International health, also called
geographic medicine or
global healthGlobal health is the health of populations in a global context and transcends the perspectives and concerns of individual nations. Health problems that transcend national borders or have a global political and economic impact, are often emphasized...
, is a field of
healthAt the of the creation of the World Health Organization , in 1948, Health was defined as being "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity"....
care, usually with a public health emphasis, dealing with health across regional or national boundaries. One subset of international medicine,
travel medicineTravel medicine or emporiatrics is the branch of medicine that deals with the prevention and management of health problems of international travelers.-Globalization and travel:...
, prepares travelers with immunizations, prophylactic medications, preventive techniques such as bednets and residual pesticides, in-transit care, and post-travel care for exotic illnesses. International health, however, more often refers to health personnel or organizations from one area or nation providing direct health care, or health sector development, in another area or nation. It is this sense of the term that is explained here. More recently,
public healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based...
experts have become interested in global processes that impact on human health.
Globalization and healthGlobalization and Health is an open-access, peer-reviewed, online journal that provides an international forum for high quality original research, knowledge sharing and debate on the topic of globalization and its effects on health, both positive and negative...
, for example, illustrates the complex and changing sociological environment within which the determinants of
healthAt the of the creation of the World Health Organization , in 1948, Health was defined as being "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity"....
and
diseaseA disease or medical condition isan abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and signs...
express themselves.
The Role of NGOs
Much work in international health is performed by non-governmental organizations, or NGOs. Services provided by international health NGOs include direct health care, community potable water, vitamin supplementation, and mitigation of endemic and epidemic infectious diseases and malnutrition. Examples of NGOs dedicated to international health include:
- Care
Care may refer to:* Care , a 1980s alternative rock band from Liverpool* "Care", a 2001 episode of Law & Order: Special Victims Unit...
- Médecins Sans Frontières
Médecins Sans Frontières , or Doctors Without Borders, is a secular humanitarian-aid non-governmental organization best known for its projects in war-torn regions and developing countries facing endemic disease....
(Doctors Without Borders)
- The International Committee of the Red Cross
The International Committee of the Red Cross is a private humanitarian institution based in Geneva, Switzerland. States parties to the four Geneva Conventions of 1949 and their Additional Protocols of 1977 and 2005, have given the ICRC a mandate to protect the victims of international and...
- International Medical Corps
International Medical Corps is a global humanitarian nonprofit organization established by volunteer doctors and nurses...
- Oxfam
Oxfam International is a confederation of 14 organisations working with over 3,000 partners in more than 70 countries to find lasting solutions to poverty and injustice....
- Partners in Health
Partners In Health is a Boston, Massachusetts-based non-profit health care organization dedicated to providing a "preferential option for the poor". Founded in 1987 by Dr. Paul Farmer, Ophelia Dahl, Thomas J. White, Todd McCormack, and Dr. Jim Kim, PIH strives to bring good medical care to the...
- Project HOPE
Project HOPE is an international health care organization founded in the United States in 1958. Its most visible aspect was the SS HOPE, the first peacetime hospital ship...
- Save the Children
Save the Children is an international organisation helping children in need around the world. First established in the United Kingdom in 1919, separate national organisations have been set up in more than twenty-eight countries, sharing the aim of improving the lives of children through education,...
In Harm's Way
These organizations often go in harm's way to provide services to people affected by natural disaster or conflict. For example, Médecins Sans Frontières has lost members in the
DarfurDarfur is a region in Sudan. An independent sultanate for several hundred years, it was incorporated into Sudan by Anglo-Egyptian forces. The region is divided into three federal states: West Darfur, South Darfur, and North Darfur which are coordinated by a Transitional Darfur Regional Authority...
area, and Care International's Iraq Director,
Margaret HassanMargaret Hassan was an Irish aid worker who had worked in Iraq for many years until she was abducted and murdered by unidentified kidnappers in Iraq in 2004, at the age of 59....
(a long-time Iraq resident with dual Iraqi-British citizenship) was brutally murdered on the Internet by Al Qaeda-affiliated terrorists for the "crime" of providing services equitably among Iraqis. International Medical Corps was begun in response to the suffering of the Afghan people after the Soviet invasion of 1979, and is adept at providing services in dangerous places (see
Attacks on humanitarian workersHumanitarian aid workers belonging to United Nations organisations, PVOs / NGOs or the Red Cross / Red Crescent have traditionally enjoyed both international legal protection, and de facto immunity from attack by belligerent parties. However, attacks on humanitarian workers have occasionally...
)
The Role of International Health NGOs in International Development
Health-related NGOs also provide capacity development in areas of need; that is, helping nations develop sustainable domestic health solutions through training programs. An example of this type of aid is the
Center for International Rehabilitation, which has provided rehabilitation training for Iraqi physical therapists, physicians, and rehabilitation clinic managers in Tuzla, Bosnia and Amman, Jordan. These trainees then care for amputees, spinal and head injury patients in their home country.
NGOs vs. Missionaries
One important characteristic of NGO work is that, in the "pure" sense, they provide services based solely upon need, without political, ethnic, religious or other considerations. Thus, strictly speaking, religious
missionaryA missionary is a member of a religion who works to convert those who do not share the missionary's faith; someone who proselytizes. The word "mission" is derived from the Latin missioninimus A missionary is a member of a religion who works to convert those who do not share the missionary's faith;...
organizations that perform services as part of a proselytizing or evangelical campaign should be separated from the NGO category and simply be referred to as religious missionary organizations. Some religious relief organizations do provide services more as a duty or "charity", however, without requirements for the recipients to attend any preaching, prayer or other religious preconditions.
Harnessing the Power of Technology
As NGO practice evolves parallel with technology, NGOs have developed more scientific and precise methods of assessment, planning and operations in humanitarian assistance and complex emergencies. One example is the
Sphere ProjectThe Sphere Project was launched in 1997 to develop a set of minimum standards in core areas of humanitarian assistance. The aim of the project is to improve the quality of assistance provided to people affected by disasters, and to enhance the accountability of the humanitarian system in disaster...
's
Charter and Minimum Standards in Disaster Response. They have taken other new tools into the planning offices and field: in addition to the obligatory laptop computer, they typically rely heavily upon cellular and satellite communications, the Internet, and global information services
http://www.humanitarianinfo.org/IMToolbox/web/03_Map.html, or GIS. These technological improvements allow them to better focus efforts in areas of need, respond to evolving crises, and predict future needs. Indeed, in a related effort, the United States Holocaust Museum teamed with
Google EarthGoogle Earth is an information program that was originally called EarthViewer 3D, and was created by Keyhole, Inc, a company acquired by Google in 2004. It maps the Earth by the superimposition of images obtained from satellite imagery, aerial photography and GIS 3D globe...
to establish baseline GIS photos of crisis-torn Darfur, updating them at intervals, and uploading them to the Internet for public access. Since Internet "surfers" can browse these images and see where once-present villages are later obliterated, this teamwork gave lie to the Sudanese claim that it was engaging in neither ethnic cleansing nor genocide
http://www.ushmm.org/googleearth/projects/darfur/.
The U.S. Department of Defense
In another teamwork effort, the
Assistant Secretary of Defense (Health Affairs)The Honorable S. Ward Casscells, MD is the John E. Tyson Distinguished Professor of Medicine and Public Health, and Vice President for External Affairs and Public Policy at the University of Texas Health Science Center at Houston, and Senior Scholar at the Texas Heart Institute...
of the United States
Department of DefenseThe United States Department of Defense is the federal department charged with coordinating and supervising all agencies and functions of the government relating directly to national security and the military...
, as the DoD's senior medical officer, established the International Health Division
http://fhp.osd.mil/intlhealth/ in late 2007 to help coordinate military health doctrine and practices in international development. The International Health Division places great emphasis upon working with NGOs to provide sustainable, culturally-appropriate development activities around the world. While critics maintain that DoD does not provide aid equitably and without regard to political influence, the Asian tsunami of December, 2004 (due to the
2004 Indian Ocean earthquakeThe 2004 Indian Ocean earthquake was an undersea megathrust earthquake that occurred at 00:58:53 UTC on December 26, 2004, with an epicentre off the west coast of Sumatra, Indonesia. The quake itself is known by the scientific community as the Sumatra-Andaman earthquake...
) demonstrated that DoD was capable of working in a supporting role without regard to geopolitical gain. Indeed, the DoD was surprised at the unexpected degree of improvement in American prestige as a result of its role in Southeast Asia and months later, in the Pakistan earthquake. A similar event resulted in rapid mobilization of DoD resources in response to the
2007 Peru earthquakeThe 2007 Peru earthquake was an earthquake measuring 8.0 on the moment magnitude scale that hit the central coast of Peru on Wednesday August 15, 2007; it occurred at 23:40:58 UTC and lasted for about three minutes...
, Bangladeshi Typhoon Sidr
http://www.iht.com/articles/ap/2007/11/28/asia/AS-GEN-Bangladesh-Cyclone.php and Tropical Storm Nero in the
Dominican RepublicThe Dominican Republic is a nation on the island of Hispaniola, part of the Greater Antilles archipelago in the Caribbean region. The western third of the island is occupied by the nation of Haiti, making Hispaniola one of two Caribbean islands that are occupied by two countries...
, all in the last half of 2007, with no reasonable expectation of material gain for America.
In 2005, then-Secretary of Defense
Donald RumsfeldDonald Henry Rumsfeld is a United States businessman, politician, the 13th Secretary of Defense under President Gerald Ford from 1975 to 1977, and the 21st Secretary of Defense under President George W. Bush from 2001 to 2006...
signed DoD Directive 3000.05, "Stability, Security, Transition and Reconstruction Operations"
http://www.dtic.mil/whs/directives/corres/pdf/300005p.pdf. This document requires the DoD to assign Stability, Security, Transition and Reconstruction (SSTR) the same importance in planning and preparation as it gives to warfighting.
The rationale for SSTR is intuitive: stability promotes rule of law and economic development. These provide the base for essential services such as education,
public healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based...
and
sanitationSanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic...
, law enforcement and fire suppression. Essential services, in turn, lead to increased stability and economic opportunity. Health in the general population, and in particular the labor force, is essential to productivity and consequent stability
http://www.who.int/mediacentre/news/releases/2007/pr11/en/
Although these relationships are not necessarily linear, and there is no inherent guarantee of equitable distribution of wealth in a developing society, full employment and hope for the future may be powerful disincentives to conflict. In this way, the DoD , through SSTR operations, expects to prevent some potential conflicts and criminal activities.
The International Health Division, charged with policy implications of DoDD 3000.05, is located within the Office of the ASD(HA), reporting through Force Health Protection & Readiness. International Health develops DoD's policy on
medical ethicsMedical ethics is primarily a field of applied ethics, the study of moral values and judgments as they apply to medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.Medical...
and the practice of medicine in international health and development settings. International Health also identifies needs in developing nations and looks for non-governmental organizations (NGOs), intergovernmental organizations, and private voluntary organizations (PVOs) such as professional societies, that have the ability and expertise to address these problems. In this way, the NGOs develop helping relationships with the nations or regions they work in, fostering stability and sustainability.
Other DoD international health activities occurring on a regular basis include
medical civic action projectsA civic action program also known as civic action project is a type of operation designed to assist an area by using the capabilities and resources of a military force or civilian organization to conduct long-term programs or short-term projects...
(MEDCAPs), in which Army, Navy or Air Force medical assets provide direct care, sanitation, and other public health services to host nation (HN) locals. Such MEDCAPs are generally traced to the
Vietnam warThe Vietnam War or the Second Indochina War was a Cold War military conflict that occurred in Vietnam, Laos, and Cambodia from 1959 to 30 April 1975...
, when medical units and medical personnel assigned to combat units would organize field medical care to Vietnamese,
HmongHmong may refer to:*Hmong people, an ethnic group in China and Southeast Asia*Hmong language, a cluster of closely related Hmong-Mien languages*Hmong customs and culture*Hmong cuisine...
and others. There is a growing realization among the military that MEDCAP care may not be the best model, if the result is merely handing out antibiotics for upper respiratory infections and anti-inflammatories for aches and pains. However, projects such as de-worming, dentistry, prenatal education and care, and veterinary care, when performed in conjunction with HN health authorities and the local health infrastructure, have indisputable and long-lasting benefits to the recipients.
Similar to MEDCAPs, the military performs
Medical Readiness Training ExercisesA civic action program also known as civic action project is a type of operation designed to assist an area by using the capabilities and resources of a military force or civilian organization to conduct long-term programs or short-term projects...
(MEDRETEs),
Joint Combined Exchange TrainingJoint Combined Exchange Training or JCET programs are exercises designed to provide training opportunities for American Special Forces who are stationed outside of the United States by holding the training exercises in countries that the forces may one day have to operate in, as well as providing...
(JCET), and Humanitarian-Civic Action (HCA) exercises, all of which may have direct and indirect services as a feature of the training.
Finally, the military has unparalleled logistical and lift capabilities to respond to humanitarian assistance/disaster response(HADR) needs.
In conjunction with the
Uniformed Services University of the Health SciencesThe Uniformed Services University of the Health Sciences is a health science university run by the U.S. federal government. The primary mission of the school is to prepare graduates for service to the U.S. at home and abroad in the medical corps....
(USUHS), the
Center for Disaster and Humanitarian Medicine (CDHAM) develops curriculum, teaches disaster and humanitarian assistance principles to graduate, medical, and post-doctoral students and publishes courses on incident command and other related topics. CDHAM provides
http://www.cdham.org/controls/speerio/resources/RenderContent.aspx?data=PK0orTz5p%2bpZ6334hzIm%2blWOxCIVLVZN%2bSSIxVZhe%2bwlBHPCfa5%2bXyy5lVJBQpUYf%2bGPcS8sUhiR2utZUbDL6I8j%2bi82WUUobhmt2FTQEkwpKxHoA19YxRSX5cHLUmqcY6FFz1c7XgbdNlUwipPrEuUvLrqkIwnLs1azf8wz0MkfFYPSJv6jV8xm14sRy2wPSjMVhrzeJckauIAJHLQcNJ2%2bGkDmrrEt1k22fFls4ztTyncS%2bxrz7S%2fb1mQeqUF2QLlIrMIqaT7lSYFN3l6g6ee7UiSfft%2bWE68LGvvM74Ojeczq4%2fmJ3ZqDhpHZCYJ3HmFlDIUfhEZ3WSdt8SJn0ruDarWRE6kw&TabId=84"A Guide to NGOs"] free on-line.
External links