Hybrid warfare and public health: Conflicts in Ukraine and Nagorno-Karabakh raise the alarm

Kricorian, Katherine; Khoshnood, Kaveh; Chekijian, Sharon

doi:10.1016/j.puhip.2022.100342

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…Assessments of collaboration capacities were implemented: the WHO Joint External Evaluation in 2016 [34], the National Bridging Workshop on the International Health Regulations (IHR) and the WOAH Performance of Veterinary Services (PVS) Pathway in 2019 [35].…”

Section: Targets As Per Ohcf Areas To Be Addressed Actions and Proced...mentioning

confidence: 99%

“…This is particularly alarming given that agriculture is one of the key sectors of the Armenian economy [ 32 ]. In Armenia, as well as in many other former Soviet countries, the health care system was destabilized following independence in 1991, leading to a substantial decline in access to and quality of health services [ 33 ], and the situation has been exacerbated by the 2022–2023 Nagorno-Karabakh crisis [ 34 , 35 ]. There are high levels of out-of-pocket payments for healthcare, although there has been a steady increase in the coverage of health services since 2019 [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessing the Adoption of One Health Approaches in National Plans to Combat Health Threats: The Pilot of a One Health Conceptual Framework in Armenia

Milano,

Robbiati,

Declich

et al. 2024

TropicalMed

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Due to several factors, such as environmental and climate changes, the risk of health threats originating at the human–animal–environment interface, including vector-borne diseases (VBDs) and zoonoses, is increasing. Low-resource settings struggle to counter these multidimensional risks due to their already-strained health systems and are therefore disproportionally affected by the impact caused by these changes. Systemic approaches like One Health (OH) are sought to strengthen prevention and preparedness strategies by addressing the drivers of potential threats with a multidisciplinary and multisectoral approach, considering the whole system at the human–animal–environment interface. The integration of OH in national plans can be challenging due to the lack of effective coordination and collaboration among different sectors. To support the process of knowledge coproduction about the level of OH integration in prevention and preparedness strategies against health threats in Armenia, a situation analysis was performed on Crimean–Congo hemorrhagic fever/virus and anthrax (identified by local stakeholders as priorities to be addressed with the OH approach), and actions to strengthen the national OH system were identified with the support of a OH conceptual framework. The study highlighted that multidisciplinary and multisectoral efforts towards prevention and preparedness against VBDs and zoonoses threats need to be strengthened in Armenia, and priority actions to integrate the OH approach were identified.

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Section: Targets As Per Ohcf Areas To Be Addressed Actions and Proced...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing the Adoption of One Health Approaches in National Plans to Combat Health Threats: The Pilot of a One Health Conceptual Framework in Armenia

Milano,

Robbiati,

Declich

et al. 2024

TropicalMed

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show abstract

“…Access to essential healthcare was a major challenge in the region, limiting and, in some cases, completely disrupting the availability of services for vulnerable and at-risk population groups including, children, women and the elderly. Furthermore, all cancer prevention and care programs were paused, compromising access to early detection and life-saving treatments [ 12 , 13 ]. The information on cancer patients’ lived experiences in this climate of prolonged humanitarian crisis remained limited.…”

Section: Introductionmentioning

confidence: 99%

Barriers to access to cancer care for patients from the conflict-affected region of the Nagorno-Karabakh Republic: A qualitative study

Hovhannisyan,

Philip,

Arakelyan

et al. 2024

PLOS Glob Public Health

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Access to essential health services is a basic human right, yet many cancer patients living in conflict-affected regions face multiple obstacles to service use. The (former) Nagorno-Karabakh Republic was a conflict-affected region in the South Caucasus populated predominantly by ethnic Armenians. Multiple acute armed conflicts, the recent military occupation of the region, and the prolonged military blockade of the Lachin Corridor (a humanitarian corridor connecting Nagorno-Karabakh to Armenia) exacerbated existing social, health, economic, and political fragilities in this region. As a result, cancer services were disrupted, with limited clarity on how the ongoing military blockade of a humanitarian corridor affected cancer patients’ experiences of accessing cancer care locally and in bordering Armenia. Our study aimed to describe the experiences of patients from Nagorno-Karabakh in accessing the cancer care services they needed. We conducted remote semi-structured interviews with adult (aged ≥18 years) cancer patients receiving cancer care from three university hospitals in Armenia and face-to-face interviews with cancer care professionals from these hospitals. Interviews were conducted during the blockade of the Lachin Corridor between March and May 2023. Data were analysed thematically using a deductive approach. Twelve adult cancer patients (9 women) and 12 cancer care professionals participated. A key barrier to accessing cancer services was attributed to the Azerbaijani military occupation of the region and the blockade of a major roadway connecting Nagorno-Karabakh to Armenia. Patients talked in length about the challenges of finding transport and travelling long distances to reach essential cancer services in Armenia. Policies of free anti-cancer medication provision and decentralised medication supply were paused because of the military occupation, affecting patients’ timely access to anti-cancer medication. Out-of-pocket expenses for treatment, anti-cancer medication, travel, and temporary accommodation in Armenia placed a significant financial burden on cancer patients, exacerbated by the humanitarian crisis. Conflict-affected regions blockaded by military forces lack the capacity and targeted support to sustain their essential health services and provide care to those in need of life-saving treatments. Coordinated action from national and international organisations and governments is urgently needed to enhance humanitarian assistance and healthcare support to patients, their families and wider communities affected by military blockades and armed conflicts.

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“…The current global crisis affects all spheres of human life and activities. The consequences of intense and lasting psychological stress caused by the ongoing COVID-19 pandemic, war in Europe, use of unconventional weapons, mass killings, violence, migration, and desperation will affect the health of millions and result in new outbreaks of chronic clinical conditions in the years and decades to come [1][2][3][4]. Although there are no definite estimates of the scale of the health crisis, it is obvious that the global population will face a new syndemic that drives aging and triggers agingrelated diseases.…”

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confidence: 99%

Comprehensive and Multidisciplinary Rehabilitation in the Time of Crisis

Bashkirtsev

Gaevska

Zimba

et al. 2022

AAEE

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Comprehensive and multidisciplinary rehabilitation is gaining momentum as a useful strategy that aims to improve physical, psychological, and social components of health in subjects affected by violence, trauma, and mental distress. Previous and current wars have prioritized essential diagnostic and rehabilitative services to civil subjects and military servicepersons which can be delivered by skilled physiatrists and allied specialists. Stratifying subjects in need of various rehabilitative procedures and offering them psychological support, balanced nutrition, musculoskeletal care, and socialisation in a safe and relaxing atmosphere may improve their mental and functional capacities and resolve numerous health issues. The choice of comprehensive rehabilitative procedures depends on their availability and understanding of complementary effects of various interventions.

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Hybrid warfare and public health: Conflicts in Ukraine and Nagorno-Karabakh raise the alarm

Cited by 3 publications

References 10 publications

Assessing the Adoption of One Health Approaches in National Plans to Combat Health Threats: The Pilot of a One Health Conceptual Framework in Armenia

Assessing the Adoption of One Health Approaches in National Plans to Combat Health Threats: The Pilot of a One Health Conceptual Framework in Armenia

Barriers to access to cancer care for patients from the conflict-affected region of the Nagorno-Karabakh Republic: A qualitative study

Comprehensive and Multidisciplinary Rehabilitation in the Time of Crisis

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