorable clinical outcomes. The elevation of the risk of infection exposure can be related to gender due to the presence of a larger contingent of women in essential services, as well as frontline and cleaning professionals who regardless of gender have the greatest exposure to the virus. Such exposures can contribute to the development of fear of contaminating themselves or their family members associated also with the work stress, both of which are related to the emergence of mental disturbances in these populations. Furthermore, conditions of unsanitary living and low socioeconomic status, populations at war, pre-existing social barriers, and ethnicity have contributed to more impact of the pandemic both in the exposure to the virus and access to health services, COVID-19 management, and management of other pathologies. At the same time, factors such as the closing of non-essential services, the loss of jobs, and the increase in household spending aggravated the social vulnerabilities and impacted the family economy. Lastly, the COVID-19 pandemic contributed still more to the impact on women's health since it propitiated a favorable environment for increasing domestic violence rates, through the segregation of women from social life, and increasing the time of the victims with their aggressors.

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Chronic Health Crises and Emergency Medicine in War-torn Yemen, Exacerbated by the COVID-19 Pandemic

Cited by 7 publications

References 25 publications

The Silent Casualties: War's Impact on Medical Students and Medical Education

The Silent Casualties: War's Impact on Medical Students and Medical Education

Population mortality before and during armed conflict in Yemen: geospatial and statistical analysis of cemetery data

Syndemic aspects between COVID-19 pandemic and social inequalities

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