Surviving crisis: how systems and communities cope with instability, insecurity and infection

Abstract

The relationship between political conflict and infectious diseases has been established by many studies, yet the way affected communities respond to infectious diseases as effects of political conflict has not been carefully examined. The recognition of this research gap led the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and its Steering Committee on Strategic Social, Economic and Behavioural Research (SEB) in collaboration with the De La Salle University’s (DLSU) Social Development Research Center (SDRC), to organize an international workshop entitled “Surviving Crisis: How systems and communities cope with instability, insecurity and infection,” which was held on April 3-7, 2002 at the DLSU International Center in Manila, Philippines. The meeting brought together participants from Africa, Asia and South America, who shared the history of political conflict of their respective countries and how these experiences affected the health system and the health of the community. The participants discussed the coping strategies and adaptations made by com¬munities and the people’s resilience amidst adversity. The workshop also served as an occasion to clarify concepts associated with collective violence such as crisis, resilience and vulnerability. The need to examine gender as an issue that cuts across biological sex categories surfaced from the violence inflicted on both men and women in difficult political circumstances. Moreover, the vital roles of international and local emergency and disaster agencies in assisting communities, local governments and health providers vis-a-vis the exigencies of political conflict were discussed. The development of a conceptual framework during the five-day meeting raised basic research questions which led to a multi-country research proposal to explore the resilience of communities in crisis through qualitative research methods. This proposal was then submitted, reviewed and eventually given financial support by the TDR’s Steering Committee on Strategic Social, Economic and Behavioural Research for implementation in 2003. It was expected that this multi-country study would generate insights and hypotheses for testing in other places that may have similar experiences of collective violence. It is hoped that the outcomes of this initial gathering of public health experts, health and social scientists, and representatives of agencies engaged in complex emergency assistance, would lead to the development of a network of individuals and institutions interested in pursuing research that makes a difference; research that assists in stimulating the establishment of appropriate policies and interventions which bolster and support communities, social institutions and health systems in the context of political conflict.