Search Results (149)

Background: Since the election of Hamas in 2006, Gaza has endured eight major military conflicts, culminating in the ongoing 2023–2025 war, now surpassing 520 days. This protracted violence, compounded by a 17-year blockade, has resulted in the near-total collapse of Gaza’s health system. Over 49,000 deaths, widespread displacement, and the destruction of more than 60% of health infrastructure have overwhelmed both local capacity and international humanitarian response. Objectives: This narrative review aims to examine and synthesize the current literature (October 2023–April 2025) on the health crisis in Gaza, with a specific focus on identifying key themes and knowledge gaps relevant to rebuilding a sustainable health system. The review also seeks to outline strategic pathways for recovery in the context of ongoing conflict and systemic deprivation. Methods: Given the urgency and limitations of empirical data from conflict zones, a narrative review approach was adopted. Fifty-two sources—including peer-reviewed articles, editorials, reports, and correspondence—were selected through targeted searches using Medline and Google Scholar. The analysis was framed within a public health and political economy perspective, also taking health system building blocks into consideration. Results: The reviewed literature emphasizes emergency needs: trauma care, infectious disease control, and supply chain restoration. Innovations such as mobile clinics and telemedicine offer interim solutions. Gaps include limited attention to mental health (including that of health workers), local governance, and sustainable planning frameworks. Conclusions: Sustainable reconstruction requires a durable ceasefire; international stewardship aligned with local ownership; and a phased, equity-driven strategy emphasizing primary care, mental health, trauma management, and community engagement. Full article

To obtain actionable information for humanitarian and other emergency responses, an accurate classification of news or events is critical. Daily news and social media are hard to classify based on conveyed information, especially when multiple categories of information are embedded. This research used large language models (LLMs) and traditional transformer-based models, such as BERT, to classify news and social media events using the example of the Sudan Conflict. A systematic evaluation framework was introduced to test GPT models using Zero-Shot prompting, Retrieval-Augmented Generation (RAG), and RAG with In-Context Learning (ICL) against standard and hyperparameter-tuned bert-based and bert-large models. BERT outperformed GPT in F1-score and accuracy for multi-label classification (MLC) while GPT outperformed BERT in accuracy for Single-Label classification from Multi-Label Ground Truth (SL-MLG). The results illustrate that a larger model size improves classification accuracy for both BERT and GPT, while BERT benefits from hyperparameter tuning and GPT benefits from its enhanced contextual comprehension capabilities. By addressing challenges such as overlapping semantic categories, task-specific adaptation, and a limited dataset, this study provides a deeper understanding of LLMs’ applicability in constrained, real-world scenarios, particularly in highlighting the potential for integrating NLP with other applications such as GIS in future conflict analyses. Full article

The frequent occurrence of natural disasters creates a symmetry-breaking scenario between pre-disaster planning and post-disaster rescue operations, such as post-disaster supply–demand mismatches for materials and the risk of potential facility failures. Thus, we propose a dual-uncertainty multi-scenario multi-period facility location allocation model for humanitarian rescue. The model employs two polyhedral uncertainty sets to represent facility failure risks and demand uncertainty at disaster points. Moreover, by constructing diverse disaster scenarios, it simulates material distribution schemes across different relief periods, enhancing its realism. Given that the model integrates three subproblems—facility location, supply–demand matching analysis, and emergency material allocation—we design a hybrid algorithm (DCSA-MA) that combines the discrete crow search algorithm (DCSA) and the material allocation (MA) method for its solution. Experimental results demonstrate that the model maintains a relatively high material satisfaction rate even under significant demand fluctuations. The number of facility failures has a direct bearing on emergency rescue effectiveness. The DCSA-MA method achieves a superior material satisfaction rate compared to other algorithms across various disaster scenarios and multiple rescue periods. Furthermore, DCSA-MA outperforms other algorithms in terms of solution quality, convergence, computational time, and stability. These findings indicate that DCSA-MA is an effective and highly stable approach. Full article

Background/Objectives: Non-Communicable Diseases (NCDs) place an excessive strain on health systems in disaster-affected settings and may lead to a parallel public health emergency lasting months or years after a disaster. Although NCDs are increasingly recognized as a major challenge in disasters and humanitarian emergencies, a dedicated and standardized response plan is missing, as well as a shortage of evidence-based guidelines for NCD management in theses contexts. Over the years, Emergency Medical Teams (EMTs) have traditionally been deployed to manage acute conditions such as trauma and infectious diseases that quickly impact health systems. However, greater attention is needed to address acute exacerbation of NCDs and to ensure continuity of care for people with chronic health needs in disasters and emergencies. Methods: We conducted a scoping review exploring the EMTs’ management of chronic NCDs during disasters and humanitarian emergencies, in order to identify the strategies adopted, the challenges faced, and the recommendations provided to address this health problem. The online databases PubMed, Scopus, and EBSCO were searched to identify relevant papers. Results: After screening the papers against the eligibility criteria, 17 publications were retrieved. Five different areas of intervention concerning EMTs and NCDs management were identified: (i) EMTs pre-departure preparation, operational time, and length of stay; (ii) EMTs staff composition and training; (iii) EMTs logistics; (iv) EMTs integration with local health services; (v) EMTs clinical data record. Conclusions: The findings emerging from this study showed that NCDs significantly impact disaster response in different settings, underlining the need to implement a range of EMTs activities to guarantee assistance for chronic health needs. In view of strengthening the ability of health systems to cope with the NCDs’ burden, the EMTs’ initiatives should be considered as a bridge between the support provided during the acute phase of an emergency and the continuation of care ensured by the system in its early recovery phase. Full article

Climate change, driven by natural factors and human activity, produces significant environmental changes worldwide. One consequence is increased rainfall, which leads to intense and increasingly frequent storms, sudden increases in river flows, and increased likelihood of emergencies linked to natural disasters. This framework proposes a model based on the System Dynamics (SD) approach that aims to monitor the increase in flow in rapid-response catchments (RRCs). The model evaluates humanitarian logistics strategies to manage supplies during emergency situations and it is based on dynamic simulation, whose advantages are the analysis of causal relationships between variables and their behavior over time, mathematical support during the creation of the simulation model, and the creation of a graphical interface that allows the user to carry out a visual analysis of the variables involved in the model. The results show, through a case study, the implementation of a containment plan based on early decision-making from rapid-response catchment monitoring to generate humanitarian logistics strategies preventing material and human damage. Therefore, the main contribution of this framework is the creation of a simulation model that involves the synergy between two different systems: the analysis of RRC behavior and the humanitarian logistics plan to establish provision policies (food, water and medicine) based on the number of people at risk. Full article

This study aimed to apply the integrated WASH assessment tool and assess the performance of WASH services in three Internally Displaced Person (IDP) camps in Rakhine State, Myanmar. The tool was applied in a unique non-household setting that is vulnerable to annual storms and storm-induced flooding, while also facing the complexity of political and social constraints. The assessment focused on nine components of the tool: water, sanitation, hygiene, financial, institutional, environmental impacts, technical, social, and climate change. Afterwards, the overall WASH services performance of the three IDP camps was determined. The assessment revealed good performance in water, financial, institutional, and social components across all camps. However, environmental impact, technical, and climate change components showed the need for improvement due to recurrent climate hazards, and their impacts on WASH facilities, such as latrine destruction, saltwater intrusion into handpumps, and increased diarrhea cases. Based on the findings, the study recommends constructing disaster-resilient latrines, reinforcing handpumps with watertight materials, elevating wellheads to prevent contamination, and forming emergency response teams with appropriate training. Overall, Ohn Taw Gyi (South) and Kaung Doke Khar (2) camps had a good level of WASH performance with a 6.38 sum of net scores of components (SAS), and with 6.06 SAS, respectively. Thet Kae Pyin camp had a moderate level of performance with 5.35 SAS. The application of the assessment tool provided valuable data to support evidence-based decision-making. It serves as a useful resource for WASH professionals, humanitarian organizations, and local governments to evaluate service performance and ensure sustainable service provision in their areas. Full article

Saudi Arabia has emerged as a key middle power, leveraging niche diplomacy to expand its global influence. This study examines how the Kingdom strategically employs mediation, religious diplomacy, humanitarian aid, energy leadership, and sports diplomacy to shape regional and international dynamics. Unlike great powers, middle powers focus on specialized areas where they hold a comparative advantage, allowing them to exert influence despite material constraints. Saudi Arabia’s diplomatic recalibration aligns with its Vision 2030 agenda, prioritizing economic diversification, regional stability, and multilateral engagement. Saudi Arabia enhances its geopolitical significance by positioning itself as a mediator in regional conflicts, reinforcing its religious leadership, investing in sports diplomacy, and maintaining energy dominance. This study contributes to understanding middle power strategies in international relations, highlighting Saudi Arabia’s role as a stabilizing force in an evolving global order. Full article

As supply chains become increasingly digitized and decentralized, ensuring security, traceability, and data integrity has emerged as a critical concern. Blockchain technology has shown significant potential to address these challenges by providing immutable records, transparent data flows, and tamper-resistant transaction logs. However, the effective application of blockchain in real-world supply chains requires the careful evaluation of both architectural design and technical limitations, including scalability, interoperability, and privacy. This review systematically examines existing blockchain-based supply chain solutions, classifying them based on their structural models, cryptographic foundations, and storage strategies. Special attention is also given to underexplored humanitarian logistics scenarios. It introduces a three-dimensional evaluation framework to assess security, traceability, and integrity across different architectural approaches. In doing so, it explores key technological enablers, including advanced mechanisms such as zero-knowledge proofs (ZKPs) and cross-chain architectures, to meet evolving privacy and interoperability demands. Furthermore, this study outlines a conceptual cross-chain interaction scenario involving permissioned and permissionless blockchain networks, connected through a bridge mechanism and supported by representative smart contract logic. The model illustrates how decentralized stakeholders can interact securely across heterogeneous blockchain platforms. By integrating quantitative metrics, architectural simulations, and qualitative analyses, this paper contributes to a deeper understanding of blockchain’s role in next-generation supply chains, offering guidance for researchers and practitioners aiming to design resilient and trustworthy supply chain management (SCM) systems. Full article

This perspective lays out the challenges and conundrums facing global health and discusses possible solutions applicable in the future. The world is facing numerous challenges that include those associated with globalization, climate change, emerging diseases, continuation of non-communicable diseases, reemerging communicable diseases, antimicrobial resistance (AMR), wars, terrorism, and humanitarian crises, among others. The recent challenges exaggerated by the COVID-19 pandemic have exposed vulnerabilities within healthcare systems, particularly in low- and middle-income countries (LMIC). The solutions must be interprofessional and multifarious with collaborative efforts and partnerships. One world order seems to be a far-fetched ideal utopian goal, but it can be a remedy for ensuring health for all. In the meantime, strengthening the World Health Organization’s role in coordinating global health efforts and improving its capacity to respond to future health crises will be critical in ensuring that the vision of a unified, healthier world becomes a reality. Full article

The growing need for effective and sustainable solutions in humanitarian construction has prompted scholars and practitioners to explore technical approaches that address the challenges of natural disasters, health emergencies, armed conflicts and migratory flows. These solutions often encompass temporary shelters, durable shelters and multifunctional buildings designed to balance rapid deployment, cultural sensitivity and environmental sustainability. However, the assessment of sustainability in humanitarian construction remains insufficiently defined due to the complexities of crises, the variability of local materials and the impact of local climatic conditions. This study aims to bridge this gap by integrating Building Information Modeling (BIM) and simulation tools such as COMSOL Multiphysics 6.0 to study sustainable strategies for humanitarian housing. Using case studies aligned with IFRC, UNHCR and CRL (Red Cross of Luxembourg) family shelter standards, the research assessed a Climate and Local Skill-Centered Design (CLCD) by examining the performance of key design elements, including wall material emissivity and reflectance, natural lighting, and energy efficiency within the context of indoor thermal comfort. Simulation results revealed that wall finishing material reflectance significantly influences average daylight factors (D), with variations of 2% to 5% linked to lower reflectance values and changes in the window-to-floor ratio (WFR). Conversely, thermal comfort metrics indicated minimal variations in heat discomfort hours, maintaining indoor temperatures between 19 °C and 25 °C, consistent with ASHRAE Standard 55 thermal comfort criteria. This paper underscores the importance of integrating advanced IT tools and green local techniques and materials to optimize humanitarian housing for health, comfort and environmental performance, offering actionable insights for future humanitarian sustainable designs. Full article

This preliminary empirical study delves into the “agrafa”, the “unwritten” or “uncharted” parts of a Greek adoption phenomenon and Greek–American relations that may, however, still be accessed via archival investigations, mixed research methods, and efforts to hone life writing skills. At stake is the case of the post-WWII adoptions of some 4000 Greek children who were sent to the United States between the years 1950 and 1975. This study asks how the related negotiations were transacted, especially in the early years of the intercountry adoption phenomenon. It challenges the researcher today to create a life writing narrative out of scant snippets and dense allusions and to disclose the dynamics of overlooked interactions, such as the consumerist and occasionally racist attitudes of some, though certainly not all, prospective adoptive parents. Thus, this article highlights formerly dismissed interactions, not necessarily numerically representative interactions, given that the window of opportunity has passed to interview adoptive parents of Greek children who pursued these foreign adoptions in the 1950s–1960s and to quantify their actions and reactions more systematically. Many of the adoptive parents of the 1950s–1960s, however, left their impressions, demands, and frustrations in writing. Those writings have yet to be studied, and their more deliberate, explicit language must be acknowledged, even amid generally more positive depictions of postwar intercountry adoption. I show that the victorious post-WWII era saw a sense of American entitlement emerge among the prospective adoptive parents that has since been whitewashed. Waiving the banner of altruism or humanitarianism (as a couple or as a superpower, respectively), some adoptive parents embarked on adoptions from Greece from a position of cultural as well as political and economic superiority. Their expectation was that the “destitute” partner should comply, that the Greeks themselves should not “talk back” when “poor orphans” were about to be “saved” from “illegitimacy” and lack of prospects. Full article

PICO-SM was a prospective longitudinal study investigating the psychological impact of the COVID-19 pandemic on patients with colorectal cancer treated in a large UK tertiary cancer centre. Here, we present the impact of the third wave of the pandemic (December 2021 to February 2022), when the Omicron variant became prevalent in the UK, and the complete longitudinal comparison across the entire duration of this study. Patients were invited to complete a questionnaire, including screening psychometric tools. In total, n = 312 patients were included in the final analysis. Specifically, in this Omicron-predominant wave, n = 96 patients were studied in detail: the mean age was 64 years, 64% were male, 33% reported poor well-being, 27% anxiety, 11% depressive symptoms, and 3% trauma-related symptoms. The participants who had investigations cancelled (OR 9.22, 95% CI 1.09–77.85; p = 0.041) or felt that the pandemic would affect their mental health (OR 3.82, 95% CI 1.96–7.44; p < 0.001) had an increased risk of anxiety according to a multivariate analysis. Similarly, independent predictors of poor well-being included concern that the pandemic would affect their cancer treatment (OR 4.59, 95% CI 1.03–20.56; p = 0.046) or mental health (OR 3.90, 95% CI 1.38–11.03; p = 0.010). The psychological distress experienced by patients, particularly anxiety, remained high during the third wave of the COVID-19 pandemic. These results align with our previously reported findings, emphasising the importance of continuing cancer treatment amidst an ongoing humanitarian emergency. Full article

Background: The humanitarian supply chain (HSC) literature has observed significant growth in past years. The wide range of research areas and the interdisciplinary nature of humanitarian work have generated the need to examine and classify the literature. Previous reviews have examined particular research domains such as quality, data analytics, performance measurement, and dynamics capabilities. This article examines the HSC literature, tracing its evolution and proposing a systematic review and roadmap for future researchers. Method: We adopted bibliometric, network, and citation analyses to extract insights into the HSC literature. Results: The integrated approach helped map the previous literature and identified research keywords, clusters, authors’ collaborative network, and seven research fields. The literature classification and clustering were performed for the articles published before the literature surge during the COVID-19 pandemic to avoid potential biases that could arise from the significant increase in HSC research published during this period. Conclusions: Some of the original contributions to this article include the classification of research clusters and the identification of emerging research topics in the HSC domain. Our findings indicate research opportunities in the sustainability, performance measurement, and innovation aspects of the HSC. This study provides potential research roadmaps for future research in this field. Full article

Background/Objectives: Child acute malnutrition is a global public health problem, affecting 45 million children under 5 years of age. The World Health Organization recommends monitoring weight gain weekly as an indicator of the correct treatment. However, simplified protocols that do not record the weight and base diagnosis and follow-up in arm circumference at discharge are being tested in emergency settings. The present study aims to use machine learning techniques to predict weight gain based on the socio-economic characteristics at admission for the children treated under a simplified protocol in the Diffa region of Niger. Methods: The sample consists of 535 children aged 6–59 months receiving outpatient treatment for acute malnutrition, for whom information on 51 socio-economic variables was collected. First, the Variable Selection Using Random Forest (VSURF) algorithm was used to select the variables associated with weight gain. Subsequently, the dataset was partitioned into training/testing, and an ensemble model was adjusted using five algorithms for prediction, which were combined using a Random Forest meta-algorithm. Afterward, Receiver Operating Characteristic (ROC) curves were used to identify the optimal cut-off point for predicting the group of individuals most vulnerable to developing low weight gain. Results: The critical variables that influence weight gain are water, hygiene and sanitation, the caregiver’s employment–socio-economic level and access to treatment. The final ensemble prediction model achieved a better fit (R² = 0.55) with respect to the individual algorithms (R² = 0.14–0.27). An optimal cut-off point was identified to establish low weight gain, with an Area Under the Curve (AUC) of 0.777 at a value of <6.5 g/kg/day. The ensemble model achieved a success rate of 84% (78/93) at the identification of individuals below <6.5 g/kg/day in the test set. Conclusions: The results highlight the importance of adapting the cut-off points for weight gain to each context, as well as the practical usefulness that these techniques can have in optimizing and adapting to the treatment in humanitarian settings. Full article

The Lancang–Mekong Region encompasses six countries, covering an area exceeding five million square kilometers and containing a population of more than 400 million. Floods in this region may cause extremely serious losses of lives and property. However, due to the severe shortage of flood disaster data, loss data and meteorological monitoring data, the assessment of flood disaster risks in this region remains highly formidable. In view of this, we systematically integrated the flood disaster data from EM-DAT (the Emergency Events Database), Desinventar (a disaster information management system), Reliefweb (a humanitarian information service provided by the United Nations Office for the Coordination of Humanitarian Affairs), and ADRC (the Asian Disaster Reduction Center), coupled with GLDAS (Global Land Data Assimilation System) precipitation data and the population and economic data from the World Bank, and comprehensively considered vulnerability, exposure, and loss criteria to assess the flood disaster risks in the Lancang–Mekong Region. The research findings are as follows: (1) From 1965 to 2017, a total of 370 floods occurred in the Lancang–Mekong Region, among which the proportion of floods in Vietnam and Thailand combined was as high as 43.7%. In contrast, the number of floods in Qinghai and Tibet in China was relatively small, with a combined proportion of only 1.89%. (2) When mild flood disasters occur, the southern part of Myanmar, the western part of Thailand, and the northeastern part of Vietnam are faced with relatively large loss threats; when moderate flood disasters occur, the central part of Myanmar, the eastern part of Cambodia, and the southern part of Vietnam are faced with comparatively large loss threats; when severe flood disasters occur, high-loss areas are mainly concentrated in the southern part of Vietnam. (3) Considering exposure, vulnerability, and hazards comprehensively, the high-risk areas of floods in the Lancang–Mekong Region are mainly distributed in the central–southern part of Myanmar, the northeastern part of Vietnam, and the southern part of the area bordering Cambodia and Vietnam; the medium-risk areas are mainly distributed in the central part of Thailand and the eastern part of Sichuan in China; relatively speaking, other areas in the Lancang–Mekong Region have a lower flood risk level. This research can provide references for flood risk assessment in regions with scarce data and technical support for flood disaster prevention and control as well as risk management in the Lancang–Mekong Region. Full article