American efforts in international health
The U.S. Department of Defense
In another teamwork effort, the Assistant Secretary of Defense (Health Affairs) of the United States Department of Defense, as the DoD's senior medical officer, established the International Health Division 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 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 earthquake, Bangladeshi Typhoon Sidr [7] and Tropical Storm Nero in the Dominican Republic, all in the last half of 2007, with no reasonable expectation of material gain for America.
In 2005, then-Secretary of Defense Donald Rumsfeld signed DoD Directive 3000.05, "Stability, Security, Transition and Reconstruction Operations". [8] This document requires the DoD to assign Stability, Security, Transition and Reconstruction (SSTR) the same importance in planning and preparation as it gives to war.
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 health and sanitation, 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. [9]
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 ethics 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 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 war, when medical units and medical personnel assigned to combat units would organize field medical care to Vietnamese, Hmong 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 Exercises (MEDRETEs), Joint Combined Exchange Training (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 Sciences (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. The handbook on military-NGO relations, "A Guide to Non-Governmental Organizations for the Military" is available free on-line.
Médecins Sans Frontières, also known as Doctors Without Borders, is a charity that provides humanitarian medical care. It is a non-governmental organisation (NGO) of French origin known for its projects in conflict zones and in countries affected by endemic diseases. The organisation provides care for diabetes, drug-resistant infections, HIV/AIDS, hepatitis C, tropical and neglected diseases, tuberculosis, vaccines and COVID-19. In 2019, the charity was active in 70 countries with over 35,000 personnel; mostly local doctors, nurses and other medical professionals, logistical experts, water and sanitation engineers, and administrators. Private donors provide about 90% of the organisation's funding, while corporate donations provide the rest, giving MSF an annual budget of approximately US$1.63 billion.
A non-governmental organization (NGO) is an organization that generally is formed independent from government. They are typically nonprofit entities, and many of them are active in humanitarianism or the social sciences; they can also include clubs and associations that provide services to their members and others. NGOs can also be lobby groups for corporations, such as the World Economic Forum. NGOs are distinguished from international and intergovernmental organizations (IOs) in that the latter are more directly involved with sovereign states and their governments.
An internally displaced person (IDP) is someone who is forced to leave their home but who remains within their country's borders. They are often referred to as refugees, although they do not fall within the legal definitions of a refugee.
Humanitarian aid is material and logistic assistance, usually in the short-term, to people in need. Among the people in need are the homeless, refugees, and victims of natural disasters, wars, and famines. The primary objective of humanitarian aid is to save lives, alleviate suffering, and maintain human dignity.
James Jude Orbinski is a Canadian physician, humanitarian activist, author and leading scholar in global health. Orbinski was the 2016-17 Fulbright visiting professor at the University of California, Irvine, and as of September 1, 2017, he is professor and inaugural director of the Dahdaleh Institute of Global Health Research at York University in Toronto, Ontario, Canada. He was previously the CIGI Chair in Global Health Governance at the Balsillie School of International Affairs and Wilfrid Laurier University (2012-2017), Chair of Global Health at the Dalla Lana School of Public Health (2010-2012) and full professor at the Faculty of Medicine, University of Toronto (2003-2012), where he was the founding Saul Rae Fellow at Massey College. Orbinski's current research interests focus on the health impacts of climate change, medical humanitarianism, intervention strategies around emerging and re-emerging infectious diseases, and global health governance.
A humanitarian crisis is defined as a singular event or a series of events that are threatening in terms of health, safety or well-being of a community or large group of people. It may be an internal or external conflict and usually occurs throughout a large land area. Local, national and international responses are necessary in such events.
Humanitarian assistance is aid and action designed to save lives, alleviate suffering, and maintain human dignity during and after man-made crises and disasters. It encompasses a wide range of activities, including providing food, water, shelter, medical care, and protection. Humanitarian assistance is grounded in the principles of humanity, impartiality, neutrality, and independence.
Emergency is a humanitarian NGO that provides free medical treatment to the victims of war, poverty, and landmines. It was founded in 1994. Gino Strada, one of the organization's co-founders, served as EMERGENCY's Executive Director. It operates on the premise that access to high-quality healthcare is a fundamental human right.
Medical Emergency Relief International (Merlin) is a former British international non-governmental health charity which sends medical experts to global emergencies. In July 2013, Merlin merged with Save the Children.
An international non-governmental organization (INGO) is an organization which is independent of government involvement and extends the concept of a non-governmental organization (NGO) to an international scope.
There are a number of meanings for the term humanitarian. Here, humanitarian pertains to the practice of saving lives and alleviating suffering. It is usually related to emergency response whether in the case of a natural disaster or a man-made disaster such as war or other armed conflict. Humanitarian principles govern the way humanitarian response is carried out.
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.
Foreign internal defense (FID) is a term used by the military in several countries, including the United States, France, and the United Kingdom, to describe an integrated, or multi-country approach to combating actual or threatened insurgency in a foreign state. This foreign state is known as the Host Nation (HN) under the US doctrine. The term counter-insurgency is commonly used for FID.
The International Committee of Military Medicine (ICMM) is an international and intergovernmental organization consisting of more than one hundred states. The ICMM was established in 1921, in response to concerns over the lack of care provided during World War I. It was created to strengthen cooperation between the health services of the armed forces worldwide.
The International Organization for Peace, Care and Relief is a non-governmental organization based in Tripoli, Libya. Founded in 1999, the organisation has special Consultative Status with the Economic and Social Council of the United Nations (ECOSOC) and has an independent legal and financial status. The president of the organization is Khaled K. El-Hamedi.
United States aid to Sudan has three key objectives: a definitive end to conflict, gross human rights abuses, and genocide in Darfur; implementation of the north–south Comprehensive Peace Agreement that results in a peaceful post-2011 Sudan, or an orderly path toward two separate and viable states at peace with each other; and ensuring that Sudan does not provide a safe haven for international terrorists. Sudan has experienced two civil wars since 1955, the second of which lasted 22 years. During this time, the U.S. was the largest provider of foreign aid to Sudan, largely focused on humanitarian aid through the U.S. Agency for International Development. Sudan is listed as the U.S. government's highest priority in Africa due to "its importance for counter-terrorism and regional stability, as well as the magnitude of human rights and humanitarian abuses" U.S. foreign aid to Sudan has begun to see some positive indicators of performance although critical reaction has said that aid to Sudan is neither strategic nor focused.
Qatar Charity is a humanitarian and development non-governmental organization in the Middle East. It was founded in 1992 in response to the thousands of children who were made orphans by the Afghanistan war and while orphans still remain a priority cause in the organization's work with more than 150,000 sponsored orphans, it has now expanded its fields of action to include six humanitarian fields and seven development fields.
Eric David Rasmussen is an American physician specializing in methods for global disaster response and their intersection with modern medical ethics. He was selected as the founding CEO of the TED Prize awarded to Larry Brilliant of Google.org in 2006 and in 2013 became the CEO of Infinitum Humanitarian Systems, a Seattle-based international consulting firm specializing in the humanitarian sciences.
Michael Johannes VanRooyen is an American humanitarian and physician, best known for his expertise in emergency medicine and aid delivery in humanitarian crises. VanRooyen is the co-founder and current director of the Harvard Humanitarian Initiative at Harvard University, a university-wide research center that aims to provide practice-based solutions to "relieve human suffering in war and disaster" through interdisciplinary research, education, and policy-development. A leader in the humanitarian field, Boston magazine posited that "the Harvard professor's exploits have inspired legions of followers to dedicate themselves to helping right the political, military, and environmental wrongs of the world."
Frederick M. "Skip" Burkle, Jr. is an American physician known for his work in human rights, international diplomacy and peacemaking, humanitarian assistance, and disaster response. He has been called "the single most talented and experienced post-conflict health specialist working for the United States government." His medical qualifications include pediatrics, emergency medicine, psychiatry, public health, and tropical medicine.
