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This updated edition of the influential Development Against Democracy is a critical guide to postwar studies of modernisation and development. In the mid-twentieth century, models of development studies were products of postwar American policy. They focused on newly independent states in the Global South, aiming to assure their pro-Western orientation by promoting economic growth, political reform and liberal democracy. However, this prevented real democracy and radical change. Today, projects of democracy have evolved in a radically different political environment that seems to have little in common with the postwar period. Development Against Democracy, however, testifies to a revealing continuity in foreign policy, including in justifications of 'humanitarian intervention' that echo those of counterinsurgency decades earlier in Latin America, the Middle East and Southeast Asia. Irene L. Gendzier argues that the fundamental ideas on which theories of modernisation and development rest have been resurrected in contemporary policy and its theories, representing the continuity of postwar US foreign policy in a world permanently altered by globalisation and its multiple discontents, the proliferation of 'failed states,' the unprecedented exodus of refugees, and Washington's declaration of a permanent war against terrorism.

Ideas of 'sovereignty as responsibility' and 'the responsibility to protect' have become increasingly accepted by the society of states in recent years. The origins of these ideas are appropriately traced to earlier European concepts of popular resistance and humanitarian intervention. However, Europe is not unique in possessing a heritage of sovereign accountability. Almost two thousand years before sovereignty emerged in early modern Europe, philosophers in Ancient China developed remarkably similar concepts about the responsibilities of legitimate rule. Confucian scholars, in particular Mencius, argued that rulers were established by Heaven for the benefit of the people. The people, in turn, could rightfully hold their rulers to account. They had the right to banish a bad ruler and even to kill a tyrant. Moreover, a benevolent ruler was justified in waging 'punitive war' against the tyrannical ruler of another state, in order to punish him and to comfort the people. Recognition of this non-European heritage of sovereign accountability opens up new possibilities for dialogue between those who would promote present-day concepts of 'sovereignty as responsibility' and those who perceive these concepts as merely Western and alien principles grounded in Western and alien values.

This paper looks at the way in which the idea of the Precautionary Principle, increasingly influential in environmental and other policy areas, is being and might be used in foreign and security policy. It aims to contrast the relative precision with which the term is used in the environmental arena with the current usage in international relations. Contrasting the Precautionary Principle with ideas of precaution, prevention, pre-emption and similar terms in post-structuralist analyses of risk, humanitarian intervention and US foreign policy in the aftermath of 11 September 2001, the paper identifies costs and benefits in deploying a more carefully specified account of the Precautionary Principle. In particular, it highlights key issues of regulatory authority and the way in which policy-makers and analysts understand and respond to the limits of knowledge and knowledge systems as important challenges to which careful use of the Precautionary Principle can potentially contribute. The paper concludes by suggesting that both policy-making and policy analysis could potentially be improved by adapting and extending the idea of the Precautionary Principle as it is deployed in other policy arenas.

AbstractInternational non‐governmental organisations (INGOs) are prominent actors in the international arena, aiming to improve the life of disadvantaged people. However, INGOs often do not succeed in doing this. Consequently, INGO legitimacy is regularly questioned. Increased transparency and tightened accountability mechanisms are often‐mentioned solutions to this problem. Based on an analysis of four dimensions of INGO legitimacy—normative, regulatory, cognitive and output legitimacy—we argue that this is not necessarily adequate. We conclude that INGO mission statements create a normative source of legitimacy, but that this, in itself, is not enough to ground INGO legitimacy: it also needs to be institutionalised and organised. However, as a result of power relations and resulting pressures for accountability and transparency, as defined by their external stakeholders, INGOs experience a permanent struggle to reconcile their mission with the requirements for regulatory, cognitive and output legitimacy. The more these stakeholders press for increased organisation of INGO work, the more the pursuit of the core objectives of INGOs is obstructed. We illustrate this argument with the case of the post‐Tsunami humanitarian intervention (2004/2005). Copyright © 2008 John Wiley & Sons, Ltd.

Abstract
Background
While current estimates suggest that up to three million additional surgical procedures are needed to meet the needs of forcibly displaced populations, literature on surgical care for refugee or forced migrant populations has often focused on acute phase and war-related trauma or violence with insufficient attention to non-war related pathologies. To our knowledge, no study has compared refugee versus host population utilization of surgical services in a refugee camp-based hospital over such an extended period of twenty years. The aim of this paper is to first describe the patterns of surgical care by comparing refugee and host population utilization of surgical services in Nyarugusu refugee camp between 2000 and 2020, then evaluate the impact of a large influx of refugees in 2015 on refugee and host population utilization.

Methods
The study was based on a retrospective review of surgical logbooks in Nyarugusu refugee camp (Kigoma, Tanzania) between 2000 and 2020. We utilized descriptive statistics and multiple group, interrupted time series methodology to assess baseline utilization of surgical services by a host population (Tanzanians) compared to refugees and trends in utilization before and after a large influx of Burundian refugees in 2015.

Results
A total of 10,489 operations were performed in Nyarugusu refugee camp between 2000 and 2020. Refugees underwent the majority of procedures in this dataset (n = 7,767, 74.0%) versus Tanzanians (n = 2,722, 26.0%). The number of surgeries increased over time for both groups. The top five procedures for both groups included caesarean section, bilateral tubal ligation, herniorrhaphy, exploratory laparotomy and hysterectomy. In our time series model, refugees had 3.21 times the number of surgeries per quarter at baseline when compared to Tanzanians. The large influx of Burundian refugees in 2015 impacted surgical output significantly with a 38% decrease (IRR = 0.62, 95% CI 0.46–0.84) in surgeries in the Tanzanian group and a non-significant 20% increase in the refugee group (IRR = 1.20, 95% CI 0.99–1.46). The IRR for the difference-in-difference (ratio of ratios of post versus pre-intervention slopes between refugees and Tanzanians) was 1.04 (95% CI 1.00–1.07), and this result was significant (p=0.028).

Conclusions
Surgical care in conflict and post-conflict settings is not limited to war or violence related trauma but instead includes a large burden of obstetrical and general surgical pathology. Host population utilization of surgical services in Nyarugusu camp accounted for over 25% of all surgeries performed, suggesting some host population benefit of the protracted refugee situation in western Tanzania. Host population utilization of surgical services was apparently different after a large influx of refugees from Burundi in 2015.

Inhalation of ash can be of great concern for affected communities, during and after volcanic eruptions. Governmental and humanitarian agencies recommend and distribute a variety of respiratory protection (RP), commonly surgical masks but, also, industry-certified N95-style masks. However, there is currently no evidence on how wearable they are within affected populations or how protective wearers perceive them being against volcanic ash (which will influence the likelihood of uptake of recommended interventions). Volunteers living near Mt. Sinabung, Sumatra, Indonesia, participated in a field wearability study, which included a high-efficiency mask certified to industry standards (N95-equiv.) ; a standard, pleated surgical mask (Surgical) ; a Basic flat-fold mask (Flat-fold), and the surgical mask plus a scarf tied over the top (Surgical Plus) to improve fit. These types of RP had all performed well during earlier laboratory filtration efficiency tests. The N95-equiv. mask had performed significantly better than the other RP in the subsequent total inward leakage volunteer trials, whilst the Flat-fold and Surgical masks performed poorly, letting in a third of PM2.5 particles (data published elsewhere). Thirty volunteers wore each mask for a 15-min walk before being asked to rate the comfort, breathability and perceived protection and fit of each. After wearing all of the masks, volunteers compared and identified their preferred type of protection. The feedback received from the volunteers suggested that the Surgical Plus and N95-equiv. masks were rated as being significantly hotter and more humid than other masks. The Flat-fold was rated to have better breathability than the other masks. The N95-equiv. mask was ranked as providing the best level of effectiveness of the four masks tested. Ultimately, when asked which type of mask they would choose to wear during ashfall, 33% selected the Flat-fold mask due to its comfort and simplicity, with the Surgical Plus being the least likely to be chosen of the four tested. The study findings are of benefit to agencies who need to make informed decisions on the procurement and distribution of RP for use by those affected in future eruptions and the provision of advice to communities on their usage.

Worlds Apart tells of a well-meaning foreign policy establishment often deaf to the voices of everyday people. Its focus is the Bosnian War, but its implications extend to any situation that prompts the consideration of military intervention on humanitarian grounds. Ambassador Swanee Hunt served in Vienna during the Bosnian War and was intimately involved in American policy toward the Balkans. During her tenure as ambassador and after, she made scores of trips throughout Bosnia and the rest of the former Yugoslavia, attempting to understand the costly delays in foreign military intervention. To that end, she had hundreds of conversations with a wide range of politicians, refugees, journalists, farmers, clergy, aid workers, diplomats, soldiers, and others. In Worlds Apart, Hunt's eighty vignettes alternate between the people living out the war and "the internationals" deciding whether or how to intervene. From these stories, most of which she witnessed firsthand, she draws six lessons applicable to current conflicts throughout the world. These lessons cannot be learned from afar, Hunt says, with insiders and outsiders working apart. Only by bridging those worlds can we build a stronger paradigm of inclusive international security.

BACKGROUND: Self-care interventions offer a solution to support the achievement of three goals of the World Health Organization (WHO): to improve universal health coverage, reach people in humanitarian situations, and improve health and well-being. In light of implementing WHO consolidated guidelines on self-care interventions to strengthen sexual and reproductive health (SRH) in the Eastern Mediterranean Region (EMR), especially during the COVID-19 pandemic, pharmacists from four different EMR countries discussed the current SRH situation, inequality gaps, barriers to SRH service access and the pharmacist's crucial role as a first-line responder to patients before, during and after COVID-19. CASE PRESENTATION: Self-care interventions for SRH allow health care providers to serve a greater number of patients, improve progress toward universal health coverage, and reach people in humanitarian crises. In fact, these interventions can be significantly enhanced by utilizing community pharmacists as first-line health care providers. This review highlights the important role of community pharmacists in promoting self-care interventions and empowering individuals, families and communities. As a result, well-informed individuals will be authoritative in their health decisions. Exploring self-care interventions in the EMR was done through reviewing selected SRH services delivery through community pharmacists before and during the COVID-19 pandemic in Egypt, Jordan, Lebanon and Somalia. Before the COVID-19 pandemic, community pharmacists were found to be excluded from both governmental and nongovernmental SRH programmes. During the pandemic, community pharmacists managed to support patients with self-care interventions, whether voluntarily or through their pharmacy associations. This highlights the need for the health care decision-makers to involve and support community pharmacists in influencing policies and promoting self-care interventions. CONCLUSION: Self-care interventions can increase individuals' choice and ...

El artículo presenta una aproximación analítica de la noción de seguridad humana, que no se encuentra inscrita dentro de los estudios tradicionales de seguridad y que se erige como un enfoque polémico en el debate académico y político en las últimas décadas. En este sentido, el artículo presenta, en una primera fase, el estado del arte del desarrollo histórico y conceptual de la seguridad humana, seguido de una interpretación basada en diversas visiones teóricas de las relaciones internacionales y paradigmas de la seguridad. En una segunda fase se analiza la praxis de esta nueva noción y sus implicaciones políticas, cifradas en una eventual condicionalidad de la cooperación internacional y en la legitimidad de la intervención humanitaria. La conclusión a la que llegan las autoras es que la seguridad humana se constituye en una noción ambivalente que transita entre los límites del cálculo estratégico y el supuesto altruismo implícito en los principios de política exterior. ; --- This Article exposes an analytical approach about Human Security concept which is not under traditional security studies framework. In consequence, It has been building up itself as a polemic issue area in academic and political debate during last decades.Firstly, the article focuses on Human Security conceptual construction based on some International Relations theoretical insights and security paradigms in order to demonstrate its ambiguity. The second part analyzes the modus operandi of this concept taking into consideration two of its main political implications: new possible requirements for international cooperation and humanitarian intervention.In conclusion, the two authors asserted that Human Security is an ambivalent concept linked with both, a classical strategically calculus as well as with a rationalist-altruist principles implicit in the foreign policy. ; O artigo apresenta uma aproximação analítica da noção de segurança humana, que não se encontra inscrita dentro dos estudos tradicionais de segurança e que se erige como um foco polémico no debate acadêmico e político nas últimas décadas. Neste sentido, o artigo apresenta, em uma primeira fase, o estado da arte do desenvolvimento histórico e conceitual da segurança humana, seguido de uma interpretação baseada em diversas visões teóricas das relações internacionais e paradigmas da segurança. Em uma segunda fase analisa-se a praxe desta nova noção e suas implicações políticas, cifradas em uma eventual condicionalidade da cooperação internacional e na legitimidade da intervenção humanitária. A conclusão à que chegam as autoras é que a segurança humana se constitui em uma noção ambivalente que transita entre os limites do cálculo estratégico e o suposto altruísmo implícito nos princípios de política exterior.