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Abstract
Although COVID-19 cases and deaths in different clusters of Bangladesh were increasing rapidly for most of the year 2020, surprisingly very few cases were reported in the urban slums, identified as the potential hotspots of Coronavirus. While the epidemiological puzzle of the low incidence of COVID-19 in slums remains unresolved, an ethnography in an urban slum in Dhaka, the capital city of Bangladesh, reveals how, in the context of indifference from the state, the slum dwellers themselves initiated several informal but robust interventions to tackle the pandemic. This study reveals the power of community governance from below, which we understand using Bayat's (2013) concept of 'quiet encroachment' and Roy's (2009) argument about the role of informality in urban governance. To adapt to the pandemic situation, we applied an innovative 'peer research' approach for data collection.

This essay focuses on sensory aspects of care in situations surrounding defecation in hospitals and other care institutions. Sensory activity does not merely encompass pleasant experiences that enhance healing and well-being. Anthropologists—and other disciplines as well—have paid little attention to unpleasant and disgusting experiences that our senses meet and that may rather increase pain and suffering in the context of care. Our essay therefore reflects on a common but highly uncomfortable aspect of being a—sometimes bedridden—patient: defecation. The sensory effects of human defecation are well known. They affect at least four of the five traditional senses. But equally repulsive are the social and emotional effects that defecation in a hospital context has on both patients and professional and other care providers. The essay is based on anthropological observations and the authors' personal experiences in Bangladesh, Ghana and the Netherlands and covers a wide variety of cultural and politicoeconomic conditions. It further draws on (scarce) scientific publications as well as on fictional sources. Extensive quotations from these various sources are presented to convey the lived sensorial experience of disgust and overcoming disgust more directly to the reader.

Abstract
This paper is based on an ethnographic study conducted in a public hospital in Bangladesh. The study shows how the social dynamics necessary to deal with the structural realities of the hospital give this cosmopolitan institution a local character. In this paper, we describe this local character by focusing on the lower-level hospital staff, such as ward boys, cleaners, and gatemen. Social inequality and exclusion are rampant in Bangladeshi public hospitals. Doctors and nurses are unwilling to communicate with patients and their relatives, while the latter are unable to approach the former for specific help or information. Our research, shows how low-level support workers fill the void between the two "factions" and act as brokers transporting information and activities between these factions. By doing so they do not only make a crucial contribution to the functioning of the ward, but also gain considerable influence in spite of their low position.

This essay focuses on sensory aspects of care in situations surrounding defecation in hospitals and other care institutions. Sensory activity does not merely encompass pleasant experiences that enhance healing and well-being. Anthropologists—and other disciplines as well—have paid little attention to unpleasant and disgusting experiences that our senses meet and that may rather increase pain and suffering in the context of care. Our essay therefore reflects on a common but highly uncomfortable aspect of being a—sometimes bedridden—patient: defecation. The sensory effects of human defecation are well known. They affect at least four of the five traditional senses. But equally repulsive are the social and emotional effects that defecation in a hospital context has on both patients and professional and other care providers. The essay is based on anthropological observations and the authors' personal experiences in Bangladesh, Ghana and the Netherlands and covers a wide variety of cultural and politicoeconomic conditions. It further draws on (scarce) scientific publications as well as on fictional sources. Extensive quotations from these various sources are presented to convey the lived sensorial experience of disgust and overcoming disgust more directly to the reader.

Background: The community form of palliative care first constructed in Kerala, India has gained recognition worldwide. Although it is the subject of important claims about its replicability elsewhere, little effort has gone into studying how this might occur. Drawing on translation studies, we attend to under-examined aspects of the transfer of a community palliative care intervention into a new geographic and institutional context. Methods: Over a period of 29 months, we conducted an in-depth case study of Sanjeevani, a community-based palliative care organization in Nadia district, West Bengal (India), that is modelled on the Kerala approach. We draw upon primary (semi-structured interviews and field notes) and secondary data sources. Results: We identify the translator's symbolic power and how it counteracts the organizational challenges relating to socio-economic conditions and weak histories of civil society organizing. We find that unlike the Kerala form, which is typified by horizontal linkages and consensus-oriented decision-making, the translated organizational form in Nadia is a hybrid of horizontal and vertical solidarities. We show how translation is an ongoing, dynamic process, where community participation is infused with values of occupational prestige and camaraderie and shaped by emergent vertical solidarities among members. Conclusions: Our findings have implications for how we understand the relationship between locations, institutional histories, and healthcare interventions. We contribute to translation studies in healthcare, and particularly to conversations about the transfer or 'roll out' of palliative care interventions from one geography to another.

Compassion is an emotional response to the suffering of others. Once felt, it entails subsequent action to ameliorate their suffering. Recently, 'compassion' has become the flagship concept to be fostered in the delivery of end-of-life care, and a rallying call for social action and public health intervention. In this paper, we examine the emerging rhetorics of compassion as they relate to end-of-life care and offer a critique of the expanding discourse around it. We argue that, even where individuals 'possess' compassion or are 'trained' in it, there are difficulties for compassion to flow freely, particularly within Western society. This relates to specific sociopolitical structural factors that include the sense of privacy and individualism in modern industrialised countries, highly professionalised closed health systems, anxiety about litigation on health and safety grounds, and a context of suspicion and mistrust within the global political scenario. We must then ask ourselves whether compassion can be created intentionally, without paying attention to the structural aspects of society. One consequence of globalisation is that countries in the global South are rapidly trying to embrace the features of modernity adopted by the global North. We argue that unrealistic assumptions have been made about the role of compassion in end-of-life care and these idealist aspirations must be tempered by a more structural assessment of potential. Compassion that is not tied to to realistic action runs the risk of becoming empty rhetoric.

Compassion is an emotional response to the suffering of others. Once felt, it entails subsequent action to ameliorate their suffering. Recently, 'compassion' has become the flagship concept to be fostered in the delivery of end-of-life care, and a rallying call for social action and public health intervention. In this paper, we examine the emerging rhetorics of compassion as they relate to end-of-life care and offer a critique of the expanding discourse around it. We argue that, even where individuals 'possess' compassion or are 'trained' in it, there are difficulties for compassion to flow freely, particularly within Western society. This relates to specific sociopolitical structural factors that include the sense of privacy and individualism in modern industrialised countries, highly professionalised closed health systems, anxiety about litigation on health and safety grounds, and a context of suspicion and mistrust within the global political scenario. We must then ask ourselves whether compassion can be created intentionally, without paying attention to the structural aspects of society. One consequence of globalisation is that countries in the global South are rapidly trying to embrace the features of modernity adopted by the global North. We argue that unrealistic assumptions have been made about the role of compassion in end-of-life care and these idealist aspirations must be tempered by a more structural assessment of potential. Compassion that is not tied to to realistic action runs the risk of becoming empty rhetoric.

Context: Around the world there is increasing interest in end of life issues. An unprecedented number of people dying in future decades will put new strains on families, communities, services and governments. It will also have implications for representations of death and dying within society and for the overall orientation of health and social care. What interventions are emerging in the face of these challenges? Methods: We conceptualize a comprehensive taxonomy of interventions, defined as 'organized responses to end of life issues'. Findings: We classify the range of end of life interventions into 10 substantive categories: policy, advocacy, educational, ethico-legal, service, clinical, research, cultural, intangible, self-determined. We distinguish between two empirical aspects of any end of life intervention: the 'locus' refers to the space or spaces in which it is situated; the 'focus' captures its distinct character and purpose. We also contend that end of life interventions can be seen conceptually in two ways – as 'frames' (organized responses that primarily construct a shared understanding of an end of life issue) or as 'instruments' (organized responses that assume a shared understanding and then move to act in that context). Conclusions: Our taxonomy opens up the debate about end of life interventions in new ways to provide protagonists, activists, policy makers, clinicians, researchers and educators with a comprehensive framework in which to place their endeavours and more effectively to assess their efficacy. Following the inspiration of political philosopher John Rawls, we seek to foster an 'overlapping consensus' on how interventions at the end of life can be construed, understood and assessed.

Abdullatif,Husseini:Community and Public Health Nahed,Mikki:Community and Public Health Phillimore,Peter:Newcastle University ; Background Cardiovascular diseases and diabetes mellitus present an increasing challenge for health care in the occupied Palestinian territory (oPt). Effective access to health care is a core prerequisite to the effective management of the two diseases. A main goal for policy makers is to improve access for patients to the services they need. However, improvement of access needs a thorough understanding of the barriers to health care encountered by patients. The aim in this study was to show the main barriers to health-care access that are reported by patients with cardiovascular diseases and diabetes mellitus attending clinics in Ramallah, West Bank, oPt. Methods A qualitative method based on theory developed from data generated during field research was used to develop a framework of patients' perceptions of access to health care and management of illness. Data were gathered as part of a larger project (Mediterranean Studies of Cardiovascular disease and Hyperglycaemia: Analytical Modelling of Population Socio-economic transitions) from four clinics selected to represent the main health-care providers in the oPt: an outpatient cardiology clinic (urban setting) and three primary health-care clinics (rural and refugee-camp settings). 40 patients had exit interviews and 16 had in-depth interviews; 12 in-depth interviews were done with patients' family members, and eight in-depth interviews with the clinic staff. Findings Factors that are related to patients and systems interact to form barriers or facilitators to health care and effective illness management, and were noted in all three themes that became apparent from the interviews: availability (central physical location and distance from home, patient's waiting time, availability of the needed drugs and laboratory tests, and the presence of specialist staff); affordability of drugs that were not provided at the local formulary and thus were not provided to patients free of charge, and needed laboratory tests that were not available at the centre; patients' acceptability of or satisfaction with care (previous social ties between patients and providers; sense of belonging to or ownership of the centre; patients' views of the importance of seeking care; and patients' expectations of what providers should inform them about and how they should deal with their illness). The last theme became apparent differently between primary and secondary health-care centres—patients at the primary health-care centres expressed higher satisfaction than for secondary health care, determined by strong social ties and a sense of belonging to the providers and the health-care centre. Interpretation For patients, health services are not only places for the provision of health care, albeit varied, but they are also sites of social relations. Patients' perceptions of their access to health care differ, dependent on their socioeconomic, political, and cultural influences, and should also be taken into serious consideration in future policy development.

More than one billion people are affected by neglected tropical diseases (NTDs) and many of these diseases are preventable. While the grouping of these conditions as NTDs has generated vast mapping, mass drug administration and surveillance programmes, there is growing evidence of gaps and weaknesses in purely biomedical approaches, and the need for responses that also recognise the social determinants of health. In order to unpack the social and political determinants of NTDs, it is important to view the problem from a social science perspective. Given this background, the Social Sciences for Severe Stigmatizing Skin Diseases (5S) Foundation has recently been established by the Centre for Global Health Research at Brighton and Sussex Medical School. The broad aim of the 5S Foundation is to incorporate social science perspectives in understanding and addressing the problems around three NTDs, namely, podoconiosis, mycetoma and scabies. This protocol paper sets out the aims and approaches of the 5S Foundation while activities such as research, public engagement, training and capacity building get underway.

Article published in : Journal of Epidemiol Community Health, September 2010, vol. 64, Suppl. 1 ; Historically, policy initiatives have made variable contributions to improvements in public health. Today there is a growing interest in translating evidence from health research into healthy public policy. Although research evidence may be a component of policy development, it is rarely enough, because policy makers are subject to a wide range of influences. Furthermore, researchers and policy makers usually work within different time frames and rules of evidence. There is a growing, albeit limited, literature on how researchers can most effectively engage with policy makers. Evidence suggests that more active and effective dialogue between researchers and policy makers is needed, in the formulation of research questions, presentation of evidence, and drafting and choice of policy options. Aim To develop, implement, and evaluate an interactive approach to informing policy for the prevention and management of cardiovascular disease (CVD) and diabetes. Setting This work is being undertaken in four eastern Mediterranean territories, known to have high burdens of CVD and diabetes: Palestine, Tunisia, Turkey and Syria. Methods and results Available epidemiological data are being identified, appraised and used to populate the IMPACT CHD Policy Model in order to examine CHD trends. Two corresponding epidemiological models have been developed to examine trends in type 2 diabetes and ischaemic stroke. An intensive review of the literature and consultation assists in the identification of efficacious policy interventions. A situation analysis is being undertaken within each country using mixed methods, which include: key informant and in depth interviews, document reviews, and participant observation. Its aim is to review current policy (stated and implemented), perceived facilitators and barriers to policy change, including health beliefs, and aspects of the health system. Policy makers are explicitly involved as key informants, participants, advisors and "lobbyists". The epidemiological modelling, evidence based reviews, and situation analyses are together being used to generate diverse policy

Wasim,Maziak:Florida International University Fouad,Fouad:American University of Beirut Rana,Khatib:Community and Public Health ; Article published in : Bull World Health Organ 2012 ; 90 pp. 847–853 | doi:10.2471/BLT.12.104968 ; Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a "policy effectiveness–feasibility loop" (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach.

Article published in online journal : Global Health Action : 2019, vol. 12, 1569838 ; ABSTRACT Background: This paper examines one EC-funded multinational project (RESCAP-MED), with a focus on research capacity building (RCB) concerning non-communicable diseases (NCDs) in the Mediterranean Middle East and North Africa. By the project's end (2015), the entire region was engulfed in crisis. Objective: Designed before this crisis developed in 2011, the primary purpose of RESCAPMED was to foster methodological skills needed to conduct multi-disciplinary research on NCDs and their social determinants. RESCAP-MED also sought to consolidate regional networks for future collaboration, and to boost existing regional policy engagement in the region on the NCD challenge. This analysis examines the scope and sustainability of RCB conducted in a context of intensifying political turmoil. Methods: RESCAP-MED linked two sets of activities. The first was a framework for training early- and mid-career researchers through discipline-based and writing workshops, plus short fellowships for sustained mentoring. The second integrated public-facing activities designed to raise the profile of the NCD burden in the region, and its implications for policymakers at national level. Key to this were two conferences to showcase regional research on NCDs, and the development of an e-learning resource (NETPH). Results: Seven discipline-based workshops (with 113 participants) and 6 workshops to develop writing skills (84 participants) were held, with 18 fellowship visits. The 2 symposia in Istanbul and Beirut attracted 280 participants. Yet the developing political crisis tagged each activity with a series of logistical challenges, none of which was initially envisaged. The immediacy of the crisis inevitably deflected from policy attention to the challenges of NCDs. Conclusions: This programme to strengthen research capacity for one priority area of global public health took place as a narrow window of political opportunity was closing. The key lessons concern issues of sustainability and the paramount importance of responsively shaping a context-driven RCB.