The Oxford Handbook of Humanitarian Medicine is a practical guide covering all aspects of the provision of care in humanitarian situations and complex emergencies. It includes evidence-based clinical guidance, aimed specifically at resource limited situations, as well as essential non-clinical information relevant for people working in field operations and development. The handbook provides clear recommendations, from the experts, on the unique challenges faced by health providers in humanitarian settings including clinical presentations for which conventional medical training offers little preparation. It provides guidance for syndromic management approaches, and includes practical guidance on the integration of context specific mental health care.
The handbook goes beyond the clinical domain, however, and also provides detailed information on the contextual issues involved in humanitarian operations, including health systems design, priorities in displacement, security and logistics. It outlines the underlying drivers at play in humanitarian settings, including economics, gender based inequities, and violence, guiding the reader through the epidemiological approaches in varied scenarios. It details the relevance of international law, and its practical application in complex emergencies, and covers the changing picture of humanitarian operations, with increasingly complicated and chaotic contexts and the escalation of violence against humanitarian providers and facility.
The Oxford Handbook of Humanitarian Medicine draws on the accumulated experience of humanitarian practitioners from a variety of disciplines and contexts to provide an easily accessible source of information to guide the reader through the complicated scenarios found in humanitarian settings.
Table of Contents
Part 1: Practical and professional issues in humanitarian medicine
1: Introduction to humanitarian medicine, Amy Kravitz, Sheri Fink, Jennifer Turnbull
2: Responses & responders, Patrick Robitalle, Sandrine Tiller
3: Health priorities in displacement, Gustavo Fernandez, Jennifer Turnbull, Françoise Bouchet-Saulnier, Alena Koscalova, Kiran Jobanputra, Ana Maria Tijerino, Philippa Boulle, Veronique Mulloni, Iza Ciglenecki, Nathalie Avril, Tammam Aloudat, Monica Rull, Pierre Maury, Isabelle Voiret,
4: Health systems design, Jorge Castilla Echenique, Andre Griekspoor, Hyo Jeong Kim
5: Gender based violence in humanitarian crises, Jennifer Scott, Rose Leonard Molina, Jocelyn Kelly
6: Mental Health in humanitarian emergencies, Peter Ventevogel, Lynne Jones, Inka Weissbecker, Vanessa Cavallera
7: Epidemiology, P. Gregg Greenough, Andrew James Willis
8: Understanding economic effects of humanitarian intervention, Dirk-Jan Omtzigt
9: International Law for healthcare workers, Françoise Bouchet-Saulnier
10: Security, Norman Sheehan, Chris Houston
11: Medical care under fire: a perspective from the international medical organization Médecins Sans Frontières (MSF), Camille Michel, Kenneth Lavelle, Thomas Nierle
12: Medical logistics in humanitarian settings, Bernard Chomilier, Christine Chomilier
13: Working for international organizations, Rod Volway
Part 2: Introduction to clinical humanitarian medicine
14: Approach to clinical care in humanitarian contexts, Raghu Venugopal
15: Mass casualty triage, Christos Giannou, Jennifer Turnbull
16: Medical triage, Peter Moons
17: Approach to paediatric care, Jaap Karsten, Laurent Hiffler, Daniel Martinez Garcia
Part 3: Syndromic management
18: Shock, Laura Hawryluck, Miroslav Stavel
19: Fever, Laura Sauve, Kevin Chan
20: Anaemia, Margaret Salmon, Lily Muldoon, Max Ritzenberg
21: Pain, Joseph O'Neill
22: Jaundice, Michelle Tubman
23: Lymphadenopathy, Anna MacDonald
24: Cough and breathlessness, Joseph O'Neill
25: Oedema, Anne Aspler
26: Unintentional weight loss in adults, James Maskalyk
27: Diarrhoea and vomiting, Peter Moons
28: Malnutrition, Kevin Chan, Jennifer Turnbull
Part 4: Infectious diseases
29: Malaria, Elizabeth Ashley
30: Neglected tropical diseases, Jan Hajek
31: TB and HIV in humanitarian contexts, Peter Saranchuk
32: Clinical suspicion of ebola, Tim Jagatic, Craig Spencer
33: Venomous animal bites and stings and marine poisoning, Professor David Warrell
34: Global impact of antimicrobial resistance (AMR), Catherine Berry
35: Response to epidemic disease, AnneMarie Pegg
Part 5: Clinical guidelines
36: Cardiac conditions, Saleem Kassam
37: Respiratory illness, Aditya Nadimpalli, Philippa Boulle
38: Gastrointestinal, Ingo Hartlapp
39: Neurology, Aaron Berkowitz
40: Urology, Axel Bex
41: Reproductive health, Marianne Stephen
42: Obstetrics, Susan Ann O'Toole, Benjamin Black
43: Neonatology, Jonathan Spector, Marie Claude Bottineau
44: Ophthalmology, William Mapham
45: ENT, Laurent Bonnadrot, Sarah Giles, Olivier Malard, Elisabeth Sauvaget
46: Chronic noncommunicable diseases, Philippa Boulle, Tammam Aloudat
47: Palliative Care, Joseph O'Neill
Part 6: Surgery and procedures
48: Major trauma, David Nott
49: Medical management of the surgical abdomen, Massey Beveridge, Marco Baldan
50: Wound care and minor surgical procedures, Massey Beveridge
51: Burns, Massey Beveridge
52: Orthopaedics and limb injuries, David Rowley
Part 7: Investigations and studies
53: Laboratory, Cara Kosack
54: Blood transfusion, Cara Kosack, Monique Guegen
55: Ultrasound, Matthew Lyon, W. Ted Kuhn
Part 8: Water, sanitation, and waste
56: Water, sanitation and hygiene (WASH), Peter Maes, Joos Van Den Noortgate, Rafael Van Den Bergh
57: Medical waste management, Joos Van den Noortgate, Peter Maes, Rafael Van den Bergh
Contributors:
Tammam Aloudat (Chapter 3: Health priorities in displacement; Chapter 46: Chronic non-communicable diseases)
Deputy Medical Director, Medical Department, Médecins Sans Frontières, Geneva, Switzerland
Elizabeth Ashley (Chapter 29: Malaria)
Director of Clinical Research Myanmar, Oxford Clinical Research Unit, Yangon, Myanmar
Centre for Tropical Medicine and Global Health, University of Oxford, UK
Anne Aspler (Chapter 25: Oedema)
Emergency Medicine, University of Toronto, Canada
Nathalie Avril (Chapter 3: Health priorities in displacement)
Nutrition Advisor, Médecins Sans Frontières Operational Centre, Geneva, Switzerland
Marco Baldan (Chapter 49: Medical management of the surgical abdomen)
General Surgeon, Delegate Regional Surgeon for the Near and Middle East, International Committee of the Red Cross, Beirut, Lebanon
Aaron Berkowitz (Chapter 39: Neurology)
Director, Global Neurology Program, Brigham and Women's Hospital, Boston, MA, USA
Assistant Professor of Neurology, Harvard Medical School, Boston, MA, USA
Health and Policy Advisor in Neurology, Partners in Health, Boston, MA, USA
Catherine Berry (Chapter 34: Global impact of antimicrobial resistance)
Clinical Advisor, Médecins Sans Frontières-UK, Chancery Exchange, London, UK
Massey Beveridge (Chapter 49: Medical management of the surgical abdomen; Chapter 50: Wound care and minor surgical procedures; Chapter 51: Burns)
Adjunct Assistant Professor of Surgery, University of Toronto, Canada
Axel Bex (Chapter 40: Urology)
Urologic Surgeon, Division of Surgical Oncology, Department of Urology, Netherlands Cancer Institute, Amsterdam, Netherlands
Benjamin Oren Black (Chapter 42: Obstetric care)
Senior Registrar, Obstetrics, Gynaecology & Sexual Health, Homerton University Hospital, London, UK
Laurent Bonnardot (Chapter 45: Ear, nose, and throat)
ENT and Emergency Physician, Médecins Sans Frontières, Paris, France
Marie Claude Bottineau (Chapter 43: Neonatology)
Pediatrician and Neonatology, MSF International Pediatrics Working Group Leader, MSF-CH Women & Children Health Pool Leader, Médecins sans Frontières Operational Centre, Geneva, Switzerland
Françoise Bouchet-Saulnier (Chapter 3: Health priorities in displacement Chapter 9: International Law)
Doctor of Law and Magistrate, International Legal Director of Médecins sans Frontières, Paris, France
Philippa Boulle (Chapter 3: Health priorities in displacement; Chapter 37: Respiratory illness; Chapter 46: Chronic non-communicable diseases)
Chronic Non-Communicable Disease Advisor; Chronic Conditions Team Leader, Médecins sans Frontières, Geneva, Switzerland
Jorge Castilla Echenique (Chapter 4: Health systems design)
Senior Health Advisor, Emergency Operations, WHO Health Emergencies Programme, World Health Organization, Geneva, Switzerland
Vanessa Cavallera (Chapter 6: Mental health in humanitarian emergencies)
Independent Consultant
Kevin Chan (Chapter 19: Fever; Chapter 28: Malnutrition)
Chair, Pediatrics, Memorial University and Clinical Chief, Children's Health, Eastern Health, St. John's, Newfoundland, Canada
Bernard Chomilier (Chapter 12: Medical logistics in humanitarian settings)
Logistics Expert, retired
Christine Chomilier (Chapter 12: Medical logistics in humanitarian settings)
Logistics Expert, retired
Iza Ciglenecki (Chapter 3: Health priorities in displacement)
Operational Research Coordinator, Médecins Sans Frontières Operational Centre, Geneva, Switzerland
Gustavo Fernandez (Chapter 3: Health priorities in displacement)
Migration Senior Project Manager, Médecins Sans Frontières Operational Centre, Geneva, Switzerland
External Relations Officer, Partnership and Non-State Actors Department, World Health Organization, Geneva, Switzerland
Sheri Fink (Chapter 1: Introduction to humanitarian medicine)
Fellow, FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Christos Giannou (Chapter 15: Mass casualty triage)
Honorary Lecturer, Queen Mary & Barts, Blizard Institute, University of London, UK
Former Head Surgeon, International Committee of the Red Cross, retired
Sarah Giles (Chapter 45: Ear, nose, and throat)
Locum Family/Emergency Physician
P. Gregg Greenough (Chapter 7: Epidemiology)
Assistant Professor, Global Health & Population, Harvard T.H. Chan School of Public Health; Faculty, Harvard Humanitarian Initiative, Cambridge, MA, USA
Andre Griekspoor (Chapter 4: Health systems design)
Senior Humanitarian Policy Adviser, Emergency Operations, WHO Health Emergencies Programme, World Health Organization, Geneva, Switzerland
Monique Gueguen (Chapter 54: Blood transfusion)
Medical Laboratory Advisor, Médecins sans Frontières, Paris, France
Jan Hajek (Chapter 30: Neglected tropical diseases)
Clinical Assistant Professor, Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, Canada
Ingo Hartlapp (Chapter 38: Gastrointestinal Illness)
Senior Physician, Department for Internal Medicine/Gastroenterology/Infectiology/Oncology, Vivantes Auguste-Viktoria-Hospital, Berlin, Germany
Member, Médecins sans Frontières, Germany
Laura Hawryluck (Chapter 18: Shock)
Associate Professor Critical Care Medicine, University of Toronto, Canada
Physician Lead, Critical Care Rapid Response Team, University Health Network, Toronto, Canada
Member, Médecins Sans Frontières Telemedicine Program, Canada
Laurent Hiffler (Chapter 17: Approach to paediatric care)
Paediatric Advisor, MSF Operational Center Barcelona-Athens, Dakar, Senegal
Chris Houston (Chapter 10: Security)
Senior Program Officer (Humanitarian), Grand Challenges Canada
Board member, Médecins sans Frontières, Canada
Module Lead, Global Health Education Initiative, Postgraduate Medical Education, University of Toronto, Canada
Tim Jagatic (Chapter 32: Clinical suspicion of Ebola)
Physician, Médecins Sans Frontières, Ontario, Canada
Kiran Jobanputra (Chapter 3: Health priorities in displacement)
Head of Manson Unit, Médecins Sans Frontières, London, UK
Lynne Jones (Chapter 6: Mental health in humanitarian emergencies)
Fellow, FXB Center for Health and Human Rights, Harvard University, Boston, MA, USA
Honorary Consultant Child and Adolescent Psychiatrist, Cornwall Partnership NHS Foundation Trust, Cornwall, UK and South London and Maudsley NHS Foundation Trust, London, UK
Jaap Karsten (Chapter 17: Approach to paediatric care)
Médecins Sans Frontières, Amsterdam, The Netherlands
Saleem Kassam (Chapter 36: Cardiac conditions)
Consultant, Director, Cardiac Catheterization Laboratory, Rouge Valley Health System, Toronto, Canada
Vice President, Médecins Sans Frontières, Canada
Jocelyn T.D. Kelly (Chapter 5: Gender-based violence in humanitarian crises)
Director, Women in War Program, Harvard Humanitarian Initiative, Cambridge, MA, USA
Hyo Jeong Kim (Chapter 4: Health systems design)
Technical Officer, Emergency Operations, WHO Health Emergencies Programme, Geneva, Switzerland
Cara Kosack (Chapter 53: Laboratory; Chapter 54: Blood transfusion)
Leader, Diagnostic Network, Médecins sans Frontières, Amsterdam, The Netherlands
Alena Koscalova (Chapter 3: Health priorities in displacement)
Tropical Medicine Adviser, Médecins sans Frontières, Operational Centre, Geneva, Switzerland
Amy S. Kravitz (Chapter 1: Introduction to humanitarian medicine)
Medical Officer, United States Agency for International Development (USAID), Washington, DC, USA
W. Ted Kuhn (Chapter 55: Ultrasound)
Former Director, International Medicine, Co-director, Ultrasound Fellowship, Medical College of Georgia, Augusta University, GA, USA
Kenneth Lavelle (Chapter 11: Medical care under fire: a perspective from the international medical organization Médecins Sans Frontières)
Deputy Director of Operations, Médecins Sans Frontières, Geneva, Switzerland
Matthew Lyon (Chapter 55: Ultrasound)
Executive Director, Center for Ultrasound Education, Medical College of Georgia, Augusta University, GA, USA
Anna MacDonald (Chapter 23: Lymphadenopathy)
Emergency Physician, St Michael's Hospital, North York General Hospital, Toronto, Canada
Peter Maes (Chapter 56: Water, sanitation, and hygiene; Chapter 57: Medical waste management)
Water, Hygiene and Sanitation Unit Coordinator, Water, Hygiene & Sanitation Unit, Médecins Sans Frontières - O.C. Brussels, Belgium
Olivier Malard (Chapter 45: Ear, nose, and throat)
ENT - Head and Neck Surgery Department, Centre Hospitalier Universitaire de Nantes, France
William Mapham (Chapter 44: Ophthalmology)
Ophthalmologist, Stellenbosch University, South Africa
Daniel Martinez Garcia (Chapter 17: Approach to paediatric care)
Paediatric Advisor, Medical Department, Médecins Sans Frontières, OCG Women & Child Health Unit, Geneva, Switzerland
James Maskalyk (Chapter 26: Patient with unintentional weight loss)
Emergency Physician, Assistant Professor, University of Toronto, Canada
Pierre Maury (Chapter 3: Health priorities in displacement)
Médecins Sans Frontières, Geneva, Switzerland
Camille Michel (Chapter 11: Medical care under fire: a perspective from the international medical organization Médecins Sans Frontières)
Legal Advisor for International Humanitarian Law and Medicolegal Issues, Médecins Sans Frontières, Geneva, Switzerland
Rose Leonard Molina (Chapter 5: Gender-based violence in humanitarian crises)
Faculty Physician, Division of Global and Community Health, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
Associate Scientist, Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA
Instructor in Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA
Obstetrician-Gynecologist, The Dimock Center, Roxbury, MA, USA
Peter Moons (Chapter 16: Medical triage; Chapter 27: Diarrhoea and vomiting)
Consultant Paediatrician, Academic Pediatric Center Suriname, Paramaribo, Suriname
Lily Muldoon (Chapter 20: Anaemia)
Emergency Medicine Resident, Department of Emergency Medicine, University of California San Francisco, CA, USA
Veronique Mulloni (Chapter 3: Health priorities in displacement)
Water, Hygiene and Sanitation Technical Referent, Technical Support to the Operations, Médecins Sans Frontières, Geneva, Switzerland
Aditya Nadimpalli (Chapter 37: Respiratory illness)
Primary Care Ultrasound Fellow, School of Medicine, University of South Carolina, Columbia, SC, USA
Thomas Nierle (Chapter 11: Medical care under fire: a perspective from the international medical organization Médecins Sans Frontières)
President, Médecins Sans Frontières, Geneva, Switzerland
David Nott (Chapter 48: Major trauma)
Consultant Surgeon, Imperial College, London, UK
Dirk-Jan Omtzigt (Chapter 8: Understanding economic effects of humanitarian intervention)
Analyst, UNOCHA Regional Office for Southern and Eastern Africa
Joseph O'Neill (Chapter 21: Pain; Chapter 24: Cough and breathlessness; Chapter 47: Palliative care)
Palliative Medicine, University of Maryland/Shore Regional Health, Easton, MD, USA
James Orbinski (Humanitarianism Today)
Professor and Director, Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
Susan Ann O'Toole (Chapter 42: Obstetric care)
Obstetrician-Gynaecologist, Collingwood, ON, Canada
AnneMarie Pegg (Chapter 35: Response to epidemic disease)
Emergency Coordinator, Médecins Sans Frontières, Paris, France
Associate Clinical Faculty, University of Calgary, Department of Family Medicine, Calgary, Canada
Max Ritzenberg (Chapter 20: Anaemia)
Emergency Medicine Resident, Department of Emergency Medicine, University of California, San Francisco, CA, USA
Patrick Robitaille (Chapter 2: Responders and responses)
Director of Programmes and International Development, Médecins du Monde/Doctors of the World, Canada
David Rowley (Chapter 52: Orthopaedics and limb injuries)
Emeritus Professor, University of Dundee, UK
Monica Rull (Chapter 3: Health priorities in displacement)
Médecins Sans Frontières, Geneva, Switzerland
Margaret Salmon (Chapter 20: Anaemia)
Faculty Global Health Emergency Medicine, University Health Network, Toronto, Canada
Assistant Professor, Department of Emergency Medicine, University of Toronto, Canada
Peter Saranchuk (Chapter 31: Tuberculosis and HIV in humanitarian contexts)
TB/HIV Adviser, Southern Africa Medical Unit (SAMU), Médecins Sans Frontières, Cape Town, South Africa
Elisabeth Sauvaget (Chapter 45: Ear, nose, and throat)
Chief of ENT - Head and Neck surgery department, Hôpital Saint Joseph, Paris, France
Laura Sauve (Chapter 19: Fever)
Clinical Assistant Professor, Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, Canada
Jennifer Scott (Chapter 5: Gender-based violence in humanitarian crises)
Director, Division of Global and Community Health, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
Associate Scientist, Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA
Instructor, Harvard Medical School, Boston, MA, USA
Norman Sheehan (Chapter 10: Security)
Risk Management Consultant
Jonathan Spector (Chapter 43: Neonatology)
Executive Director, Global Health, Novartis Institutes for BioMedical Research, Cambridge, MA, USA
Craig Spencer (Chapter 32: Clinical suspicion of Ebola)
Director of Global Health in Emergency Medicine, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA
Assistant Professor of Medicine and Population and Family Health, Columbia University Medical Center, New York, NY, USA
Miroslav Stavel (Chapter 18: Shock)
Staff Paediatrician and Neonatologist, Royal Columbian Hospital, New Westminster, Canada
Marianne Stephen (Chapter 41: Reproductive health)
Specialist Registrar Obstetrics and Gynaecology; Field Doctor, Médecins Sans Frontières
Ana Maria Tijerino (Chapter 3: Health priorities in displacement)
Mental Health Advisor, MSFCH - Médecins Sans Frontières, Geneva, Switzerland
Sandrine Tiller (Chapter 2: Responders and responses)
Strategic Adviser, Médecins Sans Frontières, London, UK
Michelle Tubman (Chapter 22: Jaundice)
Attending Physician, Emergency Medicine, Alberta Health Services, Edmonton, Canada
Clinical Lecturer, Department of Emergency Medicine, University of Alberta, Edmonton, Canada
Jennifer Turnbull (Chapter 15: Mass casualty triage; Chapter 28: Malnutrition; co-editor of Chapter 1: Introduction to humanitarian medicine; Chapter 3: Health priorities in displacement; Chapter 17: Approach to paediatric care)
Attending Physician, Division of Pediatric Emergency Medicine, McGill University Health Centre, Montreal Children's Hospital, Canada
Assistant Professor, Department of Pediatrics, McGill University, Montreal, Canada
Rafael Van den Bergh (Chapter 56: Water, sanitation, and hygiene; Chapter 57: Medical waste management)
Senior Operational Research and Technical Support Officer, Water, Hygiene & Sanitation Unit, Médecins Sans Frontières Operational Centre, Brussels, Belgium
Joos Van den Noortgate (Chapter 56: Water, sanitation, and hygiene; Chapter 57: Medical waste management)
Responsible Training, Research & Development, Operational Research Unit, Médecins Sans Frontières Operational Centre, Brussels, Belgium
Peter Ventevogel (Chapter 6: Mental health in humanitarian emergencies)
Senior Mental Health Officer, UNHCR, Geneva, Switzerland
Raghu Venugopal (Chapter 14: Approach to clinical care in humanitarian contexts)
Médecins Sans Frontières Telemedicine Coordinator
Assistant Professor of Medicine, University of Toronto, Canada
Attending Physician, Department of Emergency Medicine, University Health Network, Toronto, Canada
Isabelle Voiret (Chapter 3: Health priorities in displacement)
Médecins Sans Frontières, Geneva, Switzerland
Rod Volway (Chapter 13: Working for international organizations)
Humanitarian Development Professional
David A. Warrell (Chapter 33: Venomous animal bites and stings and marine poisoning)
International Director, Royal College of Physicians, London, UK
Emeritus Professor of Tropical Medicine and Honorary Fellow of St Cross College, University of Oxford, UK
Inka Weissbecker (Chapter 6: Mental health in humanitarian emergencies)
Senior Global Mental Health and Psychosocial Support Advisor, International Medical Corps, Washington, DC, USA
Andrew James Willis (Chapter 7: Epidemiology)
Epidemiologist, Médecins Sans Frontières, Montreal, Canada
