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The Center for Refugee and Disaster Relief

Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
Center for Refugee and Disaster Response
 

Center News

CRDR Faculty Dr. Tom Kirsch and Dr. Wietse A. Tol in Nepal following the April 2015 Earthquake 

ThamelEarthquake2Dr. Tom Kirsch traveled to Nepal with the Earthquake Engineering Research Institute (EERI) on a multidisciplinary reconnaissance team to study the impacts of the April 25, 2015 earthquake and its aftershocks on critical infrastructure in the country. Dr. Kirsch has been working with Nepali experts and Dr. Judy Mitrani-Reiser from the Whiting School of Engineering to assess the impact of the earthquakes of hospitals and other health facilities. The EERI has been sending reconnaissance teams following impactful earthquakes through its Learning from Earthquakes program for over 40 years. The objectives of these reconnaissance missions are to identify knowledge gaps where further research is most needed and to identify practices that will improve mitigation measures, disaster preparedness, and emergency response for future disasters. Right, damage from the earthquake in Katmandu's Thamel District. See posts about Dr. Kirsch's time in Nepal on our facebook page.

Dr. Kirsch is the Director of the Center for Refugee and Disaster Response in the Johns Hopkins Bloomberg School of Public Health, and an Associate Professor in the Department of Emergency Medicine at the Johns Hopkins University School of Medicine. He is also an Associate Professor in the Department of Health at the Bloomberg School of Public Health, and in the Department of Civil Engineering at the Whiting School of Engineering.

With funding from CRDR’s Advisory Committee Dr. Wietse Tol and Liv Jensen are working in Nepal providing technical support to the Transcultural Psychosocial Organization Nepal (TPO Nepal). TPO Nepal is a Nepali non-governmental organizations leading the mental health and psychosocial support response to the earthquakes in 7 of the 14 affected districts. Technical support is focused on transitioning to mental health and psychosocial needs after the immediate crisis phase. This is the second week in which we are providing technical expertise to TPO Nepal. TPO Nepal is now working in all of the 14 districts affected by the earthquake. They continue to provide support on monitoring and evaluation strategies; capacity building of a new cadre of community psychosocial workers who can provide more structured support (beyond psychological first aid); dissemination of information on services; and connecting with new donors. TPO Nepal recently celebrated its 10-years anniversary, although not as elaborate as planned. A good thing to know: a toll-free hotline staffed by counselors is now operational for anyone with mental health and psychosocial concerns: 16600102005.

Wietse A. Tol, PhD is the Dr. Ali & Rose Kawi Assistant Professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health and the Program Director of the Peter C. Alderman Foundation.

Kathmandu_Park

A temporary camp in a Kathmandu park.


ThamelEarthquake

The old district of Thamel was hard hit by the earthquake.

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Associate Snapshot: Lauren Sauer

Lauren Sauer, M.S., has a diverse background in disaster management and response. Lauren studied astrophysics at BU, where her research on earthquakes on other planets eventually led her to disaster research on this planet. Her current research interests include critical infrastructure protection and resource management in disasters. In September, Lauren will be starting her PhD in health policy and management at the Johns Hopkins Bloomberg School of Public Health, supported by a Resilient Interdependent Infrastructure Processes and Systems (RIPS) grant from National Science Foundation. She has recently published work on modeling the benefits of mobilizing Ebola survivors for the epidemic responsethe use of “reverse triage” to increase pediatric surge capacity during disasters, and the utility and risks of spontaneous volunteers in disaster response.

LaurenContinuingPromise     LaurenIndonesia

Left, Lauren heads to Haiti on the USS Iwo Jima with Continuing Promise Mission 2010. On the right, Lauren in Manado, Indonesia, where she helped lead a subject matter expert exchange on disaster management.

Much of Lauren’s recent work has been focused on the Ebola epidemic response in both West Africa and in the United States, including:

  • Acting as the Ebola response liaison for the Johns Hopkins institutions, both medical and academic through the Office of Critical Event Preparedness and Response (CEPAR). CEPAR was responsible for establishing Ebola response protocols and working with the state of Maryland to rule out suspected Ebola patients. Lauren and the Ebola Response Team were recipients of the Maryland Hospital Association’s Distinguished Service Award for their work.
  • Working with the Nebraska biocontainment unit, the largest and most effective facility of its kind in the nation, on the mental health effects of having a highly infectious disease patient on the hospital, community, and general health infrastructure.
  • Presenting a qualitative analysis to map intervention efforts to the Ebola epidemic curve at the 19th World Congress on Disaster and Emergency Medicine in Cape Town, South Africa.

Lauren is the chair of the disaster interest group for the Society for Academic Emergency Medicine, where she studies the most effective research methods in disaster and other emergency settings. She is also co-director of  the Johns Hopkins School of Medicine disaster course.

 

Lauren will soon be heading to Nepal with the Earthquake Engineering Research Institute (EERI) to study the impact of the earthquake on health care infrastructure.

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The U.S. Helped Beat Back Ebola - Only Not In The Way You Might Think When hundreds of US troops were sent to West Africa to help fight Ebola, the plan was to train health care workers and build new field hospitals. While these objectives were only partially achieved, the US military achieved successes in other ways. Dr. Tom Kirsch, CRDR Director, was interviewed by NPR Goats and Soda for a story highlighting the importance of the logistical capacities brought in by the US military to the region’s ability to effectively fight the virus. 

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Faculty Snapshot: Hannah Tappis

Dr. Hannah Tappis, a former CRDR Doctor of Public Health student, is now an associate with the center. She holds part-time faculty with CRDR and spends the rest of her time with the JHU affiliate Jhpeigo, an international public health non-profit. Dr. Tappis was recently appointed the co-chair of the research sub-working group of the Inter-Agency Working Group on Reproductive Health in Crisis, a coalition of UN, government, NGO, and other organizations working together to advance sexual and reproductive health in areas affected by conflict and natural disaster. Dr. Tappis' recent published works include research on the availability and distribution of human resources available for emergency obstetric and new born care in Afghanistanan assessment of the capacity of the Afghanistan health care system to provide post-abortion care, and studying the effectiveness of young mothers’ clubs in improving women’s knowledge of reproductive health in informal settlements in Nairobi, Kenya.

 

  • systematic review focusing on the effectiveness and efficiency of cash-based aid in humanitarian emergencies for the Campbell Collaboration

  • A UNHCR-funded project working to develop community and reproductive health score cards to be used globally as a multi-sector evaluation tool for humanitarian responses. Dr. Tappis presented this work at the 2015 Annual Meeting of the Inter-Agency Working Group on Reproductive Health in Crises. Download and read her presentation and others from the meeting here.

Dr. Tappis' current work focuses on public health projects across the globe, including:

HannahAfghanistan

  • Working with Jhpiego in Afghanistan to help implement a 5-year Family Planning, Maternal, Newborn and Child Health Project funded by USAID. This project aims to provide technical assistance to the reproductivehealth sector in order to increase utilization of high-quality health care services in the country. Above, Dr. Tappis in the ancient city of Herat in Western Afghanistan.

  • The USAID-funded Human Resources for Health Project in Ethiopia. This project is working to increase the capacity of human resources in the public health sector through health worker training, policy systems strengthening, and curriculum development

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Dr. Courtland Presents at the Prince Mahi-Dol Award Ceremony in Thailand

CourtGrandPalce

 

Dr. Robinson was invited to speak at the Prince Mahi-Dol award ceremony, given annually by the Thai Royal Family for achievements in medicine and public health. He presented a paper on the health of migrant youth in Asia, with a focus on Burmese migrants in Thailand. Dr. Robinson and his wife in front of the Grand Palace in Thailand.

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Faculty Snapshot: Gilbert Burnham

Dr. Gilbert Burnham created the Center for Refugee and Disaster Response in 1998, and was the director of the center until 2013. He has extensive experience in emergency preparedness and response, particularly the development, implementation, and evaluation of programs that address the humanitarian needs of vulnerable populations. Recent published works include recommendations for strengthening the delivery of targeted HIV care during the Ebola outbreak in West Africaa review of Medecins Sans Frontieres’ operative procedures for the elderly in low-resource settings, andresearch on the infectious disease burden and correlates of HIV and Hepatitis C infection among people who inject drugs in Afghanistan.

Current work:

  • Dr. Burnham continues 13 years of work in Afghanistan, working as part of a Dutch group assessing performance of the health services in Afghanistan and the health status of the population. Data generated through these surveys helps guide national health policy for Afghanistan.
  • For the past nine years Dr. Burnham has guided research studies in Iraq for USAID and other organizations. An 11-year study of injuries in Baghdad is just being published. Assessments of health needs among internally displaced populations (IDPs) in southern Iraq is scheduled for completion in June 2015. In the North, the mortality patterns among displaced Yazidis and Christians is being studied.
  • With center faculty Dr. Shannon Doocy, Dr. Burnham is developing a project design and measurement methods for a cash-based assistance program  for persons unable to access medicines for chronic condition in the Ukraine with the International Federation of Red Cross and Red Crescent Societies.

Recently completed work:

  • Working with the 17 national Red Cross/Red Crescent societies of the region, a document on strategic priorities for national societies has been created with help from MSPH students Kia Guanco and Emily Lyles. A second publication, Communities in Crisisthreats and opportunities in the MENA Region is being produced by the same working group.
  • In December 2014, Dr. Burnham led an international team which conducted an evaluation of the Red Cross Ebola control projects in Guinea, Sierra Leone and Liberia on behalf of the International Federation of Red Cross and Red Crescent Societies.

Dr. Burnham also teaches the Health Emergencies in Large Populations (H.E.L.P.) course. The 27th H.E.L.P. course will be held in Baltimore July 13-31, 2015. This course offers humanitarian workers training in public health principles particular to disaster and conflict populations and disaster epidemiology. Read more and register here.

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Faculty Snapshot: Nancy Glass

Nancy Glass is running across Congo! In May 2015, she will be participating in an 300 km, 7-day, 7-marathon run with ten other women to raise awareness and funds for female farmers and cooperatives working toward gender equality. Read more (and donate!) here.

When she is not running across countries, Nancy is a public health nurse and researcher. Her work focuses on clinical care and interventions in the areas of violence prevention and health disparities, particularly in developing countries. Previous work includes a web-based intervention for abused women in New Zealand, researching social interactions in the aftermath of conflict-related trauma experiences among women in DRC, and how livestock and animal assets buffer impacts of conflict-related traumatic events on mental health symptoms for rural women in the DRC. Below, a leader of the livestock microfinance intervention Pigs for Peace (left), and Nancy with a pig (right).

Pigs for Peace  Nancy and Pigs for Peace

Nancy is currently working on a number of projects, both domestically and abroad:

  • Social norms and community-based care programming for response and primary prevention of sexual violence against women and girls affected by conflict. This is a community-based trial testing the effectiveness of a gender-based violence prevention and response program in humanitarian settings (UNICEF). Nancy has been invited to speak on this research at the London School of Economics and Political Science.
  • Microfinance intervention to improve the health of trauma survivors in DRC. This is a community-based trial to test the effectiveness of a village-led microfinance program on health, economics, and stigma reduction for survivors of trauma and violence in DRC (NIMHD). Nancy recently spoke on this project at the Futures Without Violence 7th Biennial National Conference on Health and Domestic Conference in Washington D.C.
  • Primary prevention of sexual and intimate partner violence for adolescents who experience conflict and non-conflict related stressors in South Africa (Sexual Violence Research Initiative and Medical Research Council of South Africa)
  • Gender-based violence survey in three regions of Somalia in partnership with the Somali government (Consortium of UNICEF, UNWomen, World Bank).
  • Effectiveness of a safety app used to respond to dating violence for college women. Findings will inform the science of technology interventions for college-aged women in abusive/dating relationships and friends of college-aged women in abusive intimate/dating relationship (NICHD).

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President Obama Thanks U.S. Health Care Workers Fighting Ebola

Tom Kirsch at the White House

IMAGE: BLOOMBERG/GETTY IMAGES

Dr. Tom Kirsch, the director of the Center for Refugee and Disaster Response, was among medical workers standing behind President Obama as he praised health care workers fighting Ebola. The President called on the nation to honor those who had served in West Africa as the "American heroes" they are. Watch President Obama's remarks here.

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The Effectiveness of Disaster Relief

NPR Goats and Soda: Billions Go To Victims Of Disaster And Disease. Does It Really Help? Nick van Praag, formerly of the UNHCR, World Bank, and Age Khan Development Network, began the organization Ground Truth to monitor the effectiveness of international aid programs. CRDR faculty Dr. Courtland Robinson comments on the growing trend of incoporating on the ground information with the dissemination of disaster aid.

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Faculty Snapshot: Shannon Doocy

Jordan Survey Team

Shannon Doocy’s research focuses on communities affected by disasters and conflict, particularly the monitoring and evaluation of humanitarian assistance programs, nutrition and food security, and cash interventions. Past projects include measuring the impact of post-tsunami programs in Indonesiapreventing malnutrition in post-conflict populations, and recovery following natural disasters in Haiti and Pakistan. She recently completed a UNHCR-funded project with Hannah Tappis in which they developed community and reproductive health balanced score cards to be used globally as a multi-sector evaluation tool for humanitarian responses. Dr. Doocy is currently working on a number of projects internationally with a diverse group of organizations, including the UNHCR, Save the Children, and the International Medical Corps:

 

  • A systematic review of the effectiveness and efficiency of cash-based approaches in protracted and sudden onset emergencies. With co-investigator Hannah Tappis.

  • Assessing access to health care and health status of Syrian refugees in Lebanon and Jordan (Jordan survey team pictured above). Findings will help inform program targeting and implementation strategies in the health sector. With co-investigator Gilbert Burnham and William Weiss.

  • Improved management of non-communicable diseases through the effectiveness of a MHealth Intervention – a health software application and a patient controlled health record. Findings will provide management guidelines that can be adapted by other agencies working with displaced populations. With co-investigator Gilbert Burnham.

  • Providing technical support to international Orthodox Christian charities with humanitarian assistance programs in Syria. Particular support in characterizing displacement and support for needs assessments.

  • Evaluation of USAID development food assistance program in South Kivu, DRC, looking at the effectiveness of different nutrition, education, and livelihood interventions on child stunting and household food security. Below, researchers measure a child's length in South Kivu. Child length

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Long-Term Health Problems After Disasters

U.S. News: Long-term Health Problems After Natural Disaster Strikes While international media and humaniatrian aid is often quick to come immediately after a disaster, lasting health effects receive less attention. CRDR faculty member Dr. Courtland Robinson comments on these "chronic emergencies," or the continued effects of disasters on health care and health care infrastructure of disaster-hit communities.

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Faith-Based Organizations and International Aid

NPR Goats and Soda: These Dedicated Ebola Fighter Are Men And Women On A Mission: When the Ebola crisis began, faith-based organizations and local religious groups were some of the first to respond. Ranging from multinational organizations like Catholic Charities to single churches, these groups experienced varying levels of effectiveness. CRDR director Dr. Tom Kirsch comments on the role of faith-based organizations in international aid.

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Faculty Snapshot: Tom Kirsch

Dr. Tom Kirsch is the Director of the Center for Refugee and Disaster Response. He is a practicing emergency physician and has extensive experience in domestic and international disaster management and response. His research interests include developing methods to measure disaster responses, assessing the impact on and resiliency of healthcare infrastructure in disasters, and creating disaster triage tools for better resource management during disaster responses. Recent published work includes an analysis of the effect of the 2011 Christchurch earthquake on the functionality of a hospital systema comparison between the humanitarian responses following the 2010 Pakistan floods and Haiti earthquakethe use of spontaneous volunteers in disaster response, and translating professional obligations to care for patients with Ebola Virus Disease into practice in non-epidemic settings (Dis Med Public Health Prep; 2015, in press).

He is currently working on a number of projects, both domestically and abroad, with FEMA, the American Red Cross, UNICEF, and the Government of Liberia: 

  • A review of behavior practices for personal safety in earthquakes with CRDR faculty member Lauren Sauer. Findings will help inform American Red Cross recommendations for the best methods of individual protection during an emergency (American Red Cross).
  • Increasing the preparedness of houses of worship with CRDR faculty member Lauren Sauer. Houses of worship have traditionally played an important role in disaster response, particularly in providing food and shelter to vulnerable populations. This project consisted of seven training programs across the country to help houses of worship better prepare for disasters and increase their response capacity (FEMA)​

Dr. Kirsch has also been involved with a number of projects concerning the Ebola outbreak in West Africa, and was invited to the White House in October to meet with President Obama and other government leaders dealing with the US response to Ebola (back row, second fom right). 

Tom Kirsch White House

These projects include:

  • A review of Ebola interventions in Liberia with Liberian government officials. This research focuses on the timeline and success of interventions implemented during the outbreak to identify best practices.
  • Ebola disease surveillance with Tolbert Nyenswah, Deputy Minister of Health of Liberia and JHU alum.
  • The construction of a model of the epidemiological spread of the Ebola Virus in Liberia with Dr. David Peters of the JHUSPH Department of International Health and in conjunction with UNICEF​.

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Surgery During an Ebola Outbreak

CRDR faculty membera Dr. Adam Kushner, along with Stanford professor of surgery Sherry M. Wren, wrote a protocol for operating on patients with possible or confirmed cases of Ebola. The protocol was released by the American College of Surgeons and mentioned in a Washington Post article about the risks of performing surgery in the Ebola outbreak.

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Johns Hopkins Helps Train Congolese Health Workers to Fight Ebola

CRDR faculty member Dr. Nancy Glass was among a team of Johns Hopkins faculty from the Bloomberg School of Public Health, the School of Nursing, and the School of Medicine that helped train Congolese health care workers in Ebola management and prevention. Dr. Glass assisted in the development and implementation of a comprehensive training program that combined the first-hand knowledge the DRC has with this disease and Ebola management best practices. Read more about the project on the JHU Hub.

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The Nurse's Role in Disaster Relief

Veenema headshotEbola Update: Nurses on the Front Line CRDR faculty and JHU School of Nursing Associate Professor Tener Goodwin Veenema provides perspective on the role of nurses in the Ebola response. Nurses are often on the front line of disaster response, and their safety is of the utmost importance when considering emergency preparedness. Dr. Veenema discusses lessons learned from the Ebola response, including the importance disaster training and personal protective equipment in protecting our nation's nurses.

 

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Training Houses of Worship in Disaster Response

Houses of worship have traditionally played an important role in disaster response, particularly in providing food and shelter to vulnerable populations. CRDR faculty members Dr. Tom Kirsch and Lauren Sauer recently ran seven FEMA-supported training programs across the country to help houses of worship better prepare for disasters and increase their response capacity. “Churches reach a lot of people no one else reaches. They have a unique opportunity to reach large parts of the population and have a role in support at a difficult time” Dr. Kirsch told the Washington Times. Read the full article here

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The Humanitarian Crisis in Syria

Video Presentation

Paul Spiegel On November 25th 2013, Dr. Paul Spiegel from the United Nations High Commissioner for Refugees (UNHCR) spoke about the humanitarian crisis in Syria at the Johns Hopkins Bloomberg School of Public Health.

Dr. Spiegel is the Deputy Director of the Division of Programme Support and Management at the UNHCR and is a Johns Hopkins University Alumni.

To download the video click here: download

To watch the video on youtube click here: YouTube

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Mental Health in Conflicts

Study on Treating Sexual Violence in War-Torn Countries

Woman walkingIn conflict-ridden countries around the world, rape and other forms of sexual violence are being used as weapons of war. In these settings, treatment services for victims are limited. A trial led by researchers at the Johns Hopkins Bloomberg School of Public Health examined an evidence-based group psychotherapy treatment for sexual violence survivors in the Democratic Republic of the Congo (DRC). According to the study, this group therapy achieved more dramatic results in reducing symptoms of post-traumatic stress disorder (PTSD), depression and anxiety compared to individual support services. The results are published in the June 6 edition of the New England Journal of Medicine.

“Survivors of sexual violence have high rates of depression, anxiety and post-traumatic stress symptoms,” said Judith K. Bass, PhD, MPH, lead author of the study and assistant professor with the Bloomberg School’s Department of Mental Health. “We know what works for treating these victims in developed countries, but very little has been done to determine what treatments can help women in war-torn, resource-poor settings.”
Eastern DRC, where the trial was conducted, has experienced conflict for more than 20 years. A recent study showed that 40 percent of the women – 2 out of every 5 women – had experienced rape. For the Johns Hopkins trial, researchers worked with the International Rescue Committee and local psychosocial workers to provide sexual violence survivors with either individual support or Cognitive Processing Therapy (CPT), which consisted of 1 individual session and 11 group sessions. The psychosocial CPT providers were trained and supervised by collaborators at the University of Washington. Treatment was randomly assigned across 16 villages. All participants were screened for symptoms of PTSD, depression and anxiety.

While the researchers observed reduced symptoms of PTSD, depression and anxiety among women in both the individual-support and CPT participants, the results were significantly more dramatic among CPT participants. Six months after treatment, only 9 percent of women in the CPT condition met criteria for probable PTSD, depression or anxiety compared to 42 percent of women in the individual-support condition.
“We saw women, who had once felt too stigmatized to be a part of their community, re-engage after receiving CPT and they expressed that they felt they could again be productive members of their families and communities.” said Bass.

Controlled Trial of Psychotherapy for Congolese Survivors of Sexual Violence” was written by Judith K. Bass, PhD, MPH; Jeannie Annan, PhD; Sarah McIvor Murray, MSPH; Debra Kaysen, PhD; Shelly Griffiths, MSW; Talita Cetinoglu, MD; Karin Wachter, MEd; Laura K. Murray, PhD; and Paul A. Bolton, MBBS.
Funding for the research was provided by the U.S. Agency of International Development Victims of Torture Fund and the World Bank.

To access the abstract on the NEJM please click here

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Mental Health in the Humanitarian Context

New Joint Training Course in Pakistan

PakistanA new 2-year training course titled "Mental Health Services Research in a Humanitarian Context" was inaugurated in April 2013, at the Institute of Psychiatry, WHO Collaborating Center for Mental Health Research and Training, Benazir Bhutto Hospital, Rawalpindi, Pakistan.

The course is a joint collaboration between Johns Hopkins University, the University of Liverpool and the Institute of Psychiatry, and was organized under the auspices of SHARE (South Asian Hub for Advocacy, Research and Education) with the Institute of Psychiatry serving as the administrative hub of SHARE.

The course, which comprises of four modules, will be taught over a 2-year period with research exercises to be conducted between each teaching module. Each module will run for 7 days: 6 days’ module teaching and one day application to research proposals with the assistance of mentors.

The course has been developed using the DIME model developed by the Johns Hopkins University, taking participants through each step of the research process: from design to delivery and evaluation. Dr. Paul Bolton, an associate scientist with the Johns Hopkins Bloomberg School of Public Health and the Center for Refugee and Disaster Response has extensive expertise in program design, implementation and evaluation and was the principal course tutor with Anna Chiumento from University of Liverpool as a supporting tutor.

The course aims to produce a cohort of skilled researchers and practitioners able to make a significant contribution to mental health research in a humanitarian context in the South Asia region.

The inauguration day of the course was held on 22nd April and it began with a presentation by Prof. Fareed Minhas, who gave an introduction of Institute of Psychiatry. He emphasized on the relentless support of British council in supporting mental health research over the years. Prof. Atif Rahman who is the principal investigator for SHARE further elaborated upon the role of the British Council and he highlighted the LINKS, Inspire, DelPHE projects and the support of British council in the ongoing SHARE activities. Ms Nishat Riaz, the Head of programmes, Higher Education, Pakistan from the British Council explained the wide-ranging collaboration between the Institute of Psychiatry and the British Council over the years. The Chief guest for the event, Principal Rawalpindi Medical College Prof. Mohammmad Umer also discussed the overwhelming need for an ethically grounded sound research apporach in mental health in humanitarian context. The inauguration session was attended by the Principal, the faculty of the Rawalpindi medical college, British Council representatives, tutors from Johns Hopkins University and University of Liverpool. In addition, international regional participants from Nepal and Srilanka and national participants of the course also attended the session.

The Module 1 of the course, ‘Introduction and Qualitative Assessment’which spanned over 8 days of training, aimed at imparting to the participants, the principles of qualitative assessments and interviews and were introduced to the basic principles of conducting a qualitative assessment on a given population by identifying priority problems from a local perspective. Processes of ethical considerations were highlighted in detail.

The course teaching involved classroom-based modules with role-playing involving free list interviews and key informant interviews and learning to carry out compilation of qualitative data followed by qualitative analysis of the data. Practical application of research skills were discussed at length as each participant will lead their own research project under the guidance of an experience mentor and supported by course tutors. The real strength of this course is to impart knowledge and to develop practical skills of ethically grounded scientific research to the participants who then would be able to contribute towards capacity building within the region.

Mentor supervision of participants forms an integral part of this course and makes the backbone of the field research, training and supervision of the participants. Mentors from each nominating institution will supervise the participants to conduct research assignments within allotted time between course modules and ensure that assignments are completed prior to the commencement of next module.
For in depth evaluation of the course extensive feedback was obtained on specially designed feedback forms. The feedback was obtained from tutors, mentors and participants. A focus group was also held by a third party in order to obtain impartial comments from the participants about relevance of course materials, teaching styles and practical application of course contents.

Pakistan 2The course is jointly supported by the development of an online learning environment, which comprises of creation of closed online community. The online forum will have an inbuilt up repository of course materials and supporting literature, as well as podcasts etc. and would provide as a platform for interactive discussions and supervision by tutors.
The second module for the course ‘Mental Health Services Research in Humanitarian Context’ has been scheduled to be delivered in October 2013.

For more information about the course, please contact:

Dr. Bushra Razzaque
Research Administrator
SHARE(South Asian Hub for Advocacy Research and Education)
Institute of psychiatry, WHO Collaborating Center for Mental Health Research and Training
Benazir Bhutto Hospital, Rawalpindi
Email: bushrazzaque@gmail.com

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Severe Food Insecurity and Famine

Somalia Study Report

Court RobinsonA new study, co-authored by Courtland Robinson, core faculty member of the Center for Refugee and Disaster Response, estimates that famine and severe food insecurity in Somalia claimed the lives of about 258,000 people between October 2010 and April 2012, including 133,000 children under 5. The study, led by Francesco Checchi of the London School of Hygiene and Tropical Medicine and jointly funded and commissioned by the United Nations Food and Agriculture Organization’s (FAO) Food Security and Nutrition Analysis Unit for Somalia (FSNAU) and the USAID-funded Famine Early Warning Systems Network (FEWS NET), is the first scientific estimate of the death toll from the food security emergency that lasted in Somalia from late 2010 to early 2012.

The study, titled "Mortality among populations of southern and central Somalia affected by severe food insecurity and famine during 2010-2012", was released on May 2, 2013 and has made headline news on ReliefWeb (http://reliefweb.int/) and was featured in a large number of print, television, radio and online media outlets worldwide.
Somalia graph
Somalia Map“Our study was not designed to explore causes of excess mortality,” Checchi and Robinson concluded, “and others are better placed to interpret these findings in context and translate them into action. Nevertheless, an obvious rational use of our estimates would be to ensure that in Somalia and food security-related emergencies elsewhere, future early warning and surveillance alerts do translate into tangible, immediate relief interventions to support livelihoods, health and nutrition in the affected communities.”

For more information on this important analysis you can freely access the full study, statistical datasets and codes by clicking here.

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Dealing with Trauma

Mental Health Training in Mae Sot, Thailand

AMHR trainingSome members of the faculty involved with the Center for Refugee and Disaster Response are part of the Applied Mental Health Research group.

The AMHR group has recently been working in collaboration with a local organization in Thailand to help adults from Burma/Myanmar who have experienced traumas.

AMHR training

The AMHR group recently completed a randomized controlled trial, testing a counseling intervention called "Common Elements Treatment Approach" (CETA), which demonstrated strong effectiveness in reducing symptoms of depression and trauma.

The team recently completed a cascading training model (Training of the Trainers approach) - in which they trained two of the local supervisors to train on the CETA model, with the support of the AMHR team on site to coach them throughout the process. AMHR is now working with these local partners to expand coverage of services in both Thailand and Burma/Myanmar.

For more information about the work of the AMHR, please click here.

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Disaster Medical Sciences Award

Dr. Thomas Kirsch to receive award at ACEP assembly

Dr. KirschThe Center for Refugee and Disaster Response is proud to inform you that Dr. Thomas Kirsch, a co-director of the Center, is the first recipient of an important award as communicated by the ACEP below:

"We are pleased to announce that Thomas D. Kirsch, MD, MPH, FACEP is the first recipient of the annual American College of Emergency Physicians (ACEP) Disaster Medical Sciences Award. This is a new award that was recently approved by the ACEP Board of Directors.

The Disaster Medicine Award is given by ACEP based on nominations solicited from ACEP membership including the Disaster Preparedness and Response Committee, Chapter Offices and the Disaster Medicine Section. This award recognizes emergency physicians who have taken up the College's challenge to expand the knowledge base of disaster medicine and assume leadership roles. This includes activities like, Research and publications, Service to organizations that support disaster medicine, Humanitarian activities; including providing medical care in disasters, Leadership activities, Teaching and Advocacy and/or legislative efforts.

The award will be presented at this year’s ACEP, Scientific Assembly in Seattle, Washington during the Disaster Medicine Section, annual meeting. Scientific Assembly will be held this year on October 14-17, 2013.

Congratulations to Dr. Kirsch".

For more information about Dr. Kirsch click here

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PLOS Blog

Earthquakes, Cyclones, Tsunamis, Floods and Volcanoes – assessing the human impact of each

Web page picRecently, the PLOS Blog featured an interesting serie about the impact of disaster on humans.

The serie's authors, amongst other, included Dr. Thomas Kirsch and Dr. Shannon Doocy, who are respectively co-Director and Faculty of the Center for Refugee and Disaster Response.

The Blog can be found by clicking on the link here (PLOS Blog)

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Low Resource Environment Medicine

The Johns Hopkins Austere Medicine Course - 2013

Austere Picture"Austere Medicine" is the practice of medicine in a resource-constrained environment, in the wilderness, in developing countries and after a disaster.

The 8th annual Johns Hopkins Austere Medicine course was conducted over the past two weeks using a combination of lectures, simulations and scenarios to teach leadership, teamwork and critical decision-making. Twenty three Hopkins medical students spent time in lectures, simulations and ‘in the wild’, camping in Patapsco State Park to live and work in a limited resource environment. They were taught by faculty from the Hopkins School of Medicine and the Bloomberg School of Public Health with support from MPH students and emergency medicine residents.

The Hopkins course is a unique a multidisciplinary program that trains medical students for health and public health practice in any low-resource environment. The course uses a universal approach to teach critical skills needed for international humanitarian assistance, disaster medicine and wilderness medicine. These skills include the following;

Medical skills
• A standard, ‘ABCD’ evaluation approach
• Triage, efficiency of intervention, diagnosis of consequence
• Injury stabilization and management
• Domestic and global infectious diseases

Public Health skills
• Practical epidemiology
• Food and Nutrition
• Water and Sanitation

Management skills:
• Leadership
• Teamwork
• Communications

Survival skills
• Cultural adaptation
• Living with limited resources
• Environmental safety: Weather and war

For more information on the course please visit the Johns Hopkins Medicine Website page: (http://www.hopkinsmedicine.org/som/wildernessmedicine/)

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Global Health

Dr. Alex Vu receives Excellence in Global Health Advising Award from Johns Hopkins University President Ron Daniels

Dr. VuDr. Alexander Vu is heading the development of the Assessment Screen to Identify Survivors Toolkit for Gender Based Violence (ASIST-GBV), a project in collaboration with team of researchers from the School of Public Health Department of Epidemiology Center for Public Health ad Human Rights, School of Medicine International Emergency and Public Health Fellowship program and the School of Nursing. The 7-item ASIST-GBV screening instrument is designed to function as a ‘rapid test’ for early and confidential identification of GBV and, thus, immediate referral of survivors to existing GBV health, protection, legal, and social services, as needed. Currently, no such GBV screening tool exists in the literature. The team has completed the validation and feasibility studies of the ASIST-GBV screening instrument among female refugees living in Ethiopia and among female internally displaced persons in Colombia. The team hopes to use the ASIST-GBV toolkit to help GBV service providers identify GBV survivors among the Syrian refugees in Lebanon. Currently, the team has completed the qualitative phase and is now in the validation phase of adapting the ASIST-GBV among male refugees living in Uganda. The next step is to work with UNHCR to implement the ASIST-GBV toolkit in refugee camps being supported by UNHCR in acute and protracted emergency settings. Dr. Vu is going to present the team's findings in the Global Health and Innovation Conference at Yale on April 13, 2013.

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Pediatric Surgical Needs in Sub-Sahara

West African College of Surgeons Conference in Togo
Dr. Kushner in Togo2Dr. Adam Kushner, as part of a Sierra Leone delegation, recently attended the 53rd. Annual Scientific Conference of the West African College of Surgeons held in Lome, Togo.

Since 2008 Dr. Kushner has worked extensively with local surgeons in Sierra Leone to document surgical needs and improve surgical care.

At the meeting, along with Nigerian colleagues, he administered a survey developed by an expert panel of pediatric surgeons from around the world. The survey documents deficiencies in personnel, infrastructure, procedures, equipment and supplies necessary to care for the surgical needs of children.

The data collected from hospitals throughout West, East and Southern African facilities will help develop a snapshot of pediatric surgical needs throughout sub-Saharan Africa and help plan interventions.

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Health Services in Iraq

Publication in the Lancet

Lancet pictureProfessor Burnham from the Johns Hopkins Bloomberg School of Public Health, in collaboration with Professor Al Hilfi from the Al Kindy College of Medicine, Baghdad, Iraq, and Professor Lafta from the Al Munstansiriya University, Baghdad, Iraq, have recently published in the Lancet a review of the health status of Iraqis and the health system in Iraq.

For more information on this important analysis and to access the full publication, please click here: The Lancet.com: Iraq Review. The document is freely accessible once you register as an user.

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Health in North Korea:

Dr. Burnham speaks at Seoul National University

Burnham in SeoulDr. Gilbert Burnham recently spoke to a team of researchers on North Korean health systems issues at Seoul National University.

This event was part of a long collaboration with South Korean researcher who are tracking health development in North Korea. Johns Hopkins in collaboration, with members of this team have been working on a number of joint research studies related to access to health services in North Korea including the increasing burden of non-communicable diseases, and the persistent problems of multi-drug resistant tuberculosis.

Dr. Haewon Lee, standing by the right side of Dr. Burnham in the picture, is a key member of the team and a Johns Hopkins University MPH graduate and post-doctoral fellow who worked with the Center for Refugee and Disaster Response during her studies in Baltimore.

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