Quality design: a planning methodology for the integration of refugee and local health services,West Nile,Uganda

In an emergency, the international community responds to the immediate health needs of refugees through the establishment of action-oriented, life-saving services. Healthcare delivery is often managed with limited, if any, coordination with local health management structures. In situations where refugees remain in the host country for many years, sustainability issues inevitably arise. Refugee-hosting governments may ultimately be called upon to assume the management and funding of refugee services. Planning for service integration, while protecting against declines in service quality, is a challenge in the typically resource-poor host environments. This paper discusses these issues by presenting the experience of the West Nile districts in northern Uganda, and describes quality design as a relevant planning methodology. Quality design is a systematic planning approach that documents and directly incorporates the service users' self-defined expectations and needs.     

Use of the genus Artemia in ecotoxicity testing

Information related to varied uses of several species of the genus Artemia (commonly known as brine shrimp), is dispersed among literature from several scientific areas, such as Ecology, Physiology, Ecotoxicology, Aquaculture and Genetics. The present paper reviews information related to Artemia that may be considered relevant for ecotoxicity testing. Integration of different areas of scientific knowledge concerning biology, life cycle and environmental needs of Artemia is of crucial importance when considering the interpretation of results drawn from tests involving this genus. Furthermore, this paper provides suggestions to overcome problems related to toxicity assessment with the use of Artemia as test organism in bioassays, under the scope of estuarine, marine and hypersaline environments. Aspects related to variability in results, adoptable toxicity end-points, culture conditions, characteristics of species and strains, influence of geographical origins over physiological features and responses to exposure to chemical agents are considered.     

The patchiness of epifoliar fungi in tropical forests: host range, host abundance, and environment

Fungal symbioses affect the diversity, dynamics, and spatial patterns of trees in tropical forests. Their ecological importance is partly driven by their inherent patchiness. We used epifoliar fungi, a guild of common, benign, obligate, fungal symbionts of plants, as a model system to evaluate the relative importance of host phylogeny, host relative abundance, and microclimate on the three-dimensional distribution of plant-fungus symbioses. In parallel studies in rainforests in Panama and Australia, most epifoliar fungi were able to colonize several plant lineages but showed significant host preferences within the local plant community. More closely related plant species were not more likely to share fungal symbionts. Instead, fungal species were more likely to be shared by more abundant hosts, which supported a greater number and diversity of fungi. Environmental conditions strongly affected spatial distributions, with sites in the dark understory 2.5- to fourfold more likely to have epifoliar fungi than in the exposed forest canopy. In the understory, fungal incidence increased with canopy openness. Canopy trees supported only a subset of the fungal symbionts found in the understory, suggesting that adult trees are not reservoirs of these fungal symbionts for understory juveniles.     

A METHODOLOGY FOR SELECTING AMONG WATER QUALITY ALTERNATIVES1

While reservoirs are constructed to regulate stream flows for several beneficial purposes including flood control, water supply, hydroelectric power, irrigation and low flow augmentation and to enhance water based recreation, they create problems of water quality that offer a new dimension to the task of efficient operation. Among other potential deleterious effects, thermal stratification in reservoirs inhibits mixing and causes a deterioration of dissolved oxygen levels in lower layers. Several investigators have examined the thermal properties of reservoirs and resultant effects upon dissolved oxygen and have suggested alternative schemes for alleviating detrimental effects (1,2,3,4,5). The objective of this paper is to outline a methodology for evaluating some of these alternatives in a river-reservoir system where downstream water quality control is one of several purposes to be served by the reservoir.     

The post-war tin agreements: An assessment

International collaboration between tin producers has existed for over 20 years. Although normally considered moderately successful, there is some evidence that these agreements have lasted largely because of their relative ineffectiveness. The author looks at the ecpnomic basis of the tin agreements and at the policy of the International Tin Council (ITC) during the years 1956–1976. He goes on to consider the future role of export controls and at the possibility of indexing the agreements to take into account inflation.     

Combinations of Horizontal and Vertical Flow Constructed Wetlands to Improve Nitrogen Removal

Nitrogen removal in wetlands is achieved through two pathways: (a) N cycling and (b) storage. N cycling is a permanent removal pathway. There has been an increasing interest in the development of technologies to alleviate permanent nitrogen removal limitation in constructed wetlands by ensuring prevalence of conditions enhancing N cycling. The purpose of this study is to review an emerging technology of vegetated submerged bed constructed wetland system aimed at improving nitrogen removal in wetlands through rational system design. The design and performance of this system type is evaluated. The oxygen transfer capacity and nitrogen removal mechanisms on system performance are evaluated. Constructed wetland combinations most commonly consist of vertical flow (VF) and horizontal flow (HF) beds where VF and HF are aimed at nitrification and denitrification, respectively. Nitrate nitrogen accumulation is the most limiting factor in typical VF based systems.     

Editorial: Special issue on composite sampling

Environmental and Ecological Statistics -     

The Accuracy of Mortality Reporting in Displaced Persons Camps During the Post-emergency Phase

For humanitarian organisations, accurate data are essential to identify emerging health problems and determine programme needs. We visited 45 post-emergency phase displaced persons camps and collected three months' mortality data which we compared with organisations' routine mortality reports. Organisations reported 612 deaths and we identified 741 deaths, for a mortality-reporting ratio, defined as the number of organisation-reported deaths divided by the number of investigator-identified deaths, of 83 per cent. For the majority of camps which under-reported deaths, mortality reporting ratios were significantly higher for women than men, and for camps with central mortality registers rather than those without. In the few camps which over-reported deaths, these occurred primarily among children younger than five years of age, probably due to the inclusion of abortions and stillbirths. Despite the overall under-reporting of deaths by humanitarian organisations, the existing health information systems appear to estimate mortality rates adequately in these post-emergency camps. However, organisations should improve the precision and completeness with which they report the characteristics of deaths in order to provide valuable data to target their programmes at the most vulnerable people.     

Immediate and long-term assistance following the bombing of the US Embassies in Kenya and Tanzania

On 7 August 1998 truck bombs destroyed the US Embassies in Kenya and Tanzania.(1) The response in both countries was characterised by an absence of incident command, limited pre-hospital care, a disorganised hospital response and a lack of transportation for those injured. In the next five years USD 50 million was provided by the United States Agency for International Development (USAID) to alleviate the resulting suffering, support reconstruction and strengthen disaster preparedness capacity in the two countries. These two programmes have enhanced awareness of disaster management issues, improved training capacity, built response structures and provided material resources. Their design and implementation provide lessons for future disasters in developing countries. The assistance programmes evolved very differently. In Kenya the programme largely excluded the public sector and the potential for government coordination, while the Tanzanian programme concentrated heavily on central government and regional hospital structures-largely omitting the non-governmental or civil society sector. Excluding key stakeholders raises concerns about programme sustainability and the ability to respond effectively to future emergencies.