Disasters
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The impact of conflict, particularly conflict arising during civil wars, on the provision of healthcare is a subject that has not been widely considered in conflict-related research. Combatants often target health services to weaken or to defeat the enemy, while attempts to maintain or improve health systems also can comprise part of counter-insurgency 'hearts-and-minds' strategies. ⋯ These concepts provide a useful lens with which to understand better how health services are affected by conflict, while the empirical case study presented in the paper illustrates dynamics that may be repeated in other contexts. The concepts and case study set out in this paper should prove useful to healthcare providers working in conflict zones, including humanitarian aid agencies and their employees, increasing their understanding of the social and political dynamics that they are likely to face during future conflict-related complex emergencies.
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This paper looks at the three-way relationship between the Government of Chad, humanitarians, and the United Nations Mission in the Central African Republic and Chad (MINURCAT) from 2004 until June 2011. Chad was never comfortable with the international presence of either humanitarians or peacekeepers and asserted its sovereignty increasingly during this period. ⋯ This association between the UN mission and humanitarian agencies contributed to making the latter the target of repressive practices by the government, such as the imposition of armed escorts. Facing a steep learning curve, Chad and its state officials gradually appropriated the discourse of the humanitarian and international community and ultimately, in 2010, requested the departure of MINURCAT, claiming that they could meet the protection needs of vulnerable populations in eastern Chad on their own.