Contemporary issues in humanitarianism: selected resources

As Tony Vaux points out in his Guest Editorial in this issue, the concept of humanitarianism applies to both war and general disaster, and is based on the principle that ‘in extreme cases of human suffering external agents may offer assistance to people in need, and in doing so should be accorded respect and even “rights” in carrying out their functions’. However, policy makers in humanitarian agencies, and aid workers on the ground, face a bewilderingly complex set of challenges in determining such ‘rights’. Gone are any comfortable certainties about what in the commercial sector is known as ‘the licence to operate’, and claims to the moral high ground of ‘neutrality’ have an increasingly hollow ring. Perhaps more to the point, such assumptions are of little practical use to frontline workers who may risk ambush, abduction, deportation, or even their lives as the result of their professional activities. Nor do outdated road maps help relief agencies to orient their decisions on whether to withdraw or continue providing material assistance in the knowledge that a proportion of it is fuelling the violence or lining the pockets of conflict profiteers. There are no standard ‘off-the-peg’ answers, because each situation must be considered on its own merits. And of course no aid agencies share an identical mandate, or have precisely the same expertise or history of involvement with the affected population – all factors that must be weighed up in deciding what is the appropriate course of action.

For reasons of space, we have not sought to cover the areas of early warning, prevention, and mitigation associated with ‘natural’ disasters, although of course the two are always linked, as became very clear in wake of the Asian tsunami in Aceh and Sri Lanka. It has long been recognised that since catastrophic events disproportionately affect the poor and marginalised, they expose and may intensify existing social divides and structural injustice. For instance, in his seminal work on the 1943 Bengal famine, Poverty and Famines: An Essay on Entitlement and Deprivation (OUP, 1984) Amartya K Sen argued that such food shortages do not occur in functioning democracies. Similarly, Roger Plant's, Guatemala: Unnatural Disaster (Latin America Bureau, 1978) showed how the 1974 earthquake triggered an intensification in state violence that was to result in the death or disappearance of 200,000 Guatemalans and create ‘a nation of widows and orphans’.

In accordance with the focus of this issue, we have given priority to publications and organisations that reflect on some direct involvement in humanitarian endeavour, rather than giving priority to more policy-oriented or scholarly works or academic institutions. We have included literature on the 1994 genocide in Rwanda, since this was such a defining event for humanitarianism; and some recent publications concerning the US-led invasions of Afghanistan in October 2001 (‘Operation Enduring Freedom’) and Iraq in March 2003 (‘Operation Iraqi Freedom’), since these have significantly redefined the global landscape of policy and practice within which humanitarian agencies operate. Inevitably we can offer only a glimpse of the growing literature in these fields, but we hope in so doing that readers, and particularly those directly involved in humanitarian endeavours, will be encouraged to explore the issues further.     

Reducing racial and ethnic health disparities: exploring an outcome-oriented agenda for research and policy

Eliminating racial and ethnic disparities in health status and health care, a major focus of Healthy People 2010, remains on the national agenda and among the priorities for the administration of President George W. Bush. Even though the elimination of racial and ethnic health disparities challenges the whole nation, individual states are on the front line of many initiatives and are often the focus of important policy efforts. In addition, it is important to focus on states because they are already responsible for much of the health and public health infrastructure, and several states have developed initiatives dating back to the release of Margaret Heckler's report on the gaps in health outcomes by race in 1985. This article makes the case for an outcome-oriented approach and provides a summary of lessons learned based upon preliminary investigations into constructing and applying two indices, the disparity reduction profile to measure effort and the disparity index to measure outcomes.     

Factors influencing help-seeking from informal networks among African American victims of intimate partner violence

The purpose of this study was to gain an understanding of the challenges African-American women in abusive relationships face when they consider seeking-help from their informal networks. Data are reported from interviews with 15 African-American women who were self-identified as having survived physical intimate partner violence. A 13-item, semi-structured interview guide was developed in order to elicit information from participants. All of the interviews were audio-recorded, transcribed, and coded for analysis. This analysis revealed emergent themes from these interviews concerning the social factors and perceptions that influence help-seeking behavior. Participants perceived their informal networks as willing to offer instrumental support. However, informal networks were not emotionally supportive. Participants also noted that the African-American community at-large believes victims of violence to be "stupid" for remaining in violent relationships. Additional results are also discussed. Results may be used to help enhance efforts to reduce the rates of intimate partner violence among African-Americans.     

Characterization of human control region sequences of the African American SWGDAM forensic mtDNA data set

The scientific working group on DNA analysis Methods (SWGDAM) mitochondrial DNA (mtDNA) population data set is used to infer the relative rarity of control region mtDNA profiles obtained from evidence samples and of profiles used for identification of missing persons. In this study, the African American haplogroup patterns in the SWGDAM data were analyzed in a phylogenetic context to determine relevant single nucleotide polymorphisms (SNPs) and to describe haplogroup distributions for Africans observed in these data sets. Over 200 SNPs (n=217) were observed in the African American data set (n=1148). These SNPs ranged from having 1-39 changes in the phylogenetic tree, with sites 152 and 16519 being the most variable. On average there were 5.8 changes for a character on the tree. The most variable sites (with 19 or more changes each) observed included 16093, 16129, 16189, 16311, 16362, 16519, 146, 150, 152, 189, and 195. These rapidly changing sites are consistent with other published analyses. Only 34 SNPs are needed to identify all clusters containing 10 or more individuals in the African American data set. The results show that the African American SWGDAM mtDNA data set contains variation consistent with that described in continental African populations. Thirteen of the 18 haplogroups previously observed in African populations were observed and include: L1a, L1b, L1c, L2a, L2b, L2c, L3b, L3d, L3e1, L3e2, L3e3, L3e4 and L3f. Haplogroup L2a is the most commonly observed cluster (18.8%) in the African American data set. The next most common haplogroups in the African American data set include the clusters L1c (11.0%), L1b (9.1%), L3e2 (9.0%) and L3b (8.1%). Approximately 8% of the haplogroups observed within African Americans were common in European Caucasians or East Asians; these were H (n=32), J (n=4), K (n=5), T (n=2), U5 (n=6), U6 (n=9 also known from North Africa), A (n=12), B (n=7), C (n=4), and M (n=16), respectively. The European Caucasian and East Asian haplogroups are expected due to admixture between individuals with recent ancestry in Western Eurasia and sub-Saharan Africa. The genetic characterization of these relevant data sets is fully consistent with other published mtDNA genetic variation. The sequence diversity observed in this data set makes it a valuable tool for forensic applications.     

Reflections on partner violence: 20 years of research and beyond

The authors reflect on past research and technology as well as their hopes for future innovations within the field of intimate partner violence. They review work that has contributed to current conceptual definitions of partner violence, particularly those that have shaped the field's broadened perspective. They discuss technological and measurement innovations that have contributed to more accurate assessments of violence prevalence. The authors believe that via these technologies, the true extent of violence within the home has been made known. In conclusion, the authors argue that to reduce violence between partners, there is an overwhelming need for future researchers to build on past data, develop improved theories, and apply those ideas to prevention and intervention techniques and programs. Furthermore, they believe that it is imperative for current and future programs to be extensively evaluated and tested for their effectiveness.     

We've had training, now what? Qualitative analysis of barriers to domestic violence screening and referral in a health care setting

The present study assesses barriers to identification and referral of domestic violence (DV) victims by staff at a health care institution following a 3-hr DV training program in which 752 health care providers participated. Focus groups are conducted with staff in hospital departments that serve a high volume of women. Responses to focus group questions identify system-wide and individual hospital department barriers. These barriers have implications for health care organizations trying to implement DV screening protocols through training alone to change staff behavior in diverse clinical settings. Limitations of this study and future research recommendations are also discussed.