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This paper explores some implications of Hurricane Katrina, especially
as it affected, and will continue to affect, African Americans. Our
observations stem largely from our ongoing examination of the demography
of African Americans, including motivations to leave the South
historically, and recent changes generating a significant "return
migration" of African Americans to the South. The specific case of
Katrina-related migration requires examining issues of race and
class—including the destinations to which Katrina's victims
were displaced and key features of the place to which they might return.
We leave for others the evaluation of ongoing political debates concerning
responsibility for who did what, and why. Our focus is on New Orleans as a
place, and what prospects exist for reconstituting that place in light of
past, present, and prospective demographic trends. We first review recent
work on place and identity, and describe the general features of past
migration patterns of African Americans—both from the South and back
to the South. We then identify important features of New Orleans as a
distinctive place on the U.S. landscape, in part by comparing New Orleans
with other southern cities using the 1% Integrated Public Use Microdata
Series (IPUMS) sample of 2000 U.S. Census data. Finally, we assess the
prospects of the reconstitution of New Orleans as a place resembling what
it was prior to Katrina, by examining the intersecting factors of race,
class, and ethnicity in shaping how, and by whom, the city may be
resettled. We project that the city will be smaller, more White and
Hispanic, more affluent, and more tourism/ entertainment-oriented than
its pre-Katrina reality. Given the difficulty of making such projections,
we conclude with an analysis of various demographic portraits of what the
racial composition of New Orleans may become, depending on (1) its future
size, and (2) relative rates of return migration by White and Black New
Orleanians.

Abstract  Using samples of census data from the University of Minnesota Population Center's "Integrated Public Use Microdata Series" (IPUMS), we describe trends in African‐American migration to the South across recent decades, and explore the applicability of the concept of "return migration" to various demographic patterns. Our findings suggest that the return movement contains multiple migration streams involving African‐Americans of higher socio‐economic status (compared with both origin and destination populations) moving to both urban and rural destinations. These patterns represent clear differences from the earlier 20th century's "Great Migration" of African‐Americans from South to North. The recent return migration streams suggest that the South may be replacing the North as a "land of promise" for some upwardly mobile African‐Americans, and may also reflect what Carol Stack (1996) has termed a "call to home" as a motivating factor shaping recent African‐American migration to the rural South.

AbstractProject closure is a core feature of humanitarian action. However, how decisions to end projects are made, and how closure is planned and implemented, has implications for upholding ethical commitments, and can have positive or negative consequences for affected communities, local stakeholders, and humanitarian organizations and their staff. To better understand the ethical dimensions of closing humanitarian projects, we undertook an investigation of national and international humanitarian workers' experiences.Guided by interpretive description methodology, we conducted an exploratory qualitative study with two rounds of semi-structured interviews. Four national and five international staff of non-governmental organizations with experience of humanitarian health project closure took part. The participants had diverse professional roles and disciplinary backgrounds. All participants took part in the first round of interviews which focused on experiences and perceptions of ethics and project closure. Analysis of these interviews contributed to the development of a draft "ethics guidance note." Five of the participants took part in the second round of interviews which focused on receiving feedback on the draft guidance note. We used constant comparative techniques and a recursive approach to data collection and analysis. In this article, we draw on both rounds of interviews to present findings related to how participants understood and experienced ethical responsibilities, challenges, and opportunities for humanitarian project closure.We identified six recurrent ethical concerns highlighted by interviewees regarding closure of humanitarian projects: respectfully engaging with partners and stakeholders, planning responsively, communicating transparently, demonstrating care for local communities and staff during project closure, anticipating and acting to minimize harms, and attending to sustainability and project legacy. We present these ethical concerns according to the temporal horizon of humanitarian action, that is, arising across five phases of a project's timeline: design, implementation, deciding whether to close, implementing closure, and post-closure.This exploratory study contributes to discussions concerning the ethics of project closure by illuminating how they are experienced and understood from the perspectives of national and international humanitarian workers. The interview findings contributed to the development of an ethics guidance note that aims to support project closures that minimize harms and uphold values, while being mindful of the limits of ethical ideals in non-ideal circumstances.

Little is known about the effects of social context or "place" factors (e.g., characteristics of local populations) on African Americans' perceptions and experiences of racism. Using data from 42,445 U.S. black women collected during the 1997 follow-up wave of the Black Women's Health Study, we investigated the association between neighborhood racial composition ("percent black" at the block-group level in 2000 Census data) and perceptions of racial discrimination. Perceived racial discrimination was measured using self-reports of the frequency of discrimination in "everyday" settings (e.g., being treated as if you are dishonest) and "lifetime" occurrences of discrimination on the job, in housing, and by the police. There was a linear inverse relationship between neighborhood percent black and perceived discrimination, i.e., higher percent black was associated with lower levels of discrimination. Our results support the conclusions that, relative to contexts in which blacks are a small minority, more evenly-mixed (i.e., integrated) contexts result in lower levels of discrimination (contact hypothesis), and mostly black contexts evidence the lowest levels of discrimination (ethnic density hypothesis).

AbstractBackgroundHumanitarian non-governmental organizations provide assistance to communities affected by war, disaster and epidemic. A primary focus of healthcare provision by these organizations is saving lives; however, curative care will not be sufficient, appropriate, or available for some patients. In these instances, palliative care approaches to ease suffering and promote dignity are needed. Though several recent initiatives have increased the probability of palliative care being included in humanitarian healthcare response, palliative care remains minimally integrated in humanitarian health projects.MethodsWe conducted a qualitative study using interpretive description methodology to investigate humanitarian policy-makers' and health care professionals' experiences and perceptions of palliative care during humanitarian crises. In this article, we report on the analysis of in-depth interviews with 24 participants related to their perceptions of obstacles to providing palliative care in humanitarian crises, and opportunities for overcoming these obstacles. Among the participants, 23 had experience as humanitarian health professionals, and 12 had experience with policy development and organizational decision-making.ResultsParticipants discussed various obstacles to the provision of palliative care in humanitarian crises. More prominent obstacles were linked to the life-saving ethos of humanitarian organizations, priority setting of scarce resources, institutional and donor funding, availability of guidance and expertise in palliative care, access to medication, and cultural specificity around death and dying. Less prominent obstacles related to continuity of care after project closure, equity, security concerns, and terminology.ConclusionOpportunities exist for overcoming the obstacles to providing palliative care in humanitarian crises. Doing so is necessary to ensure that humanitarian healthcare can fulfill its objectives not only of saving lives, but also of alleviating suffering and promoting dignity of individuals who are ill or injured during a humanitarian crises, including persons who are dying or likely to die.

Article ; La recherche interventionnelle en santé mondiale est souvent effectuée au moyen de partenariats scientifiques internationaux. Mais la réalisation de telles recherches, notamment dans les pays à faible revenu où les enjeux de pouvoir, d'argent et de relations interculturelles sont exacerbés, soulève de nombreux défis éthiques, notamment concernant la conduite responsable lors des recherches collaboratives. L'un d'eux est la conservation, l'accès, l'utilisation et la publication des données. Malgré l'existence de multiples politiques et documents phares sur l'éthique et la conduite responsable de la recherche, les chercheurs en recherche interventionnelle sont encore peu outillés pour faire face à ce défi. Dans le contexte d'un programme de recherches interventionnelles réalisées au Burkina Faso, les auteurs souhaitent partager leur expérience dans le développement d'une politique interne concernant leurs données. Après avoir évoqué le contexte global et particulier, l'article présente le processus de formulation et d'adoption de cette politique par les chercheurs d'une équipe interdisciplinaire et internationale (Allemagne, Burkina Faso, Canada, France). Les valeurs qui enchâssent cette politique interne sont la transparence, la prévention, le consensus autour du processus de production, le respect des principes internationaux, l'accès libre aux connaissances produites et la préoccupation pour leur diffusion et utilisation. La politique se présente en plusieurs parties : objet, types et statuts des chercheurs impliqués, conservation des données, accès et utilisation des données, production scientifique et paternité. Les principaux défis rencontrés par les chercheurs pour formuler cette politique sont analysés dans un souci de partage pour susciter un débat rarement abordé. La confiance, la transparence et le respect mutuel doivent être au cœur de tout partenariat scientifique en recherche interventionnelle. ; Interventional global health research is often carried out through international scientific partnerships. However, the conduct of such research, especially in low-income countries where issues of power, money and intercultural relations are exacerbated, raises many ethical challenges particularly related to responsible conduct in collaborative research. One of these challenges is the storage, access, use and publication of data. Despite the existence of multiple influential policies and documents on ethics and the responsible conduct of research, researchers in intervention research are still not equipped to deal with such challenges. In the context of an intervention research program conducted in Burkina Faso, the authors would like to share their experience in the development of an internal policy concerning their data. After presenting the global and the particular context, the paper presents the process of policy formulation and its adoption by the researchers of an interdisciplinary and international team (Burkina Faso, Canada, France, Germany). The values that entrench this internal policy are: transparency, prevention, consensus about the production process, respect for international principles, free access to the knowledge produced and concerns regarding its dissemination and use. The policy is presented in several parts: aim, types and status of the participating researchers, data storage, access and use of data, scientific production and authorship. The main challenges faced by researchers in formulating this policy are analyzed in a shared desire to spark a debate that is rarely addressed. Trust, transparency and mutual respect should be central to any scientific partnership in intervention research.

This document is a summary public version of the Ethics Recommendations for Crisis Translation Settings produced by some of the INTERACT project team. INTERACT is the International Network in Crisis Translation, a project funded by the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 734211. Further information about the project as a whole is available at: https://sites.google.com/view/crisistranslation/home

PurposeIn this paper, the authors propose a new lens to examine international humanitarian organizations' responsibilities in the context of project closure, what authors call "an ethics of the temporary". The authors offer this as an orienting ethical ideal to facilitate the moral imagination of humanitarian planners, practitioners and stakeholders.Design/methodology/approachThe authors drew on recent philosophical work on responsibilities for global justice to analyze an ethical concern inherent to humanitarian practice, the proper scope of responsibility in the context of closure of humanitarian projects.FindingsThe ethics of the temporary includes four elements: situating humanitarian action temporally with attention to the past and how it shapes a current crisis and crisis response, focusing attention on anticipating and seeking to mitigate potential harm, promoting sustainability and greater equity going forward and emphasizing inclusive, collaborative approaches. The authors propose a set of questions that can foster discussion and reflection about the scope of humanitarian responsibilities at project closure.Practical implicationsAlthough the authors' work is primarily conceptual, it has many practical implications for humanitarian policy and practice. It can support critical reflection and offers a process for considering the scope of responsibility at project closure and decisions around how to close a given intervention in a manner that avoids causing harm and advances equity.Originality/valueVery little work has been done on ethical closure of humanitarian projects. Most literature offers critiques. This essay contributes a new approach to closure, the ethical ideal and practice of an ethics of the temporary.

AbstractWith no cure and a high mortality rate, Ebola virus disease (EVD) outbreaks require preparedness for the provision of end-of-life palliative care. This qualitative study is part of a larger project on palliative care in humanitarian contexts. Its goal was to document and deepen understanding of experiences and expectations related to end-of-life palliative care for patients infected with Ebola virus disease (EVD) in West African Ebola treatment centres (ETCs) during the 2013–2016 epidemic. It consisted of 15 in-depth semi-structured interviews with individuals impacted by EVD in a Guinean ETC: either as patients in an ETC, healthcare providers, healthcare providers who were also EVD patients at one point, family relations who visited patients who died in an ETC, or providers of spiritual support to patients and family. Analysis was team based and applied an interpretive descriptive approach. Healthcare delivery in humanitarian emergencies must remain respectful of patient preferences but also local and contextual values and norms. Of key importance in the Guinean context is the culturally valued experience of "dying in honour". This involves accompaniment to facilitate a peaceful death, the possibility of passing on final messages to family members, prayer, and particular practices to enact respect for the bodies of the deceased. Participants emphasized several challenges to such death in Ebola treatment centres (ETCs), as well as practices they deemed helpful to alleviating dying patients' suffering. An overarching message in participants' accounts was that ideally more would have been done for the dying in ETCs. Building on participants' accounts, we outline a number of considerations for optimizing end-of-life palliative care during current and future public health emergencies, including for COVID-19.