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The scientific literature on noma (Cancrum Oris) has clearly increased in recent decades, but there seems to have been limited analysis of issues around the psycho-social impacts of this disease. Even when these issues have been... more
The scientific literature on noma (Cancrum Oris) has clearly increased in recent decades, but there seems to have been limited analysis of issues around the psycho-social impacts of this disease. Even when these issues have been addressed, the focus has tended to be on patient experiences, whereas the community dimension of the disease and the role of healthcare professionals and community leaders in mitigating these impacts remain largely unexplored. A study in the form of semi-directed interviews with 20 noma survivors and 10 healthcare professionals and community leaders was conducted between January and March 2021 in Burkina Faso with the aim of describing the experiences of noma survivors, generating knowledge about living with the burden of the disease and understanding the attitudes of community leaders towards the disease. The results reveal that noma is a disease that affects economically vulnerable populations and leads to extreme household poverty. As far as treatment is ...
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ABSTRACT. Noma is a rapidly progressing infection of the oral cavity, mostly affecting children aged between 2 and 5 years. If untreated, mortality can reach 90% within a few weeks after the onset of symptoms. Most of the published... more
ABSTRACT. Noma is a rapidly progressing infection of the oral cavity, mostly affecting children aged between 2 and 5 years. If untreated, mortality can reach 90% within a few weeks after the onset of symptoms. Most of the published literature on noma are case reports or case series from Africa. Studies including noma survivors in Asia are limited. We present a case series of noma survivors in Laos. A retrospective analysis of data collected to monitor the care provided to Lao noma survivors who presented for treatment from 2002 to 2020 was conducted. The review assessed data including sociodemographic characteristics, diagnosis, mouth opening, self-reported quality of life at admission and after surgery, and the names used for the disease. Of the 50 patients included, 25 (50%) were female. The median age of self-reported onset of acute noma was 4 years (interquartile range [IQR] 2–7 years). The noma survivors came from 14/17 (82%) of Lao provinces. There were 64 surgeries conducted ...
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Objectif. Connaitre les attitudes des decideurs face a l'existence des conflits en fin de vie et aux besoins d'une politique de leur prevention et gestion. Methodes. Enquete par questionnaire a reponses ouvertes complete... more
Objectif. Connaitre les attitudes des decideurs face a l'existence des conflits en fin de vie et aux besoins d'une politique de leur prevention et gestion. Methodes. Enquete par questionnaire a reponses ouvertes complete d'entretiens menes aupres de 24 decideurs dans le domaine des soins palliatifs et de politique de sante du canton du Valais. Le questionnaire a porte sur l'existence des conflits, les parties qui s'opposent, les causes, les effets, les modes de resolution et le role de l'Etat dans la prevention et gestion de ces conflits. Resultats. Les decideurs interroges reconnaissent l'existence des conflits au sein des equipes ou entre les structures de soins et entre les equipes, les patients et les familles. Les difficultes de communication, le manque de formation, les problemes d'organisation et les differences de valeurs sont identifies comme les causes majeures de ces conflits. Ces derniers conduisent a l'epuisement professionnel, aux frustrations, a la demotivation, au gaspillage des energies et auraient des couts economiques et sociaux eleves. L'Etat a un role a jouer mais ne dispose d'aucune politique determinee en la matiere. Ces attitudes varient en fonction de la categorie des repondants. Conclusion. Une meilleure connaissance des conflits en fin de vie, la recherche d'outils adaptes de leur detection, et celle des modeles adequats de leur resolution sont necessaires a l'elaboration d'une politique de sante appropriee dans ce domaine.
Research Interests: Humanities, Art, Leadership, Political Science, Ethique, and 9 moreHomme, Attitude, Conflit, Santé publique, Qualité, Soins palliatifs, Gérontologie, Soin, and Fin De Vie
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Aims: To describe the perception of "Good death" among health personnel working in nursing homes in French-speaking Switzerland and to identify the differential explanatory factors. Methods: A cross sectional study with a... more
Aims: To describe the perception of "Good death" among health personnel working in nursing homes in French-speaking Switzerland and to identify the differential explanatory factors. Methods: A cross sectional study with a self-administered questionnaire, adapted from the "the' new measure of concept of good death", was done among health personnel in 5 nursing homes (2 in Geneva and 3 from Valais) in spring 2004. One hundred and sixty one persons participated at the study representing over 90% of the personel contacted. Results: Four points were considered hallmarks of "Good death" by more than 80% of respondents: i.e. pain control, serenity and peace, presence of family members or close friends, respect of the last will. Up to 70% further consider as important elements the support of health professionals, the opportunity to transmit one's values and access to spiritual and/or religious support. Around 50% of respondents also consider as important "being able to chose the place of death", "having time to prepare one self", "staying conscious to the end" and "having control over body functions". These perceptions vary according to the place of work, the sex, the training in palliative care, the professional experience and of the number of deaths with which respondents were confronted. Conclusion: There seems to be converging opinions among health personel on what "Good death" should be. Public health decisions makers need to be informed on this.
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Lorsqu'elles sont confrontees a des situations de conflits, les infirmieres et les aides-soignantes exercant en soins palliatifs adoptent des attitudes a la fois convergentes et divergentes, aussi bien dans l'identification des... more
Lorsqu'elles sont confrontees a des situations de conflits, les infirmieres et les aides-soignantes exercant en soins palliatifs adoptent des attitudes a la fois convergentes et divergentes, aussi bien dans l'identification des parties et des causes, que dans les modes de resolution utilises et des lecons a en tirer. Les facteurs explicatifs sont multiples. Ces observations posent un defi aux decideurs et aux acteurs du domaine des soins palliatifs tant au niveau strategique qu'operationnel.
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Le lieu de deces est un espace geographique dans lequel la cessation d'une ou plusieurs vies humaines intervient et donne lieu a un constat medical ou judiciaire. Le lieu de deces peut etre connu ou inconnu, choisi ou involontaire,... more
Le lieu de deces est un espace geographique dans lequel la cessation d'une ou plusieurs vies humaines intervient et donne lieu a un constat medical ou judiciaire. Le lieu de deces peut etre connu ou inconnu, choisi ou involontaire, approprie ou non. A cet effet, notre auteur a pose des questions troublantes lors d'un atelier au congres de la SSMI a Lausanne. Peut-on mourir ou on veut?
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Aims: To describe perceptions of “good death” among health personnel working in nursing homes in French-speaking Switzerland, and to identify differential explanatory factors. Methods: A cross-sectional study with a self-administered... more
Aims: To describe perceptions of “good death” among health personnel working in nursing homes in French-speaking Switzerland, and to identify differential explanatory factors. Methods: A cross-sectional study with a self-administered questionnaire, adapted from the New Measure of the Concept of Good Death, was carried out among health personnel in five nursing homes (two in Geneva and three in Valais) in spring 2004. One hundred and sixty-one persons participated at the study representing over 90% of the personnel contacted. Results: Four things were considered hallmarks of “good death” by more than 80% of respondents: pain control, serenity and peace, the presence of family members or close friends, and the respect of final wishes. Up to 70% also considered the following elements important: the support of health professionals, the opportunity to communicate one’s values, and access to spiritual and/or religious support. Around 50% of respondents also considered it important “to be able to choose the place of death,” “to have time to prepare oneself,” “to stay conscious to the end,” and “to have control over body functions.” These perceptions vary according to place of work, sex, training in palliative care, professional experience, and of the number of deaths respondents have dealt with. Conclusion: There seem to be converging opinions among health personnel on what “good death” is. Public health decisions makers need to be aware of this.
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Research Interests: Art and Political Science
Background: Over the past decades, the health and human rights movement has become a public health actor that cannot and should not be ignored when defining public health policies. Little has been published about the scientific... more
Background: Over the past decades, the health and human rights movement has become a public health actor that cannot and should not be ignored when defining public health policies. Little has been published about the scientific contribution of the movement, be it in terms of volume, topics, content, diffusion channels, production, or target sites. Objective: This article aims to characterize the scientific production of articles focusing on "health and human rights" and to describe its evolution over a decade. Methods: A systematic review of the literature was done. The following databases were considered: Medline, Embase, BDSP, Wholis, Saphir, Rero and Web of Science. The analysis focused on English and French contributions published between January 1, 1999 and December 31, 2008. Results: Nine hundred twenty eight articles, published in 377 different journals, were reviewed. Among these articles, 43.7% had been written by one author and 56.3% by two or more authors. Over the studied decade, the production volume increased threefold. Most frequent developed topics were related to health systems (18.3%), mental health (11.5%), HIV/AIDS (10.3%), reproductive health (9.2%). Emerging topics included: the rights of patients (2.7%), new technologies (2.5%), and handicap (2.5%). Studies were classified according to their design in social analysis (42.7%), reviews of the literature (19.8%), qualitative studies (17.9%), editorials (12.5%), epidemiological studies (6.8%). Most studies were published in public health (34.5%) and biomedical journals (29.0%), while some appeared in social science journals (4.7%). The studies were related to global issues/settings (43.9%) or more specifically to country settings, for example, the United States (9.3%), Great Britain (7.8%), South Africa (3.3%), Australia (3.0%), Canada (2.6%), France (2.3%), and India (1.9%). The authors were mainly from industrialized countries. Conclusion: The publication of articles on health and human rights issues is increasing, and new topics are being addressed. Yet more evidence-based studies might be necessary to scientifically strengthen the domain.
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Research Interests: Medical Sociology, Philosophy, Ethics, Epistemology, Human Rights, and 15 moreGlobal Health, Public Health Ethics, Medical Theory and Philosophy, Public Health, Health Policy, Research, Medicine And Health Care, Medicine, Knowledge, Humans, Human right, Health Science, Public health systems and services research, International health, and International Health
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Research Interests: Nursing, Health Promotion, Distance Education, Africa, Public Health, and 15 moreMedicine, Curriculum, Workforce Development, Humans, Needs Assessment, Human Resources for Health, Workforce, International health, World Health Organization, International Health, Clinical Competence, Health Priorities, Internet, Health Manpower, and Inservice training
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La penurie de main-d'œuvre de sante publique competente represente au niveau mondial un probleme majeur. La situation est particulierement difficile en Afrique sub-saharienne. En 2008, l'Organisation Mondiale de la Sante et de la... more
La penurie de main-d'œuvre de sante publique competente represente au niveau mondial un probleme majeur. La situation est particulierement difficile en Afrique sub-saharienne. En 2008, l'Organisation Mondiale de la Sante et de la Global Health Workforce Alliance a lance un appel a propositions pour un programme de formation en sante publique mettant l'accent sur le developpement des personnels de sante et ciblant specifiquement l'Afrique. Notre article presente l’elaboration, la mise en œuvre et l'evaluation d'une Maitrise d’Etudes avancees en sante publique. Le projet a ete developpe en collaboration avec des etablissements universitaires partenaires de dix pays africains francophones et bureaux locaux, le bureau regional et le HQ de l'OMS.
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We conducted a systematic review of the scientific literature between 1996 and 2013 on rape in war-ridden Eastern Democratic Republic of Congo (DRC) in order to better understand the interest of the scientific community in describing the... more
We conducted a systematic review of the scientific literature between 1996 and 2013 on rape in war-ridden Eastern Democratic Republic of Congo (DRC) in order to better understand the interest of the scientific community in describing the magnitude and characteristics of the problem. The literature search was conducted in French and English using several databases (Pubmed, PsycInfo, Sapphire, BDSP, Embase, Rero, and Web of Science) with the key words “rape and DRC” combined with several Medical Subject Headings concepts. Our systematic review yielded 2,087 references, among which only 27 are original studies, that is 20 are based on population surveys and the remaining 7 are original data based on case studies and reviews. Ten studies provided prevalence rates of rape victims, 18 provided specific information on the profile of the victims, 10 reported that most of the perpetrators of rape were military personnel, 14 referred to the negligence of the government in protecting victims, ...
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The purpose of this study was to assess the need of healthcare and non-healthcare professionals for training in the field of health and human rights as a basis for developing relevant education programs. In 2007 a self-administered survey... more
The purpose of this study was to assess the need of healthcare and non-healthcare professionals for training in the field of health and human rights as a basis for developing relevant education programs. In 2007 a self-administered survey questionnaire was sent to 360 health professionals and human rights activists in Chad, the Democratic Republic of the Congo, the Republic of the Congo, Mali, Burkina-Faso, and Ivory Coast. The response rate was 67% (242/360). The most common training needs involved planning tools (87%), types of human rights violations in health systems (85%), risk factors for human rights violations (80%), and human rights monitoring tools (74%). The preferred training approaches were mixed and participative methods (60%) and practical applications as a means of validation (65%). There was a high degree of homogeneity between the needs expressed by the healthcare and non-healthcare professionals. The findings of this survey indicate that healthcare and non-healthc...
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■ Une enquete menee par une equipe suisse vise a connaitre les perceptions des professionnels de sante quant a l'existence, aux causes et aux facteurs de risque des pratiques sociales, economiques et politiques portant atteinte aux... more
■ Une enquete menee par une equipe suisse vise a connaitre les perceptions des professionnels de sante quant a l'existence, aux causes et aux facteurs de risque des pratiques sociales, economiques et politiques portant atteinte aux droits des personnes souffrant de maladies mentales (PSMM) ■ Un questionnaire a ete soumis a des professionnels de sante dans 17 pays de 4 continents ■ Des themes comme l'enfermement, les violences physiques, le rationnement de soins, l'isolement dans les structures de soins, les mesures de contrainte et les atteintes graves aux droits fondamentaux des patients, ont ete releves dans les resultats de l'enquete ■ Pour pres de 60 % des repondants, l'existence de ces pratiques est attribuable au contexte economique, social et politique des pays concernes.
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The Child and youth health service of the Canton of Geneva is an important actor in support of abused children attending school. Incidence of child abuse is stable at around 3.5 per 1,000 school children. Physical, psychological abuse and... more
The Child and youth health service of the Canton of Geneva is an important actor in support of abused children attending school. Incidence of child abuse is stable at around 3.5 per 1,000 school children. Physical, psychological abuse and neglect are the types most frequently encountered. The main risk factors for abuse are precarious socio-economic situations, parenting issues and finally issues related to young people themselves. Although the incidence of abuse is stable in recent years, with respect to the growing number of children attending school, we can conclude that the absolute number of children at risk increases, confirming the need to develop and maintain common policies and prevention actions in this area
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The World Health Organization considers training in palliative care for healthcare professionals a priority. Indeed, increased life expectancy and a high prevalence of chronic and incurable diseases further emphasise the need for... more
The World Health Organization considers training in palliative care for healthcare professionals a priority. Indeed, increased life expectancy and a high prevalence of chronic and incurable diseases further emphasise the need for well-trained healthcare professionals in palliative care. The European Association for Palliative Care (EAPC) shares the concern of the WHO. Some countries, such as France and Canada, have developed national action plans to implement basic training and continued education in palliative care. In Switzerland, the ‘Manifeste de Fribourg’ called for a similar action plan in palliative care training and set it as a top priority
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Background The Republic of Guinea-Bissau in West Africa has a high HIV/AIDS disease burden and has experienced political instability in the recent past. Our study used qualitative methods to better understand key stakeholders’ perceptions... more
Background The Republic of Guinea-Bissau in West Africa has a high HIV/AIDS disease burden and has experienced political instability in the recent past. Our study used qualitative methods to better understand key stakeholders’ perceptions of the effects of chronic political instability on the HIV/AIDS response in Guinea-Bissau from 2000 to 2015 and lessons learned for overcoming them. Methods Seventeen semi-structured in-depth key informant interviews were conducted in Bissau, Guinea-Bissau in 2018. Interviews were recorded and transcribed verbatim, coded thematically, and analyzed inductively. Results Four themes emerged: (1) constantly start over; (2) the effects of instability rippling from central level throughout the health pyramid; (3) vulnerable populations becoming more vulnerable; and (4) coping mechanisms. Conclusions Stakeholders from government, civil society, and donor organizations have recognized instability’s effects as a barrier to mounting an effective local respon...
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general population and health care
Aims: To describe perceptions of “good death” among health personnel working in nursing homes in French-speaking Switzerland, and to identify differential explanatory factors. Methods: A cross-sectional study with a self-administered... more
Aims: To describe perceptions of “good death” among health personnel working in nursing homes in French-speaking Switzerland, and to identify differential explanatory factors. Methods: A cross-sectional study with a self-administered questionnaire, adapted from the New Measure of the Concept of Good Death, was carried out among health personnel in five nursing homes (two in Geneva and three in Valais) in spring 2004. One hundred and sixty-one persons participated at the study representing over 90% of the personnel contacted. Results: Four things were considered hallmarks of “good death” by more than 80% of respondents: pain control, serenity and peace, the presence of family members or close friends, and the respect of final wishes. Up to 70% also considered the following elements important: the support of health professionals, the opportunity to communicate one’s values, and access to spiritual and/or religious support. Around 50% of respondents also considered it important “to be ...
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The theme of the 8th edition of the Geneva Health Forum (GHF) was Improving access to health: learning from the field. While ‘the field’ often denotes people, patients, communities, and healthcare workers, we challenge the notion and its... more
The theme of the 8th edition of the Geneva Health Forum (GHF) was Improving access to health: learning from the field. While ‘the field’ often denotes people, patients, communities, and healthcare workers, we challenge the notion and its usage. A group of like-minded conference participants set up a working group to examine the term ‘the field’ and look at questions related to language, power, participation, and rights. By highlighting deficiencies of existing terms and jargon, we explain why language is a form of power that matters in public health. We describe global, regional, and national case studies that facilitate full participation to achieve more equitable health outcomes. By concluding with concrete recommendations, we hope to contribute to these shared goals: to correct power imbalances between health authorities and the people that they intend, and are expected, to serve. The authors are all members of the working group.
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Education and training in human rights has been set as a priority by the United Nations. Health and human rights are closely related. Training professionals from various backgrounds in human rights might ultimately contribute to improve... more
Education and training in human rights has been set as a priority by the United Nations. Health and human rights are closely related. Training professionals from various backgrounds in human rights might ultimately contribute to improve the health of individuals and communities. We present the 5 years' experience with a 3-week residential developed at the University of Geneva and implemented with the support/participation of international organizations (IOs) and non-governmental organizations active in the health and human rights sector. Over the years, roughly 150 students from 43 nationalities, with many different educational backgrounds, attended the course. The male/female ratio was 1/5. The adopted educational approach was multifold and comprised lectures from academics and experts with field experience, group work, individual case studies, journal clubs, and site visits. Evaluation data show that site visits at IOs were highly appreciated as well as networking opportunitie...
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Objectif. Connaitre les attitudes des decideurs face a l'existence des conflits en fin de vie et aux besoins d'une politique de leur prevention et gestion. Methodes. Enquete par questionnaire a reponses ouvertes complete... more
Objectif. Connaitre les attitudes des decideurs face a l'existence des conflits en fin de vie et aux besoins d'une politique de leur prevention et gestion. Methodes. Enquete par questionnaire a reponses ouvertes complete d'entretiens menes aupres de 24 decideurs dans le domaine des soins palliatifs et de politique de sante du canton du Valais. Le questionnaire a porte sur l'existence des conflits, les parties qui s'opposent, les causes, les effets, les modes de resolution et le role de l'Etat dans la prevention et gestion de ces conflits. Resultats. Les decideurs interroges reconnaissent l'existence des conflits au sein des equipes ou entre les structures de soins et entre les equipes, les patients et les familles. Les difficultes de communication, le manque de formation, les problemes d'organisation et les differences de valeurs sont identifies comme les causes majeures de ces conflits. Ces derniers conduisent a l'epuisement professionnel, aux frustrations, a la demotivation, au gaspillage des energies et auraient des couts economiques et sociaux eleves. L'Etat a un role a jouer mais ne dispose d'aucune politique determinee en la matiere. Ces attitudes varient en fonction de la categorie des repondants. Conclusion. Une meilleure connaissance des conflits en fin de vie, la recherche d'outils adaptes de leur detection, et celle des modeles adequats de leur resolution sont necessaires a l'elaboration d'une politique de sante appropriee dans ce domaine.
Research Interests: Humanities, Art, Leadership, Political Science, Ethique, and 9 moreHomme, Attitude, Conflit, Santé publique, Qualité, Soins palliatifs, Gérontologie, Soin, and Fin De Vie
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Are conflicts to an organization what pain is to an organism?OBJECTIVES: To explore the similarities and the differences between pain and conflicts in palliative care settings, and to better understand the potential importance of... more
Are conflicts to an organization what pain is to an organism?OBJECTIVES: To explore the similarities and the differences between pain and conflicts in palliative care settings, and to better understand the potential importance of conflicts in end of life quality of care.METHODS: Comparative and reflective methods focusing on how conflicts and pain are taken care of in health structures.RESULTS: Pain and conflicts present numerous similarities such as identity, typology, prevalence, warning function, economic and social costs, denial, occultation and hurdles to appropriate management. Differences also exist regarding pain – there are prevention programs on local and international levels; there are specific research and training programs; and there is also some social visibility. This does not yet exist on a larger scale regarding conflicts.CONCLUSION: Decision makers at clinical and public health levels should probably push to label conflicts as indicators of quality of care and deve...