Review of Policies and Guidelines on Infant Feeding in Emergencies: Common Ground and Gaps

Recent crises in regions where exclusive breastfeeding is not the norm have highlighted the importance of effective policies and guidelines on infant feeding in emergencies. In 1993, UNICEF compiled a collection of policy and guideline documents relating to the feeding of infants in emergency situations. In June 2000 Save the Children, UK, UNICEF and the Institute of Child Health undertook a review of those documents, updating the list and identifying the common ground that exists among the different policies. The review also analysed the consistency of the policy framework, and highlighted important areas where guidelines are missing or unclear. This article is an attempt to share more widely the main issues arising from this review. The key conclusions were that, in general, there is consensus on what constitutes best practice in infant feeding, however, the lack of clarity in the respective responsibilities of key UN agencies (in particular UNICEF, UNHCR and WFP) over issues relating to co-ordination of activities which affect infant-feeding interventions constrains the implementation of systems to support best practice. Furthermore, the weak evidence base on effective and appropriate intervention strategies for supporting optimal infant feeding in emergencies means that there is poor understanding of the practical tasks needed to support mothers and minimise infant morbidity and mortality. We, therefore, have two key recommendations: first that the operational UN agencies, primarily UNICEF, examine the options for improving co-ordination on a range of activities to uphold best practice of infant feeding in emergencies; second, that urgent attention be given to developing and supporting operational research on the promotion of optimal infant-feeding interventions.     

Media messages and the needs of infants and young children after Cyclone Nargis and the WenChuan Earthquake

Infants and young children are vulnerable in emergencies. The media plays an important role in aid delivery and has a positive impact when reports are accurate. However, the media has been implicated in encouraging harmful aid in the form of donations of infant formula and other milk products. Internet‐based media reports were collected after Cyclone Nargis in Myanmar and the WenChuan Earthquake in China (2008) and examined for content related to infant and young child feeding. Common messages identified included that: babies are vulnerable; stress prevents breastfeeding; and providing infant formula saves lives. Messages rarely reported included that: artificial feeding is dangerous; and breastfeeding protects infants. This analysis suggests that current patterns of media reporting may encourage harmful aid and increase child morbidity and mortality. Aid organisations should encourage the media to report accurately on the needs of infant and young children in emergencies so as to improve aid delivery.     

Supporting breastfeeding in emergencies: protecting women's reproductive rights and maternal and infant health

Women have the right to support that enables them to breastfeed. Supporting breastfeeding in emergencies is important because artificial feeding places mothers and children at risk. In emergencies, artificial feeding is dangerous to the infant, difficult and requires substantial resources. In contrast, breastfeeding guards infant health. It is also protective against postpartum haemorrhage, maternal depletion, maternal anaemia and closely spaced births and should therefore concern not only nutritionists, but also those involved in reproductive health. However, it is common for women's ability to breastfeed to be undermined in emergencies by the indiscriminate distribution of breast-milk substitutes and the absence of breastfeeding support. Controlling the distribution of breast-milk substitutes, providing supportive environments, and appropriate medical and practical assistance to breastfeeding women safeguards the health and well-being of mothers and babies. Greater collaboration between the nutrition and reproductive health sectors is required to promote best practice in protecting breastfeeding women and their children in emergencies.     

Human immuno-deficiency virus and infant feeding in complex humanitarian emergencies: priorities and policy considerations

Issues surrounding mother-to-child transmission of HIV/AIDS pose considerable challenges in complex humanitarian emergencies. The risk of vertical transmission through breastfeeding is well recognised, but safe alternatives are limited by the social, economic and environmental conditions of emergency situations. In 2000, the World Health Organisation published a technical report on behalf of the UNFPA/UNICEF/WHO/UNAIDS Inter-agency Task Team on Mother-to-child Transmission of HIV which outlined revised recommendations for infant feeding by HIV-positive women. This paper outlines reasons why these recommendations may be insufficient during the initial stages of complex humanitarian emergencies and proposes recommendations for establishing infant-feeding policy. Methods of mother-to-child transmission of HIV are reviewed and recent research findings are discussed. Rationale for modifying the 2000 UNFPA/UNICEF/WHO/UNAIDS infant-feeding recommendations in complex emergency situations is explored from the perspective of the infant, the mother and humanitarian field staff. Ethical limitations and future priorities are considered. The paper concludes with recommendations and a policy decision-making framework for consideration during the initial stages of humanitarian crises.     

Humanitarianism and Local Service Institutions in Angola

The role of local service institutions is not a major focus of current discourse on humanitarianism and complex emergencies. These institutions, in the few places where they are mentioned, are usually presented as either the seed of civil society and future democracy, or as pawns and components of the predatory economic, political and military élites. Few would deny that examples can be found which conform to both of these stereotypes. This simplistic representation of local institutions ignores the perspectives of the actors themselves — the nurses, extension agents, school teachers and others who actually staff most NGO-supported projects. The debate has focused on what ‘we’ should do; the moral dilemmas of aid agencies and their expatriate staff, inevitably leading to the question of whether or not humanitarian workers should stay or leave situations in which aid may be causing more harm than good. Without denying the fundamental importance of these issues, it is important to consider also how the discourse has unfortunately moved away from those humanitarian workers who have no such choice, since they live there. Current concerns about keeping humanitarian aid from feeding local political and military struggles may inadvertently and paradoxically serve to constrain room for man?uvre in the field, particularly among those individuals with the greatest tacit understanding of the predatory environment. There is a need to understand how actors in local service institutions make sense of their own situations, including the factors which frame their moral dilemmas and their day-to-day choices. By analysing the organisational processes within local service institutions, this study is intended to provoke consideration of how these individuals and their institutions may be effectively supported in complex emergencies through a focus on how they themselves deal with danger and complexity. It is suggested that there is a value in considering the lessons learnt in recent years about how service organisations in the North function in turbulent environments. This experience points to the importance of allowing workers the discretion to develop a relationship with their clients, and in so doing make sense of a confusing and ambivalent environment.     

人类的行为与地质灾害

全面科学地分析了人类的行为与地质灾害后，针对我国当前的实际情况，提出了几个值得深思的问题，试图提醒人们如何规范自己的行为，以达到保护环境，预防和减轻地质灾害之目的。     

From Policy to Practice: Challenges in Infant Feeding in Emergencies During the Balkan Crisis

The preparation and dissemination of policy statements are necessary but insufficient to prevent the inappropriate use of infant-feeding products in emergencies. The widespread failure of humanitarian agencies operating in the Balkan crisis to act in accordance with international policies and recommendations provides a recent example of the failure to translate infant-feeding policies into practice. This article explores the underlying reasons behind the failures which include: (1) the weak institutionalisation of policies; (2) the massive quantities of unsolicited donations of infant-feeding products: (3) the absence of monitoring systems; (4) inadequate co-ordination mechanisms; (5) the high costs of correcting mistakes; and (6) the cumulative effects of poor practice. Efforts to uphold best practice during the crisis are also documented. Finally, the article identifies actions that could be undertaken in advance of and during future emergencies to enhance the application of infant feeding policies in emergencies.     

How violence against women and girls undermines resilience to climate risks in Chad

What consequences does ‘everyday violence’ have on the abilities of survivors to protect themselves from further risks? This paper seeks to establish the linkages between violence and people's resilience capacities to survive and adapt to environmental changes, particularly those living in fragile economic and political contexts such as Chad. It investigates not only how the adverse consequences of violence against women and girls affect the health status and livelihoods of survivors, but also their capacities, and those of their household and community members, to further protect themselves from other risks. Empirical evidence collected in Chad as part of the BRACED (Building Resilience and Adaptation to Climate Extremes and Disasters) programme shows that ‘everyday violence’ undermines resilience‐building at the individual, household, and community level. These results have serious implications for development programmes and the role they need to play to better promote both gender equality and resilience to shocks and stresses.     

塑料排水技术及其在环境岩土工程中的应用

介绍了常用塑料排水材料及其技术要求和性能;阐述了目前国内塑料排水技术在环境岩土工程中的应用状况,并就应用塑料排水技术解决岩土工程中的安全、生态和环境保护等问题提出了思路。笔者认为在岩土工程建设中,根据工程场地的地理、地质和生态环境条件,合理采用塑料排水材料,充分应用塑料排水技术,可以有效地保证工程设施的安全,实现环境岩土工程系统的相互促进和协调发展。文中同时介绍了塑料排水带真空和堆载预压地基固结渗透量的计算方法,可供参考。     

Successes and failures in post-disaster resettlement

In this article I examine the problem of the resettlement of populations after disaster. After considering the complexity of the resettlement process in general and the reasons resettlement is often chosen by authorities following disaster, I discuss a theoretical perspective from development project resettlement which may have relevance for disaster research. This is followed by an examination of those factors in post-disaster resettlement projects which have proved important in affecting successful or unsuccessful outcomes. Site, layout, housing and popular input are presented as crucial issues in the determination of success or failure in post-disaster resettlement. Case material from Turkey, Iran and Peru is presented to illustrate how failure to attend to these issues produces unsuccessful resettlement villages. Case material from Turkey is used to illustrate how attention to these factors improves chances of success in resettlement. Material from cases of voluntary, spontaneous post-disaster resettlement in Guatemala is also presented to underscore the importance of popular participation for successful resettlement despite insufficiencies in design and material inputs. The article ends with a brief consideration of resistance to resettlement and alternative policies.     

The Role of Food Aid in Drought and Recovery: Oxfam's North Turkana (Kenya) Drought Relief Programme, 1992–94

Regional droughts carry the seeds of catastrophe: the immediate risk is famine; the long-term risk is destitution. Preventing both situations is an appropriate, if not essential, goal for relief agencies. In the past, responses to hunger in Turkana District (north-west Kenya) have taken the form of traditional feeding programmes. A better understanding of the boom/bust cycles in pastoralist systems has, however, produced new relief strategies. A central tenet of these strategies is the acceptance that relief aid should assume two roles: humanitarian—to overcome food deficits—and economic—to overcome 'income' deficits. Arguments in favour of a broader role for food aid are tested with a case study of a drought relief programme in north Turkana between 1992–1994. Field studies confirmed that when food aid is integrated as an asset into household resources, it can strengthen economic recovery. Ultimately, the extent to which relief operations are able to protect both people's lives and their livelihoods is the key to more sustainable development in drought-prone areas.     

Mother Nature versus human nature: public compliance with evacuation and quarantine

Effectively controlling the spread of contagious illnesses has become a critical focus of disaster planning. It is likely that quarantine will be a key part of the overall public health strategy utilised during a pandemic, an act of bioterrorism or other emergencies involving contagious agents. While the United States lacks recent experience of large-scale quarantines, it has considerable accumulated experience of large-scale evacuations. Risk perception, life circumstance, work-related issues, and the opinions of influential family, friends and credible public spokespersons all play a role in determining compliance with an evacuation order. Although the comparison is not reported elsewhere to our knowledge, this review of the principal factors affecting compliance with evacuations demonstrates many similarities with those likely to occur during a quarantine. Accurate identification and understanding of barriers to compliance allows for improved planning to protect the public more effectively.     

The promise of acceptance as an NGO security management approach

This paper explores three questions related to acceptance as a security management approach. Acceptance draws upon relationships with community members, authorities, belligerents and other stakeholders to provide consent for the presence and activities of a non‐governmental organisation (NGO), thereby reducing threats from these actors. Little is documented about how NGOs gain and maintain acceptance, how they assess and monitor the presence and degree of acceptance, or how they determine whether acceptance is effective in a particular context. Based on field research conducted in April 2011 in Kenya, South Sudan and Uganda, we address each of these three issues and argue that acceptance must be actively sought as both a programme and a security management strategy. In the paper we delineate elements common to all three contexts as well as missed opportunities, which identify areas that NGOs can and should address as part of an acceptance approach.     

突发性地震灾害危机的预警和应急管理机制

借鉴SARS事件的经验教训,探讨了如何加快构建突发性地震灾害危机的预测预警、应急处理、信息发布和宣传教育等四个方面的管理机制,并提出了建立地震灾害预警等级及其相应的应急预案和信息发布措施的新思维.     

Building disaster resilience using social messaging networks: the WeChat community in Houston,Texas, during Hurricane Harvey

Analyses of disaster resilience have focused increasingly on the role of social capital and online social networks in recovery. This study complements this field of work by investigating three key issues. First, it examines how a social messaging application, WeChat, helped individuals to access and to mobilise three types of social capital—bonding, bridging, and linking—during Hurricane Harvey, a Category 4 storm that made landfall in Louisiana and Texas in the United States in August 2017, resulting in significant flooding and loss of life. Second, it pinpoints and assesses quantitatively how individuals' WeChat group usage and social capital influenced their post-disaster well-being. Third, it demonstrates how a minority and immigrant community in Houston, Texas, overcame the disadvantages commonly observed in other disaster research through the utilisation of social media. The findings of this study should aid governmental and community efforts to foster resilience in the face of natural and human-induced hazards.     

Dilemmas and challenges for the shelter sector: lessons learned from the Sphere revision process

Key dilemmas and challenges for those involved in the shelter sector are described, based on issues that emerged from the extensive global consultative process undertaken to inform the revision of the Sphere handbook. The range of perspectives on the major themes is presented, with suggestions as to how these issues could be progressed. Themes include the poor definition of the sector and the lack of a consistent approach among the leading shelter actors; the absence of a common terminology; the conflict between "temporary" versus "durable" solutions; the disconnect between technical advisers and the field; the need for greater recognition of local coping strategies and the local context; the involvement of recipients and host governments in policy development; the need for better "how-to" guidance; and the limited incorporation of the emerging themes of livelihoods etc. to date.     

超网络上突发事件的信息传播模式构建

随着突发事件的发生频率不断增高,事件种类也不断增多,如何防范与应对已成为当前面临的最重要问题之一。超网络是高于又超于现存网络的网络,它可以用来描述和表示各种网络之间的相互作用和影响。在韦斯特利—麦克莱恩传播模式的基础上,建立了超网络模型上的突发事件的信息传播模式,并提出了突发事件的应对策略。     

Race, Ethnicity and Disasters in the United States: A Review of the Literature

In this paper we synthesise past disaster research that addresses issues of race and ethnicity in the United States. Using an eight-stage typology to organise the findings, this literature review presents the results from a wide range of studies. The synthesis shows how various racial and ethnic groups perceive natural hazard risks and respond to warnings, how groups may be differentially affected, both physically and psychologically, and how disaster effects vary by race and ethnicity during the periods of emergency response, recovery and reconstruction. We show that studies have important findings, many illustrating that racial and ethnic communities in the US are more vulnerable to natural disasters, due to factors such as language, housing patterns, building construction, community isolation and cultural insensitivities. By presenting these studies together, we are able to witness patterns of racial and ethnic inequalities that may be more difficult to see or interpret in individual studies that take place in one specific time and place. We conclude the review with policy and research recommendations.     

Towards guidelines for post‐disaster vulnerability reduction in informal settlements

Although the development community has long recognised that securing land tenure and improving housing design can benefit significantly informal settlement residents, there is little research on these issues in communities exposed to natural disasters and hazards. Informal settlements often are located on land left vacant because of inherent risks, such as floodplains, and there is a long history worldwide of disasters affecting informal settlements. This research tackles the following questions: how can informal settlement vulnerabilities be reduced in a post‐disaster setting?; and what are the key issues to address in post‐disaster reconstruction? The main purpose of the paper is to develop a set of initial guidelines for post‐disaster risk reduction in informal settlements, stressing connections to tenure and housing/community design in the reconstruction process. The paper examines disaster and reconstruction responses in two disaster‐affected regions—Jimani, Dominican Republic, and Vargas State, Venezuela—where informal settlements have been hit particularly hard.     

New tools for emergency managers: an assessment of obstacles to use and implementation

This paper focuses on the role of the formal response community's use of social media and crowdsourcing for emergency managers (EMs) in disaster planning, response and recovery in the United States. In‐depth qualitative interviews with EMs on the Eastern seaboard at the local, state and federal level demonstrate that emergency management tools are in a state of transition—from formal, internally regulated tools for crisis response to an incorporation of new social media and crowdsourcing tools. The first set of findings provides insight into why many EMs are not using social media, and describes their concerns that result in fear, uncertainty and doubt. Second, this research demonstrates how internal functioning and staffing issues within these agencies present challenges. This research seeks to examine the dynamics of this transition and offer lessons for how to improve its outcomes—critical to millions of people across the United States.