Nord-Ost: Russia's Medical Failure in the 2002 Crisis

The 2002 hostage crisis at a Moscow theater transfixed the attention of the world. While the initial assault, led by Spetsnaz commandos, successfully secured the building, the Russian security force's utter failure at coordinating with medical services led to the preventable deaths of over 100 hostages.

Contagion to unrest: Investigating the link between disease and civil unrest in Africa

Scholars, policymakers, and citizens alike remain invested in the impact of infectious diseases worldwide. Studies have found that emerging diseases and disease outbreaks burden global economies and public health goals. This article explores the potential link between measles outbreaks and various forms of civil unrest, such as demonstrations, riots, strikes, and other anti-government violence, in four central African countries from 1996 to 2005. Using a difference-in-differences model, we examine whether disease outbreaks have a discernible impact on the prevalence of civil unrest. While our findings indicate that the relationship between disease and civil unrest is not as strong as previously suggested, we identify a notable trend that warrants further investigation. These results have significant implications for health and policy officials in understanding the complex interplay between state fragility, civil unrest, and the spread of disease.

An apolitical risk assessment of the 2024 US elections: The threat of widespread riots and significant business disruption

Civil disorder has always plagued humanity, with violence being triggered by real or perceived grievances, rumours and speculation, and internal or external agitators. The risk to people, communities, businesses and the rule of law is not isolated to a particular country or society. The propensity for violence and how it is incited is, however, an evolving threat with the advent of the 'modern riot'. The causes of violence centre on economic and social injustice, sports- and event-related riots, a reaction to police or security forces and political unrest. As the US nears the contentious 2024 elections, the failing trust in the three branches of government combined with external global tensions and conflict, threats from domestic extremist groups, a rising acceptance of violence as a means of settling political disagreements, hostile nation actors and international terror groups that exploit societal instability create fertile conditions for widespread violence. Exacerbating these factors are the risks from artificial intelligence (AI) deepfake, rapid mass communications, the citizen journalist, prominent influencers amplifying grievances and inflammatory media reporting. This convergence of exacerbators and accelerants for political discord offers the potential for serious security risks and significant business disruption.

Building and Testing of a Conceptual Model to Describe and Measure the Health of People as Affected by Post-traumatic Stress Disorder During Social Unrest: A Confirmatory Factor Analysis and Structural Equation Modeling

Background

Social unrest affects people's health and well-being. People's health-related needs during social unrest are concerns in both research and clinical practice. This study aimed to build and test a framework to describe and understand the health status and needs of people with post-traumatic stress disorder (PTSD) during social unrest.

Methods

This study was a cross-sectional survey. A total of 460 people who had experienced post-traumatic distress as a result of the social unrest in 2019 and 2020 were included. A conceptual model comprised four essential areas, namely posttraumatic distress symptoms, participation restrictions, perceived stigma and functional disability, was built from literature. Part 1 validated four instruments that evaluate and define the factor structure of these four areas, In Part II, structural equation modeling was used to test and validate a combined model.

Results

Factors underlying the four areas were defined. Analysis using structural equation modeling confirmed a best fit of the model. PTSD symptoms, perceived stigma and participation restriction during social unrest contributed significantly to functional disability; PTSD symptoms exerted a direct effect on participation restriction and perceived stigma; and the effect of PTSD symptoms on functional disability was mediated through its influence on perceived stigma during social unrest.

Conclusions

A community-based inclusive approach is essential to understand the holistic needs of people with PTSD during social unrest. To improve health and well-being in addition to evaluating mental health impacts, considering interactions with the rapid change and stressful social environment is essential.

Temporal clustering of disorder events during the COVID-19 pandemic

The COVID-19 pandemic has unleashed multiple public health, socio-economic, and institutional crises. Measures taken to slow the spread of the virus have fostered significant strain between authorities and citizens, leading to waves of social unrest and anti-government demonstrations. We study the temporal nature of pandemic-related disorder events as tallied by the "COVID-19 Disorder Tracker" initiative by focusing on the three countries with the largest number of incidents, India, Israel, and Mexico. By fitting Poisson and Hawkes processes to the stream of data, we find that disorder events are inter-dependent and self-excite in all three countries. Geographic clustering confirms these features at the subnational level, indicating that nationwide disorders emerge as the convergence of meso-scale patterns of self-excitation. Considerable diversity is observed among countries when computing correlations of events between subnational clusters; these are discussed in the context of specific political, societal and geographic characteristics. Israel, the most territorially compact and where large scale protests were coordinated in response to government lockdowns, displays the largest reactivity and the shortest period of influence following an event, as well as the strongest nationwide synchrony. In Mexico, where complete lockdown orders were never mandated, reactivity and nationwide synchrony are lowest. Our work highlights the need for authorities to promote local information campaigns to ensure that livelihoods and virus containment policies are not perceived as mutually exclusive.

Homicide committed by individuals with severe mental illnesses: A comparative study before and after the Tunisian revolution of January 14th, 2011

BACKGROUND

Many studies have established a correlation between the increase of homicide rates, and economic crises and rapid social changes following historical events. We propose to analyse the impact of the Tunisian Revolution on homicide rates in Tunisia in a clinical population.

METHODS

We conducted a retrospective comparative study of all individuals who commited an homicide and were admitted, at least once, to the forensic psychiatry unit in Razi Hospital between January 1st, 2004 and December 31st, 2018 after a decision of irresponsibility by reason of insanity.

RESULTS

The number of homicides committed by the individuals with mental illness included in our study was multiplied by a factor of 1.3 after the revolution, with a prevalence of 11.0% between 2004 and 2011, compared to a prevalence of 14.7% during the period 2011-2018. No significant difference was noted between the two groups regarding the socio-demographic characteristics or the characteristics of the act committed.

CONCLUSION

Our results highlighted that political and socio-economic crises following the Tunisian revolution significantly contributed to an increase of homicide rates in people with severe mental illness. Thus, macro-level socioeconomic determinants would be important to consider in homicide prevention strategies.

COVID-19 and Fake News in the Dominican Republic

The first case of novel coronavirus disease (COVID-19) in the Dominican Republic coincided with a period of political crisis. Distrust in governmental institutions shaped the critical phase of early response. Having a weak public health infrastructure and a lack of public trust, the Ministry of Health (MoH) began the fight against COVID-19 with a losing streak. Within 45 days of the first reported case, the political crisis and turmoil caused by "fake news" are limiting the capacity and success of the MoH response to the pandemic.

COVID-19 pandemic and civil unrests in Africa: implication of recent #EndSARS protests for increased community transmission in Nigeria

The recent Coronavirus disease (COVID-19) caused by the novel strain of coronavirus (SARS-CoV-2 virus) has become a worldwide public health crisis with associated high mortality rates globally. Human to human transmission of the infection emphasizes the importance of adhering to public and social measure to halt its spread. However, the recent #ENDSARS protests led by angry youths in Nigeria resulted to complete flouting of all WHO guidelines meted to curb the spread of the virus. Given that the nation is the most populous African country with over 50 percent of her population been youths, this situation has huge implications for the country and Africa as a whole. The risk of community transmission occasioned by the protest, coupled with travels and active mobility across countries within the continent increases the risk of community transmission with possible increases in new cases over the next few weeks to months. From the foregoing, it is expedient to increase awareness and enforcement of the use of personal protective equipment especially use of nose masks, face shields and frequent hand washing or sanitizing in public places. These individual-targeted measures will go a long way to curtail the imminent community transmission of COVID-19 across Nigeria. It is therefore recommended that Government and non-governmental agencies across the region actively engage to increase collaborative efforts; screening facilities and access to these services across the country, as well as accentuate regular adherence to preventive measures to the general public.

South Sudan: a young country’s fight against COVID-19

COVID-19 is a highly infectious disease that has started to creep into African countries including South Sudan. Following confirmation of the first few cases, the government enacted preventive measures to curb community transmission. However, daunting challenges deter these precautionary measures. Just after two years the country took its independence from Sudan, civil conflicts sparked and continue to overburden and undermine the fragile healthcare system. The conflicts have caused disruption of health services, destruction of health facilities, death and migration of health workers, displacements of a huge number of people. This scenario continues while the country is grappling with the pandemic. Other concerning issues include: insufficient COVID-19 testing capacity, limited medical and personal protective equipment and an inadequate number of health workers which leave the country ill-equipped in the battle against the pandemic. Non-compliance of COVID-19 prevention protocols by the general public due to high rate of poverty and social stigma contribute to the spread of the virus. The current situation in South Sudan make evident that there is a need for an immediate ceasefire by the warring sides so the available health services including COVID-19 efforts, are not disrupted to ensure the safety of all. The government needs to further build the capacity of its health sector with the cooperation of its international health allies to be able to provide its citizens with the health services they need.

Preparing for campus demonstrations and protests: Four key focus areas

Over the past few years, the number of demonstrations and protests in Western countries has been increasing. These protests have tested the limits of free speech and expression, leading to individuals and groups attempting to, and in some cases succeeding in, shutting down speech with which they do not agree or find offensive. This has been particularly acute on college campuses, most notably at the University of California, Berkeley and Auburn University in Alabama, where speakers with far-right conservative views were forced to cancel their planned speeches because of safety and security concerns. As a result, colleges and universities throughout the USA are re-examining their policies and procedures for speaking engagements and demonstrations and protests, and how to manage them effectively while keeping their campus communities safe. This paper suggests methods by which universities can put into place policies, procedures and guidelines to minimise the possibility of an event becoming violent and overwhelming university resources while at the same time balancing the need for security and an environment that promotes the free exchange of ideas and expression.