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Palliative Care in Humanitarian Crises

Medical humanitarian organizations don’t generally deal well with death. This may come as a surprise, since it’s a sombre reality of this line of work that frontline staff are often witness to death and dying. Contrary to the humanitarian’s general propensity for self-aggrandizement, it’s not always possible to save lives. So what then of the oft-cited dual imperative to alleviate suffering and preserve dignity?
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The Ebola clinical trials: a precedent for research ethics in disasters

The West African Ebola epidemic has set in motion a collective endeavour to conduct accelerated clinical trials, testing unproven but potentially lifesaving interventions in the course of a major public health crisis. This unprecedented effort was supported by the recommendations of an ad hoc ethics panel convened in August 2014 by the WHO.

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Defective interfering genomes and Ebola virus persistence

Michael Jacobs and colleagues (The Lancet, 2016, Vol. 388, p. 498-503) provide clinical and virological evidence of a relapse of Ebola virus disease (EVD) presenting as acute meningo-encephalitis 9 months after recovery from an acute infection. However exceptional, this case adds to an increasing number of reports suggesting that Ebola virus can persist for months in immune-privileged anatomical sites, such as semen, ocular tissues, breastmilk, and the central nervous system.

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Voices in global health: present realities, future challenges

2016 will already be remembered as a year of great setbacks in the pursuit of global health and wellbeing; mass social upheaval in the Middle East and north Africa, driven by conflict and a legacy of persistent structural violence, continues to challenge the notion of our shared humanity, while the end of the world's worst Ebola virus outbreak in west Africa has prompted sombre reflection and fierce critique of systemic failures in global outbreak response.

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Opportunities, limits and challenges of perceptions studies for humanitarian contexts

This article aims to advance understanding and discussion of perceptions studies as a method for strengthening humanitarian performance. Perceptions studies are qualitative studies produced for and often by humanitarian organisations, based on analysis of local perceptions of humanitarian efforts. While these studies are normatively asserted as valuable within the humanitarian sector, there has been no synthesis to date of their potential and limitations.

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Volunteers and responsibility for risk-taking: Changing interpretations of the Charter of Médecins Sans Frontières

The Charter of Médecins Sans Frontières (MSF), the guiding document for all of the organization's members, states in the final paragraph that volunteers "understand the risks and dangers of the missions they carry out". Through a review of the different periods in the history of MSF, this article analyzes the changing interpretations that the organization's successive leaders have given to this reference to the acceptance of risk by individuals.

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Experimental Treatment with Favipiravir for Ebola Virus Disease (the JIKI Trial): A Historically Controlled, Single-Arm Proof-of-Concept Trial in Guinea

Ebola virus disease (EVD) is a highly lethal condition for which no specific treatment has proven efficacy. In September 2014, while the Ebola outbreak was at its peak, the World Health Organization released a short list of drugs suitable for EVD research. Favipiravir, an antiviral developed for the treatment of severe influenza, was one of these. In late 2014, the conditions for starting a randomized Ebola trial were not fulfilled for two reasons.

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Deplorable conditions in French ‘Refugee Camp’

The suffering endured by refugees and other exiles in the northern port town of Calais, France, has been the subject of significant media attention in recent months. Renewed interest in the plight of Calais' encamped population began to peak in April 2015, at the same time that the French authorities forcibly closed the largest settlement, situated in woodland adjacent to an active titanium oxide factory. Residents of this settlement were relocated to a nearby segment of sandy grassland that was once both a waste disposal site and a local shooting range.

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Reaching out to Ebola victims: Coercion, persuasion or an appeal for self-sacrifice?

The 2014–2015 Ebola crisis in West Africa has highlighted the practical limits of upholding human rights and common ethical principles when applying emergency public-health measures. The role of medical teams in the implementation of quarantine and isolation has been equivocal, particularly when such measures are opposed by communities who are coerced by the temporary suspension of civil liberties. In their encounters with Ebola victims, outreach teams face moral dilemmas, where the boundaries are unclear between coercion, persuasion and appeals for self-sacrifice.

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