O'Dempsey T J D, Munslow B
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Ann Trop Med Parasitol. 2006 Jul-Sep;100(5-6):501-15. doi: 10.1179/136485906X97381.
A new political economy of conflict has emerged in the aftermath of colonialism and the Cold War. Complex political emergencies have been simmering in the post-colonial world for more than three decades. Intra-country armed conflict, often combined with natural disasters, at present contributes to the displacement of over 20 million people world-wide. The international community remains profoundly uncomfortable with the complex political emergencies of the new era, torn between the respect for national sovereignty upon which the international political system of the United Nations and other agencies is built, and the growth of concern with human rights and a burgeoning International Humanitarian Law. Globalisation may have brought many benefits to some but there are also many losers. The Word Bank and the International Monetary Fund imposed structural adjustment policies to ensure debt repayment and economic restructuring that have resulted in a net reduction in expenditure on health, education and development. A downward spiral has been created of debt, disease, malnutrition, missed education, economic entrapment, poverty, powerlessness, marginalization, migration and instability. Africa's complex political emergencies are particularly virulent and tenacious. Three examples that are among the most serious humanitarian emergencies to have faced the world in recent times--those in Angola, the Democratic Republic of Congo and Sudan--are reviewed here in detail. The political evolution of these emergencies and their impact on the health of the affected populations are also explored.
殖民主义和冷战之后出现了一种新的冲突政治经济学。复杂的政治紧急情况在后殖民世界已酝酿了三十多年。国内武装冲突,往往与自然灾害交织在一起,目前导致全球超过2000万人流离失所。国际社会对新时代复杂的政治紧急情况深感不安,在尊重国家主权(联合国和其他机构的国际政治体系正是建立在这一基础之上)与对人权的日益关注以及新兴的国际人道法之间左右为难。全球化或许给一些人带来了诸多益处,但也造就了许多输家。世界银行和国际货币基金组织推行结构调整政策以确保债务偿还和经济结构调整,这导致了卫生、教育和发展方面的支出净减少。由此形成了一个债务、疾病、营养不良、教育缺失、经济困境、贫困、无力、边缘化、移民和不稳定的恶性循环。非洲复杂的政治紧急情况尤为严重且顽固。这里详细审视了近期世界面临的最严重人道主义紧急情况中的三个例子——安哥拉、刚果民主共和国和苏丹的情况。还探讨了这些紧急情况的政治演变及其对受影响人群健康的影响。