Gerontological aspects of improving the quality of medical and social assistance to older displaced persons in the context of the COVID-19 pandemic in Ukraine

Исследование посвящено вопросам организации медицинского и социального обслуживания переселенцев пожилого возраста на уровне первичной медико-санитарной помощи (ПМСП) на Украине, определению основных задач и особенностей организации и предоставления им паллиативной и хосписной помощи (ПХП) в условиях пандемии COVID-19. По результатам социологического исследования с использованием методов опроса, экспертных оценок были проанализированы социально-психологические характеристики переселенцев пожилого возраста, особенностей их социальной адаптации, финансирования и медико-социального обслуживания. Были определены пути улучшения организации амбулаторной помощи переселенцам старшего возраста на уровне ПМСП, включающие структурную модернизацию и оптимизацию организационного обеспечения. Внедрение доступных и экономически обоснованных подходов позволяет усилить взаимодействие специалистов учреждений здравоохранения и социальной защиты, оптимизировать соблюдение стандартов и принципов медицинской помощи. В рамках организации ПХП базовыми являются европейские подходы формирования стратегии непрерывности предоставления паллиативной помощи в условиях пандемии COVID-19. Внедрение предлагаемых подходов в организации медицинской и социальной помощи на уровне амбулаторий ПМСП и обеспечение доступной ПХП являются актуальными для переселенцев пожилого возраста, находящихся в группе повышенного риска при пандемии COVID-19. This work aimed to study the organization of medical-social services for the elderly internally displaced persons at the level of primary medico-sanitary aid (PMSA) in Ukraine, assessment of the main tasks and specifics of organization and provision of palliative and hospice care (PHC) under COVID-19 conditions. As a result of the sociological investigation, using the questionnaire methods and experts’ evaluations, we have analyzed the socio-psychological characteristics of the elderly internally displaced persons, the specifics of their social adaptation, financing and medico-social servicing at the level PMSA, including structural modernization and optimization of organizational provision. The introduction of an affordable and economically viable system allows for the interaction of specialists from health care and social protection institutions, and optimizes compliance with the standards and principles of medical care. Within the framework of the PНC, we use the European approaches of formation of the strategy of palliative care expansion under COVID-19 pandemic. One of the main tasks is the provision of constant PHC. Introduction of the organization-structural system of the medical-social care at the PMSA level and provision of accessible and highly qualitative constant PHC are actual for the elderly displaced people, who are in the group of high risk COVID-19 death group.

South Sudan: The SDF and “Protection of Civilians”

The Japan Engineering Groups (JEG) deployment to the United Nations Mission in South Sudan (UNMISS) from 2012 to 2017 exhibited consecutive aspects of “integration” and “robustness.” During the first two years, Japan’s method of “integration,” or the “All Japan” approach, fit well with UNMISS’s focus on statebuilding. It yielded various outcomes, not only in the restoration of facilities and infrastructure (e.g., road construction) but also in the nonengineering support provided to the locals (e.g., job training). With the outbreak of de facto civil war in December 2013, however, UNMISS’s top priority moved from statebuilding to Protection of Civilians (PoC), thereby intensifying inclinations toward “robustness.” Afterward, the JEG mostly focused on the construction of a PoC site, that is, a shelter for evacuated locals and internally displaced people. While security in South Sudan continued to deteriorate, the amendment to the Peacekeeping Operations (PKO) Act as part of the 2015 Peace and Security Legislation enabled the Government of Japan (GoJ) to assign the JEG to partial security missions, such as the “coming-to-aid” duty. In the end, however, the GoJ abruptly withdrew the JEG in May 2017, thereby discontinuing the series of SDF deployments to United Nations Peacekeeping Operations since 1992.

Temporal trends of hepatitis C virus transmission in internally displaced people who inject drugs in Odessa, Ukraine

BackgroundDue to practical challenges associated with genetic sequencing in low resource environments, the burden of hepatitis C virus (HCV) in forcibly displaced people is understudied. We examined the use of field-applicable HCV sequencing methods and phylogenetic analysis to determine HCV transmission dynamics in internally displaced people who inject drugs (IDPWID) due to war in eastern Ukraine.MethodsIn this cross-sectional study, we used modified respondent-driven sampling to recruit IDPWID who have settled in Odessa, Ukraine. We generated partial and near full length genome (NFLG) HCV sequences using Oxford Nanopore MinION in a simulated field environment. Maximum likelihood and Bayesian methods were used to establish phylodynamic relationships.FindingsBetween June and September 2020, we collected epidemiological data and whole blood samples from 164 IDPWID. Rapid testing identified an HIV, anti-HCV, and HIV/HCV co-infection prevalence of 39%, 67.7%, and 31.1%, respectively. We generated 57 partial or NFLG HCV sequences and identified eight transmission clusters, of which at least two originated within a year and a half post-migration. Unstable housing post-migration was associated with more reports of injection drug use in the past 30 days (p=0.048).InterpretationLocal generation of viral sequencing data and phylogenetic analysis in rapidly changing low-resource environments, such as those faced by forcibly displaced people, can inform timely adaptation of prevention and treatment.FundingOxford University John Fell Fund, ISS Wellcome Trust, Branco Weiss Fellowship.

Socio-Economic Impact of Land Acquisition in Chhattisgarh

As we know land reforms on land acquisition is directly associated with different development. It aims to improve poor people access towards mean of social welfare. In fact India and Chhattisgarh state is not an exception the above rule and policies. For land reform and acquisition in Chhattisgarh. In this research paper, an attempt has been made to cover various land displacements in Chhattisgarh. This research paper has been prepared mainly on the basis of secondary data from it. Like other places, Chhattisgarh has also seen the following effects of land displacement, such as in social life, in children, in women, in employment, the opposite effect is seen. An attempt has been made to explain the impact of land displacement in Korba, Chhattisgarh, where the common life of the displaced people has been particularly affected.

Forced Migration

Forced migration refers to the forcibly induced movement of people, for example, when migrants are forced to flee to escape conflict or persecution or become trafficked. The definition also encompasses situations of enforced immobility, for example, when displaced people are confined to refugee camps and detention centers. Forced displacement may occur within or across the borders of the nation-state. According to this definition, the effect of the force causing the migratory movement is crucial, and distinguishes forced migrants—who may be termed “refugee,” “trafficked person,” “stateless person,” “asylum seeker,” or “internally displaced persons” (IDPs)—from other migrants such as economic migrants. However, as anthropologists of forced migration illustrate, such distinctions by legal, state, or international organizations are not always relevant outside of institutional logics; when backed up by the force of the state, they can undermine the livelihoods and safety of migrants. The anthropology of forced migration is undertaken by researchers who aim to depict and capture the realities of forced migrants, and to understand the world from the perspective of the forced migrants themselves. The anthropology of forced migration also addresses the historical context that drives the displacement as well as how forced migrants interact with their cultural, social, religious, and economic environments, and how doing so compels cultural change. By virtue of their influence in the lives of forced migrants, anthropologists of forced migration must incorporate the terminologies and classifications of international organizations and states into their analyses, since these terminologies and classifications have tangible effects on the lives of migrants. At the same time, anthropologists of forced migration interrogate these terminologies and classifications. In so doing, they prioritize the perspectives and realities of the forced migrants over external classifications and definitions. Consequently, the anthropology of forced migration is distinguished from other disciplines that also explore forced migration such as international law and some studies in the field of refugee studies and (forced) migration studies. On a theoretical level, an analysis that centers on the experiences, perspectives, and realities of forced migrants enables novel insights into societal processes such as austerity policies, the role of borders in society and the global system, and the work of humanitarian organizations. These policies, societal dynamics, and institutions have tangible and deep effects on the lives of forced migrants. How forced migrants interact with external systems and institutions has raised vital questions on dependency and agency, which anthropologists of forced migration have discussed in their works. Many anthropologists of forced migration also aim to be helpful in improving programs for forced migrants by conveying the perspectives and experiences of forced migrants to policymakers so that such programs are more relevant to the realities of forced migrants. Anthropologists of forced migration have also used art installations and films to convey the experience of forced migration.

What About Us?

This article outlines the research being undertaken to develop the Assembling Queer Displacements Archive (AQDA). This open digital archive is the central focus of a research project that will address the lack of understanding of LGBTIQ+[i] experiences of forced displacement. These experiences are unique but have not received adequate attention. The existing body of work on ‘queering archives’ has been focused on challenging the archival approaches and practices in order to either queer these practices and/or make them more inclusive. However, this work has tended to ignore LGBTIQ+ stories of forced displacement. One reason for this lack of engagement is the lack of direct knowledge and experience of such stories by the researchers and archivists themselves. My positionality as an LGBTIQ+ forcibly displaced person has motivated me to embark on the present research project and to demonstrate inclusive practices to address these gaps in archives. In this article I explore the role that positionality plays in creating an LGBTIQ+ forced displacement archive. I offer solutions for creating an inclusive practice to collect stories of LGBTIQ+ forcibly displaced people. These solutions have the potential to support a range of digital archival projects that engage with structurally marginalised and oppressed communities. [i] It is important to acknowledge that LGBTIQ+ acronym is a Western terminology, which has become adopted in non-western countries for a variety of reasons (Anzaldua, 2009). These reasons include this terminology being a legacy of colonisation, a potential lack of respectful terminology in country languages and out of necessity to adopt commonly used language when engaging globally. These reasons are not limited to those above and may vary in different contexts. When using a term ‘LGBTIQ+’ in this article I am referring to the diversity of sex, gender, sexual orientation, bodies and relationships. The ‘plus’ sign in the acronym signals fluidity and further possible identifications.

Practical needs and considerations for refugees and other forcibly displaced persons with neurological disorders: Recommendations using a modified Delphi approach

Background: There are >70 million forcibly displaced people worldwide, including refugees, internally displaced persons, and asylum seekers. While the health needs of forcibly displaced people have been characterized in the literature, more still needs to be done globally to translate this knowledge into effective policies and actions, particularly in neurology. Methods: In 2020, a global network of published experts on neurological disease and refugees was convened. Nine physician experts from nine countries (2 low, 1 lower-middle income, 5 upper-middle, 1 high income) with experience treating displaced people originating from 18 countries participated in three survey and two discussion rounds in accordance with the Delphi method. Results: A consensus list of priority interventions for treating neurological conditions in displaced people was created, agnostic to cost considerations, with the ten highest ranking tests or treatments ranked as: computerized tomography scans, magnetic resonance imaging scans, levetiracetam, acetylsalicylic acid, carbamazepine, paracetamol, sodium valproate, basic blood tests, steroids and anti-tuberculous medication. The most important contextual considerations (100% consensus) were all economic and political, including the economic status of the displaced person’s country of origin, the host country, and the stage in the asylum seeking process. The annual cost to purchase the ten priority neurological interventions for the entire displaced population was estimated to be 220 million USD for medications and 4.2 billion USD for imaging and tests. Conclusions: A need for neuroimaging and anti-seizure medications for forcibly displaced people was emphasized. These recommendations could guide future research and investment in neurological care for forcibly displaced people.