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Dissecting Disaster

Shehzad Noorani

Dissecting Disaster (continued)

The Center was founded in 2004 with the merger of separate programs—each run jointly by Kirsch and Burnham—at the schools of Medicine and Public Health. Since then, it has grown markedly. Before 1998, when Burnham began his own group within the School of Public Health, “there was little in Baltimore that dealt with refugees and disasters, even though our students were very interested,” says Burnham.

“We knew we needed to grow something like the Center because some students see working internationally with refugees or during disasters as a major part of their careers,” he says. “Then there are other students who know they’ll need to learn something about working overseas in general. And there’s a third group that has already been overseas, and [the students] were floored by what they saw and need to understand it more before they go back.”

Kirsch himself became drawn to disaster scenes at an early age. (When a tornado hit Omaha in 1975, Kirsch, then in high school there, joined the response efforts.) His interest continued as he pursued his MD. “Like any medical student, I wanted to save the world, so when I had the chance to work in Cambodian refugee camps in 1984, I jumped at it,” Kirsch says.

He returned to the U.S. to get his MPH at the School, steered there by James Cobey, MPH ’71, who had organized the Red Cross’ refugee relief efforts along the Thai-Cambodian border (and who still teaches in the HELP course). “Jim told me, ‘If you want to do this kind of work, you have to go to Hopkins,’” Kirsch recalls. In 1986, he took a seminar course put together by Melvyn Thorne, a School of Public Health professor and former Peace Corps doctor. “The students literally met in his living room,” Kirsch remembers. “It was one of the first attempts to quantify and teach refugee response from a public health perspective—I mean anywhere, not just Hopkins.”

The type of work the Center does is still rarely found in academia. Governments mostly welcome Center researchers—even despotic leaders want to appear competent in the eyes of the public during times of distress, Burnham says. To grease the skids, Center faculty will often arrange partnerships with government agencies to help them set up and run their research programs. Not that they’re always greeted with open arms.

“We have had staff questioned by authorities,” Robinson says of his work in China interviewing traumatized North Korean refugees. “We tell them we’re working with vulnerable populations.” China shut down data collection during the 2008 Summer Olympics. When such edicts are handed down to researchers, they have to do their work under the radar, Robinson says: “You have to hide in plain sight.”

Elsewhere, their work has spun into controversy. Burnham’s 2006 study that pinned the numbers of Iraqi civilian war deaths during the U.S. occupation at 655,000, published in the British journal The Lancet, became a political football among those defending U.S. policies. His work in Iraq since then has focused on health care systems.

“Our intention is not to get into the political side but to improve situations,” he says. Burnham’s team investigated the effects of the war on social sciences and medicine to see whether they were recovering from the war. The team found that 29 percent of Iraq’s medical specialists had left the country during 2006.

 “Many had left because of assassination attempts,” Burnham says. “If you want to destabilize a country, you go after the intellectuals.” Fortunately, the situation is now looking slightly better in 2011, he adds.

The same can’t be said for Afghanistan, which Burnham calls “an ongoing humanitarian disaster.” Relief workers and disaster researchers around the world can’t do anything to shore up dicey political situations, Burnham notes. But they believe they can learn enough to prevent some types of catastrophes, or at least minimize how many people are affected by them and for how long.

He and a small team of International Health department scientists, supported by 90 full-time workers on the ground, have tracked the performance of the Afghan health system for the past nine years. Some of the team’s research on water sources and diarrhea has led to the development of national water protection policies. An assessment of hospital performance speeded up hospital reform in the nation. Their work on the spread of HIV led to major changes in Afghanistan’s HIV policies.


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  • rofingi

    indonesia 09/14/2011 02:40:40 PM

    nice news,,,, like this

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