Women and children are vulnerable to sexual violence in times of conflict, and the risk persists even after they have escaped the conflict area. The impact of rape goes far beyond the immediate effects of the physical attack and has long-lasting consequences. We describe the humanitarian community's response to sexual violence and rape in times of war and civil unrest by drawing on the experiences of Medecins Sans Frontieres/Doctors Without Borders and other humanitarian agencies. Health care workers must have a keen awareness of the problem and be prepared to respond appropriately. This requires a comprehensive intervention protocol, including antibiotic prophylaxis, emergency contraception, referral for psychological support, and proper documentation and reporting procedures. Preventing widespread sexual violence requires increasing the security in refugee camps. It also requires speaking out and holding states accountable when violations of international law occur. The challenge is to remain alert to these often hidden, but extremely destructive, crimes in the midst of a chaotic emergency relief setting. (+info)
Mass identification of persons missing from the break-up of the former Yugoslavia: structure, function, and role of the International Commission on Missing Persons.
The staff of the International Commission on Missing Persons (ICMP) is attempting to undertake the largest mass human identification effort in history. Through the generosity of numerous governmental and private corporations the ICMP has established or is currently establishing a strong network of political allies, family outreach centers, and DNA laboratories throughout the former Yugoslavia. Furthermore, the ICMP is currently working to streamline current technology as well as employ new technology in its efforts to assist in identifying missing individuals. ICMP will continue to act as a link between the family associations in the region and will synchronize the work of the DNA identification process in the countries affected by the war in the regions of the former Yugoslavia. In the longer term, ICMP seeks to contribute to the closure of the missing persons issue, to raise awareness of the human dimension of the missing persons tragedy, and to preserve a shared and common memory of the missing in the former Yugoslavia. (+info)
Epidemiology of violent deaths in the world.
OBJECTIVE: This study describes epidemiologic patterns of mortality due to suicide, homicide, and war for the world in order to serve as a benchmark against which to measure future progress and to raise awareness about violence as a global public health problem. SETTING: The world and its eight major regions. METHOD: Data were derived from The Global Burden of Disease series and the US National Center for Health Statistics to estimate crude rates, age adjusted rates, sex rate ratios, and the health burden for suicide, homicide, and war related deaths for the world and its eight major regions in 1990. RESULTS: In 1990, an estimated 1,851,000 people died from violence (35.3 per 100,000) in the world. There were an estimated 786,000 suicides. Overall suicide rates ranged from 3.4 per 100,000 in Sub-Saharan Africa to 30.4 per 100,000 in China. There were an estimated 563,000 homicides. Overall homicide rates ranged from 1.0 per 100,000 in established market economies to 44.8 per 100,000 in Sub-Saharan Africa with peaks among males aged 15-24 years old, and among females aged 0-4 years old. There were an estimated 502,000 war related deaths with peaks in rates for both sexes among people aged 0-4, 15-29, and 60-69 years old. CONCLUSION: The number of violence related deaths in the world is unacceptably high. Coordinated prevention and control efforts are urgently needed. (+info)
A population-based assessment of human rights abuses committed against ethnic Albanian refugees from Kosovo.
OBJECTIVES: This study assessed patterns of displacement and human rights abuses among Kosovar refugees in Macedonia and Albania. METHODS: Between April 19 and May 3, 1999, 1180 ethnic Albanian refugees living in 31 refugee camps and collective centers in Macedonia and Albania were interviewed. RESULTS: The majority (68%) of participants reported that their families were directly expelled from their homes by Serb forces. Overall, 50% of participants saw Serb police or soldiers burning the houses of others, 16% saw Serb police or soldiers burn their own home, and 14% witnessed Serb police or soldiers killing someone. Large percentages of participants saw destroyed mosques, schools, or medical facilities. Thirty-one percent of respondents reported human rights abuses committed against their household members, including beatings, killings, torture, forced separation and disappearances, gunshot wounds, and sexual assault. CONCLUSIONS: The present findings confirm that Serb forces engaged in a systematic and brutal campaign to forcibly expel the ethnic Albanian population of Kosovo. In the course of these mass deportations, Serb forces committed widespread abuses of human rights against ethnic Albanians. (+info)
From dust to dust: ethical and practical issues involved in the location, exhumation, and identification of bodies from mass graves.
There are many potential purposes served by the investigation of human remains: criminal fact-finding, archaeological exploration, forensic research, and others. This paper focuses on the identification of remains from mass graves to find missing persons. The primary goal of such efforts is to honor the memory of the dead by bringing closure to living family members, thus supporting the human rights of both the living and the deceased. Cultures, customs, political, and interpersonal specifics will vary, but that singular goal should remain the central guiding principle. This article presents ethical and practical issues resulting from efforts to locate, exhume, and identify the remains of mass fatalities. (+info)
Identification of human remains by immobilized sequence-specific oligonucleotide probe analysis of mtDNA hypervariable regions I and II.
AIM: A rapid analysis of mitochondrial DNA (mtDNA) sequences with an array of immobilized sequence-specific oligonucleotide (SSO) probes was tested on 18 skeletal elements recovered from mass graves in Croatia, which could not be genotyped with common forensic nuclear DNA systems (PM+DQA1 and short tandem repeat analysis). METHODS: We used duplex polymerase chain reaction (PCR) amplification of the mtDNA hypervariable regions I and II (HVI and HVII) (444 bp and 415 bp amplicons, respectively) and subsequent linear array typing, which targets six polymorphic regions and two additional sites within the human mtDNA HVI and HVII. The remaining amplified products were subjected to direct sequence analysis to obtain complete sequence information for the targeted HV regions. RESULT: Duplex PCR amplification of the mtDNA HVI and HVII was successful in providing sufficient product for typing with the array of SSO probes in 14 out of the 18 sample extracts. We report here the sequence match of one set of remains with a panel of immobilized SSO probes, followed by direct sequence analysis. The corresponding mtDNA haplotype obtained for the bone sample and the putative maternal reference was unique in a database of 105 randomly selected Croatian individuals. CONCLUSION: Mitochondrial DNA typing with an array of immobilized SSO probes can be a benefit to forensic DNA analysis of mass disaster remains and identity testing of single and mass graves. (+info)
How high should paternity index be for reliable identification of war victims by DNA typing?
AIM: To analyze statistically and logically the significance of genetic matches between skeletal remains and relatives of missing persons in the process of identification of war victims by DNA typing. METHODS: DNA was isolated from bone and blood samples and short tandem repeat (STR) loci were typed by using AmpFLSTR Profiler, Profiler Plus, and Identifiler kits. Novel mini-haplotype analysis that compares matches in all three-locus combinations of alleles was developed and used in the analysis of inbreeding in the group of 295 unrelated individuals. RESULTS: While comparing 98 skeletal remains exhumed in the process of identification of war victims in Croatia with over 3,000 genotypes of relatives of missing persons, we revealed 20 cases of 14-locus matches and 4 cases of 15-locus matches between unrelated people. We hypothesized that this unexpectedly high number of false matches might be a consequence of local inbreeding and supported this hypothesis with very low correlation between the probability of a genotype and the number of matching genotypes in the database (R(2) = 0.36). Further support for the hypothesis was obtained by the analysis of mini-haplotypes, which revealed up to 90% overrepresentation of some mini-haplotypes. CONCLUSIONS: STR DNA typing is the "golden standard" of human identification, but evidential value of a genetic match can be easily misinterpreted. Therefore, careful use of statistical methods is essential for the proper evaluation of laboratory results. Whenever possible, multiple relatives should be analyzed and other evidence based on the information about time, place, and other conditions of disappearance, as well as anthropological and other "classical" forensic data should always be put together and compared before any final decision about the identity is made. (+info)
MEDICAL ASSESSMENT OF LATE EFFECTS OF NATIONAL SOCIALIST PERSECUTION.
Emotional involvement of the examiner, hostility and mistrust on the part of the examinees and the long interval since the original events comprise some of the problems facing medical assessors of survivors of National Socialist persecution. Experience with over 100 such persons confirmed the high incidence of irreversible and usually disabling disorders, mainly functional and psychiatric-"late damage" as it has been designated in recent reports on this subject. The most common disorders encountered in the assessments of 70 survivors are reviewed. A number of organic diseases such as organic brain damage, active tuberculosis and fractures were revealed only after careful search. Recent findings by psychiatric assessors are reviewed; their plea for greater familiarity with late effects in survivors of National Socialist persecution is echoed, and the need for medical, psychiatric and social support of these unfortunate individuals is emphasized. (+info)