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1) Haitian government instability: Despite some knowledge of the Dominican Republic, I hadn't fully grasped the political instability in Haiti. This is an important factor when looking at disaster relief as political climate can often dictate how well or poorly aid is received.

2) USAID: I've chosen to delve into more about the USAID, including what countries are currently being given aid and how, including Haiti.

3) UN Peacekeeping units: obviously, a force meant to be helpful and to bring the world a little closer. Yet, the article seems to indicate peacekeeping forces can do more harm than good; I'm curious to see if this is a common theme, and if so, why this continues to occur.

The majority of the information obtained for this report comes from the work of the four authors. As members of Partners in Health or clinicians, these individuals have seen first hand the effects of social violence in patient care. Moreover, they have witnessed the effectiveness of addressing these ills to better patient outcomes. Some information was also gathered from past studies, including a report by Moore et al. detailing Baltimore's racial discrepancies in care and patient outcomes.

1) The article begins by articulating the four domains that "biosecurity" supposedly encompasses. Yet, even just by looking at these four domains with a basic knowledge of current events, one can understand these are all far from having any sense of stability. Just recently, more reports emerged of use of chlorine gas and other agents against citizens in Syria. Reluctance to vaccination has led to a re-emergence of measles and pertussis across the US. 

2) Increase awareness and attention does not always result in cooperative and cohesive actions. While there may be movement to address certain issues, this does not always encompass details of how to attack certain public concerns. One of the main examples cited in the article was a small pox scenario termed "Dark Winter". Here, officials struggled to gauge the possibility of a small pox bioterrorism attack with the cost and effect of the small pox vaccine-- which can result in death. The conflicting results of the scenario between healthcare personnel "on the ground", government officials, and the CDC's difficulty in gauging a credible threat level led to a dismissal of the program.

3) Many of the approaches by global agencies touted as medical agencies primarily center on emergency response protocols. This modality prepares them for quick, short responses to emergency problems, while neglecting long-term intervention. The article argues this approach is preferred because of the galvanizing, global responses emergencies have-- they garner attention and resources quickly, while long-term problems do not. Additionally, short-term presence is far easier to prepare for than implementing long-term solutions to medical scenarios. 

Several sources are utilized in compiling Dr. Knowles' argument. Much of the historical information comes from first-hand accounts provided at the time and compiled for posterity. A good portion of information also emerges from news articles produced in the wake of the event. This includes interviews and press releases. Historical court documentation and correspondences between parties are used for depiction of events and subsequent investigations. Several aanalysis pieces by historians also appear to be used. When discussing the parallels between scenarios, Dr. Knowles relies on his own logic to fully connect the events.

The article pays tribute to the development of immigrants into French residency due to medical issues. Should an immigrant have a serious medical condition, and be unable to procure adequate medical care in their home nation, they would be given residency. This was a curious ascent for immigrants in status; the loss of immigrant workers as an integral portion of the economy had led to a general public distaste for immigration.

The very nature of the law made it very subject to individual interpretation-- creating divisions within the health care system. Fassin notes some instances where this interpretation caused the law to fail; discontinuity between medical professionals created situations where similar conditions were met with opposing decisions. Moreover, as cited by Fassin, this also led to several scenarios where doctors allowed their personal opinions on immigration to sway their decisions.

1) "Interventions in the acute phase directly following the disaster are designed to promote survivors’ safety and stability and to help them cope with their experiences (12). One such intervention, psychological debriefing or critical incident stress debriefing, was developed in the 1980s for emergency responders and has been used with other victims of trauma (46)."

2) "Exposure to potentially traumatic events is disaster-specific and often measured differently between studies, making it difficult to compare experiences and mental health consequences or to generalize findings to all disaster-affected populations (22). Additionally, most instruments that assess symptoms of mental disorder have been developed and validated in the United States (23, 48) and may lack cultural relevance and validity in areas impacted by disasters worldwide"

3) "These studies can help us understand what factors are associated with different courses of mental illness, which can help us identify the most vulnerable populations and inform tailored interventions"

Obviously, the individual testimonies hold enormous emotional power. Having a tearful mother share of her grief at losing two children, watching former marines such as Denita McCall fight for their lives against cancer, or seeing Mike Partain's massive spreadsheet of male breast cancer incidence all strike deeply. Yet, the most compelling piece was early on in the film. Ensingmer and Partain visit a cemetery near Camp Lejeune. While there, they note the sheer number of graves from between 1957-1987-- the vast majority belonging to infants and children. This, personally, was the most moving; witnessing the sheer number of lives  lost while hearing the excuses and lackluster responses of governing bodies demonstrated just how dire this situation was.

The article primarily asserts that how a patient narrates or describes their medical history is deeply rooted in their native culture. As such, physicians must be aware of how an individual's medical experiences can be altered based on this. In turn, physicians must recognize the importance of story-telling and anecdotes when receiving information directly from patients. Narratives project the patient's experience and events through their perspective, granting professionals a glimpse into their thought processes and action patterns.

The first portion of the article focuses on the shift of sexual violence from a woman's rights issue to the larger title of "gender-violence". From there, Dr. Ticktin argues the nuances of this transition necessitated medicalizing sexual violence, and turned it into a condition to be treated by tools within the humanitarian kit. Just as how we now attempt to treat polio by handing out vaccines and flyers, rape is covered by blanket protocols and procedures. In attempts to make this issue more respected, we sacrificed the nuances of care necessary for adequate treatment.

This is further exemplified in Dr. Ticktin's description of humanitarian aid-- the preservation of life itself, with disregard to the kind of life being lived. She goes on to contend that sexual violence is by its very definition a "kind" of life, thus creating an inherent conflict in the overarching goal of treating sexual violence and humanitarian interventions.

Dr. Ticktin also pays respect to the inherent difficulty in maintaining the typical principles used during humanitarian aid efforts, especially when attempting to treat gender violence. One of her primary examples is the work of MSF in the Congo Republic. During the conflict, roadblocks would be set by armed men, and thus MSF were forced to accept military escorts-- destroying the key humanitarian tenant of neutrality. Moreover, many of these militia men were perpetrators of the sexual violence, something MSF was seeking to treat. 

Emergency response is literally the main focus of the entire article. While it seems to be only a short chapter in a much larger collection of similar essays, the report fully analyzes past and present responses to nuclear emergencies. Moreover, Dr. Schmid builds a case for how future emergencies should be handled by an international team built on expertise. This includes expertise of nuclear energy, disaster response, and nuclear policy/regulation. While she refrains from commenting fully on whether the response mounted for Fukushima can be classified as "good" or "bad", her assertions indicates a need to shift focus from preventing emergencies to how nations respond to nuclear emergencies.