The war in Ukraine 1 year on: the need to strategize for the long-term health of Ukrainians  

Spiegel, P, Kovtoniuk, P, and Lewtak, K. | The Lancet,Vol 401 | Published: February 21, 2023

1 year has passed since the unprovoked war by Russia on Ukraine began on Feb 24, 2022. The horrendous suffering and deaths among Ukrainian civilians and the massive loss of life in the military on both sides are tragic. The UN estimates there have been 7155 conflict-related civilian deaths with 11 662 people injured, which are probably gross underestimates.There are about 5·4 million internally displaced persons (IDPs) in Ukraine, and more than 8 million refugees,2 most of whom have temporary protection status and reside throughout Europe.3

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Are the health systems of EU countries hosting Ukrainian refugees ready to adapt?

Spiegel, P. | The Lancet Healthy Longevity| Published: September 16, 2022

The war in Ukraine and its direct and indirect consequences have reverberated throughout the world.The media report on the horrific consequences that are occurring daily, mostly through personal stories that attempt to encapsulate the horrors of this unprovoked war by Russia. Until this issue in The Lancet Healthy Longevity, to my knowledge there have been no peer-reviewed articles with large-scale quantitative data that analyse the health situation for Ukrainian refugees and their potential effects on health systems.

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Misplaced Skepticism on Accountability for War Crimes Against Health Care in Ukraine

Rubenstein, L. | BILL of HEALTH | Published: May 4, 2022

Russian attacks on hospitals, ambulances, and health workers in Ukraine — including more than 180 attacks confirmed by the World Health Organization, and double that number reported by the Ministry of Health — have gained global attention.

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Documenting health care attacks during conflict

Rohini Haar, Naser AlMhawish, Ahmad Tarakji, Hannah Tappis and Leonard S. Rubenstein | Elrha | Published: April 1, 2021

It was March 15, 2011, 10 years ago, when massive protests calling for government reform spread across major cities in Syria. By 19 March, dozens of protesters were killed in Dar’aa, a southwestern city near the Jordan border, after police opened fire on them. By summer the protest movement evolved into a civil war, now with myriad actors, which continues today.

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Can Cash Transfers Help Syrian Refugees Manage Diabetes?

Shannon Doocy | CALP NETWORK | Published: March 23, 2021

Providing refugees with cash assistance is increasingly common in humanitarian contexts and multipurpose cash is becoming a modality of choice.  Yet critical questions are still being explored such as who should receive cash and how can it be used by the sectors without compromising standards?

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How the Biden Administration Can Better Protect Health Care in War

 Leonard Rubenstein | JUST SECURITY | Published: February 22, 2021

Deep in the National Defense Authorization Act (NDAA), passed despite President Donald Trump’s veto, lies a modest provision, section 1299J, that provides the Biden administration with an opportunity for a foreign policy and human rights trifecta: Reforming military operational practice to be more consistent with the nation’s values and commitment to international law; providing global leadership in securing compliance with Geneva Conventions’ requirements to protect and respect health care; and advancing access to health care for people in war-torn countries in the next pandemic.

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Statement: protecting the health of migrants in ICE facilities across the U.S.

Dana McLaughlin MPH candidate ‘21, Orit Abrahim MPH, M.D. Candidate 2021, David Tellez MSPH candidate ‘21, Lauren Tejkl MSPH candidate ‘21, and Paul Spiegel M.D., MPH 

A call for increased monitoring of migrant health protections during the COVID-19 pandemic

The Center for Humanitarian Health and Lancet Migration support an investigation into the recent whistleblower report from an Immigration and Customs Enforcement (ICE) detention facility nurse claiming poor adherence to national guidelines to prevent and contain COVID-19, unsafe environments for detainees and staff, and breaches in informed consent.

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Getting Serious About Protecting Health Care in War

 Leonard Rubenstein | JUST SECURITY | Published: July 28, 2020

After years of indifference to examining whether its rules of engagement and other operational directives and practices contribute to the scourge of violence against health workers, hospitals, ambulances, and patients, the Pentagon may finally be forced to act. 

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A Declaration of U.S. Health Collaborating Centers April 28, 2020

Today, 40 respected health leaders across the United States released A Declaration of U.S. Health Collaborating Centers, an open letter urging the president and the Congress to not only to restore but increase funding for the World Health Organization (WHO). The declaration stated that the mission and capacity of WHO is needed now more than ever to combat the COVID-19 pandemic.

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JHU Faculty Express Urgent Concern about Covid-19 Spread in Prison

Leonard Rubenstein | JHU Berman Institute and Bioethics | Published: March 25, 2020 | Full Text 

More than 200 Johns Hopkins faculty in public health, bioethics, medicine, and nursing signed a letter delivered to Governor Larry Hogan.

Can Physicians Work in US Immigration Detention Facilities While Upholding Their Hippocratic Oath?

Spiegel Paul, Kass Nancy, Leonard Rubenstein.,  | JAMA | Published on August 30, 2019 | Full Text

The modern successor to the Hippocratic oath, called the Declaration of Geneva, was updated and approved by the World Medical Association in 2017.

Ebola virus disease and breastfeeding: time for attention

Ververs Mija., Arya Akanksha.,  | The Lancet, Vol 394 | Published on August 27, 2019 | Full Text

This year's Global Nutrition Cluster meeting in July, 2019, offered a platform on which to discuss all nutrition-related humanitarian emergencies.

Political violence in Sudan: the need for a coordinated, locally led humanitarian health response

Maysoon, D., Spiegel, P.,  | The Lancet, Vol 394 | Published on July 10, 2019 | Full Text

Since the fall of former Sudan President Omar al-Bashir's regime in April, 2019, the political and security situation in Sudan has been in flux. The Sudanese Transitional Military Council (TMC) and opposition groups signed a 3-year power-sharing agreement on July 4, 2019.

International failure in northwest Syria: humanitarian health catastrophe demands action

Rubenstein, L., Spiegel, P.,  | The Lancet, Vol 394 | Published on July 4, 2019 | Full Text

The 9-year conflict in Syria has resulted in one of the worst humanitarian crises of our generation, with more than 11·7 million people in need of humanitarian assistance in Syria, 11·3 million in need of health assistance, and 6·2 million internally displaced within Syria.

We must stop turning a blind eye to the world's health crises

Spiegel, P. | World Economic Forum | Pubished on February 25, 2019 Full Text

When the World Health Organization (WHO) declared lengthy humanitarian crises to be a top health threat, perhaps they had Yemen in mind. It wasn’t one individual bomb landing in Yemen that infected hundreds of thousands of people with cholera.

What impact does migration have on the health of societies?

Spiegel, P. | The Hill | Pubished on December 10, 2018 Full Text

When migrants were streaming off the fragile boats on the shores of Lesvos island in Greece, the look in their eyes was one of sadness and despair, tinged with hope. Disembarking were men, women, boys and girls from many countries, some fleeing war or political repression and others seeking safety from violence and abuse, while still others were looking for work.

The 'healthy migrant effect' re-examined among North Koreans in South Korea

Robinson, C. | Hopkins Humanitarian Health Digest | Published on August 9, 2018 Full Text

Abstract - Since the separation of Korea into North and South and the end of the Korean War in 1953, more than 31,000 North Koreans have fled their country and settled in South Korea. Most of these refugees (alternatively called defectors or migrants) came south since the mid-1990s when years of famine were followed by economic hardship, food shortages, and human rights abuses. The most common route has been through China and then following various routes through other Asian countries to reach South Korea. More than 70% of North Koreans in South Korea are female. 

It's about time for palliative care in humanitarian emergencies

Spiegel, P. | Hopkins Humanitarian Health Digest | Pubished on May 9, 2018 Full Text

Abstract - The Syrian crisis is a watershed moment in humanitarian action. It has shed a light on a myriad of complex issues and gaps, many relating to the protracted nature of conflict and displacement outside of camp settings in middle-income countries. The importance of palliative care in such contexts is critical, but rarely discussed, never mind addressed. It’s time to provide holistic palliative care in humanitarian emergencies consisting of pain management and psychosocial support, including social and spiritual aspects. 

Why It’s About Time For Palliative Care in Humanitarian Emergencies

Spiegel, P. | NewsDeeply Refugees Deeply | Published on May 15, 2018 | Full Text

Abstract - The importance of palliative care in such contexts is critical, but rarely discussed, never mind addressed. It’s time to provide holistic palliative care in humanitarian emergencies consisting of pain management and psychosocial support, including social and spiritual aspects.

Death and suffering in Eastern Ghouta, Syria: a call for action to protect civilians and health care

Spiegel, P. | The Lancet, Volume 391 | Published on February 23, 2018 | Full Text

Abstract - Since Feb 4, 2018, Syrian forces with Russian support have bombarded Eastern Ghouta, an enclave out of government control near Damascus. This military action has killed hundreds of civilians and injured more than 1550 people as of Feb 21, 2018,1 in an area where about 390 000 people, most of whom are civilians, have lived under siege since October, 2013. The recent escalation is reportedly part of a Syrian Government offensive supported by its Russian and Iranian allies to retake Ghouta. In just 1 day, on Feb 20, 2018, PAX, an international peace movement, documented 110 civilians killed and hundreds injured in 131 air strikes, 44 barrel bombs, 28 surface-to-surface “elephant” missiles, five cluster bombs, and countless other artillery and rocket fire.2 Amnesty International sees this as continuing “war crimes on an epic scale”

Attacks on health facilities and health workers: time for the Security Council to act

Rubenstein, L. | The Lancet, Volume 389 | Published on June 3, 2017 Full Text

Abstract - May 3, 2017, marked the first anniversary of a UN Security Council resolution that condemned attacks on health facilities and personnel in conflict and the “prevailing impunity” for these atrocities. But neither the Security Council nor governments have acted on the resolution. Now, a report by the Safeguarding Health in Conflict Coalition, Impunity Must End, shows that in 2016, the number and intensity of attacks on health services in 23 countries continued to be staggeringly high. In ten countries, hospitals were bombed or shelled. In 20 countries, health workers were intimidated, assaulted, and arrested, and in 11 of them they were killed. In 15 countries, humanitarian access to health assistance was severely curtailed.

The revised US refugee ban, health, and security

Rubenstein, L., Spiegel, P. | The Lancet, Vol 391 | Published on March 10, 2017 | Full Text

Abstract - President Trump issued a revised travel and refugee ban on March 6, 2017, in the wake of judicial orders preventing implementation of his previous ban.1,2 The new order discontinues the bar on entry into the USA for permanent residents, reduces from seven to six the number of predominantly Muslim countries whose nationals are suspended from entry for at least 90 days, ends the indefinite bar on entry of Syrian refugees, and eliminates a preference for religious minorities in refugee resettlement.

The academic case for repealing Trump's refugee and travel ban

Spiegel, P., Rubenstein, L. | The Lancet, Volume 389, Issue 10070, 679-680 | Published on February 9, 2017 | Full Text

Abstract - Academics provide education and undertake research to improve understanding, and hopefully make the world a better place. US President Donald Trump's recent executive order on Jan 27, 2017,1banning travel to the USA from seven predominantly Muslim countries (Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen) for 90 days, suspending the US resettlement programme for all refugees for 120 days, indefinitely suspending the entry of Syrian refugees, and reducing the number of resettled refugees from 110 000 to 50 000, has dramatically and negatively affected millions of people's lives.

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