scholarly journals Eliminating malaria in conflict zones: public health strategies developed in the Sri Lanka Civil War

2021 ◽  
Vol 6 (12) ◽  
pp. e007453
Author(s):  
Abrar Ahmed ◽  
Kara Grace Hounsell ◽  
Talha Sadiq ◽  
Mariam Naguib ◽  
Kirstyn Koswin ◽  
...  
Keyword(s):  
Civil War ◽  
Sri Lanka ◽  
Disease Burden ◽  
World Health ◽  
Conflict Zones ◽  
Non Profit ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
The Government ◽  
Public Health Strategies

Despite the 26-year long civil war, Sri Lanka was declared malaria-free by WHO in 2016. This achievement was the result of nearly 30 years of elimination efforts following the last significant resurgence of malaria cases in Sri Lanka. The resurgence occurred in 1986–1987, when about 600 000 cases of malaria were detected. Obstacles to these efforts included a lack of healthcare workers in conflict zones, a disruption of vector control efforts, gaps in the medication supply chain, and rising malaria cases among the displaced population.This article seeks to describe the four strategies deployed in Sri Lanka to mitigate the aforementioned obstacles to ultimately achieve malaria elimination. The first approach was the support for disease elimination by the government of Sri Lanka and the Liberation Tamil Tigers of Elam. The second strategy was the balance of centralised leadership of the federal government and the decentralised programme operation at the regional level. The third strategy was the engagement of non-governmental stakeholders to fill in gaps left by the conflict to continue the elimination efforts. The last strategy is the ongoing efforts by the government, military and non-profit organisations to prevent the reintroduction of malaria.The lessons learnt from Sri Lanka have important implications for malaria-endemic nations that are in conflict such as Ethiopia, Afghanistan, Yemen and Somalia. To accomplish the World Health Assembly goal of reducing the global incidence and mortality of malaria by 90% by 2030, significant efforts are required to lessen the disease burden in conflict zones. In addition to the direct impacts of conflict on population health, conflicts may lead to increased risk of spread of malaria, both within a country and consequently, abroad.

Rebel Jurisdiction, Due Process, and Tamil Tiger Justice

2021 ◽  
pp. 219-354
Author(s):  
René Provost
Keyword(s):  
Sri Lanka ◽  
International Law ◽  
Due Process ◽  
Armed Conflicts ◽  
Court System ◽  
Conflict Zones ◽  
Legal Standards ◽  
Rebel Governance ◽  
Law And Courts ◽  
The Government

Chapter 3 examines the implication of a broad requirement of due process for rebel courts, taking as a case study the judicial system put into place by the Liberation Tigers of Tamil Eelam (LTTE) in Sri Lanka. The LTTE launched an armed insurgency against the government of Sri Lanka in the early 1980s, eventually controlling nearly 40 percent of national territory. The LTTE developed an independent civil administration which included a state-like court structure with seventeen distinct courts at trial, appeal, and supreme court levels. The group also enacted comprehensive civil and criminal codes, as well as other important pieces of legislation. The chapter takes this exceptionally sophisticated insurgent court system to interrogate the concept of rebel jurisdiction, exploring the foundations in public international law of the extent and limits of territorial, subject-matter, and personal jurisdictions of rebel law and courts. The analysis then turns to the thorny issue of due process requirements that must be met under international humanitarian and human rights law to consider as fair a trial before a rebel court. The precise content of the requirement of a fair trial under international law does vary in situations of emergency like international and non-international armed conflicts. In addition, legal standards must be adjusted to reflect the nature of non-state courts and the particular contextual challenges faced by rebel governance in conflict zones. On that basis, each applicable due process guarantee is analysed to determine the precise requirements it imposes on rebel justice.

scholarly journals Conservation and sustainable use of biodiversity in the islands and lagoons of northern Sri Lanka

2020 ◽  
Author(s):  
Devaka Weerakoon ◽  
Sampath De A. Goonatilake ◽  
Tharanga Wijewickrama ◽  
Arjan Rajasuriya ◽  
Naalin Perera ◽  
...  
Keyword(s):  
Civil War ◽  
Sri Lanka ◽  
Coastal Waters ◽  
Sustainable Use ◽  
Terrestrial Ecosystems ◽  
Northern Province ◽  
Biodiversity Assessment ◽  
Rapid Biodiversity Assessment ◽  
Palk Bay ◽  
The Government

After the 30-year long civil war was over, the Government of Sri Lanka commenced an accelerated programme to develop the Northern Province. If not carefully planned, such a programme will result in the loss of biodiversity and the consequent loss of services that ecosystems provide humans. Therefore, documenting the biodiversity found within coastal, nearshore and offshore islands of the Northern Province was identified as a need that would help both planners and conservation biologists alike. This report presents the results of a rapid biodiversity assessment of a 949 km stretch from Mannar to the Kokkilai Lagoon, including 22 coastal islands, five coastal stretches and four lagoons, extending across four districts (Jaffna, Mannar, Kilinochchi and Mullaittivu), 20 Divisional Secretariats Divisions and 264 Grama Niladhari Divisions. For terrestrial ecosystems, assessments were carried out during November 2015 and March 2016, and for marine surveys in the coastal waters of Palk Bay and Palk Strait, during November 2015 and March 2016.

scholarly journals Sri Lankan Patterns of Female Cancers: Incidence and Mortality Over 1995-2010

2021 ◽  
Vol 6 (1) ◽  
pp. 27-33
Author(s):  
Palatiyana V. S. C Vithana ◽  
Dompeyalage S. A.F Dheerasinghe ◽  
Hadagiripathira M. I Handagiripathira ◽  
Shreeni Alahapperuma ◽  
Irosha Nilaweera ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Sri Lanka ◽  
Cancer Incidence ◽  
Cancer Mortality ◽  
Uterine Cancer ◽  
World Health ◽  
Sri Lankan ◽  
Incidence And Mortality ◽  
Uterine Cancers

Background: Neoplasms are the second leading cause of deaths in Sri Lanka. Present study analysed the trends in incidence and mortality of all cancers, breast cancer, cervical, ovarian and uterine cancers among Sri Lankan females over 1995-2010. Methods: Cancer incidence was obtained from national hospital-based cancer registries. Cancer mortality was abstracted from World Health Organization database and Department of Census and Statistics Sri Lanka. Number of new cases and deaths were obtained by five-year age group for all cancers by sex and breast, cervical, ovarian and uterine cancers for females. Particular cancer specific incidence and mortality rates were directly age-standardised to the Segi-Doll world standard population. Age-standardised incidence and mortality for young adults (20-34 years), adults (35-64 years) and older adults (over 64 years) by the type of the female cancer over 1995-2010 were calculated. Results: Age-standardised rates for incidence for all cancers among females rose from 63.3 to 87.5 per 100 000 population during 1995-2010 and its morality increased from 44.5 to 53.5 per 100 000 population. In spite of having similar trends in both sexes, cancer incidence among females remained higher while mortality persisted lower than males. Breast cancer was the commonest cancer among females with its incidence and mortality increasing through-out. Cervical cancer incidence increased during 1995-2000, declined slightly in 2005 and remained stable over 2006-2010.Cervical cancer mortality remained stable over 1995-1999, declined in 1999-2003, increased slightly throughout 2003-2006 and remained stable during 2007-2010. Ovarian cancer incidence remained stable over 1995-2010. Its mortality remained stable over 1995-2000, declined slightly during 2000-2003 and increased in 2003-2010. Uterine cancer incidence and mortality increased steadily throughout 1995-2010. For all these cancers, incidence and mortalityin 0-34 years remained low.Conclusions: Increasing trend of cancer incidence and mortality among females over 1995-2010, directs the need of revisiting female cancer control programmes. 

scholarly journals State Reluctance towards Inclusive Policies in Post-Civil War Sri Lanka

2020 ◽  
Vol 13 (3) ◽  
pp. 109
Author(s):  
Mansoor Mohamed Fazil ◽  
Mohamed Anifa Mohamed Fowsar ◽  
Mohamed Bazeer Safna Sakki ◽  
Thaharadeen Fathima Sajeetha ◽  
Vimalasiri Kamalasiri
Keyword(s):  
Civil War ◽  
Sri Lanka ◽  
Ethnic Politics ◽  
The State ◽  
Research Approach ◽  
State And Society ◽  
Key Factor ◽  
Ruling Elites ◽  
International Power ◽  
The Government

This study aims to identify the factors preventing the state from responding in a manner that will avoid future conflict in post-civil war Sri Lanka. After the government ended the separatist struggle of the Liberation Tigers of Tamil Eelam (LTTE) by bringing the civil war to an end in May 2009, the protracted and destructive 30-year war presented an opportunity for both state and society to learn many useful lessons from the long war. These lessons could have enabled the government to reconstitute the state as an inclusive institution, one in which minorities could also participate to ensure just and equitable development for all Sri Lankans. This study uses a qualitative research approach that involves analysis of critical categories. Findings of this study offer some crucial insights about Sri Lanka’s ethnic politics, particularly, the various factors have influenced the state to avoid inclusive policies. The key factor is the dilemma of post-independent political culture or traditions amongst ruling elites resulted in the avoidance of inclusive policies. This study also reveals some other factors that contestations between different social forces within society, within the state, and between the state and society still prevail in Sri Lanka, hampering the institution of inclusive policies. Further, the paper highlights the failure of India and the International Community to pressurize the state of Sri Lanka to introduce inclusive mechanisms due to international power balance (China factor).

scholarly journals World Health Organization estimates of the global and regional disease burden of four foodborne chemical toxins, 2010: a data synthesis

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 1393 ◽  
Author(s):  
Herman Gibb ◽  
Brecht Devleesschauwer ◽  
P. Michael Bolger ◽  
Felicia Wu ◽  
Janine Ezendam ◽  
...  
Keyword(s):  
Burden Of Disease ◽  
Food Supply ◽  
Disease Burden ◽  
Disease Incidence ◽  
Case Fatality ◽  
World Health ◽  
Peanut Allergen ◽  
Major Pathway ◽  
Life Years ◽  
Incidence And Mortality

Background Chemical exposures have been associated with a variety of health effects; however, little is known about the global disease burden from foodborne chemicals. Food can be a major pathway for the general population’s exposure to chemicals, and for some chemicals, it accounts for almost 100% of exposure.  Methods and Findings Groups of foodborne chemicals, both natural and anthropogenic, were evaluated for their ability to contribute to the burden of disease.  The results of the analyses on four chemicals are presented here - cyanide in cassava, peanut allergen, aflatoxin, and dioxin.  Systematic reviews of the literature were conducted to develop age- and sex-specific disease incidence and mortality estimates due to these chemicals.  From these estimates, the numbers of cases, deaths and disability adjusted life years (DALYs) were calculated.  For these four chemicals combined, the total number of illnesses, deaths, and DALYs in 2010 is estimated to be 339,000 (95% uncertainty interval [UI]: 186,000-1,239,000); 20,000 (95% UI: 8,000-52,000); and 1,012,000 (95% UI: 562,000-2,822,000), respectively.  Both cyanide in cassava and aflatoxin are associated with diseases with high case-fatality ratios.  Virtually all human exposure to these four chemicals is through the food supply.  Conclusion Chemicals in the food supply, as evidenced by the results for only four chemicals, can have a significant impact on the global burden of disease. The case-fatality rates for these four chemicals range from low (e.g., peanut allergen) to extremely high (aflatoxin and liver cancer).  The effects associated with these four chemicals are neurologic (cyanide in cassava), cancer (aflatoxin), allergic response (peanut allergen), endocrine (dioxin), and reproductive (dioxin).

scholarly journals The End of Sri Lanka’s Civil War and the Fall of the Liberation Tigers of Tamil Eelam (LTTE): A Critical Analysis of the Contributed Factors to the Defeat of the LTTE

2020 ◽  
Vol 13 (4) ◽  
pp. 147
Author(s):  
M. M. Fazil ◽  
M. A. M. Fowsar
Keyword(s):  
Civil War ◽  
Sri Lanka ◽  
Social Force ◽  
War On Terrorism ◽  
Key Factors ◽  
Global War On Terrorism ◽  
The Government ◽  
Set Up ◽  
Major Factors ◽  
Global War

Sri Lanka came to the international limelight through the backdrop of its undesirable war against the Liberation Tigers of Tamil Eelam (LTTE) that lasted over three decades. The LTTE was formed as a social force, and then it transformed as a leading armed movement to forward their decades-long quest to set up a Tamil homeland in Sri Lanka. The government ended the LTTE’s secessionist struggle in May 2009 after a lengthy and bloody battle. Several national and international factors played a crucial role in ending the civil war sooner. The study used a qualitative method of inquiry to explore the key factors that led to the fall of the LTTE, a vigorous armed movement that attempted to set up a separate state in the Island of Sri Lanka. The findings show that strong political leadership, fortified security forces, implementing sophisticated national security strategies, the split of the LTTE and the global war on terrorism are the major factors that had a significant impact and contributed in the LTTE being defeated in 2009.

scholarly journals Women, Civil War and Struggle for Survival: A Study of Tamil Women in Ampara District of Sri Lanka

2021 ◽  
Vol 9 (2) ◽  
pp. 73
Author(s):  
Athula Withanawasam
Keyword(s):  
Civil War ◽  
Sri Lanka ◽  
Armed Conflict ◽  
Public Assistance ◽  
Age Difference ◽  
Male Partners ◽  
The Government ◽  
Post War ◽  
The Impact ◽  
Tamil Women

Even though the civil war in Sri Lanka officially ended in 2009, the hardship created by war is long-lasting and will take years to reconcile. This research is about the impact of war politics on women of Tamil community in the Ampara district of Sri Lanka during the period of armed conflict. The findings of this study reveal that the girls of the Tamil community were forcefully recruited to join the Tamil militant groups. Hence, parents found the only way to rescue their children and to assure their existence was to arrange teenage marriages. Most of those marriages were not legally registered. This paved the way for the male partners to abandon their spouses, often with children. The women whose children were forcefully recruited to militant forces and whose life was lost in the battle filed were given the dignity of ‘Veera Thai’ (Heroine Mother) with an allowance as gratitude for bearing such a war hero. However, it was revealed the title itself had resulted in many types of hardships. The government also deliberately denied any public assistance to those families. The study has found that the women in the numerically weakest groups during war time, irrespective of age difference, had undergone many and varied hardship. The study further has identified that the hardship experienced by these women continued even in the post-civil war context. Therefore, the study urges that these types of hardship faced by women in the post-war context need to be handled with political sensitivity to the equity and justice for women.

Lymphatic filariasis in the Southeast Asian region; status and control options.

2020 ◽  
Vol 15 (059) ◽  
Author(s):  
Nilmini T. G. A. Chandrasena
Keyword(s):  
Sri Lanka ◽  
Lymphatic Filariasis ◽  
Disease Burden ◽  
Public Health Problem ◽  
Southeast Asian ◽  
World Health ◽  
Selective Treatment ◽  
Preventive Chemotherapy ◽  
Asian Region ◽  
Health Organization

Abstract The Global Program to Eliminate Lymphatic Filariasis (GPELF) was launched in year 2000 by the World Health Organization (WHO) with the goal set for elimination by 2020. Over half the global disease burden lies in the Southeast Asian region (SEAR). The preventive chemotherapy (PC) programme has been initiated in all the WHO SEAR member states with varying levels of progress. Maldives, Sri Lanka and Thailand have achieved the goal of elimination as a public health problem (EPHP) within the stipulated period with Bangladesh working towards validation in 2021. Both Sri Lanka and Thailand are continuing with post-validation surveillance combined with selective treatment, striving for zero transmission in-parallel with the morbidity management and disability prevention program (MMDP). Timor-Leste appears close to reaching critical transmission thresholds with 100% coverage and triple therapy in the last round of PC. Data on MMDP activities are insufficient to comment on reaching EPHP status. PC coverage and country reports indicate ongoing transmission in Nepal, Myanmar, Indonesia and India requiring further rounds of PC. The PELF has made considerable progress in the SEAR towards elimination but there still remain significant transmission and disease burden in the highly populated countries in SEAR.

scholarly journals A nationwide trend analysis in the incidence and mortality of Creutzfeldt–Jakob disease in Japan between 2005 and 2014

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yoshito Nishimura ◽  
Ko Harada ◽  
Toshihiro Koyama ◽  
Hideharu Hagiya ◽  
Fumio Otsuka
Keyword(s):  
Disease Burden ◽  
Vital Statistics ◽  
Incidence Rates ◽  
Joinpoint Regression ◽  
Incidence And Mortality ◽  
Jakob Disease ◽  
Long Term Trends ◽  
The Government ◽  
Adjusted Incidence

Abstract In the era of hyper-ageing, Creutzfeldt–Jakob disease (CJD) can become more prevalent as an important cause of dementia. This study aimed to evaluate the trends in crude and age-adjusted CJD-associated mortality and incidence rates in Japan using national vital statistics data on CJD-associated deaths among individuals aged over 50 years, as well as the government-funded nationwide CJD surveillance data (pertaining to the years 2005–2014) in Japan. The data were analysed using the Joinpoint Regression Program to estimate the long-term trends and average annual percentage changes (AAPCs). Overall, the AAPCs of age-adjusted CJD-associated mortality rates rose significantly over the study period (3.2%; 95% confidence interval [CI] 1.4–5.1%). The AAPC of the age-adjusted incidence rates also increased (overall 6.4%; 95% CI 4.7–8.1%). The CJD-associated increases in the mortality and incidence rates were especially prominent among adults over the age of 70 years. Given this trend in aging of population, the disease burden of CJD will continue to increase in severity. Our findings thus recommend that policymakers be aware of the importance of CJD and focus on preparing to address the increasing prevalence of dementia.

scholarly journals Disease Burden, Risk Factors, and Recent Trends of Liver Cancer: A Global Country-Level Analysis

Liver Cancer ◽  
2021 ◽  
pp. 1-16
Author(s):  
Junjie Huang ◽  
Veeleah Lok ◽  
Chun Ho Ngai ◽  
Cedric Chu ◽  
Harsh K. Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Cancer ◽  
Cancer Incidence ◽  
Disease Burden ◽  
Antiviral Treatment ◽  
Temporal Trends ◽  
World Health ◽  
Older Individuals ◽  
Incidence And Mortality ◽  
Increasing Trend

<b><i>Background:</i></b> This study aimed to evaluate the updated disease burden, risk factors, and temporal trends of liver cancer based on age, sex, and country. <b><i>Methods:</i></b> We estimated the incidence of liver cancer and its attribution to hepatitis B virus (HBV) and hepatitis C virus (HCV) in 2018 based on the Global Cancer Observatory and World Health Organization (WHO) Cancer Causes database<i>.</i> We extracted the prevalence of risk factors from the WHO Global Health Observatory to examine the associations by weighted linear regression. The trend analysis used data from the <i>Cancer Incidence in Five Continents</i> and the WHO mortality database from 48 countries. Temporal patterns of incidence and mortality were calculated using average annual percent change (AAPC) by joinpoint regression analysis. <b><i>Results:</i></b> The global incidence of liver cancer was (age-standardized rate [ASR]) 9.3 per 100,000 population in 2018, and there was an evident disparity in the incidence related to HBV (ASR 0.2–41.2) and HCV (ASR 0.4–43.5). A higher HCV/HBV-related incidence ratio was associated with a higher level of alcohol consumption (β 0.49), overweight (β 0.51), obesity (β 0.64), elevated cholesterol (β 0.70), gross domestic product (β 0.20), and Human Development Index (HDI; β 0.45). An increasing trend in incidence was identified in many countries, especially for male individuals, population aged ≥50 years, and countries with a higher HCV/HBV-related liver cancer incidence ratio. Countries with the most drastic increase in male incidence were reported in India (AAPC 7.70), Ireland (AAPC 5.60), Sweden (AAPC 5.72), the UK (AAPC 5.59), and Norway (AAPC 4.87). <b><i>Conclusion:</i></b> We observed an overall increasing trend of liver cancer, especially among male subjects, older individuals, and countries with a higher prevalence of HCV-related liver cancer. More efforts are needed in enhancing lifestyle modifications and accessibility of antiviral treatment for these populations. Future studies should investigate the reasons behind these epidemiological changes.

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