Providing health services during a civil war: the experience of a garrison town in South Sudan

The impact of conflict, particularly conflict arising during civil wars, on the provision of healthcare is a subject that has not been widely considered in conflict‐related research. Combatants often target health services to weaken or to defeat the enemy, while attempts to maintain or improve health systems also can comprise part of counter‐insurgency ‘hearts‐and‐minds’ strategies. This paper describes the dynamics associated with the provision of health services in Malakal, an important garrison town in South Sudan, during the second Sudanese civil war (1983–2005). Drawing on the concepts of opportunity hoarding and exploitation, it explores the social and political dynamics of service provision in and around the town during the war. These concepts provide a useful lens with which to understand better how health services are affected by conflict, while the empirical case study presented in the paper illustrates dynamics that may be repeated in other contexts. The concepts and case study set out in this paper should prove useful to healthcare providers working in conflict zones, including humanitarian aid agencies and their employees, increasing their understanding of the social and political dynamics that they are likely to face during future conflict‐related complex emergencies.     

Modeling sediment and nitrogen export from a rural watershed in eastern Canada using the soil and water assessment tool

Watershed simulation models can be used to assess agricultural nonpoint-source pollution and for environmental planning and improvement projects. However, before application of any process-based watershed model, the model performance and reliability must be tested with measured data. The Soil and Water Assessment Tool version 2005 (SWAT2005) was used to model sediment and nitrogen loads from the Thomas Brook Watershed, which drains a 7.84 km rural landscape in the Annapolis Valley of Nova Scotia, Canada. The Thomas Brook SWAT model was comprised of 28 subbasins and 265 hydrologic response units, most of them containing agricultural land use, which is the main nonpoint nitrogen source in the watershed. Crop rotation schedules were incorporated into the model using field data collected within Agriculture and Agri-Food Canada's Watershed Evaluation of Beneficial Management Practices program. Model calibration (2004-2006) and validation (2007-2008) were performed on a monthly basis using continuous stream flow, sediment, and nitrogen export measurements. Model performance was evaluated using the coefficient of determination, Nash-Sutcliff efficiency (NSE), and percent bias (PBIAS) statistics. Study results show that the model performance was satisfactory (NSE > 0.4; > 0.5) for stream flow, sediment, nitrate-nitrogen, and total nitrogen simulations. Annual corn, barley, and wheat yields were also simulated well, with PBIAS values ranging from 0.3 to 7.2%. This evaluation of SWAT demonstrated that the model has the potential to be used as a decision support tool for agricultural watershed management in Nova Scotia.     

Environmental implications of material leached from coal

Samples of coal were collected from different seams at a South African coal mine and comparative leaching experiments were carried out under various pH conditions and times to investigate the leaching behavior and potential environmental impact of possibly hazardous elements such as As, Cd, Co, Cr, Mn, Ni, Pb, Th and U. The calculated leaching intensities, sequential extraction results and cumulative percentages demonstrate that the leaching behavior of the elements is strongly influenced by the pH, the leaching time and the properties and occurrences of the elements. The leached concentrations of As, Cd, Co, Cr, Mn, Ni and Pb exceeded the maximum concentrations recommended by the Environmental Protection Agency (EPA) for surface water.     

Disinfection and removal of human pathogenic bacteria in arctic waste stabilization ponds

Wastewater stabilization ponds (WSPs) are commonly used to treat municipal wastewater in Arctic Canada. The biological treatment in the WSPs is strongly influenced by climatic conditions. Currently, there is limited information about the removal of fecal and pathogenic bacteria during the short cool summer treatment season. With relevance to public health, the objectives of this paper were to determine if treatment in arctic WSPs resulted in the disinfection (i.e., removal of fecal indicator bacteria, Escherichia coli) and removal of selected human bacterial pathogens from the treated effluent. The treatment performance, with focus on microbial removal, was assessed for the one-cell WSP in Pond Inlet (Nunavut [NU]) and two-cell WSP in Clyde River (NU) over three consecutive (2012–2014) summer treatment seasons (late June-early September). The WSPs provided a primary disinfection treatment of the wastewater with a 2–3 Log removal of generic indicator E. coli. The bacterial pathogens Salmonella spp., pathogenic E. coli, and Listeria monocytogenes, but not Campylobacter spp. and Helicobacter pylori, were detected in the untreated and treated wastewater, indicating that human pathogens were not reliably removed. Seasonal and annual variations in temperature significantly (p < 0.05) affected the disinfection efficiency. Improved disinfection and pathogen removal was observed for the two-cell system in Clyde River as compared to the one-cell system in Pond Inlet. A quantitative microbial risk assessment should be performed to determine if the release of low levels of human pathogens into the arctic environment poses a human health risk.     

Estrogenic and androgenic activities in total plasma measured with reporter-gene bioassays: relevant exposure measures for endocrine disruptors in epidemiologic studies?

Measurements of estrogenic and androgenic activities in total plasma with Chemically Activated LUciferase gene eXpression (CALUX?) bioassays could provide biologically relevant measures for exposure to endocrine disruptors in epidemiologic studies. The objective of this study was to explore the effects of a variety of sources of potential endocrine disruptors on estrogenic and androgenic activities in total plasma measured by CALUX?. Plasma samples and interview data on sources of potential endocrine disruptors were collected from 108 men with different exposures profiles. CALUX? measurements (BioDetection Services) involved human U2-OS cell lines controlled by the estrogen receptor alpha and the androgen receptor. Mean differences (beta) in 17β-estradiol equivalents (EEQs) and dihydrotestosterone equivalents (AEQs) between exposure groups were estimated using general linear models. Mean plasma AEQs and EEQs were 9.1×10(-1)ng/ml and 12.0pg/ml, respectively. Elevated AEQs were found in smokers (beta 1.9 (95%CI 0.1-3.6)×10(-1)ng/ml) and heavy drinkers (1.4 (0.2-3.1)×10(-1)ng/ml), and in men occupationally exposed to disinfectants (1.6 (0.3-3.5)×10(-1)ng/ml) or welding/soldering fumes (1.4 (-0.2-2.9)×10(-1)ng/ml). Occupational exposure to pesticides, disinfectants, and exhaust fumes seemed to be associated with increased plasma EEQs: 1.5 (-0.2-3.2)pg/ml, 2.1 (0.2-3.9)pg/ml, and 2.9 (0.6-5.2)pg/ml, respectively. Moderate to high plasma dioxin levels, measured in a subgroup by the dioxin-responsive CALUX?, were accompanied by a 20% increase in AEQs. This is the first study in which CALUX? was used to assess hormone activities in total plasma. Although the results are not yet readily interpretable, they indicate that these measurements can be valuable for epidemiologic studies on endocrine disruptors and give direction for further research.     

Towards a general relationship between climate change and biodiversity: an example for plant species in Europe

Climate change is one of the main factors that will affect biodiversity in the future and may even cause species extinctions. We suggest a methodology to derive a general relationship between biodiversity change and global warming. In conjunction with other pressure relationships, our relationship can help to assess the combined effect of different pressures to overall biodiversity change and indicate areas that are most at risk. We use a combination of an integrated environmental model (IMAGE) and climate envelope models for European plant species for several climate change scenarios to estimate changes in mean stable area of species and species turnover. We show that if global temperature increases, then both species turnover will increase, and mean stable area of species will decrease in all biomes. The most dramatic changes will occur in Northern Europe, where more than 35% of the species composition in 2100 will be new for that region, and in Southern Europe, where up to 25% of the species now present will have disappeared under the climatic circumstances forecasted for 2100. In Mediterranean scrubland and natural grassland/steppe systems, arctic and tundra systems species turnover is high, indicating major changes in species composition in these ecosystems. The mean stable area of species decreases mostly in Mediterranean scrubland, grassland/steppe systems and warm mixed forests.     

Plant communities in relation to flooding and soil contamination in a lowland Rhine River floodplain

Using canonical correspondence analysis (CCA), relationships were investigated between plant species composition and flooding characteristics, heavy metal contamination and soil properties in a lowland floodplain of the Rhine River. Floodplain elevation and yearly average flooding duration turned out to be more important for explaining variation in plant species composition than soil heavy metal contamination. Nevertheless, plant species richness and diversity showed a significant decrease with the level of contamination. As single heavy metal concentrations seemed mostly too low for causing phytotoxic effects in plants, this trend is possibly explained by additive effects of multiple contaminants or by the concomitant influences of contamination and non-chemical stressors like flooding. These results suggest that impacts of soil contamination on plants in floodplains could be larger than expected from mere soil concentrations. In general, these findings emphasize the relevance of analyzing effects of toxic substances in concert with the effects of other relevant stressors.     

Are national biodiversity strategies and action plans appropriate for building responsibilities for mainstreaming biodiversity across policy sectors? The case of Finland

The Convention on Biological Diversity's national biodiversity strategies and action plans (NBSAPs) are major mechanisms for mainstreaming biodiversity into national policies. This article examines whether and how the NBSAPs contribute to mainstreaming biodiversity across policy sectors in Finland in order to halt biodiversity loss. We have developed an innovative analytical framework where the concept of responsibility addresses how motivations for mainstreaming can be built, and the concept of social learning outcomes addresses the extent of institutional changes for biodiversity. The Finnish NBSAP processes have been able to build diverse forms of responsibility (liability, accountability, responsiveness and care) in different policy sectors by providing new knowledge, careful process design and developing institutional linkages. Despite pro-biodiversity outcomes in the targeted policy sectors, the responsibilities do not diffuse from the environmental administration to other policy sectors to a sufficient extent. Closing this ‘responsibility gap’ is a key challenge for building effective environmental policies.