Oxford Handbook of Humanitarian Medicine

1142 Pages·2019·44.753 MB·English

by  Amy Kravitz, Alexander van Tulleken

OXFORD MEDICAL PUBLICATIONS
Oxford Handbook of
Humanitarian
Medicine
ii
Published and forthcoming Oxford Handbooks
Oxford Handbook for the Foundation Oxford Handbook of Infectious
Programme 5e Diseases and Microbiology 2e
Oxford Handbook of Acute Oxford Handbook of Integrated Dental
Medicine 3e Biosciences 2e
Oxford Handbook of Anaesthesia 4e Oxford Handbook of Humanitarian
Oxford Handbook of Cardiology 2e Medicine
Oxford Handbook of Clinical and Oxford Handbook of Key Clinical
Healthcare Research Evidence 2e
Oxford Handbook of Clinical and Oxford Handbook of Medical
Laboratory Investigation 4e Dermatology 2e
Oxford Handbook of Clinical Oxford Handbook of Medical Imaging
Dentistry 6e Oxford Handbook of Medical
Oxford Handbook of Clinical Sciences 2e
Diagnosis 3e Oxford Handbook for Medical School
Oxford Handbook of Clinical Oxford Handbook of Medical Statistics
Examination and Practical Skills 2e Oxford Handbook of Neonatology 2e
Oxford Handbook of Clinical Oxford Handbook of Nephrology and
Haematology 4e Hypertension 2e
Oxford Handbook of Clinical Oxford Handbook of Neurology 2e
Immunology and Allergy 3e Oxford Handbook of Nutrition and
Oxford Handbook of Clinical Dietetics 2e
Medicine – Mini Edition 9e Oxford Handbook of Obstetrics and
Oxford Handbook of Clinical Gynaecology 3e
Medicine 10e Oxford Handbook of Occupational
Oxford Handbook of Clinical Pathology Health 2e
Oxford Handbook of Clinical Oxford Handbook of Oncology 3e
Pharmacy 3e Oxford Handbook of Operative
Oxford Handbook of Clinical Surgery 3e
Specialties 10e Oxford Handbook of
Oxford Handbook of Clinical Ophthalmology 4e
Surgery 4e Oxford Handbook of Oral and
Oxford Handbook of Complementary Maxillofacial Surgery 2e
Medicine Oxford Handbook of Orthopaedics
Oxford Handbook of Critical Care 3e and Trauma
Oxford Handbook of Dental Oxford Handbook of Paediatrics 2e
Patient Care Oxford Handbook of Pain Management
Oxford Handbook of Dialysis 4e Oxford Handbook of Palliative Care 3e
Oxford Handbook of Emergency Oxford Handbook of Practical Drug
Medicine 4e Therapy 2e
Oxford Handbook of Endocrinology Oxford Handbook of
and Diabetes 3e Pre- Hospital Care
Oxford Handbook of ENT and Head Oxford Handbook of Psychiatry 3e
and Neck Surgery 2e Oxford Handbook of Public Health
Oxford Handbook of Epidemiology for Practice 3e
Clinicians Oxford Handbook of Rehabilitation
Oxford Handbook of Expedition and Medicine 3e
Wilderness Medicine 2e Oxford Handbook of Reproductive
Oxford Handbook of Forensic Medicine Medicine & Family Planning 2e
Oxford Handbook of Gastroenterology Oxford Handbook of Respiratory
& Hepatology 2e Medicine 3e
Oxford Handbook of General Oxford Handbook of Rheumatology 4e
Practice 4e Oxford Handbook of Sport and
Oxford Handbook of Genetics Exercise Medicine 2e
Oxford Handbook of Genitourinary Handbook of Surgical Consent
Medicine, HIV, and Sexual Health 2e Oxford Handbook of Tropical
Oxford Handbook of Geriatric Medicine 4e
Medicine 3e 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
OXFORD MEDICAL PUBLICATIONS
Oxford Handbook of
Humanitarian
Medicine
ii
Published and forthcoming Oxford Handbooks
Oxford Handbook for the Foundation Oxford Handbook of Infectious
Programme 5e Diseases and Microbiology 2e
Oxford Handbook of Acute Oxford Handbook of Integrated Dental
Medicine 3e Biosciences 2e
Oxford Handbook of Anaesthesia 4e Oxford Handbook of Humanitarian
Oxford Handbook of Cardiology 2e Medicine
Oxford Handbook of Clinical and Oxford Handbook of Key Clinical
Healthcare Research Evidence 2e
Oxford Handbook of Clinical and Oxford Handbook of Medical
Laboratory Investigation 4e Dermatology 2e
Oxford Handbook of Clinical Oxford Handbook of Medical Imaging
Dentistry 6e Oxford Handbook of Medical
Oxford Handbook of Clinical Sciences 2e
Diagnosis 3e Oxford Handbook for Medical School
Oxford Handbook of Clinical Oxford Handbook of Medical Statistics
Examination and Practical Skills 2e Oxford Handbook of Neonatology 2e
Oxford Handbook of Clinical Oxford Handbook of Nephrology and
Haematology 4e Hypertension 2e
Oxford Handbook of Clinical Oxford Handbook of Neurology 2e
Immunology and Allergy 3e Oxford Handbook of Nutrition and
Oxford Handbook of Clinical Dietetics 2e
Medicine – Mini Edition 9e Oxford Handbook of Obstetrics and
Oxford Handbook of Clinical Gynaecology 3e
Medicine 10e Oxford Handbook of Occupational
Oxford Handbook of Clinical Pathology Health 2e
Oxford Handbook of Clinical Oxford Handbook of Oncology 3e
Pharmacy 3e Oxford Handbook of Operative
Oxford Handbook of Clinical Surgery 3e
Specialties 10e Oxford Handbook of
Oxford Handbook of Clinical Ophthalmology 4e
Surgery 4e Oxford Handbook of Oral and
Oxford Handbook of Complementary Maxillofacial Surgery 2e
Medicine Oxford Handbook of Orthopaedics
Oxford Handbook of Critical Care 3e and Trauma
Oxford Handbook of Dental Oxford Handbook of Paediatrics 2e
Patient Care Oxford Handbook of Pain Management
Oxford Handbook of Dialysis 4e Oxford Handbook of Palliative Care 3e
Oxford Handbook of Emergency Oxford Handbook of Practical Drug
Medicine 4e Therapy 2e
Oxford Handbook of Endocrinology Oxford Handbook of
and Diabetes 3e Pre- Hospital Care
Oxford Handbook of ENT and Head Oxford Handbook of Psychiatry 3e
and Neck Surgery 2e Oxford Handbook of Public Health
Oxford Handbook of Epidemiology for Practice 3e
Clinicians Oxford Handbook of Rehabilitation
Oxford Handbook of Expedition and Medicine 3e
Wilderness Medicine 2e Oxford Handbook of Reproductive
Oxford Handbook of Forensic Medicine Medicine & Family Planning 2e
Oxford Handbook of Gastroenterology Oxford Handbook of Respiratory
& Hepatology 2e Medicine 3e
Oxford Handbook of General Oxford Handbook of Rheumatology 4e
Practice 4e Oxford Handbook of Sport and
Oxford Handbook of Genetics Exercise Medicine 2e
Oxford Handbook of Genitourinary Handbook of Surgical Consent
Medicine, HIV, and Sexual Health 2e Oxford Handbook of Tropical
Oxford Handbook of Geriatric Medicine 4e
Medicine 3e 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
iv
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-t o- 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-p regnant
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.
v
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 ap-
parent—or waiting to strike.
Despite intense media exposure and ostensible political support by dis-
interested parties, in truth many campaigns in Humanitarian Medicine have
proved social misfits lacking loyal and authoritative parents; judged retro-
spectively 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-e merging ‘ground’ emergencies with
plague, pestilences, starvation, torture and war- related human disasters of
every possible kind, but to essential strategic measures. The authors suc-
cinctly explore the need to predict, to resource, as well as develop tailor-
made 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, pro-
vide, and instruct. Within the ethical framework of conventional medi-
cine, it offers support those who holistically improve well-b eing 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 dis-
cretion 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 mili-
tary intervention and colonization, wayward and permanently starved of re-
sources. 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 para-
chute 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 co-
authors 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
iv
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-t o- 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-p regnant
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.