Michael M
International Committee of the Red Cross, Geneva, Switzerland.
JAMA. 1996 Aug 7;276(5):364-8.
To evaluate access to and distribution and quality of medical supplies donated by humanitarian aid organizations to hospitals and health services during the war in Bosnia and Croatia.
Retrospective survey of 68 representatives of hospitals and field hospitals regularly caring for inpatients between May 1994 and April 1995.
Three study areas: the Republic and Federation of Bosnia-Herzegovina, Republika Srpska (part of Bosnia-Herzegovina controlled by Bosnian Serbs), and Republika Srpska Krajina (part of Croatia controlled by Croatian Serbs during the study period).
Of 68 hospital representatives, 44 completed the survey (65% response rate). Respondents did not include representatives from 11 hospitals and field hospitals that could not be contacted because of operational obstacles resulting from the ongoing war.
Lack of supplies was reported as an important limitation by 62% (26/42) of respondents, followed by lack of staff and security, physical isolation, and lack of infrastructure. Antibiotics were mentioned by 76% (32/42) of respondents as the unavailable drug or item most urgently needed. The majority of drug and medical supplies used to treat patients had been supplied by 5 humanitarian aid organizations. The frequency with which respondents mentioned their ¿own means¿ (eg, from the ministry of health or respective municipalities) was relatively low (9%), reflecting the high degree of dependency on humanitarian aid. All respondents rated the quality of donated supplies and the working relationship with the donating organization as ¿very good¿ or ¿satisfactory¿; 93% 41/44) of respondents indicated that the donated supplies were appropriate. Six of 44 respondents preferred to receive supplies as part of assembled kits; 70% (31/44) preferred to receive such assistance as loose supplies according to demand.
During war, access and security are beyond the control of humanitarian agencies. Assistance coordination, however, must be provided. Although a consensus on policies and objectives between different humanitarian organizations is difficult to reach, satisfactory complementarity can be achieved. The systematic and continuous gathering of information at the recipient and user level, beginning at the early phase of the conflict, is recommended to maintain appropriate assistance.
评估在波斯尼亚和克罗地亚战争期间,人道主义援助组织捐赠给医院和医疗服务机构的医疗用品的获取、分配情况及质量。
对1994年5月至1995年4月期间定期照料住院患者的68家医院和野战医院的代表进行回顾性调查。
三个研究区域:波斯尼亚和黑塞哥维那共和国及联邦、斯普斯卡共和国(波斯尼亚和黑塞哥维那的一部分,由波斯尼亚塞族人控制)以及斯普斯卡克拉伊纳共和国(在研究期间由克罗地亚塞族人控制的克罗地亚的一部分)。
68名医院代表中,44人完成了调查(回复率为65%)。由于持续战争导致的行动障碍,11家医院和野战医院的代表无法联系,未纳入受访者。
62%(26/42)的受访者报告称物资短缺是一个重要限制因素,其次是人员和安全短缺、物理隔离以及基础设施匮乏。76%(32/42)的受访者提到抗生素是最急需但无法获得的药品或物品。用于治疗患者的大多数药品和医疗用品由5个人道主义援助组织提供。受访者提及“自身途径”(如来自卫生部或各自的市政府)的频率相对较低(9%),这反映出对人道主义援助的高度依赖。所有受访者对捐赠物资的质量以及与捐赠组织的工作关系评价为“非常好”或“令人满意”;93%(41/44)的受访者表示捐赠物资合适。44名受访者中有6人更倾向于以组装套件的形式接收物资;70%(31/44)的受访者更倾向于根据需求以散装物资的形式接收此类援助。
在战争期间,获取和安全超出了人道主义机构的控制范围。然而,必须提供援助协调。尽管不同人道主义组织之间难以就政策和目标达成共识,但可以实现令人满意的互补。建议从冲突早期开始,在受援方和用户层面系统、持续地收集信息,以维持适当的援助。